Changes in the levels of knowledge and attitudes of dental hospital staff about domestic violence following attendance at an awareness raising seminar

OBJECTIVES

To assess changes in dental team knowledge and awareness about domestic violence following attendance at a brief training intervention.

MATERIALS AND METHODS

Seventy-five dental hospital staff at the University of Manchester Dental Hospital attended a two-hour session delivered by Manchester's City Wide NHS Domestic Violence Project manager. Participants completed identical questionnaires immediately before and after the session. Paired t-tests were conducted to determine changes in responses to individual questions before and after training. Independent sample t-tests were also conducted to compare mean responses by sex.

RESULTS

Statistically significant improvements were seen in 50% of attitude questions and 100% of knowledge questions. After training, there was improved recognition that interpersonal violence was a health issue and that the dental profession should be more involved in identification of abuse. There was also improved comfort asking about abuse and respondents were less afraid of offending the patient and less likely to blame the victims for being abused. Statistically significant sex differences at baseline were also seen for several items: females obtaining more correct answers at baseline than males.

CONCLUSIONS

Brief domestic violence training interventions can be effective in improving knowledge and attitudes amongst a dental team but could lead to false confidence in staff and should be followed by in-depth practical training and the development of appropriate processes for dealing with abuse victims.

Dimensions of good work for employees in oral and maxillofacial surgery in Sweden

The aims of this study were to describe how the employees of Oral and Maxillofacial Surgery (OMFS) clinics in Sweden perceive "good work", i.e. their image of the good dimensions that the profession should contain and to investigate if there is a discrepancy between ideal and reality for this group. The study was based on a questionnaire with 67 questions, related to quality management at the clinic, health and the content of good work in two sections, one with the headline "defines good work" and the other "fulfilled 'in my present work' ". Each section was subdivided into 12 parts covering aspects of good work. The maxillo-facial surgeons rated "intellectually stimulating work" as most important (91%), and the "hazard-free work environment" as least important (48%). The nurses rated "stimulating fellowship" as most important (84%), and the "opportunity for career advancement" as least important (27%). The percentage unit differences between the ideal and the reality were largest for the item "the work provides opportunities to have an influence on important decisions". Maxillo-facial surgeons had the greatest differences for that question and nurses had the greatest differences in "the work is well paid". A principal components analysis was performed and three factors explained more than half of the variance (52%). The factors were interpreted as (1) aiming at moral values and possibilities for skill discretion, as (2) career development, and as (3) work environment. The employees of OMFS clinics in Sweden emphasized free, influential, and intellectually stimulating work, but the discrepancy between ideal and reality was rather wide. Three factors of work environment could be established.

Cultural and communicational traits of oral health care: results of a Finnish case study

PURPOSE

This paper aims to describe the cultural and communicational traits of Finnish oral health care. First, employees' views and experiences regarding their organization and their position within it are investigated and, second, relations between different individual and organizational factors are analyzed. Finally, a conceptual framework of organizational coherence is constructed.

DESIGN/METHODOLOGY/APPROACH

The paper shows that data collection (n = 58, 84 percent response rate) was carried out in 2002 at a Finnish dental clinic by using a semi-structured questionnaire. The data were analyzed statistically by using, among other things, non-parametric tests and a structural equation model (LISREL) and qualitatively by using content analysis.

FINDINGS

The paper finds that the organization was described as role-dependent and task-centered. Unidirectional chain of communication and responsibility for interaction were observed as the descriptive traits of communication, regardless of satisfaction or dissatisfaction with the communication. Developmental challenges involved opportunities to exert influence in the organization as well as giving and receiving feedback in leadership relations. It was found that a good sense of one's position in the organization was positively associated with several essential experiences (e.g. confidence, openness and equality), regarding organizational factors.

ORIGINALITY/VALUE

It appears in this paper likely that, by adopting the perspective of organizational coherence, it will be possible to approach the reality of an oral health care organization. As such a new and informative perspective is added.

Smoking cessation as a dental intervention--views of the profession

OBJECTIVE

To undertake a questionnaire-based survey to determine the attitudes and activities of dental professionals in primary care in the Northern Deanery of the UK in relation to providing smoking cessation advice.

METHODS

Questionnaires for dentists, hygienists and dental nurses were sent to hygienists to distribute to other members of the team. The information collected included: smoking status of the professionals and the practice; roles of the dental team in giving smoking cessation advice; levels of training received; and potential barriers to giving this brief intervention.

RESULTS

Over 90% of practices were smoke-free environments and significantly more dental nurses (23%) were smokers compared to dentists (10%) and hygienists (7%) (p<0.01). The majority of dentists and hygienists enquired about smoking status of their patients and all three groups believed that hygienists and dentists should offer brief smoking cessation advice. Potential barriers to delivering smoking cessation advice were identified: lack of remuneration; lack of time; and lack of training.

CONCLUSION

Dental teams in primary care are aware of the importance of offering smoking cessation advice and, with further training and appropriate remuneration, could guide many of their patients who smoke to successful quit attempts.

General health promotion in general dental practice — The involvement of the dental team Part 2: A qualitative and quantitative investigation of the views of practice principals in South Yorkshire

AIM

To investigate the factors that might influence the provision of general health promotion through seven different health interventions by dental teams in general dental practice.

METHOD

A mixed-method was used comprising cross-sectional qualitative research using semi-structured interviews of a purposive sample of 10 practice principals, and a cross sectional survey of a practice principal from every dental practice in South Yorkshire, using a self-complete questionnaire.

