为服务不足的患者提供护理:牙周病学家和牙周病住院医师的教育经历、态度和行为。

Providing care for underserved patients: periodontists' and periodontal residents' educational experiences, attitudes, and behaviors.

机构信息

Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA.

出版信息

J Periodontol. 2010 Nov;81(11):1604-12. doi: 10.1902/jop.2010.100183. Epub 2010 Jul 27.

Abstract

BACKGROUND

Patients with special health care needs (SHCNs) and patients from underrepresented minority and/or low socioeconomic backgrounds are more likely to have problems accessing oral health care services. The objectives of this study are: 1) to explore how well the dental education of periodontists prepared them to treat these underserved patients, 2) to assess related professional attitudes and confidence when treating these patients as well as professional behaviors, and 3) whether educational experiences are related with attitudes, confidence, and behaviors in this context.

METHODS

Survey data were collected from a randomly selected sample of 291 members of the American Academy of Periodontology (AAP) and 64 periodontal residents.

RESULTS

Overall, large percentages of residents agreed that their predoctoral and graduate dental educations had prepared them well to treat patients with special needs (predoctoral education: 58%; clinical graduate education: 45%; and classroom-based graduate education: 37%), from different ethnic/racial backgrounds (predoctoral education: 74%; clinical graduate education: 74%; and classroom-based graduate education: 60%), and on Medicaid (predoctoral education: 60%; clinical graduate education: 61%; and classroom-based graduate education: 42%). Practicing clinicians were least positive about their educations. Students were more positive about treating patients on Medicaid and pro bono cases than practicing clinicians. However, the two groups did not differ in their confidence when treating underserved patients. The quality of predoctoral and graduate educations regarding underserved patients correlates with the attitudes, confidence, and behaviors of providers concerning providing care for these patients.

CONCLUSIONS

The findings of this study stress the importance of preparing future periodontists in their predoctoral and graduate programs for providing care for underserved patients such as patients with SHCNs. The better that dental education prepares future periodontists to provide care for underserved patients, the more confident periodontists will be when encountering these patients in their own practices and the more likely they will be to contribute to reducing disparities in oral health care access in the United States by treating these patients.

摘要

背景

有特殊医疗需求的患者(SHCNs)和代表性不足的少数族裔和/或低社会经济背景的患者更有可能在获得口腔保健服务方面存在问题。本研究的目的是:1)探讨牙周病医生的牙科教育在多大程度上使他们能够治疗这些服务不足的患者,2)评估在治疗这些患者时的相关专业态度和信心以及专业行为,以及 3)教育经验是否与这种情况下的态度、信心和行为相关。

方法

从美国牙周病学会(AAP)的随机样本中收集了调查数据,该样本包括 291 名成员和 64 名牙周病住院医师。

结果

总体而言,很大比例的住院医师认为他们的牙前和研究生牙科教育使他们能够很好地治疗有特殊需求的患者(牙前教育:58%;临床研究生教育:45%;课堂式研究生教育:37%)、来自不同种族/族裔背景(牙前教育:74%;临床研究生教育:74%;课堂式研究生教育:60%)和医疗补助计划(牙前教育:60%;临床研究生教育:61%;课堂式研究生教育:42%)。执业临床医生对他们的教育最不看好。与执业临床医生相比,学生对治疗医疗补助计划和免费案件的患者更积极。然而,这两个群体在治疗服务不足的患者时的信心没有差异。牙前和研究生教育中关于服务不足患者的质量与提供者提供这些患者护理的态度、信心和行为相关。

结论

本研究的结果强调了在牙前和研究生课程中为未来的牙周病医生做好准备的重要性,以便为服务不足的患者提供护理,例如有特殊医疗需求的患者。牙科教育使未来的牙周病医生为治疗服务不足的患者做好准备的程度越高,牙周病医生在自己的实践中遇到这些患者时就越有信心,并且他们越有可能通过治疗这些患者来帮助减少美国口腔保健获取方面的差异。

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