Dental behaviour support: can we improve qualitative research on patient experience?

Databases included Embase, Medline (via OVID) and PsycINFO (via EBSCO). Studies referenced within included review articles were additionally screened for relevance. This review focused upon qualitative research studies and their use of dental behaviour support (DBS) tools to support dental care. Included studies were restricted to those in English and published since 1997. Screening of studies involved several authors according to pre-agreed inclusion and exclusion criteria. In the event of disagreement, a third author mediated the collaborative discussion. Included studies first provided baseline study information including the type of qualitative research, the population studied and details of the type(s) of DBS under investigation. Then the qualitative data generated by each study, together with any interpretation provided by the authors, was entered onto bespoke data collection forms. A thematic synthesis approach was adopted. The authors generated new themes supported by selected quotations. The methodological quality of each included study was explored through a recognised tool and the level of confidence provided by each study was informed by the GRADE-CERQual assessment process. Twenty-three studies were included. Most studies used semi-structured interviews, followed by focus groups and a small number of video diaries. For most studies, the focus was upon the dental care of children with a good proportion of these exploring dental general anaesthesia (DGA). Indeed, DGA was the most studied DBS technique. Whilst some studies explored adults’ experiences of DBS, none of the included studies centred upon medically compromised or older adults. The review authors identified five themes following data synthesis. These themes included the following areas (abridged and modified from the review paper): trust; information sharing; control and autonomy; perceived treatment success and failure of DBS techniques; and the longer-term impact of DBS techniques upon patients. Qualitative research has more to offer our understanding of DBS techniques and the impact they have upon patient care experience. There is a need for research to explore a wider range of DBS techniques used in isolation or in combination. Patient reported experiences of care should be considered in the development of outcome measures and any related DBS Core Outcome Set.