RESULTS

Two core categories emerged from the qualitative data: seeing health or disease and practitioners' views of the structure of dental practice. The former refers to the participants' general outlook and cut across many dimensions constituting the structure of dental practice. Health-orientated dentists were more likely to be involved in prevention and were more open-minded to expanding the dental team's role into general health promotion. However participants perceived that barriers existed to involvement such as time and financial factors, current workload and lack of personal skills. The response rate of useable questionnaires in the cross sectional survey was 84%. Reported levels of involvement in general health promotion were low. Most frequently reported barriers were 'insufficient funding' and 'poor use of time'. 'Poor use of time' and 'lack of training/knowledge' were reported less frequently for professionals complementary to dentistry (PCDs) than dentists (p<0.05). Most dentists agreed that PCDs could be trained to deliver health interventions and would be happy for PCDs to do so in their practice if reported barriers were removed.

CONCLUSIONS

Although dental teams' involvement in general health promotion is low, there is willingness to increase involvement, particularly among health-orientated dentists. Some reported barriers to involvement might be removed by impending changes to the GDS in England. Other important factors include a lack of education and workforce shortages of dentists and PCDs. Respondents indicated a high regard for PCDs and there was broad agreement that they were suitable to be involved in this work.

Smoking cessation and the dental team

Dental teams are in an ideal position to help smokers stop smoking. In spite of this, smoking cessation interventions are not often incorporated as a routine part of dental care. Surveys have shown that most dentists believe that helping patients stop smoking is important, but they are reluctant to provide smoking cessation services for their patients. However, comparatively little research has been carried out to examine the views and activities of other members of the dental team, with respect to the provision of smoking cessation support as part of dental care.This paper describes a self-administered, questionnaire-based study to investigate attitudes and practices amongst staff in the Birmingham Personal Dental Service, with respect to helping patients to stop smoking.

CLINICAL RELEVANCE

Dentists and their team members have an important role to play in smoking cessation.

Conflict resolution

The sooner conflict is identified and confronted, the more quickly it can be resolved (and the sooner, the better). When this is accomplished calmly and objectively, many areas of conflict will be eliminated. Addressing conflict as it arises also sends a clear message to the team that the practice seeks resolution, not punishment or negative consequences. In addition, the dentist and the office manager need to lead by example by avoiding gossip and encouraging open communication. The goal is to go from a parent-child relationship with the dental team to an adult-adult relationship using this series of managerial conflict resolution steps.

Self-disclosure of HIV status: perception of malaysian HIV-positive subjects towards attitude of dental personnel in providing oral care

The objective of this study was to assess the perceptions of Malaysian HIV-positive subjects towards the attitude of dental personnel in providing oral care to them. The study design was cross-sectional with the sampling frame comprising of 27 Government Drug Rehabilitation Centres throughout Malaysia. A convenience sample was then taken from 20 centres with the highest enrolment of HIV-positive subjects. A self-administered questionnaire was used to elicit information on the perception of HIV-positive subjects towards the attitude of dental personnel in providing oral care to the patient with HIV-positive. The study sample consisted of 509 HIV-positive individuals with a mean age of 31.3+/-12.9 years old. Of these, only 15.1% attended a dental clinic after confirmation of HIV-positive status. The study demonstrated that 67.5% of the HIV-positive subjects disclosed their status voluntarily to the dentists and majority of the dentists (76.9%) did not show any negative reaction on knowing their HIV positive status. There was also no difference in the attitude of auxiliary staff toward the above disclosure. In conclusion, the study showed that oral health care personnel are more receptive to the HIV-positive subjects receiving dental care and treatment.

Attractiveness ratings of anterior open bites and reverse overjets using the aesthetic component of the Index of Orthodontic Treatment Need

This study was carried out to determine the level of attractiveness of anterior open bites (AOB) and reverse overjets of varying severity. A sample of 180 non-dental students (101 females and 79 males; average age 20 +/- 0.75 years) and 45 dental professionals (12 females and 33 males; average age 35.5 +/- 5.07 years) was asked to complete a questionnaire to rate the level of attractiveness of AOB and reverse overjets of varying severity using the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN). Photographs of mild and severe AOB and reverse overjets were projected onto a white screen in a lecture theatre (15 seconds each with a 5 second interval between images). The participants were asked to record the AC grade at which they thought the projected picture of the AOB or reverse overjets had similar attractiveness. Dental awareness of non-dental students was determined by asking them their opinion on how important it was to have straight teeth (very unimportant, unimportant, important, very important), about their personal or close family members' orthodontic experiences and if they thought they were in need of any orthodontic treatment. A chi-square test was applied to record any differences between sexes and between the different groups. Backward stepwise linear regression analysis was used to determine the relationship between the students' ratings of the photographs and their dental awareness. The majority of non-dental students rated a mild AOB (93 per cent) and mild reverse overjet (96 per cent) to be aesthetically acceptable. A mild AOB and mild reverse overjet were found to be acceptable by 40 and 58 per cent of dental professionals, respectively. The differences in the ratings between dental professionals and non-dental students were significant at P < 0.001.A severe AOB was considered unattractive by both students and dental professionals. However, dental professionals rated it at the more unattractive end of the scale (P < 0.001). A severe reverse overjet was rated by the majority of the subjects as aesthetically unacceptable (85 per cent of the non-dental students and 78 per cent of the dental professionals).