Redford M, Gift H C
National Institute of Dental Research, National Institutes of Health, U.S. Public Health Service, Bethesda, MD 20892-6401, USA.
J Dent Educ. 1997 Jan;61(1):16-21.
The growing involvement of patients, third party payers, and government in the financing, planning, and delivery of health services has heightened the demand for knowledge about the process of rendering care. This study used a qualitative methodology to examine dentist-patient interactions in treatment decision-making. A series of focus groups was conducted with dentists and patients participating in an ongoing investigation of dental treatment planning conducted at the University of North Carolina. Study findings indicate that dentist-patient interactions play an important role in treatment decision-making and that both are predicated on a variety of non-clinical factors. Dentists' intuition and judgment seem to be used not only to select desired health outcomes and the means for achieving them, but also to depart from the ideal and/or to modify treatment plan presentation on a patient-to-patient basis. Patients' impressions of dentists' examination styles, personalities, and ability to relate to them as individuals seem to mediate both treatment acceptance and willingness to participate in the decision-making process. Results of this investigation suggest that any effort aimed at improving dental treatment decision-making needs to acknowledge the interplay of clinical and psychosocial factors.
患者、第三方支付者及政府在医疗服务的融资、规划和提供方面参与度的不断提高，增加了对医疗服务过程相关知识的需求。本研究采用定性研究方法，考察牙医与患者在治疗决策过程中的互动。针对参与北卡罗来纳大学正在进行的一项牙科治疗规划调查的牙医和患者，开展了一系列焦点小组讨论。研究结果表明，牙医与患者的互动在治疗决策中发挥着重要作用，且两者均基于多种非临床因素。牙医的直觉和判断似乎不仅用于选择期望的健康结果及实现这些结果的手段，还用于偏离理想情况和/或根据患者个体情况调整治疗方案的呈现方式。患者对牙医检查方式、个性以及与他们作为个体建立联系能力的印象，似乎会影响治疗接受度以及参与决策过程的意愿。本次调查结果表明，任何旨在改善牙科治疗决策的努力都需要认识到临床因素和社会心理因素之间的相互作用。
