Oral Health Centre of Expertise, Stavanger, Rogaland, Norway.
Faculty of Social Sciences at the University of Stavanger, Stavanger, Norway.
Eur J Oral Sci. 2022 Jun;130(3):e12860. doi: 10.1111/eos.12860. Epub 2022 Feb 26.
Patients with a trauma history, whether sexual abuse or torture, or dental phobia, tend to avoid dental services due to severe dental anxiety. Subsequently, they experience poor oral health, lower quality of life, and poorer general health. In Norway, a specific service (torture, abuse, and dental anxiety [TADA]) targets these patients' dental anxiety through cognitive behavioural therapy (CBT) prior to dental restoration. By exploring patients' experiences with TADA services using a realist evaluation approach, this paper aims to increase our understanding of how this type of service addresses patients' dental anxiety in terms of its mechanisms and contextual factors. Interviews with TADA patients (n = 15) were analysed through a template analysis driven by context-mechanism-outcome heuristics. The analysis revealed that patients value a dental practitioner who provides a calm and holistic approach, positive judgements and predictability elements that lean towards a person-centred care approach. Provided this, patients felt understood and cared for, their shame was reduced, self-esteem emerged, and control was gained, which led to alleviation of dental anxiety. Therefore, our findings suggest that combining CBT with a person-centred care approach helps alleviate patients' dental anxiety. This provides insights into how dental services could be executed for these patients.
有创伤史的患者，无论是性虐待或酷刑、还是牙科恐惧症，往往会因为严重的牙科焦虑而避免看牙。随后，他们的口腔健康状况较差，生活质量较低，整体健康状况也较差。在挪威，有一种专门的服务（酷刑、虐待和牙科焦虑 [TADA]）通过在牙科修复前使用认知行为疗法（CBT）来针对这些患者的牙科焦虑。通过使用现实主义评估方法来探讨 TADA 服务的患者体验，本文旨在增进我们对这种服务如何通过机制和背景因素来解决患者的牙科焦虑的理解。通过上下文-机制-结果启发式模板分析对 TADA 患者（n=15）的访谈进行了分析。分析表明，患者重视提供冷静和整体方法的牙医，重视积极的判断和可预测性元素，这些元素倾向于以以人为本的护理方法。如果提供了这些，患者会感到被理解和关心，他们的羞耻感会减少，自尊心会增强，控制力会增强，从而减轻牙科焦虑。因此，我们的研究结果表明，将 CBT 与以人为本的护理方法相结合有助于减轻患者的牙科焦虑。这为牙科服务如何为这些患者提供服务提供了一些见解。
