Katrine Gahre Fjeld

• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 10 contributors for this article] (2023). Identification and susceptibility testing of oral candidiasis in advanced cancer patients. BMC Oral Health. ISSN 1472-6831. 23(1). doi: 10.1186/s12903-023-02950-y. Full text in Research Archive
• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Fjeld, Katrine Gahre; Hove, Lene Hystad & Malterud, Karl Egil [Show all 11 contributors for this article] (2021). A mouth rinse based on a tea solution of Salvia officinalis for oral discomfort in palliative cancer care: A randomized controlled trial. Supportive Care in Cancer. ISSN 0941-4355. doi: 10.1007/s00520-021-06021-2. Full text in Research Archive Show summary

  Background: Few clinical studies evaluate interventions to reduce oral discomfort among patients in palliative care. Aim: This study examines the efficacy of a Salvia officinalis (SO) based herbal mouth rinse compared to conventional normal saline (NS) in order to improve oral health. Design: A block-randomized controlled trial. Data were collected before and after a 4-day intervention with either SO (n=44) or NS (n=44). Numerical rating scales (NRS, 0-10) and 12 items from the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Oral Health 17 (EORTC QLQ-OH17) measured patient-reported oral symptoms. An oral examination was performed before and after the intervention. Setting/participants: This study included adult patients with late-stage cancer in an inpatient hospice unit. Results: Of the 88 patients included (mean age=63.9 years, SD=10.6), 73 (83%) completed the study. At baseline, 78% reported dry mouth on the EORTC QLQ-OH17, and 80% rated dry mouth ≥4 on the NRS. Total oral health scores based on the 12 EORTC QLQ-OH17 items improved similarly in both groups (p

• Fjeld, Katrine Gahre; Eide, Hilde; Mowe, Morten; Sandvik, Leiv & Willumsen, Tiril (2018). A 1-year follow-up of a randomized clinical trial with focus on manual and electric toothbrushes’ effect on dental hygiene in nursing homes. Acta Odontologica Scandinavica. ISSN 0001-6357. 76(4), p. 257–261. doi: 10.1080/00016357.2017.1416166. Show summary

  Objective: A 2-month randomized clinical trial (RCT) study comparing electric and manual toothbrushes used by residents in nursing homes showed significant reduction in plaque score for both groups. The aim of this follow up study was to study if the effect sustained in a longer perspective when toothbrushes were used according to resident’s own preference. Materials and methods: One year after baseline of the RCT-study, 100 participants were re-examined. The simplified oral hygiene index (OHI-S) was used as outcome measure on dental plaque. Results: The mean age was 86.6, 78.1% had three or more medical diagnoses and 52.2% had moderate to severe cognitive impairment. The mean number of natural teeth was 18.8. After 1 year, mean plaque scores was significantly reduced within the population, from 1.2 to 0.7 (p < .001). A total of 46 participants preferred to use an electric toothbrush and 54 preferred manual. No significant difference in plaque score was found between electric and manual toothbrushes. Conclusion: After 1 year, the improvement in dental hygiene from the RCT study sustained for users of both electric and manual toothbrush. Focus upon tooth brushing seems to be efficient and both manual and electric toothbrushes should be available in nursing homes.

• Fjeld, Katrine Gahre; Eide, Hilde; Mowe, Morten; Hove, Lene Hystad & Willumsen, Tiril (2017). Dental hygiene registration: development, and reliability and validity testing of an assessment scale designed for nurses in institutions. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 26(13-14), p. 1845–1853. doi: 10.1111/jocn.13452. Show summary

  Abstract Aims and Objectives To develop and test the Dental Hygiene Registration (DHR), a dental hygiene assessment scale for nurses working in institutions. Background Removal of dental plaque is a key factor in preventing oral health related diseases. A simple, but reliable dental hygiene assessment scale that enables nurses to monitor residents’ dental hygiene on a daily basis, will improve monitoring oral hygiene status and quality of dental health care. Design Descriptive study on the development and evaluation of a dental hygiene registration instrument. Methods The DHR was developed and tested over several stages during the period of 2011–2014. DHR consists of a five-point-plaque score scale. The score indicates whether measures are needed. A reference group comprising both medical and dental personnel designed DHR. Dental plaque was used as a measure of dental hygiene. A pictorial series of teeth with varying amounts of plaque was used to achieve intra-examiner agreement. DHR assessments were scored fifty times to assess inter-examiner reliability between one dental hygienist and one clinical nurse. DHR was validated against the plaque index score of the Oral Hygiene Index (OHI-S). The Regional Ethics Committee approved the study (2011/915). Results Estimates for intra-examiner agreement on plaque score were good for the dental hygienist (kappa=0.7) and very good for the clinical nurse (kappa=0.8). Estimates for inter-examiner reliability for DHR between the dental hygienist and the clinical nurse was moderate (kappa=0.4). DHR corresponded significantly with OHI-S (Spearman's correlation coefficient=0.8, p<0.001) indicating good validity. Conclusion The developed DHR appears to be reliable and valid. This article is protected by copyright. All rights reserved.

