Perspectives of general dental practitioners on preventive, patient-centred, and evidence-based oral healthcare—A Q-methodology study
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.
|Persistent URL||dx.doi.org/10.1371/journal.pone.0219931, hdl.handle.net/1765/119169|
|Grant||This work was funded by the European Commission 7th Framework Programme; grant id h2020/635183 - Added Value for Oral Care (ADVOCATE)|
Baadoudi, F, van Exel, N.J.A, Ali, F.M, Maskrey, N, van der Heijden, G.J.M.G, & Duijster, D. (2019). Perspectives of general dental practitioners on preventive, patient-centred, and evidence-based oral healthcare—A Q-methodology study. PLoS ONE, 14(8). doi:10.1371/journal.pone.0219931