NIHR Academic Clinical Fellow in General Dental Practice and Honorary Lecturer, Plymouth University Peninsula Schools of Medicine & Dentistry, Plymouth, UK.
BMC Oral Health. 2014 Jun 5;14:64. doi: 10.1186/1472-6831-14-64.
Delivering improvements in quality is a key objective within most healthcare systems, and a view which has been widely embraced within the NHS in the United Kingdom. Within the NHS, quality is evaluated across three key dimensions: clinical effectiveness, safety and patient experience, with the latter modelled on the Picker Principles of Patient-Centred Care (PCC). Quality improvement is an important feature of the current dental contract reforms in England, with "patient experience" likely to have a central role in the evaluation of quality. An understanding and appreciation of the evidence underpinning PCC within dentistry is highly relevant if we are to use this as a measure of quality in general dental practice.
A systematic review of the literature was undertaken to identify the features of PCC relevant to dentistry and ascertain the current research evidence base underpinning its use as a measure of quality within general dental practice.
Three papers were identified which met the inclusion criteria and demonstrated the use of primary research to provide an understanding of the key features of PCC within dentistry. None of the papers identified were based in general dental practice and none of the three studies sought the views of patients. Some distinct differences were noted between the key features of PCC reported within the dental literature and those developed within the NHS Patient Experience Framework.
This systematic review reveals a lack of understanding of PCC within dentistry, and in particular general dental practice. There is currently a poor evidence base to support the use of the current patient reported outcome measures as indicators of patient-centredness. Further research is necessary to understand the important features of PCC in dentistry and patients' views should be central to this research.
提高质量是大多数医疗保健系统的主要目标，这一观点在英国国民保健制度（NHS）中得到了广泛认可。在 NHS 中，质量从三个关键维度进行评估：临床效果、安全性和患者体验，后者基于 Picker 患者为中心的护理原则（PCC）。质量改进是英格兰当前牙科合同改革的一个重要特征，“患者体验”很可能在质量评估中发挥核心作用。如果我们要将其作为一般牙科实践质量的衡量标准，那么了解和重视牙科中 PCC 的证据基础就非常重要。
对文献进行系统回顾，以确定与牙科相关的 PCC 特征，并确定支持将其用作一般牙科实践质量衡量标准的当前研究证据基础。
确定了 3 篇符合纳入标准的论文，这些论文展示了使用原始研究来了解牙科中 PCC 的关键特征。没有一篇论文是基于一般牙科实践的，也没有一篇论文征求了患者的意见。在牙科文献中报告的 PCC 关键特征与 NHS 患者体验框架中开发的特征之间存在一些明显的差异。
这项系统综述揭示了牙科对 PCC 的理解不足，特别是在一般牙科实践中。目前，支持使用当前患者报告的结果测量作为以患者为中心的指标的证据基础薄弱。需要进一步研究以了解牙科中 PCC 的重要特征，并且患者的意见应该是这项研究的核心。
