Evaluation of complacency about dental implants with shared decision making and satisfaction scores: A cross-sectional study

Shared decision making for patients needing dentofacial orthopedics, orthognathic surgery, and conventional non-surgical fixed appliance therapy: a comparison between Pakistani patients' and clinicians' perspective

INTRODUCTION

Shared decision making (SDM) involves presenting patients with relevant information about a health issue and reaching a clinical decision based on their preferences. However, its application in orthodontics lacks documentation.

OBJECTIVE

This study aimed to assess and compare the perspectives of patients and clinicians on SDM in different cases.

METHODS

A cross-sectional study was conducted at a tertiary care hospital in Pakistan, involving 90 patients categorized into three groups (dentofacial orthopedics, orthognathic surgery, and conventional non-surgical fixed appliance treatment). Following clinical assessment and treatment plan discussions, patients and clinicians completed a 12-item dyadic observing patient involvement in decision making (OPTION) questionnaire, to gauge their perspectives on SDM. Mean OPTION scale scores were compared using paired sample t-tests between clinicians and patients, and intergroup comparisons utilized paired sample t-tests and Pearson correlation coefficients.

RESULTS

OPTION scores were similar between patients/parents and clinicians. However, statistically significant differences were found regarding the questions about "different sources of information", "different options (including the possibility of doing nothing)" and "concerns regarding management", with the patients giving overall lower OPTION scores. Patients gave lower SDM OPTION scores for conventional orthodontic treatment, but higher scores for orthopedic and orthognathic surgery, as compared to the clinicians.

CONCLUSIONS

The current study revealed an overall consensus in the mean total scores of OPTION scales between patients and clinicians. However, when stratified, patients showed higher SDM scores for orthopedic and orthognathic cases, and lower scores for conventional orthodontic treatment.

Impact of inpatient self-efficacy and trust in physicians on inpatient satisfaction with medical services: the mediating role of patient participation in medical decision-making

Objective

Patient satisfaction reflects the social benefits of hospitals and is an important indicator of hospital performance. This study explores the mechanism through which inpatients' trust in physicians, self-efficacy, and participation in medical decision-making impact their satisfaction with medical services.

Methods

A questionnaire was administered to 814 inpatients in 10 randomly selected tertiary hospitals and 10 randomly selected secondary hospitals in Hangzhou, China. A correlation analysis and hierarchical linear regression were conducted to analyze the factors influencing inpatient satisfaction.

Results

The outcome measures of trust in physicians and participation in medical decision-making behaviors had significant positive effects on inpatient satisfaction.Trust in physicians was shown to directly influence inpatient satisfaction, while inpatient participation in decision-making partially mediated this relationship. Inpatient participation in medical decision-making fully mediated the relationship between self-efficacy and inpatient satisfaction.

Conclusion

While inpatients were relatively satisfied, there is room for improvement. Healthcare providers should improve patient trust by actively listening to their needs and providing feedback, establishing effective communication mechanisms. Patient self-efficacy can be enhanced through health education, special lectures, and case sharing. Patients should also be encouraged to actively participate in medical decision-making.

Practical implications

Based on inpatient feedback during a preliminary survey, we refined this study's questionnaire to enhance its feasibility for future research. This article shares key findings for healthcare managers and providers, advising that patient satisfaction can be enhanced through trust, self-efficacy, and participation.

A scoping review into the explanations for differences in the degrees of shared decision making experienced by patients

OBJECTIVES

In order to improve the degree of shared decision making (SDM) experienced by patients, it is necessary to gain insight into the explanations for the differences in these degrees.

METHODS

A scoping review of the literature on the explanations for differences in the degree of SDM experienced by patients was conducted. We assessed 21,329 references. Ultimately, 308 studies were included. The explanations were divided into micro, meso, and macro levels.

RESULTS

The explanations are mainly related to the micro level. They include explanations related to the patient and healthcare professionals, the relationship between the patient and the physician, and the involvement of the patient's relatives. On the macro level, explanations are related to restrictions within the healthcare system such as time constraints, and adequate information about treatment options. On the meso level, explanations are related to the continuity of care and the involvement of other healthcare professionals.

CONCLUSIONS

SDM is not an isolated process between the physician and patient. Explanations are connected to the macro, meso, and micro levels.

PRACTICE IMPLICATIONS

This scoping review suggests that there could be more focus on explanations related to the macro and meso levels, and on how explanations at different levels are interrelated.

Analytical Modeling of the Interaction of a Four Implant-Supported Overdenture with Bone Tissue

Today, an interdisciplinary approach to solving the problems of implantology is key to the effective use of intraosseous dental implantations. The functional properties of restoration structures for the dentition depend significantly on the mechanical stresses that occur in the structural elements and bone tissues in response to mastication loads. An orthopedic design with a bar fixation system connected to implants may be considered to restore an edentulous mandible using an overdenture. In this study, the problem of the mechanics of a complete overdenture based on a bar and four implants was formulated. A mathematical model of the interaction between the orthopedic structure and jawbone was developed, and a methodology was established for the analytical study of the stress state of the implants and adjacent bone tissue under the action of a chewing load. The novelty of the proposed model is that it operates with the minimum possible set of input data and provides adequate estimates of the most significant output parameters that are necessary for practical application. The obtained analytical results are illustrated by two examples of calculating the equivalent stresses in implants and the peri-implant tissue for real overdenture designs. To carry out the final assessment of the strength of the implants and bone, the prosthesis was loaded with mastication loads of different localization. In particular, the possibilities of loading the prosthesis in the area of the sixth and seventh teeth were investigated. Recommendations on the configuration of the distal cantilever of the overdenture and the acceptable level and distribution of the mastication load are presented. It was determined that, from a mechanical point of view, the considered orthopedic systems are capable of providing long-term success if they are used in accordance with established restrictions and recommendations.