Laniado Nadia, Cloidt Megan, Altonen Brian, Badner Victor
Department of Dentistry, Health+Hospitals/Jacobi Medical Center Bronx, New York, NY, 10461, USA.
Department of Research Administration, Health+Hospitals/Central Office, New York, NY, 10013, USA.
Adv Med Educ Pract. 2021 Oct 14;12:1211-1218. doi: 10.2147/AMEP.S332797. eCollection 2021.
The siloed delivery of oral and medical health care in the United States has contributed to a lack of awareness of the consequences of poor oral health and has hampered effective interprofessional education and collaboration. The aim of this study was to assess the knowledge and practice behaviors of primary care medical providers in an urban safety-net hospital regarding collaboration with dentists and integration of oral health into overall health-care delivery.
A 36-item survey was designed in a web-based platform (Survey Monkey) and electronically distributed in September 2020 to 181 primary care medical providers (physicians, nurses, physician assistants) within a municipal hospital in the Bronx, New York. The questionnaire included sections on demographics, current practices, oral health knowledge, and opinions regarding interprofessional collaboration. Descriptive statistics and bivariate analyses using the chi-square and Fisher's exact test were performed with a significance level of 0.05.
The response rate was 66% (119 respondents). The vast majority (80%) reported little or no training in oral health and 85% reported no team experience with oral health professionals. Medical providers' confidence in examining the oral cavity was positively associated with previous additional training (p = 0.001) and with team experience (p = 0.005). The two most commonly reported barriers to willingness to collaborate were lack of formal relationships with dental providers (74%) and competing priorities (69%).
Overall, there is very limited awareness and integration of oral health into the clinical practice of medical providers at this safety-net hospital. However, those providers with previous training and team experience had greater oral health confidence. Given the critical importance of oral health to overall health, increased efforts should be directed to further educate and train medical providers and address barriers to interprofessional care.
在美国，口腔保健和医疗保健各自为政的提供方式导致人们对口腔健康不佳的后果缺乏认识，并阻碍了有效的跨专业教育与协作。本研究的目的是评估一家城市安全网医院的初级保健医疗服务提供者在与牙医合作以及将口腔健康纳入整体医疗服务方面的知识和实践行为。
在基于网络的平台（Survey Monkey）上设计了一份包含36个条目的调查问卷，并于2020年9月以电子方式分发给纽约布朗克斯区一家市立医院的181名初级保健医疗服务提供者（医生、护士、医师助理）。问卷包括人口统计学、当前实践、口腔健康知识以及关于跨专业协作的意见等部分。使用卡方检验和费舍尔精确检验进行描述性统计和双变量分析，显著性水平设定为0.05。
回复率为66%（119名受访者）。绝大多数（80%）报告称几乎没有接受过口腔健康方面的培训，85%报告称没有与口腔健康专业人员的团队合作经验。医疗服务提供者检查口腔的信心与之前接受的额外培训（p = 0.001）以及团队合作经验（p = 0.005）呈正相关。最常报告的阻碍合作意愿的两个因素是与牙科服务提供者缺乏正式关系（74%）和相互竞争的优先事项（69%）。
总体而言，在这家安全网医院，医疗服务提供者对口腔健康的认识以及将其纳入临床实践的程度非常有限。然而，那些有过培训和团队合作经验的提供者对口腔健康更有信心。鉴于口腔健康对整体健康至关重要，应加大力度进一步教育和培训医疗服务提供者，并消除跨专业护理的障碍。
