The Oral Health Professional's Role in Supporting Patient Self-Care
Research type
Research Study
Full title
Understanding The Oral Health Professional's Role In Supporting Patient Self-Care In Contexts Of Social and Economic Deprivation.
IRAS ID
254020
Contact name
Emma Barnes
Contact email
Sponsor organisation
Cardiff University
Duration of Study in the UK
1 years, 8 months, 30 days
Research summary
Given increasing demands on dentistry, socio-economic differences in oral health, growing emphasis on prevention, together with recognition of the importance of oral health for wider patient well-being, there is a need to research how members of the dental team can best support self-care in contexts of social and economic deprivation. A structured review of the literature, carried out by the researcher as part of this project, showed that while much of dental professionals’ abilities are based upon on a core of scientific knowledge (biology, surgical treatment knowledge), cultural professional beliefs also influence role identity, and, the organisation, delivery and financing of dental care. These cultural traits are influenced by broader social, economic and political factors (for example, remuneration, working environment). It also highlighted that little is known about how dental professionals define prevention and how it is applied in practice. Understanding how the context of dental health care impacts on individual practitioners’ perception of their role and motivation to provide oral health education is key in optimising efforts to promote patient self-care and avoiding widening inequalities. The aim of this study is to explore how oral health education is conceptualised and delivered within a preventive and health promoting approach which encourages patient self-care. This is a qualitative study which adopts case study methodology incorporating one-to-one semi-structured interviews; face-to-face with members of the dental team and via telephone with attending patients. The wider results and conclusions from this study will inform dental professional education, explore mutually-acceptable and appropriate ways of promoting patient self-care and contribute to the development of healthcare workforce and patient care in the partner UHBs.
Results Summary
The Oral Health Professional's Role in Supporting Patient Self-Care Emma Barnes Supervised by Prof Alison Bullock, Prof Ivor ChestnuttThe research was conducted as part of Emma Barnes’ Doctorate in Philosophy (PhD) at Cardiff University (2018 - 2021).
Little is known about how dental professionals define Oral Health Education (OHE) and prevention and how it is applied in practice. Equally, there is little knowledge on patients’ expectations and understanding of OHE during their dental appointments. The main research question addressed in this thesis was “How is oral health education understood and delivered within a preventive approach?”. It focused on how dental professionals approach OHE, how patients perceive it, and the challenges faced in its practical application.
Qualitative data were gathered from semi-structured interviews with dental professionals and patients in two Health Boards in Wales. In total, data were gathered from 30 dental professionals (dentists, dental nurses, and dental therapists) and 87 patients. The data were analysed using Thematic Analysis and mapped onto the Capability-Opportunity-Motivation-Behaviour (COM-B) and Theoretical Domains Framework (TDF) using qualitative content analysis.
Both patients and dental professionals held a positive view of OHE and its role in improving oral health. Dental professionals’ saw it as part of their professional responsibility to advise patients and provide new information. Patients trusted the expertise of dental professionals and valued advice given as they wanted to keep their teeth and avoid further dental treatment.
Dental Professionals' Approach: Insufficient National Health Service (NHS) financial compensation for providing prevention compared to other interventions was said to constrain dental professionals’ time on OHE. Having to complete a high number of appointments a day was said to lead to shorter appointments which limited the ability of dental professionals to deliver OHE as they would like. The OHE interaction involved assessing patient oral disease risk to determine what advice is needed and how much information they can provide during the appointment time. Developing standard messages of advice helped to manage these decisions. Decisions were also made on how and when to raise the topic with the patient to avoid causing embarrassment or offense. Dental professionals also talked of adapting the amount of detail they provided based on patients’ perceived interest during appointments.
Patients' expectations and reactions: Trust in the dental professional and development of a good relationship were key to successful OHE delivery for patients. Patients were sensitive to the tone and style of the dental professional’s communication, especially if they viewed it as lecturing or judgmental of their oral health care efforts.
This research investigated how oral health education (OHE) was understood and implemented within preventive dentistry, highlighting the two-way nature of OHE, where both dental professionals and patients influenced each other's responses and understanding. A large amount of complex work is involved in short, time-constrained appointments. These findings underscore the need for changes to support preventive dentistry and enhance the OHE experience for both professionals and patients.REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
19/NW/0568
Date of REC Opinion
19 Sep 2019
REC opinion
Favourable Opinion