School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK
Social Work, Education and Community Wellbeing, Northumbria University Department of Social Work and Communities, Newcastle upon Tyne, UK.
BMJ Open. 2020 Jan 30;10(1):e032369. doi: 10.1136/bmjopen-2019-032369.
To investigate the practices of healthcare professionals in relation to best practice recommendations for the multidisciplinary management of people with diabetes and periodontitis, focusing on two clinical behaviours: informing patients about the links between diabetes and periodontitis, and suggesting patients with poorly controlled diabetes go for a dental check-up.
Cross-sectional design utilising online questionnaires to assess self-reported performance and constructs from Social Cognitive Theory (SCT) and Normalisation Process Theory.
Primary care medical practices (n=37) in North East, North Cumbria and South West of England Clinical Research Networks.
96 general practitioners (GPs), 48 nurses and 21 healthcare assistants (HCAs).
Participants reported little to no informing patients about the links between diabetes and periodontitis or suggesting that they go for a dental check-up. Regarding future intent, both GPs (7.60±3.38) and nurses (7.94±3.69) scored significantly higher than HCAs (4.29±5.07) for SCT proximal goals (intention) in relation to informing patients about the links (p<0.01); and nurses (8.56±3.12) scored significantly higher than HCAs (5.14±5.04) for suggesting patients go for a dental check-up (p<0.001). All professional groups agreed on the potential value of both behaviours, and nurses scored significantly higher than GPs for legitimation (conforms to perception of job role) in relation to informing (nurses 4.16±0.71; GPs 3.77±0.76) and suggesting (nurses 4.13±0.66; GPs 3.75±0.83) (both p<0.01). The covariate background information (OR=2.81; p=0.03) was statistically significant for informing patients about the links.
Despite evidence-informed best practice recommendations, healthcare professionals currently report low levels of informing patients with diabetes about the links between diabetes and periodontitis and suggesting patients go for a dental check-up. However, healthcare professionals, particularly nurses, value these behaviours and consider them appropriate to their role. While knowledge of the evidence is important, future guidelines should consider different strategies to enable implementation of the delivery of healthcare interventions.
调查医疗保健专业人员在多学科管理糖尿病和牙周炎患者方面的实践情况，重点关注两种临床行为：告知患者糖尿病和牙周炎之间的联系，以及建议糖尿病控制不佳的患者进行牙科检查。
利用在线问卷评估自我报告的表现，采用社会认知理论（SCT）和常规化过程理论（NPT）的结构。
英格兰东北部、北坎布里亚和西南部临床研究网络的初级保健医疗实践（n=37）。
96 名全科医生（GP）、48 名护士和 21 名医疗保健助理（HCA）。
参与者报告很少或根本没有告知患者糖尿病和牙周炎之间的联系，也没有建议他们去看牙医。关于未来的意向，全科医生（7.60±3.38）和护士（7.94±3.69）在告知患者糖尿病和牙周炎之间的联系方面的 SCT 近端目标（意向）评分显著高于医疗保健助理（4.29±5.07）（p<0.01）；护士（8.56±3.12）在建议患者进行牙科检查方面的得分显著高于医疗保健助理（5.14±5.04）（p<0.001）。所有专业群体都认为这两种行为都有潜在价值，护士在告知（护士 4.16±0.71；全科医生 3.77±0.76）和建议（护士 4.13±0.66；全科医生 3.75±0.83）方面的合法化（符合工作角色的认知）评分显著高于全科医生（均 p<0.01）。背景信息（OR=2.81；p=0.03）是告知患者糖尿病和牙周炎之间联系的统计学显著的协变量。
尽管有循证最佳实践建议，但医疗保健专业人员目前报告称，很少告知糖尿病患者糖尿病和牙周炎之间的联系，也很少建议患者进行牙科检查。然而，医疗保健专业人员，特别是护士，重视这些行为，并认为这些行为符合他们的角色。虽然了解证据很重要，但未来的指南应考虑采用不同的策略，以实施医疗干预措施的提供。
