Knowledgeability, Attitude and Practice Behaviors of Dental Providers Toward Provisions of Integrated Care Delivery for Patients With Prediabetes/Diabetes: Wisconsin Statewide Survey

Introduction: To conduct a statewide survey among Wisconsin-based dental providers evaluating current knowledgeability, attitudes and practice behaviors surrounding management of patients with diabetes/prediabetes in the dental setting. The study explored perceptions on feasibility, value, barriers, and current status of integrated care model (ICM) adoption by dental practicesMaterials and Methods: A 32-question paper-based survey was mailed to all licensed dentists and dental hygienists practicing in Wisconsin. The study was conducted over a 4 week period in 2019. The survey instrument was adapted from a previous validated survey and was expanded to include questions on ICM adoption. Content and validity analyses and beta testing were conducted prior to dissemination of the survey. Descriptive statistics and chi-square tests were applied for data analyses. Thematic analyses was performed on open-ended questions.Results: Survey response rate was 12% (N = 854/7,356) representing 41% dentists and 59% dental hygienists. While 68% reported educating patients on oral health-diabetes association, only 18% reported medical consultations to inform dental treatment, and “frequent” (22%) or “occasional” (40%), medical triage. Knowledge-based questions were correctly answered by >70% of participants. While 50% valued chair-side glycemic screening and 85% supported non-invasive chair-side screening to identify at-risk patients,>88% relied on patient-reported diabetic status. Barriers to ICM adoption included time investment (70%), patient activation/cooperation (62%), cost (50%), insurance coverage (50%), infrequent interdisciplinary communication (46%), lack of equipment (33%) and provider (31%).Conclusion: Low rates of ICM adoption, chair-side testing, medical consultation and triage, and need for educational curricula reform were identified.

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Dental care for drug users in Norway: Dental professionals’ attitudes to treatment and experiences with interprofessional collaboration

10.21203/rs.2.20731/v4 ◽

2020 ◽

Author(s):

Ewa Hovden ◽

Vibeke Ansteinsson ◽

Ingrid Volden Klepaker ◽

Eeva Widström ◽

Rasa Skudutyte-Rystad

Keyword(s):

Drug Users ◽

Dental Treatment ◽

Interprofessional Collaboration ◽

Care Delivery ◽

Dental Service ◽

Poor Compliance ◽

Dental Hygienists ◽

Background Characteristics ◽

Interprofessional Communication ◽

Dental Professionals

Abstract Background: The present study aimed to assess dental professionals’ attitudes and experiences related to the dental treatment of drug users and to interprofessional collaboration with the rehabilitation institutions (RIs).Methods: The study population comprised 141 dentists and dental hygienists (response rate 73%) working in the Public Dental Service (PDS) in three counties in Norway. All of the participants completed an electronically distributed questionnaire on existing practices and experiences regarding dental treatment for drug users and interprofessional collaboration with RIs. The Norwegian Centre for Research Data (NSD) approved the study.Results: Thirty-five percent of the dentists and 10% of the dental hygienists had treated five or more drug users per month (p < 0.05). The majority of dentists and dental hygienists used more time for examination and treatment of drug users compared to other patient groups. Over 70% of dental clinicians considered drug users as demanding patients due to fear, missing appointments, and poor compliance with oral hygiene advice. Multivariable logistic regression analyses showed that attitudes and experiences with dental treatment of drug users were significantly associated with background characteristics of professionals. The overall perception was that drug users often had higher expectations of dental treatment than what could be defined as necessary care and provided by the PDS. One-third of dental professionals reported that they were satisfied with the collaboration they had with RIs . Most of the respondents agreed that personnel from RIs could positively influence interprofessional collaboration by having sufficient knowledge of drug users statutory rights to free of charge dental treatment, as well as by close follow-up and motivation of patients before dental treatment.Conclusions: Dental professionals perceived the management of drug users as demanding due to dental fear, difficulties in coping with appointments, poor compliance to preventive measures, and disagreement between dental treatment defined as necessary and drug users’ expectations. Attitudes and experiences related to dental treatment of drug users were significantly associated with background characteristics of clinicians. Organizational barriers regarding leadership, accessibility, and collaborative routines, as well as lack of interprofessional communication, suggest current models of health care delivery to drug users need reviewing.

