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为精神健康障碍成年人提供口腔护理:西澳大利亚州珀斯的牙科专业人员的看法和经验。

Providing oral care for adults with mental health disorders: Dental professionals' perceptions and experiences in Perth, Western Australia.

机构信息

Dental School, University of Western Australia, Nedlands, Western Australia, Australia.

出版信息

Community Dent Oral Epidemiol. 2019 Feb;47(1):78-84. doi: 10.1111/cdoe.12427. Epub 2018 Oct 8.

Abstract

OBJECTIVE

To explore dental professionals' perceptions and experiences of providing oral health care for adults with mild to moderate mental health disorders (MHD) in Perth, Western Australia.

METHODS

A grounded theory approach guided this research which comprised semi-structured interviews with oral health professionals working in private and/or public dental facilities attended by adults with MHD. An iterative analysis of transcripts identified emerging issues that were organized into categories under which key themes were noted, coded, compared, discussed, reviewed and revised independently by two researchers to ensure rigour.

RESULTS

Sixteen interviews were conducted with six general dentists, three dental specialists, four oral health therapists (OHT) and three dental assistants. Barriers to providing oral health care for adults with MHD included limitations of the current model of care, often focused on treating advanced disease; limited inter-professional collaboration; an over-burdened public dental system and the financial constraints of private practice. Personal barriers included perceptions that people with MHD had limited capacity for self-care and preventing oral disease. Factors that would enable oral health care included training and professional development for dental professionals to work effectively with people with MHD and a more flexible, inter-professional approach that involved prevention and inviting family to consultations about oral health in primary health care settings.

CONCLUSIONS

Our study reveals structural barriers where services often appear to be inadequately prepared to meet the oral health needs of people with MHD. This suggests the need for strategies to review current models of care and encourage and support dental professionals to provide oral health care that is inclusive, inter-professional, focused on prevention and sensitive to the social context and lived experience of people with MHD.

摘要

目的

探索西澳大利亚州珀斯的牙科专业人员对轻度至中度心理健康障碍(MHD)成年人提供口腔保健的看法和经验。

方法

本研究采用扎根理论方法,对在私人和/或公共牙科机构为 MHD 成年人提供口腔保健的口腔卫生专业人员进行半结构化访谈。对转录本的迭代分析确定了新出现的问题,这些问题被组织成类别,在这些类别下注意到关键主题、编码、比较、讨论、审查和由两名研究人员独立修订,以确保严谨性。

结果

对六名普通牙医、三名牙科专家、四名口腔健康治疗师(OHT)和三名牙科助手进行了 16 次访谈。为 MHD 成年人提供口腔保健的障碍包括当前护理模式的局限性,通常侧重于治疗晚期疾病;有限的跨专业合作;负担过重的公共牙科系统和私人执业的财务限制。个人障碍包括认为 MHD 患者自我保健和预防口腔疾病的能力有限。能够提供口腔保健的因素包括为牙科专业人员提供培训和专业发展,以有效治疗 MHD 患者,以及更灵活的跨专业方法,包括在初级保健环境中进行预防,并邀请家人就口腔健康进行咨询。

结论

我们的研究揭示了结构障碍,即服务似乎常常无法充分满足 MHD 患者的口腔健康需求。这表明需要审查当前的护理模式,并鼓励和支持牙科专业人员提供包容性、跨专业、注重预防以及对 MHD 患者的社会背景和生活经历敏感的口腔保健。

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