• Matri, Kristine Lindstad; Willumsen, Tiril & Fjeld, Katrine Gahre (2015). Nye evidensbaserte tiltak for å bedre oral helse hos eldre siste 10 år. Den norske tannlegeforenings tidende. ISSN 0029-2303. 125(10), p. 872–877.
• Fjeld, Katrine Gahre; Mowe, Morten; Eide, Hilde & Willumsen, Tiril (2014). Effect of electric toothbrush on residents' oral hygiene: a randomized clinical trial in nursing homes. European Journal of Oral Sciences. ISSN 0909-8836. 122(2), p. 142–148. doi: 10.1111/eos.12113.

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• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Roa, Leonor & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2024). Preliminary data from the COOP II-study – exploring oral and general health among older people in need of short-time acute care.
• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2023). What happens to oral health when multiborbidity, polypharmacy and frailty comes along?
• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2023). Oral Health in Times of Frailty and Polypharmacy.
• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 10 contributors for this article] (2022). Orale soppinfeksjoner - mer enn Candida albicans: mikrobiologiske analyser av prøver fra alvorlig syke pasienter med kreft . Show summary

  Bakgrunn Pasienter med alvorlig kreftsykdom er utsatte for orale soppinfeksjoner, grunnet sykdommen, kreftbehandling og/eller svekket immunforsvar. Orale soppinfeksjon påvirker pasienters matlyst, ernæringstilstand og livskvalitet. Candida albicans er en vanlig soppart i munnhulen, men forekomst av non-albicans Candida-arter, og i kombinasjon med C. albicans, er økende. Artene har varierende toleranse for antimykotiske midler, det kan gi behandlingsutfordringer. Hensikten med studien var å identifisere og resistensteste Candida sopparter i munnhulen til alvorlig syke pasienter med kreft. Metode Sopprøver tatt under studien Oral Health in Advanced Cancer i perioden 2014 – 2016, ble analysert høsten 2020. Pasientprøvene ble re-dyrket ved Institutt for oral biologi, Universitetet i Oslo. Soppartene ble identifisert biokjemisk og ved DNA sekvensering, og resistenstestet for antimykotiske legemidler: fluconazole, amphotericin B, anidulafungin og nystatin. Resultat Vi analyserte totalt 56 isolater fra 45 pasienter og identifiserte syv Candida arter og en Saccharomyces. Til sammen hadde 36 pasienter oppvekst av én soppart, og 9 pasienter hadde 2 til 3 ulike sopparter i munnhulen. Av C. albicans artene var 39 av 40 følsomme for fluconazole. To Candida parapsilosis og en Candida tropicalis var resistent mot anidulafungin. En C. tropicalis var resistent mot anidulafungin. En Candida glabrata var resistent mot fluconazole. Konklusjon Studien viste at forskjellige Candida arter forekommer både i monoinfeksjoner og blandingsinfeksjoner. C. albicans var dominerende med høy følsomhet for antimykotiske midler. Blandingsinfeksjoner kan komplisere behandlingen og forårsake gjentagende infeksjoner. Mikrobiologiske prøver og analyser med identifisering og resistenstesting, bør være en del av utredningen hos pasienter med alvorlig og tilbakevendende orale soppinfeksjoner.

• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 10 contributors for this article] (2022). Oral candidiasis in advanced cancer – identification and susceptibility testing of detected Candida species. Show summary

  Introduction: Candida albicans is the most common fungal species in the oral cavity. Increased prevalence of non-C. albicans are detected, and co-infection with C. albicans may have implications for treatment, due to antifungal resistance. The aim of the study was to assess the diversity and susceptibility of oral yeasts in patients with advanced cancer. Methods: Clinical fungal isolates were sampled in 2014-2016 from 45 patients in a hospice unit. Totally 56 isolates were grown on chromID Candida plates, prepared for biochemical identification, and controlled with DNA sequencing. E-test was performed with the antifungal agents fluconazole, amphotericin B, anidulafungin and nystatin were tested. Results: A total of 56 isolates were identified. Candida species was dominated by C. albicans at 71%, followed by C. glabrata 9%, C. parapsilosis 5%, C. tropicalis 4%, C. krusei 2%, C. guilliermondii 2% and C. dubliniesis 2%. Nine patients had 2-3 different species. C. albicans strains were susceptible to fluconazole in 97.5%. One C. parapsilosis and one C. tropicalis strain were resistant to anidulafungin. One C. glabrata was resistant to fluconazole and another was just below the threshold for resistance. The sequencing confirmed the biochemical identification. Conclusion: C. albicans was the most prevalent species. Variation in susceptibility was observed in patients with mixed colonies. Combinations of Candida species and the lack of identification and susceptibility testing may lead to inadequate treatment.

• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 10 contributors for this article] (2022). Identification and susceptibility testing of oral candidiasis in advanced cancer patients – an important diagnostic tool. Show summary

  Background: Candida albicans is the most common fungal species detected in the oral cavity. Studies of oral fungal samples have shown an increased prevalence of non-C. albicans species in mixed infection with C. albicans. Non-C. albicans and C. albicans are associated with varying degrees of resistance to azole. This may have implications for treatment, due to acquired antifungal resistance. Aims: To assess the diversity and susceptibility of detected Candida species in the oral cavity in patients with advanced cancer. Methods: Clinical fungal isolates sampled in 2014-2016 from 45 patients in a hospice unit were analyzed. A total of 56 isolates were grown on chromID Candida plates. After phenotypic identification by colour of the colonies, one single colony of each species was re-cultivated and prepared for identification on a VITEK2® system. Susceptibility testing with E-test was performed on RPMI agar, and the antifungal agents fluconazole, amphotericin B, anidulafungin and nystatin were tested. Results: A total of 56 Candida isolates were identified. The diversity of Candida species was dominated by C. albicans at 89%, followed by C. glabrata 11%, C. parapsilosis 7%, C. tropicalis 4%, C. krusei 2%, C. guilliermondii 2% and C. dubliniesis 2%. Thirty-six patients had monoculture, and nine patients had 2-3 different species detected. Almost all C. albicans strains (97.5%) were susceptible to fluconazole. One C. parapsilosis and one C. tropicalis strain were resistant to anidulafungin. One C. glabrata was resistant to fluconazole and another was just below the threshold for resistance. Conclusion: C. albicans was the most prevalent Candida species in our sample. Variation in susceptibility was observed in patients with both C. albicans and C. glabrata. Combinations of Candida species and the lack of identification and susceptibility testing may lead to inadequate treatment and accelerate the development of resistance.

• Fjeld, Katrine Gahre; Hove, Lene Hystad; Shamsolebad, Hoda & Kroglund, Sara (2021). Individuell munnstellboks kan hjelpe eldre med den orale hygienen. . Sykepleien.no.
• Young, Alix; Jensen, Janicke Liaaen; Hove, Lene Hystad; Fjeld, Katrine Gahre & Blich, Carl Christian (2021). Et smil uten smerter? Dagens medisin. ISSN 1501-4290.
• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Fjeld, Katrine Gahre; Hove, Lene Hystad & Saghaug, Elisabeth [Show all 10 contributors for this article] (2019). A comparison of normal saline mouth rinse and mouth rinse based on Salvia officinalis in palliative care: A randomized controlled trial.
• Fjeld, Katrine Gahre; Hove, Lene Hystad; Bargbidi, Mitra; Abrahamsen, Siren & Heggestad, Anne Kari Tolo (2019). Eldre som ikke koopererer-etiske aspekter. Aktuell Nordisk odontologi. ISSN 1902-3545.
• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Saghaug, Elisabeth; Tollisen, Anita & Fjeld, Katrine Gahre [Show all 10 contributors for this article] (2018). Rekruttering av pasienter til en klinisk intervensjonsstudie i et Hospice.
• Gay, Caryl; Monsen, Ragnhild Elisabeth; Saghaug, Elisabeth; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 11 contributors for this article] (2017). Oral health symptoms that interfere with eating and drinking among hospice patient.
• Monsen, Ragnhild Elisabeth; Saghaug, Elisabeth; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre; Hove, Lene Hystad & Tallang, Oddveig Utheim [Show all 10 contributors for this article] (2016). Munntørrhet hos palliative pasienter - en randomisert kontrollert studie i en hospiceenhet.
• Fjeld, Katrine Gahre (2015). Munn- og tannstell som del av forebygging og behandling ved dysfagi .
• Monsen, Ragnhild Elisabeth; Saghaug, Elisabeth; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre; Hove, Lene Hystad & Tollissen, Anita [Show all 8 contributors for this article] (2015). Munnskylling med te av Salvia Officinalis som del av palliativ behandling - fra gode erfaringer til en klinisk forskningsstudie.

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