Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA.
Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
Community Dent Oral Epidemiol. 2023 Oct;51(5):854-863. doi: 10.1111/cdoe.12773. Epub 2022 Jul 19.
To understand patients' comfort with health risk assessments (HRAs) and patient and dentist factors associated with the provision of HRAs.
In this cross-sectional study, 857 patients seen by 30 dental practitioners in the United States National Dental Practice-Based Research Network reported their comfort receiving HRA for six risk factors (tobacco use, alcohol use, dietary sugar intake, human immunodeficiency virus risks, human papillomavirus risks and existing medical conditions) and whether they discussed any of the risk factors during their visits. Multi-level logistic models were used to examine the impacts of patient, practitioner, practice characteristics on the (1) number of risk factors patients were comfortable discussing and (2) number of risk factors assessed in the current dental visit.
Only a small percentage (4%) of patients reported being uncomfortable receiving any HRA during their dental visits. However, over half of the patients (53%) reported that they did not receive any HRAs during the current visit. In the regression analyses, patients who were older, male and from the suburban were more likely to be comfortable with more HRAs. Dentists were more likely to provide HRA if they were younger, not non-Hispanic white, less likely to feel that providing HRAs was beyond their scope of practice, yet more likely to feel occasional discomfort in providing HRA.
Interventions should focus on reducing dental practitioner perception that conducting HRAs is beyond their scope of practice and standardizing screening assessments for multiple risk factors.
了解患者对健康风险评估(HRA)的舒适度以及与提供 HRA 相关的患者和牙医因素。
在这项横断面研究中,美国国家牙科实践为基础的研究网络中的 30 名牙医诊治的 857 名患者报告了他们对 6 种风险因素(吸烟、饮酒、饮食糖摄入、人类免疫缺陷病毒风险、人乳头瘤病毒风险和现有医疗状况)接受 HRA 的舒适度,并报告了他们在就诊期间是否讨论了任何风险因素。多水平逻辑回归模型用于检查患者、医生、实践特征对(1)患者愿意讨论的风险因素数量和(2)当前就诊中评估的风险因素数量的影响。
只有一小部分(4%)的患者报告在看牙期间接受任何 HRA 时感到不舒服。然而,超过一半(53%)的患者报告他们在当前就诊中没有接受任何 HRA。在回归分析中,年龄较大、男性和来自郊区的患者更有可能对更多的 HRA 感到舒适。如果牙医更年轻、不是非西班牙裔白人、不太认为提供 HRA 超出他们的实践范围,那么他们更有可能提供 HRA。
干预措施应侧重于减少牙医认为进行 HRA 超出其执业范围的看法,并对多种风险因素进行标准化筛查评估。