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为残疾患者提供跨学科口腔及初级卫生保健。

Interdisciplinary oral and primary health care for patients with disabilities.

作者信息

Etminan Sodabeh, Hammerdahl Elsa, Lesondak Linda, Li Nicole, Patel Manav, Mischler Matthew, Keehn Mary, Kirschner Kristi

机构信息

University of Illinois Chicago, UI Health, Mile Square Health Center, Chicago, IL, United States.

University of Illinois Chicago, Chicago, IL, United States.

出版信息

Front Med (Lausanne). 2025 Jul 17;12:1619845. doi: 10.3389/fmed.2025.1619845. eCollection 2025.

Abstract

INTRODUCTION

Individuals with intellectual and developmental disabilities (IDD) often face access to care barriers due to limited provider training, inadequate appointment availability, transportation barriers, financial limitations, and insufficient interdisciplinary collaboration. As a result, this group is particularly vulnerable to oral health issues, experiencing higher rates of periodontal disease and dental caries compared to those without disabilities. Survey data from both dentists and caregivers highlights these obstacles, revealing that a significant proportion of providers do not treat individuals with cognitive disabilities, and patients with IDD often seek care on an emergency basis. This study explores whether a specialized model of dental care-featuring longer appointment times, desensitization techniques, accessible dental furniture, and an interdisciplinary, collaborative team of providers trained to work with individuals with disabilities-can improve dental and overall health outcomes.

METHODS

A total of 50 participants aged 18 years or older with an intellectual or developmental disability (IDD) diagnosis were recruited from a Federally Qualified Health Center (FQHC). Participants were identified by a physician specializing in IDD. Participants who consented were provided with an iPad to complete a 20-min electronic REDCap survey assessing their experiences at Mile Square Health Center, prior dental visits, and barriers to care.

RESULTS

Longer appointment times, accessible dental furniture, and providers with training in treating patients with IDD appeared to significantly improve the patient experience.

DISCUSSION

The findings suggest that longer appointment times, a non-coercive approach, and improved referral and transportation pathways can positively enhance both treatment outcomes and patient satisfaction. This study also emphasizes the importance of interdisciplinary collaboration in developing referral pathways and integration of dental care within the broader healthcare services for individuals with IDD as a model care delivery system.

摘要

引言

智力和发育障碍(IDD)患者常常面临就医障碍,原因包括医疗服务提供者培训有限、预约机会不足、交通不便、经济限制以及跨学科协作不够。因此,该群体特别容易出现口腔健康问题,与非残疾患者相比,患牙周病和龋齿的比例更高。来自牙医和护理人员的调查数据凸显了这些障碍,表明很大一部分医疗服务提供者不治疗认知障碍患者,而IDD患者常常在紧急情况下寻求治疗。本研究探讨一种专门的牙科护理模式——其特点是预约时间更长、采用脱敏技术、提供无障碍牙科设备以及由经过培训专门为残疾患者服务的跨学科协作医疗团队——是否能够改善牙科及整体健康状况。

方法

从一家联邦合格健康中心(FQHC)招募了总共50名年龄在18岁及以上且被诊断为智力或发育障碍(IDD)的参与者。参与者由一名专门从事IDD治疗的医生确定。同意参与的参与者会得到一台iPad,以完成一项20分钟的电子REDCap调查,评估他们在米尔斯奎尔健康中心的经历、之前的牙科就诊情况以及就医障碍。

结果

更长的预约时间、无障碍牙科设备以及接受过治疗IDD患者培训的医疗服务提供者似乎能显著改善患者体验。

讨论

研究结果表明,更长的预约时间、非强制方法以及改善转诊和交通途径能够积极提高治疗效果和患者满意度。本研究还强调了跨学科协作在为IDD患者制定转诊途径以及将牙科护理纳入更广泛医疗服务体系作为一种模范护理模式方面的重要性。

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