Abstract
Objective In the last 30 years, innovations in oral healthcare (OHC), such as advanced restorative techniques, shifts towards preventive and evidence-based care and changes in patients’ expectations, have increased the complexity of clinical decision-making in OHC. Little is known about the perspectives of general dental practitioners (GDPs) on the value of providing preventive, patient-centred and evidence-based OHC. This study aimed to explore the range of perspectives present amongst GDPs on OHC. Method Q-methodology was used to explore perspectives among 78 GDPs working in the Netherlands. Participants were asked to sort 50 statements representing three central domains in OHC: i.) restorative versus preventative OHC, ii.) disease-centred versus patient-centred OHC and iii.) expertise-based versus evidence-based OHC. Opinion statements about delivering OHC were formulated on the basis of published literature and input from OHC professionals. By-person factor analysis was used to reveal clusters of communality in statement rankings, which were interpreted and formed perspectives on OHC. Results Four perspectives, explaining 47% of variance, on OHC were identified amongst GDPs: ‘the patient-focused dentist who values prevention’, ‘the outcome-oriented dentist who values learning from colleagues’, ‘the team player with ultimate care responsibility’ and ‘the dentist who considers oral health the responsibility of the patient.’ Conclusion Q-methodology can be effectively used to describe the different perspectives that GDPs have on the challenges of preventive, patient-centred and evidence-based OHC. GDPs should not be seen as a homogenous group; rather they have different views and approaches to the care they provide. This has implications for health systems; awareness of the heterogeneity of practitioners’ perspectives can potentially be used to develop bespoke quality of care improvement strategies that constructively engage with each of these different groups.
| Original language | English |
|---|---|
| Article number | e0219931 |
| Journal | PLoS ONE |
| Volume | 14 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 20 Aug 2019 |
Bibliographical note
Funding Information:The author F. Ba?doudi has been financially supported by funds from the European Commission Horizon 2020 research and innovation program under grant agreement 635183. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors would like to thank the the Royal Dutch Dental Association (KNMT) for cooperation to use their platforms for GDP recruitment. We thank Herman Wiegman, Arjun van der Dussen, Puck van der Wouden, Rinus Kersten, Annemarie Verhoef, Niels Naaraat, Amanda van Exel and Ri?t Hummel who provided insight and knowledge in developing the statement set, and Arnela Suman for helping with data collection. Special thanks is given to Dr. Josef Bruers for involving his network and facilitating contacts with the KNMT. We also thank all GDPs who participated in the study.
Publisher Copyright:
© 2019 Baâdoudi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.