Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Institute of Health and Care sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Int J Dent Hyg. 2020 Aug;18(3):220-227. doi: 10.1111/idh.12431. Epub 2020 Mar 10.
Dental hygienists (DHs) have an important role in the treatment of patients with periodontitis. The objective of the current qualitative interview study was to gain understanding about personal and organizational factors that influence best-evidenced DH practice in the treatment of periodontitis.
Data were obtained by interviewing Swedish DHs, who had been engaged in a preceding clinical field study on evidence-based periodontal therapy. Qualitative content analysis was used for analysis. Data sampling was terminated after 18 interviews, when deemed that sufficient amount of information had been gained.
In the analysis of the interview data, a main theme was identified as "I know what to do, but I do as I usually do; DHs' ambivalence between theory and practice in the treatment of patients with periodontitis." The results elucidated that the DHs were well aware of "what to do" in order to offer their patients adequate periodontal care, but this knowledge was not congruent with how they usually worked. Established routines and culture at the clinic, DHs' predetermined beliefs about lack of motivation and ability to cooperate among patients, lack of time and reflection, economic demands in care and lack of interest and support by co-working dentists were barriers to best-evidenced DH practice in periodontal care.
The results elucidate the complexity of best-evidenced DH practice in the treatment of periodontal patients and indicate needs for quality improvement of the periodontal care provided in general dental practice, by actions taken on both individual/professional and organizational levels.
口腔保健师（DHs）在牙周炎患者的治疗中发挥着重要作用。本定性访谈研究的目的是了解影响牙周炎最佳循证 DH 实践的个人和组织因素。
通过对参与先前基于证据的牙周治疗临床实地研究的瑞典 DHs 进行访谈获得数据。采用定性内容分析进行分析。在 18 次访谈后，当认为已经获得了足够的信息时，就停止了数据采样。
在访谈数据的分析中，确定了一个主题，即“我知道该怎么做，但我还是按惯例做；DHs 在治疗牙周炎患者时理论与实践之间的矛盾。”研究结果表明，DHs 非常清楚“该做什么”，以便为患者提供足够的牙周护理，但他们的实际做法却与这一认识并不相符。既定的临床常规和文化、DHs 对患者缺乏积极性和合作能力的先入为主的观念、缺乏时间和反思、护理中的经济需求以及共同工作的牙医缺乏兴趣和支持，这些都成为了牙周护理中最佳循证 DH 实践的障碍。
研究结果阐明了牙周炎患者最佳循证 DH 实践的复杂性，并表明需要在个人/专业和组织层面采取行动，以改善普通牙科实践中提供的牙周护理质量。
