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牙医对患者的偏好:维度及其与医疗服务提供者、执业情况和服务特征的关联

Dentist preferences for patients: dimensions and associations with provider, practice, and service characteristics.

作者信息

Brennan David S, Spencer A John

机构信息

Dental School, Faculty of Health Sciences, The University of Adelaide, South Australia.

出版信息

Int J Behav Med. 2006;13(1):69-78. doi: 10.1207/s15327558ijbm1301_9.

Abstract

Provider-patient relations may influence the nature of care provided. The aim of this study was to examine dentist preferences for patients, relate these to characteristics of dentists and practices, and to services provided. A random sample of Australian dentists completed mailed questionnaires (response = 60.3%). Four factor-based subscales and an overall scale (Selectivity) were derived from a 37-item battery. The 4 subscales comprised treatment adherence (behavior relevant to the treatment situation), personal adaptability (willingness to cooperate when expected to do so), social interactiveness (positive affect, communicativeness, and appreciativeness), and enabling characteristics (willing and able to pay, and good dental knowledge). Reliability was adequate (Cronbach's alpha = 0.71-0.90). Treatment adherence was associated with higher orthodontic rates, but a lower extraction rate; social interactiveness was associated with higher extraction and denture rates; personal adaptability was associated with higher orthodontic rates, but lower general/miscellaneous service rates; enabling characteristics was associated with higher endodontic and crown and bridge rates; selectivity was associated with higher rates of diagnostic, preventive, and total services per visit. The associations with service rates indicated that provider preferences were related to treatment behavior that could affect the mix of services, indicating that the nature of care provided may be influenced by the provider-patient relation.

摘要

医患关系可能会影响所提供护理的性质。本研究的目的是调查牙医对患者的偏好,将这些偏好与牙医及诊疗机构的特征以及所提供的服务联系起来。对澳大利亚牙医进行随机抽样,让他们填写邮寄的问卷(回复率 = 60.3%)。从一个包含37个条目的量表中得出了四个基于因素的子量表和一个总体量表(选择性)。这4个子量表包括治疗依从性(与治疗情况相关的行为)、个人适应性(在期望时愿意合作)、社交互动性(积极情感、沟通能力和感激之情)以及促成因素(愿意且有能力支付费用,并且有良好的牙科知识)。信度足够(克朗巴哈系数 = 0.71 - 0.90)。治疗依从性与较高的正畸治疗率相关,但拔牙率较低;社交互动性与较高的拔牙率和假牙佩戴率相关;个人适应性与较高的正畸治疗率相关,但一般/杂项服务率较低;促成因素与较高的牙髓病治疗以及冠桥修复率相关;选择性与每次就诊时较高的诊断、预防和总服务率相关。与服务率的关联表明,提供者的偏好与可能影响服务组合的治疗行为有关,这表明所提供护理的性质可能会受到医患关系的影响。

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