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Dental care for drug users in Norway: dental professionals’ attitudes to treatment and experiences with interprofessional collaboration

BMC Oral Health ◽

10.1186/s12903-020-01240-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Ewa S. Hovden ◽

Vibeke E. Ansteinsson ◽

Ingrid Volden Klepaker ◽

Eeva Widström ◽

Rasa Skudutyte-Rysstad

Keyword(s):

Drug Users ◽

Dental Treatment ◽

Interprofessional Collaboration ◽

Care Delivery ◽

Dental Service ◽

Poor Compliance ◽

Dental Hygienists ◽

Background Characteristics ◽

Interprofessional Communication ◽

Dental Professionals

Abstract Background The present study aimed to assess dental professionals’ attitudes and experiences related to the dental treatment of drug users and to interprofessional collaboration with the rehabilitation institutions (RIs). Methods The study population comprised 141 dentists and dental hygienists (response rate 73%) working in the Public Dental Service (PDS) in three counties in Norway. All of the participants completed an electronically distributed questionnaire on existing practices and experiences regarding dental treatment for drug users and interprofessional collaboration with RIs. The Norwegian Centre for Research Data (NSD) approved the study. Results Thirty-five percent of the dentists and 10% of the dental hygienists had treated five or more drug users per month (p < 0.05). The majority of dentists and dental hygienists used more time for examination and treatment of drug users compared to other patient groups. Over 70% of dental clinicians considered drug users as demanding patients due to fear, missing appointments, and poor compliance with oral hygiene advice. Multivariable logistic regression analyses showed that attitudes and experiences with dental treatment of drug users were significantly associated with background characteristics of professionals. The overall perception was that drug users often had higher expectations of dental treatment than what could be defined as necessary care and provided by the PDS. One-third of dental professionals reported that they were satisfied with the collaboration they had with RIs. Most of the respondents agreed that personnel from RIs could positively influence interprofessional collaboration by having sufficient knowledge of drug users statutory rights to free of charge dental treatment, as well as by close follow-up and motivation of patients before dental treatment. Conclusions Dental professionals perceived the management of drug users as demanding due to dental fear, difficulties in coping with appointments, poor compliance to preventive measures, and disagreement between dental treatment defined as necessary and drug users’ expectations. Attitudes and experiences related to dental treatment of drug users were significantly associated with background characteristics of clinicians. Organizational barriers regarding leadership, accessibility, and collaborative routines, as well as lack of interprofessional communication, suggest current models of health care delivery to drug users need reviewing.

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Dental care for drug users in Norway: Dental professionals’ attitudes to treatment and experiences with interprofessional collaboration

10.21203/rs.2.20731/v1 ◽

2020 ◽

Author(s):

Ewa Hovden ◽

Vibeke Ansteinsson ◽

Ingrid Volden Klepaker ◽

Eeva Widström ◽

Rasa Skudutyte-Rystad

Keyword(s):

Drug Users ◽

Dental Treatment ◽

Interprofessional Collaboration ◽

Care Delivery ◽

Dental Service ◽

Poor Compliance ◽

Dental Hygienists ◽

Interprofessional Communication ◽

Study Results ◽

Dental Professionals

Abstract Objective: The present study aimed to assess dental professionals’ attitudes and experiences related to the dental treatment of drug users and experiences with interprofessional collaboration with the rehabilitation institutions. Materials and methods: The study population comprised 141 dentists and dental hygienists (response rate 73%) working in the Public Dental Service (PDS) in three counties in Norway. All of the participants completed an electronically distributed questionnaire on existing practices and experiences regarding dental treatment for drug users and interprofessional collaboration with rehabilitation institutions (RIs). The Norwegian Centre for Research Data (NSD) approved the study. Results: The majority of dentists and dental hygienists in the present study used more time for examination and treatment of drug users compared to other patient groups. Over 70% of dental clinicians considered drug users as demanding patients due to fear, missing appointments, and poor compliance with oral hygiene advice. The overall perception was that drug users often had higher expectations of dental treatment than what could be defined as necessary care and provided by the PDS. One-third of dental professionals reported that they were satisfied with the collaboration they had with RIs . Most of the respondents agreed that personnel from rehabilitation institutions could positively influence interprofessional collaboration by having sufficient knowledge of drug users statutory rights to free of charge dental treatment, as well as by close follow-up and motivation of patients before dental treatment. Conclusions: Dental professionals perceived the management of drug users as demanding due to dental fear, difficulties in coping with appointments, poor compliance to preventive measures, and disagreement between dental treatment defined as necessary and drug users’ expectations. Organizational barriers regarding leadership, accessibility, and collaborative routines, as well as lack of interprofessional communication, suggest current models of health care delivery to drug users need reviewing.

