Anderson R, Thomas D W
Centre for Health Economics Research and Evaluation, University of Technology, Sydney, NSW, Australia.
Community Dent Health. 2003 Jun;20(2):106-11.
To understand from the patient's perspective the types of dental problem which present at weekends, how they affect people, and the care-seeking behaviour of emergency dental patients.
Consecutive patients attending two emergency dental clinics at weekends were interviewed prior to seeing the dentist. The audio-recorded interview transcripts were analysed using the "framework" method of applied qualitative data analysis.
A community-based and a dental hospital emergency dental clinic.
44 emergency dental patients.
Pain was the main presenting symptom, a key domain of quality of life and the underlying cause of most other quality of life effects. However, for patients deciding what symptoms mean--crucially whether they mean they need to see a dentist urgently--a wide range of other contextual factors come into play. These go beyond the individual patient's recent and current perception of symptom intensity. They encompass past experience of similar symptoms, past care-seeking experiences, anticipated effects on quality of life, anticipated service availability, joint decision-making and lay information from family and friends, professional opinions from non-dentists, expectations concerning what work dentists should do, and what symptoms distinguish "simple toothache" from more serious problems.
The effects of, and meanings which people attach to, acute dental symptoms are complex. Combined with poor awareness of the existence of emergency dental services it is not surprising that patients' pathways to care are correspondingly complicated. The planning of emergency dental services should be based on a broader, patient-derived understanding of the need for them.
从患者角度了解周末出现的牙科问题类型、这些问题如何影响人们以及急诊牙科患者的就医行为。
在周末前往两家急诊牙科诊所就诊的连续患者在看牙医之前接受了访谈。使用应用定性数据分析的“框架”方法对录音访谈记录进行了分析。
一家社区急诊牙科诊所和一家牙科医院急诊牙科诊所。
44名急诊牙科患者。
疼痛是主要的就诊症状，是生活质量的关键领域，也是大多数其他生活质量影响的潜在原因。然而，对于患者判断症状意味着什么——至关重要的是它们是否意味着他们需要紧急看牙医——一系列其他背景因素也会起作用。这些因素超出了个体患者近期和当前对症状强度的感知。它们包括过去类似症状的经历、过去的就医经历、对生活质量的预期影响、预期的服务可及性、共同决策以及来自家人和朋友的非专业信息、非牙医的专业意见、对牙医应做工作的期望，以及哪些症状能区分“简单牙痛”和更严重的问题。
人们对急性牙科症状的影响及赋予其的意义是复杂的。再加上对急诊牙科服务存在的认识不足，患者的就医途径相应地复杂也就不足为奇了。急诊牙科服务的规划应基于更广泛的、源自患者的对这些服务需求的理解。
