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了解患者和牙医在牙外伤管理中的观点:一项混合方法研究。

Understanding patients' and dentists' perspectives in dental trauma management: A mixed-methods study.

作者信息

Ode Wataru, Lopez Violeta, Wong Mun Loke, Schou Lone, Yu Victoria Soo Hoon

机构信息

Faculty of Dentistry, National University of Singapore, Singapore.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

出版信息

Dent Traumatol. 2018 Oct;34(5):320-328. doi: 10.1111/edt.12415. Epub 2018 Aug 24.

Abstract

BACKGROUND/AIM: Patients suffering dental trauma are unprepared for the disability challenge and necessary rehabilitation, while a traumatic event places an expanded demand on the dentist who is focused on treating disease. The aim of this study was to examine the impact of traumatic dental injuries (TDI) on patients and to compare patients' and dentists' perceptions of the event.

MATERIAL AND METHODS

TDI patients (aged ≥ 21 years) attending a tertiary dental hospital from 2011 to 2013, and their dentists were recruited with informed consent. An exploratory sequential mixed-methods design was adopted. The Oral Health Impact Profile (OHIP-14) quantitatively identified patients with "very often," "fairly often" or "occasionally" in at least one of the OHIP-14 questions (Phase 1) to participate in the qualitative phase of the study through focus group discussions (FGD) (Phase 2). FGD for dentists was conducted separately.

RESULTS

Quantitative analysis showed 28%-55% of TDI patients had "occasional" to "very often" discomfort during eating, increased self-consciousness and embarrassment. Qualitative analysis showed patients were concerned with aesthetic disability, treatment cost and potential tooth loss but overcame their negative outlook and accepted prescribed protective measures. Dentists appreciated patients' concerns about aesthetics and functional disruptions but were less attuned to patients' sense of guilt and fear of judgement.

CONCLUSIONS

TDI exert functional, psychological and social impacts on patients. Patients' and dentists' perspectives were useful for understanding the need for continuity of care, and the findings could contribute to effective TDI management.

摘要

背景/目的:遭受牙外伤的患者对残疾挑战和必要的康复治疗毫无准备,而创伤性事件对专注于治疗疾病的牙医提出了更高的要求。本研究的目的是探讨牙外伤(TDI)对患者的影响,并比较患者和牙医对该事件的看法。

材料与方法

2011年至2013年在一家三级牙科医院就诊的TDI患者(年龄≥21岁)及其牙医在获得知情同意后被招募。采用探索性序列混合方法设计。口腔健康影响量表(OHIP-14)通过在至少一个OHIP-14问题中定量识别出“非常频繁”“相当频繁”或“偶尔”出现相关情况的患者(第一阶段),通过焦点小组讨论(FGD)参与研究的定性阶段(第二阶段)。对牙医的FGD单独进行。

结果

定量分析显示,28%-55%的TDI患者在进食时“偶尔”至“非常频繁”地感到不适,自我意识增强且感到尴尬。定性分析显示,患者担心美观残疾、治疗费用和潜在的牙齿脱落,但克服了消极态度并接受了规定的保护措施。牙医理解患者对美观和功能障碍的担忧,但对患者的内疚感和对评判的恐惧不太敏感。

结论

TDI对患者产生功能、心理和社会影响。患者和牙医的观点有助于理解持续护理的必要性,研究结果可为有效的TDI管理提供参考。

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