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Dental care for drug users in Norway: Dental professionals’ attitudes to treatment and experiences with interprofessional collaboration

10.21203/rs.2.20731/v2 ◽

2020 ◽

Author(s):

Ewa Hovden ◽

Vibeke Ansteinsson ◽

Ingrid Volden Klepaker ◽

Eeva Widström ◽

Rasa Skudutyte-Rystad

Keyword(s):

Drug Users ◽

Dental Treatment ◽

Interprofessional Collaboration ◽

Care Delivery ◽

Dental Service ◽

Poor Compliance ◽

Dental Hygienists ◽

Interprofessional Communication ◽

Study Results ◽

Dental Professionals

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Patients’ and healthcare professionals’ perspectives on the idiopathic pulmonary fibrosis care journey: a qualitative study

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01431-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anouk Delameillieure ◽

Fabienne Dobbels ◽

Sarah Vandekerkhof ◽

Wim A. Wuyts

Keyword(s):

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Integrated Care ◽

Healthcare Professionals ◽

Care Delivery ◽

Care Program ◽

Management Support ◽

Continuous Training ◽

Patient Reported ◽

Centre Of Excellence

Abstract Background Idiopathic pulmonary fibrosis (IPF) highly impacts patients on several life dimensions and challenges healthcare practices in providing high-quality care. Consequently, it is crucial to establish integrated care processes, maximizing patient value and patients’ individual needs. The aim of the study was to shed light on the care trajectory based on the perspectives of patients and healthcare professionals. Methods The study was conducted at a tertiary Belgian IPF centre of excellence. We conducted individual interviews with patients and healthcare professionals, guided by the Chronic Care Model (CCM) as a framework for integrated care. Thematic analysis was used to underpin data analysis. Results Experiences were gathered of nine patients with IPF (aged 57–83 years, of which the informal caregivers were present at five interviews) and nine professionals involved in the IPF care trajectory. Our findings identified pitfalls and suggestions for improvement covering all elements of the CCM, primarily at the level of the individual patient and the care team. We covered suggestions to improve the team-based care and pro-active follow-up of patients’ needs. Self-management support was highlighted as an important area and we identified possibilities, but also challenges regarding the use of patient-reported outcomes and eHealth-tools. Furthermore, the importance of continuous training for professionals and the implementation of guidelines in routine care was pointed out. Also, participants mentioned an opportunity to collaborate with community-based organizations and raised challenges regarding the overall health system. Lastly, the pertaining lack of IPF awareness and the disease burden on patients and their caregivers were covered. Conclusions Our research team has initiated a project aiming to optimize the current care delivery practice for IPF patients at a Belgian centre of excellence. These results will inform the further optimisation of the care program and the development of feasible supportive interventions.

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Dental care for drug users in Norway: Dental professionals’ attitudes to treatment and experiences with interprofessional collaboration

10.21203/rs.2.20731/v3 ◽

2020 ◽

Author(s):

Ewa Hovden ◽

Vibeke Ansteinsson ◽

Ingrid Volden Klepaker ◽

Eeva Widström ◽

Rasa Skudutyte-Rystad

Keyword(s):

