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[儿童牙科恐惧——发生率、诊断与治疗]

[Dental fear in children--frequency, diagnosis and treatment].

作者信息

Holst A

出版信息

Tandlaegebladet. 1990 Jan;94(2):64-9.

PMID:2377969
Abstract

A recent study on acceptance of dental treatment among Swedish children (11) showed that the frequency of dental fear was 3% in 4-16 year-olds. Eight percent of the children sometimes reacted in such a way that treatment could not be carried out without restraint or excessive delay. More than every other 3-year-old child resisted in some way. Positive behavior and cooperation improved with increasing age, the improvement being most pronounced among the youngest children. It was also shown that negative or no acceptance increased by each new appointment in preschool children with a large amount of treatment need. Behavior shaping is a combination of tell-show-do and positive reinforcement. It includes the following parts: Tell-show-do. Positive reinforcement. Observation of the reactions of the child. Rating the acceptance of the child. If positive: positive reinforcement and introduction of a new step. If not positive: further training on the specific step. Repetition of these parts according to a hierarchy of treatment steps from the easiest to the most difficult to accept. The child's behavior is observed and rated according to the categories of behavior as in Table 1. The treatment aims at building up the child's confidence and to attain positive acceptance of dental treatment. The child's behavior is governed by its experience, and by the way it is met in the specific situation. First, inform the child and the parent about the procedures. Try to establish a good relationship with the child and parent. Observe and be sensitive to all signals from the child and parent, especially the non-verbal.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

最近一项关于瑞典儿童牙科治疗接受度的研究(11)表明,4至16岁儿童中牙科恐惧的发生率为3%。8%的儿童有时会出现这样的反应,即若无约束或过度拖延就无法进行治疗。每三个以上的儿童中就有一个会以某种方式抗拒。积极行为和合作随着年龄增长而改善,在最小的儿童中改善最为明显。研究还表明,对于有大量治疗需求的学龄前儿童,每次新预约时负面或不接受治疗的情况都会增加。行为塑造是“告知-展示-示范”和积极强化的结合。它包括以下几个部分:告知-展示-示范。积极强化。观察儿童的反应。评估儿童的接受度。如果是积极的:给予积极强化并引入新的步骤。如果不是积极的:对特定步骤进行进一步训练。根据从最容易接受至最难接受的治疗步骤层次重复这些部分。根据表1中的行为类别观察并评估儿童的行为。治疗旨在建立儿童的信心并使其积极接受牙科治疗。儿童的行为受其经历以及在特定情境中所得到的对待方式的影响。首先,向儿童和家长告知治疗程序。努力与儿童和家长建立良好关系。观察并对来自儿童和家长的所有信号保持敏感,尤其是非语言信号。(摘要截选至250词)

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