Nurses' Emotional Encounters with the Mouth and Patient Oral Care

Objectives: Emotions are linked to behaviour and an earlier study indicated that nurses' emotions may motivate or inhibit the provision of oral care. The current investigation is to explore these emotional motivators and barriers to answer the question, “How do nurses' emotions influence oral care for patients?” Methods: Focus groups conducted with a purposively selected sample of 41 student nurses, hygienists and qualified nurses were used to identify the emotional experiences involved. Ten one-to-one semi-structured interviews were conducted with 3 existing and 7 new nursing participants to verify individual experiences of these emotions. Data were transcribed verbatim. Textual data were analysed through the constant comparison of data in order to develop the themes. Results: The sight and smell of patients' unclean oral conditions can attract nurses' attention by eliciting disgust. Hygiene related disgust and anxiety towards harm from contamination can be experienced towards a dirty mouth. These emotions can motivate positive care behaviours. Cleanliness is believed to be good care; achieving this is felt with pride and satisfaction. In contrast, feelings of moral disgust are expressed towards a lack of effort to enable a patient to become clean but where oral care has been attempted but has failed, it may be accepted with disappointment. The action taken to care for a patient's dirty mouth can be moderated by emotional disgust and anxiety. Moral disgust is felt towards to intentionally causing harm and nurses are anxious towards these moral boundaries. Conclusions: The emotion of disgust is important for initiating and motivating nurses to provide oral care for their patients. Emotional rewards can be experienced by providing care. These motivating emotions should be used in oral health promotion activities and training programmes for nurses, to overcome barriers, enable behaviour change and secure patients' oral health.