Forbes G, Rutherford S, Stirling D, Young L, Clarkson J
University of Dundee and NHS Education for Scotland.
NHS Education for Scotland.
Br Dent J. 2015 Apr 10;218(7):387-91; discussion 391. doi: 10.1038/sj.bdj.2015.245.
To understand current practice and the beliefs of dentists and hygienists towards factors which may influence the management of patients with periodontal diseases in primary dental care in Scotland. To inform the scope of a guidance publication and the future development of diagnostic analyses tools.
A qualitative approach of semi-structured telephone interviews with a randomly selected sample of dentists and hygienists was used. Interviews continued until saturation was reached and were audio-recorded and transcribed verbatim. The data were analysed using the method of framework analysis. To increase the participation of hygienists the topic guide was adapted into a self-reporting questionnaire and posted to all hygienists in Scotland.
Eighteen dentists and three hygienists were interviewed. Key themes identified were extent of control over working environment, capabilities to treat appropriately and changing patients' oral hygiene behaviour. Factors which facilitated the management of patients with periodontal diseases were 'access to a hygienist' and 'beliefs about capabilities', while 'routine and habit', 'motivation of patients' and 'time and money' were perceived as barriers. Some evidence of variation in treatment provision and of varying levels of confidence among practitioners about treating more advanced periodontal conditions was identified. Two hundred and thirty-seven hygienists returned the postal questionnaire. Agreement was found with the views of the interviewed hygienists on beliefs about capabilities and routine record-keeping.
To improve the periodontal health of patients requires consideration of both extrinsic and intrinsic factors present in primary dental care. Practitioners would find having guidance on managing patients with basic periodontal examinations of three and four, referral criteria to secondary care, record-keeping and techniques to change patients' oral hygiene behaviour particularly useful. Applying the evaluative framework pre-publication indicated where knowledge translation interventions may be required in the future.
了解苏格兰基层牙科护理中，牙医和口腔卫生员对于可能影响牙周病患者管理因素的当前做法和看法。为指导出版物的范围及诊断分析工具的未来发展提供信息。
采用定性研究方法，对随机抽取的牙医和口腔卫生员样本进行半结构化电话访谈。访谈持续进行直至饱和，并进行录音及逐字转录。使用框架分析法对数据进行分析。为提高口腔卫生员的参与度，将主题指南改编为自填式问卷并邮寄给苏格兰所有口腔卫生员。
访谈了18名牙医和3名口腔卫生员。确定的关键主题包括对工作环境的控制程度、适当治疗的能力以及改变患者口腔卫生行为。有助于牙周病患者管理的因素是“有口腔卫生员协助”和“对自身能力的信念”，而“常规与习惯”、“患者的积极性”以及“时间和金钱”被视为障碍。发现了治疗提供方面的一些差异证据，以及从业者在治疗更严重牙周病方面信心水平的差异。237名口腔卫生员回复了邮寄问卷。在关于能力信念和常规记录保存方面，与受访口腔卫生员的观点达成了一致。
要改善患者的牙周健康，需要考虑基层牙科护理中存在的外在和内在因素。从业者会发现，关于对患者进行三级和四级基本牙周检查的管理、转诊至二级护理的标准、记录保存以及改变患者口腔卫生行为的技术等方面的指导特别有用。在出版前应用评估框架表明了未来可能需要进行知识转化干预的领域。
