Mostajer Haqiqi Azadeh, Bedos Christophe, Macdonald Mary Ellen
Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada.
Community Dent Oral Epidemiol. 2016 Oct;44(5):493-503. doi: 10.1111/cdoe.12239. Epub 2016 Jun 10.
Over the last two decades, there has been an increasing trend in the number of families using emergency departments (EDs) for treating their children's nontraumatic dental problems. We do not know why families use the ED in this way; to date, little research has addressed parents' decisions. The purpose of this study was to explore the reasons that lead parents to select the ED over a dental clinic for their child's nontraumatic dental problem.
Using a qualitative descriptive design, we conducted semi-structured interviews with parents of children under age 10 who sought care for nontraumatic dental problems in an ED of a pediatric hospital. The interviews were audio-recorded, transcribed, and coded for thematic analysis using Grembowski's dental care process model as a sensitizing construct.
Fifteen parents were recruited (ten mothers and five fathers). Three salient themes were identified: (i) parental beliefs and socioeconomic challenges which contributed to their care seeking, (ii) barriers parents faced in finding oral healthcare options for their children in their communities (e.g., poor access to care and poor quality of care), and (iii) parent's high satisfaction with the care provided through the ED.
The ED was families' last resort; parents took their child to the ED because of the lack of other options in their communities rather than a belief that the ED was the best choice for dental care. The current pattern of ED use resulted in stress for these parents and repercussions for the children (e.g., pain, longer waiting, and increased complications); further, it has been shown in the literature to be an economic strain on the health system.
在过去二十年中，越来越多的家庭使用急诊科（ED）来治疗孩子的非创伤性牙科问题。我们不知道家庭为何以这种方式使用急诊科；迄今为止，很少有研究探讨父母的决定。本研究的目的是探究导致父母为孩子的非创伤性牙科问题选择急诊科而非牙科诊所的原因。
采用定性描述性设计，我们对在一家儿科医院急诊科因非创伤性牙科问题寻求治疗的10岁以下儿童的父母进行了半结构化访谈。访谈进行了录音、转录，并使用格伦博夫斯基的牙科护理流程模型作为敏感构建进行主题分析编码。
招募了15名家长（10名母亲和5名父亲）。确定了三个突出主题：（i）导致他们寻求治疗的父母信念和社会经济挑战，（ii）父母在为孩子在社区中寻找口腔医疗选择时面临的障碍（例如，获得护理的机会少和护理质量差），以及（iii）父母对通过急诊科提供的护理高度满意。
急诊科是家庭的最后选择；父母带孩子去急诊科是因为社区中缺乏其他选择，而不是因为他们认为急诊科是牙科护理的最佳选择。目前使用急诊科的模式给这些父母带来了压力，并对孩子产生了影响（例如，疼痛、等待时间更长和并发症增加）；此外，文献表明这对卫生系统是一种经济负担。
