Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3012, Bern, Switzerland.
Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Beldiletto 1, 20142, Milan, Italy.
BMC Pediatr. 2024 Nov 25;24(1):764. doi: 10.1186/s12887-024-05234-8.
This study explores the acceptance of Advanced Behavior Management Techniques (ABMTs) by parents during their children's dental treatments, comparing the opinion of parents of neurotypical children with that of parents of children with autism spectrum disorders (ASDs).
An observational cross-sectional study was conducted involving 440 parents, divided into two groups: 236 parents of neurotypical children and 204 parents of children with ASDs, recruited from pediatricians' centers and centers for ASDs children in Northern and Southern Italy. A survey assessed their familiarity and acceptance of ABMTs, including protective stabilization, conscious sedation, and deep sedation/general anesthesia. Discrete variables were expressed as absolute and relative frequencies (%) and compared with Pearson's chi-squared or Fisher's exact test. Continue variables were expressed as mean ± SD and compared with the one-way ANOVA test. Heatmap and PCA analysis were used to determine possible correlations between items.
Parents of children with ASDs showed a higher acceptance rate of ABMTs compared to parents of neurotypical children. Overall, only 30.68% of parents knew ABMTs before the survey. Differences between the two groups of parents in acceptance of Active Stabilization in emergency settings, Passive Stabilization in routine settings, and Deep sedation/general anesthesia in both settings were observed (p < 0.01). Only 6.82% of parents ever used at least one ABMT on their children. Heatmap analysis revealed that parents who have accepted one of the ABMTs tend to accept the others as well.
Differences in parental acceptance of different ABMTs was noted among the two groups of parents, with greater acceptance of ABMTs observed in the group of parents of children with ASDs. Parents of both groups have significant gaps in their knowledge of ABMTs. Therefore, increased awareness and personalized communication strategies are needed to increase acceptance of the studied techniques and, thus, facilitate access to dental care for uncooperative pediatric patients. Patient-centered behavior management strategies that meet children's needs and parents' preferences can contribute to the achievement of good oral health.
本研究旨在探讨父母在儿童牙科治疗中接受先进行为管理技术（ABMTs）的情况，比较正常儿童父母与自闭症谱系障碍（ASD）儿童父母的意见。
本研究采用观察性横断面研究，纳入了来自意大利北部和南部的儿科医生中心和 ASD 儿童中心的 440 名父母，分为两组：236 名正常儿童的父母和 204 名 ASD 儿童的父母。调查评估了他们对 ABMTs 的熟悉程度和接受程度，包括保护性稳定、意识镇静和深度镇静/全身麻醉。离散变量用绝对和相对频率（%）表示，并采用 Pearson 卡方检验或 Fisher 确切检验进行比较。连续变量用平均值±标准差表示，并采用单因素方差分析进行比较。采用热图和 PCA 分析确定项目之间的可能相关性。
与正常儿童的父母相比，ASD 儿童的父母对 ABMTs 的接受率更高。总体而言，只有 30.68%的父母在调查前了解 ABMTs。在紧急情况下使用主动稳定、常规情况下使用被动稳定以及在两种情况下使用深度镇静/全身麻醉的情况下，两组父母的接受率存在差异（p<0.01）。只有 6.82%的父母曾在自己的孩子身上使用过至少一种 ABMT。热图分析表明，接受一种 ABMT 的父母往往也会接受其他 ABMT。
两组父母对不同 ABMTs 的接受程度存在差异，ASD 儿童的父母更接受 ABMTs。两组父母在 ABMTs 知识方面存在显著差距。因此，需要提高认识并采用个性化的沟通策略，以提高对所研究技术的接受程度，从而为不合作的儿科患者提供更好的口腔保健服务。以患者为中心的行为管理策略，既能满足儿童的需求，又能满足家长的偏好，有助于实现良好的口腔健康。
