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医疗服务提供者与患者之间的关系重要吗?探索老年人的医患关系与口腔健康相关生活质量。

Do health provider-patient relationships matter? Exploring dentist-patient relationships and oral health-related quality of life in older people.

作者信息

Muirhead Vanessa Elaine, Marcenes Wagner, Wright Desmond

机构信息

Centre for Clinical and Diagnostic Oral Sciences, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK.

出版信息

Age Ageing. 2014 May;43(3):399-405. doi: 10.1093/ageing/aft183. Epub 2013 Nov 25.

Abstract

BACKGROUND

patient experience is now a key parameter in health care. Yet, very little is known about the possible impact of dentist-patient relationships on patient-centred outcomes including older peoples' oral health-related quality of life (OHRQoL).

OBJECTIVE

this study assessed the relationship between OHRQoL and dentist-patient relationships related to perceived unmet dental needs; shared decision-making; time spent discussing oral health problems; respect and confidence and trust.

PARTICIPANTS

older people aged 65 years and over living in East London, U.K. in 2011.

METHODS

a cross-sectional study using stratified random sampling recruited a representative sample of older people (n = 772). PARTICIPANTS completed an oral examination and a structured questionnaire including the Oral Health Impact Profile-14 (OHIP-14) measuring OHRQoL and five dentist-patient relationship questions taken from the U.K. 2009 Adult Dental Health Survey. Multivariate Poisson regressions modelled the association between OHRQoL and dentist-patient factors adjusting for socio-demographic factors, clinical oral indicators, and dental attendance.

RESULTS

having a perceived unmet need for dental treatment (PRR = 1.84; 95% CI: 1.32, 2.56) and expressing a lack of trust and confidence in one's dentist (PRR = 1.74; 95% CI: 1.01, 2.98) were significant predictors of poor OHRQoL among older people.

CONCLUSIONS

these findings suggest that older people with unmet dental needs and those who expressed a lack of trust and confidence in their dentist were more likely to experience poor OHRQoL reinforcing the importance of the dental patient experience in healthy ageing and well-being.

摘要

背景

患者体验如今是医疗保健中的一个关键参数。然而,对于医患关系对以患者为中心的结果(包括老年人的口腔健康相关生活质量,OHRQoL)可能产生的影响,我们知之甚少。

目的

本研究评估了OHRQoL与医患关系之间的关系,这些关系涉及未满足的牙科需求、共同决策、讨论口腔健康问题所花费的时间、尊重以及信心和信任。

参与者

2011年居住在英国东伦敦的65岁及以上老年人。

方法

一项采用分层随机抽样的横断面研究招募了具有代表性的老年人群样本(n = 772)。参与者完成了口腔检查和一份结构化问卷,其中包括用于测量OHRQoL的口腔健康影响量表-14(OHIP-14)以及从英国2009年成人牙科健康调查中选取的五个医患关系问题。多变量泊松回归模型对OHRQoL与医患因素之间的关联进行了建模,并对社会人口统计学因素、临床口腔指标和牙科就诊情况进行了调整。

结果

感觉牙科治疗需求未得到满足(PRR = 1.84;95%置信区间:1.32,2.56)以及对自己的牙医表示缺乏信任(PRR = 1.74;95%置信区间:1.01,2.98)是老年人OHRQoL较差的显著预测因素。

结论

这些发现表明,牙科需求未得到满足的老年人以及那些对自己的牙医表示缺乏信任的老年人更有可能经历较差的OHRQoL,这强化了牙科患者体验在健康老龄化和幸福生活中的重要性。

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