Gregory J, Gibson B, Robinson P G
Unit of Oral Health Services Research and Dental Public Health, Guy's, King's and St Thomas' Dental Institute, King's College London, Denmark Hill, London, UK.
Br Dent J. 2007 Apr 14;202(7):E18; discussion 406-7. doi: 10.1038/bdj.2007.150. Epub 2007 Feb 16.
Low expectations of health mean that oral health becomes a low priority for some people, an appreciation of which would help dentists when a non-attender does come to the surgery.
To provide an insight into why oral health is not important to some people and how this attitude might hinder access to dental care.
In this qualitative study, purposive sampling was used to recruit two groups of participants with sociably visible missing, decayed or broken teeth but apparently differing responses to that status. The data analysis used social systems theory as operationalised by grounded theory techniques.
The core category that emerged from the data was that people constructed their own 'margins of the relevance' of oral health. For some people oral health was highly relevant whilst for others it was not very relevant. The degree of relevance of oral health was organised along seven dimensions: the perceived 'normal' state of oral health, the perceived causes of oral health and disease, the degree of trust held in dentistry, perceptions of oral 'health' as a commodity, perceptions of the accessibility of oral health care, perceptions of 'natural' oral health and judgements of character.
If certain aspects of oral health are not relevant, little that is said about those aspects will be meaningful to people. The key is to either emphasize or gently challenge those ideas and beliefs that allow or hinder the margins of relevance.
对健康的低期望意味着口腔健康对一些人来说成为低优先级事项,理解这一点将有助于牙医应对未就诊患者前来就诊的情况。
深入了解为何口腔健康对一些人不重要,以及这种态度如何可能阻碍获得牙科护理。
在这项定性研究中,采用目的抽样法招募了两组参与者,他们都有在社交场合中可见的牙齿缺失、龋齿或牙齿破损情况,但对自身状况的反应明显不同。数据分析采用扎根理论技术实施的社会系统理论。
数据中出现的核心类别是人们构建了自己对口腔健康的“相关边际”。对一些人来说,口腔健康高度相关,而对另一些人来说则不太相关。口腔健康的相关程度沿着七个维度组织:对口腔健康“正常”状态的认知、对口腔健康和疾病成因的认知、对牙科的信任程度、对口腔“健康”作为一种商品的认知、对口腔保健可及性的认知、对“自然”口腔健康的认知以及对性格的判断。
如果口腔健康的某些方面不相关,那么关于这些方面所说的话对人们来说意义不大。关键是要么强调要么温和地挑战那些允许或阻碍相关边际的观念和信念。