Freeman R, Carson P
Dental Public Health, Division of Paediatric, Preventive and Public Health Dentistry, School of Dentistry, Queen's University, Belfast.
Int J Paediatr Dent. 2003 Sep;13(5):320-6. doi: 10.1046/j.1365-263x.2003.00480.x.
To examine the attitudes and intentions of general dental practitioners (GDPs) who work within the remit of the National Health Service (NHS) to provide relative analgesia (RA) for paediatric extractions.
All 45 GDPs working within the boundaries of one Trust were asked to complete a questionnaire to assess demography, etc., intention and attitudes to provide RA for paediatric extractions.
Ninety-eight per cent of GDPs took part. All GDPs worked within the NHS. Twenty-nine per cent of GDPs stated that they had RA equipment available in their practices and 68% stated that they discussed RA as treatment alternative. Eighty-seven per cent referred their paediatric extraction cases for dental general anaesthesia. The behavioural intention was predicted by total attitude score and the availability of RA equipment in the practice (R2=0.97, F(37,5)=260.11, P<0.001). Total attitude was predicted by clinical competency, few financial worries or time concerns and the availability of RA equipment (R2=0.91, F(38,4)=106.21, P<0.001).
This study suggests that GDPs' concerns of clinical competence and costs have an inhibiting effect upon their intention to provide RA for paediatric extractions. These concerns must be addressed by planners and policy makers if there is to be a shift from hospital-based DGA to surgery-based RA services for paediatric extractions.
调查在国民医疗服务体系(NHS)范围内工作的普通牙科医生(GDPs)对为儿童拔牙提供相对镇痛(RA)的态度和意向。
要求在一个信托范围内工作的所有45名GDPs填写一份问卷,以评估人口统计学等情况、为儿童拔牙提供RA的意向和态度。
98%的GDPs参与了调查。所有GDPs都在NHS范围内工作。29%的GDPs表示他们的诊所配备了RA设备,68%的GDPs表示他们会将RA作为一种治疗选择进行讨论。87%的GDPs会将他们的儿童拔牙病例转诊至牙科全身麻醉。行为意向由总体态度得分和诊所中RA设备的可用性预测(R2 = 0.97,F(37,5) = 260.11,P < 0.001)。总体态度由临床能力、较少的财务担忧或时间顾虑以及RA设备的可用性预测(R2 = 0.91,F(38,4) = 106.21,P < 0.001)。
本研究表明,GDPs对临床能力和成本的担忧对他们为儿童拔牙提供RA的意向具有抑制作用。如果要从基于医院的牙科全身麻醉(DGA)转向基于手术的儿童拔牙RA服务,规划者和政策制定者必须解决这些担忧。