Drug Users ◽

Dental Treatment ◽

Interprofessional Collaboration ◽

Care Delivery ◽

Dental Service ◽

Poor Compliance ◽

Dental Hygienists ◽

Background Characteristics ◽

Interprofessional Communication ◽

Dental Professionals

Abstract Background: The present study aimed to assess dental professionals’ attitudes and experiences related to the dental treatment of drug users and to interprofessional collaboration with the rehabilitation institutions (RIs). Methods: The study population comprised 141 dentists and dental hygienists (response rate 73%) working in the Public Dental Service (PDS) in three counties in Norway. All of the participants completed an electronically distributed questionnaire on existing practices and experiences regarding dental treatment for drug users and interprofessional collaboration with RIs. The Norwegian Centre for Research Data (NSD) approved the study.Results: Thirty-five percent of the dentists and 10% of the dental hygienists had treated five or more drug users per month (p < 0.05). The majority of dentists and dental hygienists used more time for examination and treatment of drug users compared to other patient groups. Over 70% of dental clinicians considered drug users as demanding patients due to fear, missing appointments, and poor compliance with oral hygiene advice. Multivariable logistic regression analyses showed that attitudes and experiences with dental treatment of drug users were significantly associated with background characteristics of professionals. The overall perception was that drug users often had higher expectations of dental treatment than what could be defined as necessary care and provided by the PDS. One-third of dental professionals reported that they were satisfied with the collaboration they had with RIs . Most of the respondents agreed that personnel from RIs could positively influence interprofessional collaboration by having sufficient knowledge of drug users statutory rights to free of charge dental treatment, as well as by close follow-up and motivation of patients before dental treatment.Conclusions: Dental professionals perceived the management of drug users as demanding due to dental fear, difficulties in coping with appointments, poor compliance to preventive measures, and disagreement between dental treatment defined as necessary and drug users’ expectations. Attitudes and experiences related to dental treatment of drug users were significantly associated with background characteristics of clinicians. Organizational barriers regarding leadership, accessibility, and collaborative routines, as well as lack of interprofessional communication, suggest current models of health care delivery to drug users need reviewing.

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The Current Status of Hearing Care: Can We Change the Status Quo?

Journal of the American Academy of Audiology ◽

10.3766/jaaa.16.7.2 ◽

2005 ◽

Vol 16 (07) ◽

pp. 410-418 ◽

Cited By ~ 6

Author(s):

Dennis Van Vliet

Keyword(s):

United States ◽

Hearing Loss ◽

Care Delivery ◽

The United States ◽

Status Quo ◽

Hearing Impaired ◽

Current Status ◽

High Quality ◽

Scientific Database ◽

The Status

The members of the profession of audiology often express concern that the services and products that have been developed to provide benefit to the hearing impaired are not sought after or delivered to the majority of those diagnosed with hearing loss. A critical look at the status quo of hearing care delivery in the United States is needed to verify this assumption and to develop strategies to improve the situation. A key concern is the lack of a comprehensive high-quality scientific database upon which to build continuous improvements in the effectiveness of the services and products that are provided to the hearing impaired.

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The effect of multimodal comprehensive care methodology training on oral health care professionals’ empathy for patients with dementia

BMC Medical Education ◽

10.1186/s12909-021-02760-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Masaki Kobayashi ◽

Mio Ito ◽

Yasuyuki Iwasa ◽

Yoshiko Motohashi ◽

Ayako Edahiro ◽

...

Keyword(s):

Health Care ◽

Oral Health ◽

Health Professionals ◽

Health Care Professionals ◽

Dental Treatment ◽

Oral Care ◽

Training Programme ◽

Comprehensive Care ◽

Dental Hygienists ◽

People With Dementia

Abstract Background The prevalence of oral diseases in people with dementia has increased, and patients with dementia have worse oral health than people without dementia. However, in the provision of oral care, these patients often exhibit care-resistant behaviours. Empathy is important for health care professionals who provide dental care for people with dementia. A study was conducted to assess whether a multimodal comprehensive care methodology training programme, Humanitude™, was associated with an improvement in empathy for people with dementia among oral health care professionals. Methods This research was a pre-post prospective study. A total of 45 dentists and dental hygienists participated in a 7-h multimodal comprehensive care methodology training programme. Participants’ empathy for their patients was evaluated with the Jefferson Scale of Physician Empathy-Health Professionals Version (JSPE-HP) before the training and 1 month after the training (primary outcome). Each participant listed 3 patients with poor oral health due to the refusal of usual oral care or dental treatment from his or her clinical practice. The oral health of the 3 care-resistant patients listed by each participant was evaluated by the Oral Health Assessment Tool (OHAT) before the training and 1 month after the training (secondary outcome). Results The post-training response rate was 87% (21 dentists and 18 dental hygienists). From pre-training to post-training, the multimodal comprehensive care methodology training significantly increased the mean empathy score (from 113.97 to 122.95, P < 0.05, effect size = 0.9). Regardless of gender, profession and years of clinical experience, all post-training subgroup scores were higher than the pre-training subgroup scores. The tongue, natural teeth, and oral hygiene scores of patients with dementia who resisted usual oral care or dental treatment, as assessed by the OHAT, were significantly improved compared with those before the training. Conclusions The multimodal comprehensive care methodology training was associated with an improvement in oral health professionals’ empathy for patients with dementia. These findings suggest that randomized controlled trials with large sample sizes will be needed. Trial registration UMIN Clinical Trials Registry (UMIN-CTR), UMIN000041687. Registered 4 September 2020 – Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047586

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