Boston Children's Hospital, Boston, Massachusetts, United States of America.
Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, United States of America.
PLoS One. 2020 May 26;15(5):e0233437. doi: 10.1371/journal.pone.0233437. eCollection 2020.
The purpose of this study was to explore factors that impact patients' ability to access high quality, expeditious oral health care by understanding medical professionals' knowledge of oral health, the care they provide to patients presenting with oral health complaints, and their perceptions of potential interventions to improve oral health care delivery.
We conducted in depth qualitative interviews, which were analyzed using an inductive content analytical approach. The study was conducted in Gugulethu, a community located outside of Cape Town, South Africa. Local public sector health services provided free-of-charge are the main source of primary health and dental care for this population. Participants included the following medical providers: doctors, clinical nurse practitioners, professional nurses, and health promoters.
Identified themes fell within the three broad subject areas: oral health knowledge, patient care, and potential interventions. Themes within oral health knowledge included (1) personal responsibility for hygiene, (2) routine oral health care, (3) lack of knowledge among medical professionals, (4) poverty, and (5) an oral-systemic connection. Participants cited both 'clinical care knowledge' and/or 'uncertainty' about patient care for oral health complaints. Participants independently suggested interventions in three broad areas: (1) education, (2) expanded provider roles, and (3) colocation of services.
Our findings suggest that a variety of interventions, ranging from high to low resource investment, may impact access to and utilization of oral health services and thereby result in improved patient care. Future studies should develop and evaluate the suggested interventions in a range of care settings.
本研究旨在通过了解医疗专业人员对口腔健康的认识、他们为口腔健康问题患者提供的护理以及他们对改善口腔保健服务提供的潜在干预措施的看法,探讨影响患者获得高质量、迅速口腔保健的因素。
我们进行了深入的定性访谈,采用归纳内容分析方法进行分析。该研究在南非开普敦以外的古古莱图社区进行。当地的公共部门卫生服务提供免费的基本医疗和牙科服务,是该人群的主要初级保健和牙科护理来源。参与者包括以下医疗服务提供者:医生、临床护士从业者、专业护士和健康促进者。
确定的主题属于三个广泛的主题领域:口腔健康知识、患者护理和潜在的干预措施。口腔健康知识主题包括:(1)个人卫生责任;(2)常规口腔保健;(3)医疗专业人员知识匮乏;(4)贫困;(5)口腔与全身的联系。参与者提到了对口腔健康投诉的“临床护理知识”和/或“不确定性”。参与者独立提出了三个广泛领域的干预措施:(1)教育;(2)扩大提供者的角色;(3)服务的集中。
我们的研究结果表明,各种干预措施,从高到低资源投资,可能会影响口腔卫生服务的获取和利用,从而改善患者护理。未来的研究应该在一系列护理环境中开发和评估建议的干预措施。