One of the barriers reported was that when patients express concerns regarding their physical health, these concerns tend to be given little importance by the healthcare professional. discussed the importance of this topic being included on the agenda in mental health organizations, which are often only focused on psychiatric and psychological problems. MHNs state that they lack the relevant expertise, and there is a lack of practical interventions for MHNs to use when supporting patients regarding oral health. MHNs indicate that they hesitate to take action and would like to be more attentive in this area. From a holistic perspective, supporting the general health of patients with a psychotic disorder, including oral health, is one of the tasks of a mental health nurse (MHN), which is one of the main health professions at the forefront of everyday care services. Inadequate oral health self-management, a lower tooth-brushing frequency, a lack of motivation for proper oral hygiene, and poor psychosocial functioning are known as other barriers to adequate oral health in this patient group. Several studies among patients with (severe) mental illness showed that oral health and oral-health-related quality of life are substandard within the unhealthy lifestyle domain. An unhealthy lifestyle is an important cause of the gap in mortality. The gap in mortality was estimated to be a 15–25 year shortened life expectancy in patients diagnosed with a (severe) mental illness, including in countries where the quality of healthcare is acknowledged to be good. Epidemiological studies showed that the lifespan of patients with a psychotic disorder is shorter than that of the general population without mental illness. For instance, poor oral health in patients with a psychotic disorder may lead to poor self-image, low self-esteem, decreased self-confidence, social phobia, loneliness, depression, and suicidal intent these people are ashamed and are afraid to go outside, and therefore, participate less in society. Since the World Health Organization emphasized that oral health is integral and essential to general health and wellbeing, oral health has improved in the general population however, vulnerable patients are an exception to this. The differences between the perceived role and MHNs’ practice in oral health highlighted the need for role clarification and professional leadership of MHNs regarding oral health, which should be considered when developing interventions. These findings suggest that a toolkit with interventions for MHNs that are tailored to the personas that emerged from our research should be developed by MHNs in co-creation with designers. Our findings were as follows: the attitudes and perspectives differed from not feeling any responsibility to a holistic obligation, including oral health suggestions for interventions for MHNs ranged from interventions focusing on improving skills and knowledge to using practical tools most MHNs recognized themselves within a persona that had a holistic obligation that included oral health in addition, the MHNs indicated that they considered the issue of oral health in this patient group important, but, in practice, took little responsibility for that role. Four personas were found based on attitudes and perspectives, barriers, needs, suggestions for interventions, and site conditions regarding practicing oral care in this patient group. We analyzed the data thematically and reflected on insights into unique personas, which were then validated by conducting semi-structured interviews (n = 19) and member checking. We used a human-centered design with contextual interviews (n = 10) to address the key issues of the problems and needs of MHNs working with patients with a psychotic disorder. We aimed to develop and validate personas that reflect the attitudes and needs of MHNs regarding oral health in patients with a psychotic disorder. Mental health nurses (MHNs) are professionally the appropriate target group to support maintaining and increasing oral health. In mental health, oral health is often given little attention.
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