牙科团队在重度肥胖成年人牙科管理中的障碍与促进因素：一项定性分析

Dental team barriers and enablers for the dental management of adults with severe obesity: a qualitative analysis.

作者信息

Malik Zanab, McBride Kate A, Williams Kathryn, Cockrell Deborah, Collins Clare E

机构信息

School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.

Oral Health Services, Central Coast Local Health District, Gosford, NSW, Australia.

出版信息

BDJ Open. 2024 Nov 2;10(1):83. doi: 10.1038/s41405-024-00264-x.

DOI:10.1038/s41405-024-00264-x

PMID:39488515

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11531496/

Abstract

BACKGROUND

Broad challenges regarding the dental management of people with severe obesity experienced by general dentists have been minimally explored. The perspectives of the dental team regarding these multifaceted issues are currently unknown and they potentially impede the delivery of optimal dental care to this population and contribute to poor oral and general health.

AIMS

Our qualitative study aimed to identify and explore barriers and enablers in the dental management of adults with severe obesity among dental professionals and support staff in Australia.

METHODS

Focus groups and semi-structured interviews (n = 34 participants) were conducted with dental professionals (n = 23) and support staff (n = 11). Recordings were transcribed verbatim and synthesised using thematic, inductive analysis.

RESULTS

Multiple barriers to adequate provision of dental care for people living with severe obesity in both general and specialist dental settings were identified. Key themes emerged related to the clinical challenges reported by participants in providing dental management for people living with severe obesity, appropriateness of existing bariatric dental service provision and safety of care. Enablers to access were identified, including increased availability of bariatric dental chairs, environmental modifications, education of both patients and the entire dental team and for guideline development.

CONCLUSION

The current study explored multiple barriers to optimal dental management of people living with severe obesity in both general and specialist dental settings. Enablers should be used to inform future practice. The optimisation of existing bariatric dental service provision requires urgent review with solutions guided by systemic change. Study findings suggest a review of current health systems, economics, access barriers, policies and procedures and education and training beyond the individual level are needed. Future directions to improve the dental management of people living with severe obesity are proposed.

摘要

背景

普通牙医在为严重肥胖人群提供牙科治疗时面临的广泛挑战鲜有研究。目前尚不清楚牙科团队对这些多方面问题的看法，这些看法可能会阻碍为该人群提供最佳牙科护理，并导致口腔和全身健康状况不佳。

目的

我们的定性研究旨在确定并探讨澳大利亚牙科专业人员和辅助人员在为严重肥胖成年人提供牙科治疗时的障碍和促进因素。

方法

对牙科专业人员（n = 23）和辅助人员（n = 11）进行了焦点小组讨论和半结构化访谈（共34名参与者）。录音逐字转录，并采用主题归纳分析法进行综合分析。

结果

在普通牙科和专科牙科环境中，为严重肥胖患者提供充分牙科护理存在多重障碍。出现了与参与者在为严重肥胖患者提供牙科治疗时报告的临床挑战、现有肥胖症牙科服务提供的适宜性以及护理安全性相关的关键主题。确定了促进就医的因素，包括增加肥胖症牙科椅的可用性、环境改造、对患者和整个牙科团队的教育以及制定指南。

结论

本研究探讨了普通牙科和专科牙科环境中为严重肥胖患者提供最佳牙科治疗的多重障碍。应利用促进因素为未来的实践提供参考。现有肥胖症牙科服务的优化需要紧急审查，并在系统变革的指导下寻求解决方案。研究结果表明，需要对当前的卫生系统、经济学、就医障碍、政策和程序以及个人层面以外的教育和培训进行审查。提出了改善严重肥胖患者牙科治疗的未来方向。