Gallagher Jennifer E, Colonio-Salazar Fiorella B, White Sandra
Dean for International Affairs, Newland-Pedley Professor of Oral Health Strategy/Honorary Consultant in Dental Public Health, King´s College London, Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Host Microbiome Interactions, Denmark Hill Campus, Bessemer Road, SE5 9RS, London, UK.
Former Post-Doctoral Research Associate, King´s College London, UK.
Br Dent J. 2021 Jul 20:1-12. doi: 10.1038/s41415-021-3130-9.
Background Multiple determinants influence dentists' health and wellbeing. In light of recent concerns, the aim of this research was to explore contemporary influences on dentists' health and wellbeing in England, drawing on their lived experience.Methods Semi-structured interviews were conducted with a purposive sample of dentists working in England, taking into account age, gender, career stage, work sector, geographical area, position and route of entry to registration. A topic guide, informed by the literature, was used to guide the discourse. Dentists were approached via gatekeepers, supported by snowball sampling. Interviews were recorded and transcribed for analysis. Framework analysis was used, taking an interpretative phenomenological approach to develop theory.Results Twenty dentists, from a range of backgrounds, participated in this research. While health and wellbeing was reported to be more positive among dentists in their later career, those in their early career and/or with high NHS work commitments shared concerns about their physical, psychological and emotional health. Influences ranged from macro-level issues relating to professional regulation and health systems, through meso-level, notably their workplace and job specification, to micro-level issues relating to their professional careers, relationships and personal life. Dentists highlighted ethical concerns and feeling driven to deliver, together with being demoralised by a survival culture, all leading to perceived lack of control and reduced professional fulfilment. In contrast, being able to deliver quality care, innovate and effect change, as well as being valued for their delivery, were perceived to positively contribute to general health and wellbeing.Conclusion Dentists have a vital role in providing care for patients, so there are serious public health implications if urgent action is not taken to improve and sustain their health and wellbeing. This study confirms that dentists are affected by multiple contemporary influences, and although greater support is needed for individuals, organisational, system and policy changes may be required to fully address the challenges they face.
背景 多种因素影响牙医的健康和福祉。鉴于近期的种种担忧，本研究旨在借鉴英国牙医的生活经历，探讨当下对他们健康和福祉的影响因素。
方法 对在英国工作的牙医进行了有目的抽样的半结构化访谈，考虑了年龄、性别、职业阶段、工作部门、地理区域、职位以及注册进入途径等因素。使用一份基于文献的主题指南来引导访谈。通过把关人联系牙医，并辅以滚雪球抽样。访谈进行录音并转录以供分析。采用框架分析法，运用解释现象学方法来构建理论。
结果 来自不同背景的20名牙医参与了本研究。虽然据报告处于职业生涯后期的牙医的健康和福祉状况更为积极，但处于职业生涯早期和/或承担大量国民保健服务工作的牙医对自己的身体、心理和情绪健康表示担忧。影响因素范围从与专业监管和卫生系统相关的宏观层面问题，到中观层面（尤其是他们的工作场所和工作规范），再到与他们的职业生涯、人际关系和个人生活相关的微观层面问题。牙医们强调了伦理问题以及被迫提供服务的感觉，同时因一种生存文化而士气低落，所有这些都导致感觉缺乏掌控力和职业成就感降低。相比之下，能够提供高质量护理、进行创新和带来改变，以及因其服务而受到重视，被认为对总体健康和福祉有积极贡献。
结论 牙医在为患者提供护理方面发挥着至关重要的作用，因此如果不立即采取行动改善并维持他们的健康和福祉，将会产生严重的公共卫生影响。本研究证实牙医受到多种当下影响因素的作用，虽然个人需要更多支持，但可能需要进行组织、系统和政策变革，才能全面应对他们面临的挑战。
