French Kelly E, Perry Kristeen R, Boyd Linda D, Giblin-Scanlon Lori J
J Dent Hyg. 2018 Jun;92(3):23-30.
Research indicates clinicians face barriers when attempting to utilize evidence-based protocols for periodontal disease and periodontal disease diagnosis often varies between dental providers. The purpose of this study was to identify and better understand dental hygienists' perceived barriers and experiences during the process of diagnosing periodontal disease in clinical practice. This study used a qualitative design and a purposive sample of dental hygienists (n=20). Utilizing a virtual video-conferencing platform, participants logged into focus group sessions to discuss their experiences with diagnosing periodontal disease in clinical practice. Focus group sessions were recorded and transcribed. Thematic analysis involved the use of inductive coding to draw themes from the data. Dental hygienists reported being responsible for periodontal disease diagnosis, and that they utilized similar classification systems, and agreed with colleagues' periodontal disease diagnoses. However, participants reported the lack of a standardized periodontal classification system was confusing when communicating outside of their dental practice and described both intrinsic and extrinsic barriers to diagnosing disease. A common theme expressed by participants was that patients' lack of acceptance of their periodontal disease status and inability to fund treatment interfered with providing an evidence-based diagnosis and treatment plan. Newly licensed dental hygienists felt somewhat prepared to diagnose periodontal disease upon completion of their education but reported increased confidence in their skills and knowledge with years of practice and continuing education. Study data indicates dental hygienists feel the lack of a standardized periodontal classification system causes confusion and inconsistencies when communicating with other oral health care providers outside of their clinical practice setting, and dental hygienists face barriers when diagnosing periodontal disease. These findings may be instrumental in assisting educators in preparing students for clinical practice.
研究表明，临床医生在尝试使用基于证据的牙周疾病诊疗方案时面临障碍，而且牙周疾病的诊断在不同牙科医疗服务提供者之间往往存在差异。本研究的目的是识别并更好地了解牙科保健员在临床实践中诊断牙周疾病过程中所感知到的障碍和经历。本研究采用质性设计，并选取了20名牙科保健员作为目的抽样样本。参与者利用虚拟视频会议平台登录焦点小组会议，讨论他们在临床实践中诊断牙周疾病的经历。焦点小组会议进行了录音和转录。主题分析采用归纳编码从数据中提炼主题。牙科保健员报告称自己负责牙周疾病的诊断，他们使用相似的分类系统，并且认同同事对牙周疾病的诊断。然而，参与者报告称，在牙科诊所之外交流时，缺乏标准化的牙周分类系统会造成困扰，并且描述了诊断疾病时的内在和外在障碍。参与者表达的一个共同主题是，患者不接受自己的牙周疾病状况以及无力支付治疗费用，这妨碍了提供基于证据的诊断和治疗方案。新获得执照的牙科保健员在完成学业后感觉自己在一定程度上为诊断牙周疾病做好了准备，但报告称随着多年的实践和继续教育，他们对自己的技能和知识更有信心。研究数据表明，牙科保健员认为缺乏标准化的牙周分类系统会导致在与临床实践环境之外的其他口腔医疗保健提供者交流时产生混淆和不一致，并且牙科保健员在诊断牙周疾病时面临障碍。这些发现可能有助于教育工作者帮助学生为临床实践做好准备。
