Department of Oral Health Sciences at the University of Washington, Seattle, WA, USA.
JDR Clin Trans Res. 2024 Jul;9(3):212-220. doi: 10.1177/23800844231203673. Epub 2023 Oct 31.
Guidelines on effective provider-led communication are available but may be underused in dentistry, even if such guidelines could help dentists manage complex clinical scenarios like topical fluoride hesitancy. The purpose of this study was to investigate current chairside communication approaches used by dentists with fluoride-hesitant caregivers.
A 27-item semistructured interview script was developed and pretested with 3 dentists, revised, and finalized. One-on-one interviews were conducted with a purposive sample of pediatric dentists and general dentists from April to June 2020. Interviews were digitally recorded, transcribed, and analyzed to identify dentists' communication approaches used during clinical interactions with fluoride-hesitant caregivers. Thematic analyses identified themes and subthemes, and exemplary quotes were provided to illustrate each theme.
Twenty-seven dentists participated (21 pediatric dentists and 6 general dentists). The mean age of participants was 43.0 ± 8.2 y (range, 30-73). Most participants were women (88.9%), white (51.9%), and non-Hispanic (85.2%). Participants had been practicing dentistry for a mean of 13.2 ± 10.5 y (range, 2-40). There were 4 themes: leaving topical fluoride decisions completely up to the caregiver, educating the caregiver about fluoride, insisting that the caregiver accept fluoride, and engaging the caregiver and child.
Most communications approaches used by interviewed dentists to manage fluoride hesitancy in clinical settings are not evidence based. Future dental education efforts should ensure that trainees are exposed to and can demonstrate competency in appropriate, evidence-based patient-provider communication strategies.
The study highlights the need for dentists to apply evidence-based communication strategies when managing difficult clinical scenarios like fluoride hesitancy, which is important in optimizing dentist-patient trust.
有效的医患沟通指南已经存在,但在牙科领域可能未被充分利用,尽管此类指南可能有助于牙医处理氟化物抵触等复杂的临床情况。本研究旨在调查牙医在处理氟化物抵触的看护者时所采用的当前椅旁沟通方法。
制定了一个包含 27 个项目的半结构化访谈脚本,并在 3 名牙医中进行了预测试、修订,最终定稿。2020 年 4 月至 6 月,采用目的抽样法选取儿童牙医和普通牙医进行一对一访谈。对访谈进行数字录音、转录和分析,以确定牙医在与氟化物抵触的看护者进行临床互动时使用的沟通方法。主题分析确定了主题和子主题,并提供了示例引语来说明每个主题。
27 名牙医参与了研究(21 名儿童牙医和 6 名普通牙医)。参与者的平均年龄为 43.0±8.2 岁(范围 30-73 岁)。大多数参与者为女性(88.9%)、白人(51.9%)和非西班牙裔(85.2%)。参与者从事牙科工作的平均时间为 13.2±10.5 年(范围 2-40 年)。研究发现有 4 个主题:完全由看护者决定局部用氟化物、教育看护者了解氟化物、坚持看护者接受氟化物、以及让看护者和孩子参与。
在临床环境中管理氟化物抵触时,大多数接受访谈的牙医所采用的沟通方法都没有循证依据。未来的牙科教育工作应确保学员接触并能够展示适当的、基于证据的医患沟通策略,以提高医患信任。
该研究强调了牙医在处理氟化物抵触等困难临床情况时应用基于证据的沟通策略的必要性,这对于优化牙医与患者的信任关系非常重要。