Oral health Centre of Expertise in Western Norway, Bergen, Norway.
Stord Public Dental Clinic, Vestland County Municipality, Norway.
Scand J Caring Sci. 2022 Mar;36(1):27-35. doi: 10.1111/scs.12960. Epub 2021 Feb 1.
Persons who struggle with severe or long-term mental illness (SMI) have a higher prevalence of oral health problems than the general population. Obtaining and continuing dental treatment is challenging for this patient group for many reasons, and many drop out of active treatment. Our study aimed to explore perceived barriers to obtaining optimal dental health care for patients with SMI. Further, we sought to identify possible ways to facilitate for providing true access to dental services for this population.
The study utilised a flexible qualitative design with data collected during ordinary clinical practice in a public dental clinic in Norway. We conducted semi-structured face-to-face interviews with 51 persons with SMI twice: an initial interview before dental treatment and a final one after dental treatment. We applied the thematic analysis method.
Thematic analysis revealed two key themes in the participants' experiences of access to dental health services: practical conditions and relationship with the dentist. Patients reported barriers and facilitators for access to care as factors associated with patients (patient factors), with the dentist (dentist factors) and with healthcare services (system factors).
Our study indicates that persons with SMI appreciate oral health and want to obtain needed oral care and dental treatment, but they encounter barriers on several fronts. The participants offered suggestions for how to facilitate attendance and adherence. Our findings suggest that dental healthcare services require reorganisation to meet the needs of patients with SMI.
患有严重或长期精神疾病（SMI）的人比一般人群更容易出现口腔健康问题。由于多种原因，这一患者群体在获得和继续接受牙科治疗方面存在困难，许多人退出了积极治疗。我们的研究旨在探讨获得最佳口腔保健服务的障碍，以帮助患有 SMI 的患者。此外，我们还试图确定为这一人群提供真正获得牙科服务的可能途径。
本研究采用灵活的定性设计，在挪威一家公立牙科诊所的日常临床实践中收集数据。我们对 51 名 SMI 患者进行了两次半结构式面对面访谈：一次是在牙科治疗前的初始访谈，一次是在牙科治疗后的最终访谈。我们应用了主题分析方法。
主题分析揭示了参与者在获得口腔健康服务方面的经验中的两个关键主题：实际条件和与牙医的关系。患者报告了获得护理的障碍和促进因素，这些因素与患者（患者因素）、牙医（牙医因素）和医疗保健服务（系统因素）有关。
我们的研究表明，患有 SMI 的人重视口腔健康，希望获得所需的口腔保健和牙科治疗，但他们在多个方面遇到障碍。参与者提出了一些关于如何促进出勤率和坚持治疗的建议。我们的研究结果表明，牙科医疗服务需要重新组织，以满足 SMI 患者的需求。
