Dentists' perspectives on structural and system barriers hindering oral healthcare provision in residential care facilities

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology Pub Date : 2024-01-22 DOI:10.1111/cdoe.12944

Sarah Mun Yee Koh, Sayaka Tada, Gabriel Keng Yan Lee, Mun Loke Wong

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引用次数: 0

Abstract

Objectives

Oral healthcare service is not well integrated with existing healthcare policy in nursing homes (NHs) globally. This qualitative study aimed to identify dentists' perspectives on structural and system barriers that hinder oral healthcare (OHC) provision to seniors in NHs in Singapore and to understand the consequences of these barriers.

Methods

Nineteen dentists (8 males and 11 females, 36.0 [IQR: 32.0–48.5] years old) were recruited through combination of purposive and snowball sampling. Four focus group discussions were conducted via teleconferencing, and each discussion had 4–5 anonymised participants. Sessions lasted 90–120 min and were audio-recorded and transcribed verbatim. Thematic analysis was conducted on data collected using NVivo software (Version12, QRS International).

Results

Participants agreed that the current OHC system for seniors in NHs is not well developed. The challenges dentists faced were categorised in three themes: [1] general oral healthcare system level; [2] local nursing home setting level; and [3] geriatric oral healthcare education level. These challenges are complexly intertwined and have contributed to several consequences such as a shortage of dentists in NHs and their diminished motivation to serve. It has also limited the quality of dental service they are able to provide in NHs, contributing to the current poor access of dental services for seniors in NHs.

Conclusions

Dentists in Singapore face many structural and systemic barriers in providing OHC to seniors in NHs, some of which are unique to the local context. Newfound understanding of these barriers and its consequences will be helpful in developing strategic approaches to overcome these challenges.

Abstract Image

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牙科医生对阻碍在住宿护理设施中提供口腔保健服务的结构性和系统性障碍的看法。

目的：在全球范围内，口腔保健服务并没有很好地与养老院（NHs）的现有医疗保健政策相结合。这项定性研究旨在确定牙医对阻碍新加坡养老院为老年人提供口腔保健服务的结构性和系统性障碍的看法，并了解这些障碍的后果：19名牙医（8男11女，36.0 [IQR：32.0-48.5]岁）通过有目的抽样和滚雪球抽样相结合的方式被招募。通过远程会议进行了四次焦点小组讨论，每次讨论有 4-5 名匿名参与者。讨论持续了 90-120 分钟，并进行了录音和逐字记录。使用 NVivo 软件（第 12 版，QRS International）对收集到的数据进行了主题分析：结果：参与者一致认为，目前在非营利性医疗机构中为长者提供的老年保健服务体系并不完善。牙医面临的挑战分为三个主题：[1] 一般口腔医疗保健系统层面；[2] 当地养老院环境层面；[3] 老年口腔医疗保健教育层面。这些挑战错综复杂地交织在一起，造成了一些后果，如养老院牙医短缺，服务积极性降低。这也限制了他们在非营利性医疗机构所能提供的牙科服务质量，导致目前非营利性医疗机构中的老年人难以获得牙科服务：新加坡的牙医在为养老院的老年人提供口腔保健服务时面临着许多结构性和系统性的障碍，其中一些是当地特有的。对这些障碍及其后果的新认识将有助于制定克服这些挑战的战略方法。

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来源期刊

Community dentistry and oral epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.40

自引率

8.70%

发文量

审稿时长

6 months

期刊介绍： The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome. The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry. The journal is published bimonthly.