Advance care planningThe importance of acknowledgement of emotions in routine patient psychological assessment: The example of the dental setting
Section snippets
Background
Communication within dentistry has always been considered essential [1], [2]. The majority of dental schools internationally require students to be trained and assessed in their interaction with their patients. The intention is to provide patients with dental treatment and care with comparative ease. This extends, to the provision of health education, advice on oral hygiene, diet and use of fluoride [3]. An area that is very demanding, as it requires frequent use of extensive communication
Aim
The overall aim of this brief paper is to show that through a careful design of discrete interventions the researcher can investigate some of the multiple factors that construct the smooth performance in the communication process of the dental staff with their patients. The structure of the paper is to present summaries of three studies conducted by the authors, two of which are already published [15], [16]. The final study is reported in an unpublished doctoral thesis [17]. They comprise a
Methods and results
Study 1 tested the hypothesis that informing dentists about patients' dental anxiety prior to commencement of treatment reduces patients’ state anxiety [15]. A randomised controlled trial was conducted. Eight General Dental Practitioners in North Wales participated. Patients attending their first session of dental treatment, and accumulating a score of 19 or above, or scoring 5 on the MDAS on any one item were recruited. Patients were instructed to complete the Spielberger state anxiety
Discussion
The series of three studies provides a programme of research evidence that indicates the importance of the dentist focussing on the patient’s expressions of anxiety as recorded on paper in a routine screening assessment. Study 1 provided the first evidence that providing the dentist physically with the screening assessment of dental anxiety (MDAS) prior to the provision of dental treatment (including some form of invasive intervention i.e. prophylaxis, local anaesthetic injection, filling or
Clinical implications
This series of 3 inter-related studies, within a dental clinical setting, has demonstrated the importance of assessing procedural anxiety immediately prior to treatment intervention. A fascinating feature highlighted by this programme of research has been the importance of the clinician in engaging with the patient to discuss the specific features of the patient experience. We therefore propose the introduction of this screening device in routine practice, as it may benefit the psychological
Acknowledgements
This paper is on memory of Dr Jenny Hally (deceased) who conducted Study 3 as part fulfilment of her PhD (supervised by Profs R Freeman and G Humphris). This work was funded by the Chief Scientist Office, Scotland under their Clinical Academic Fellowship Scheme (grant number: CAF/07/02). We expressly thank the family of Dr Hally for permission to publish part of her work.
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