Stuart Jackie, Hoang Ha, Crocombe Len, Barnett Tony
Centre for Research Excellence in Primary Oral Health Care, Centre for Rural Health, School of Health Sciences, University of Tasmania, Locked Bag 1322, Launceston, TAS, 7250, Australia.
BMC Oral Health. 2017 Jun 19;17(1):99. doi: 10.1186/s12903-017-0389-y.
Collaboration between dental practitioners and non-dental primary care providers has the potential to improve oral health care for people in rural and remote communities, where access to oral health services is limited. However, there is limited research on collaboration between these professional disciplines. The purpose of this paper was to explore the relationships between dental practitioners and non-dental primary care providers from rural and remote areas of Queensland and to identify strategies that could improve collaboration between these disciplines from the perspective of dental participants.
Semi-structured interviews were conducted between 2013 and 2015 with visiting, local and regional dental practitioners (n = 12) who had provided dental services to patients from eight rural and remote Queensland communities that did not have a resident dentist. Participants were purposely recruited through a snow ball sampling technique. Interview data were analysed using thematic analysis with the assistance of QSR Nvivo v.10.
Four major themes emerged from the data: (1) Communication between dental practitioners and rural primary care providers; (2) Relationships between dental and primary care providers; (3) Maintenance of professional dualism; (4) Strategies to improve interprofessional relationships (with subthemes: face to face meetings; utilisation of technology; oral health training for primary care providers; and having a community based oral health contact person). Participants observed that there was a lack of communication between the dental providers who saw patients from these rural communities and the primary care providers who worked in each community. This was attributed to poor communication, the high turnover of staff and the siloed behaviours of some practitioners. Visiting dental practitioners were likely to have stronger professional relationships with hospital nursing, administrative and allied health care staff who were often long term residents of the community.
The findings suggest that there was little relationship between the dental personnel and primary care providers. Interprofessional collaboration between dental care providers and non-dental rural primary care providers in the rural and remote communities sampled could be improved by having regular face to face meetings between practitioners from across the health disciplines, providing oral health education to primary care providers, establishing and maintaining effective communication and referral pathways, and exploring a greater role for tele-dentistry.
在农村和偏远社区,口腔保健服务的可及性有限,牙科从业者与非牙科初级保健提供者之间的合作有潜力改善这些社区居民的口腔保健状况。然而,关于这些专业学科之间合作的研究有限。本文旨在探讨昆士兰州农村和偏远地区的牙科从业者与非牙科初级保健提供者之间的关系,并从牙科参与者的角度确定可改善这些学科之间合作的策略。
2013年至2015年期间,对到访的、当地的和地区的牙科从业者(n = 12)进行了半结构化访谈,这些从业者曾为昆士兰州8个没有常驻牙医的农村和偏远社区的患者提供牙科服务。参与者通过滚雪球抽样技术特意招募。访谈数据在QSR Nvivo v.10的协助下使用主题分析法进行分析。
数据中出现了四个主要主题:(1)牙科从业者与农村初级保健提供者之间的沟通;(2)牙科与初级保健提供者之间的关系;(3)专业二元性的维持;(4)改善跨专业关系的策略(子主题包括:面对面会议;技术的利用;对初级保健提供者的口腔健康培训;以及设立社区口腔健康联络人)。参与者观察到,为这些农村社区患者看病的牙科提供者与在每个社区工作的初级保健提供者之间缺乏沟通。这归因于沟通不畅、人员流动率高以及一些从业者各自为政的行为。到访的牙科从业者与医院护理、行政和专职医疗保健人员可能有更强的专业关系,这些人员往往是社区的长期居民。
研究结果表明,牙科人员与初级保健提供者之间关系不大。通过各健康学科的从业者定期举行面对面会议、为初级保健提供者提供口腔健康教育、建立和维持有效的沟通及转诊途径,以及探索远程牙科更大的作用,可以改善抽样的农村和偏远社区中牙科保健提供者与非牙科农村初级保健提供者之间的跨专业合作。