牙科医生感知到的障碍和牙医心理健康提供者提供的认知行为治疗的吸引因素。

Q1 Medicine Advances in Dental Research Pub Date : 2018-02-01 DOI:10.1177/0022034517737023
R E Heyman, A K Wojda, J M Eddy, N C Haydt, J F Geiger, A M Smith Slep
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引用次数: 2

摘要

超过五分之一的牙科患者报告有中度到重度的牙科恐惧。尽管认知行为治疗(CBT)对牙齿恐惧的疗效已经在20多个随机对照试验中进行了检验,其中2个荟萃分析发现了很强的平均效应量(d > 1),但CBT几乎没有在测试它的专业诊所之外得到推广。因此,挑战不是如何治疗牙科恐惧,而是如何以一种认识到美国医疗保健系统的回报和障碍的方式传播和实施这种基于证据的治疗。这项混合方法研究调查了通过牙科家庭内的心理健康提供者的护理来传播CBT的潜力,这种做法被称为循证协作护理(EBCC)。两项收养前研究是由来自纽约市大都会区一个自组织的基于实践的研究网络的执业牙医进行的。第一组包括3个焦点小组(N = 17),第二组涉及调查管理(N = 46)。焦点小组的参与者一致认为,牙科恐惧的CBT值得考虑,但确定了其吸引力、可行性和在社区牙科实践中的应用方面的几个问题。调查参与者表示支持促进使用EBCC作为CBT传播机制的因素,没有任何因素获得低于50%的支持。综上所述,这些发现表明EBCC可能是一个有用的框架,通过它可以提供基于证据的牙科恐惧治疗。
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Dentist-Perceived Barriers and Attractors to Cognitive-Behavioral Treatment Provided by Mental Health Providers in Dental Practices.

Over 1 in 5 dental patients report moderate to severe dental fear. Although the efficacy of cognitive-behavioral treatment (CBT) for dental fear has been examined in over 20 randomized controlled trials-with 2 meta-analyses finding strong average effect sizes ( d > 1)-CBT has received almost no dissemination beyond the specialty clinics that tested it. The challenge, then, is not how to treat dental fear but how to disseminate and implement such an evidence-based treatment in a way that recognizes the rewards and barriers in the US health care system. This mixed-method study investigated the potential of disseminating CBT through care from a mental health provider from within the dental home, a practice known as evidence-based collaborative care (EBCC). Two preadoption studies were conducted with practicing dentists drawn from a self-organized Practice-Based Research Network in the New York City metropolitan area. The first comprised 3 focus groups ( N = 17), and the second involved the administration of a survey ( N = 46). Focus group participants agreed that CBT for dental fear is worthy of consideration but identified several concerns regarding its appeal, feasibility, and application in community dental practices. Survey participants indicated endorsement of factors promoting the use of EBCC as a mechanism for CBT dissemination, with no factors receiving less than 50% support. Taken together, these findings indicate that EBCC may be a useful framework through which an evidence-based treatment for dental fear treatment can be delivered.

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Advances in Dental Research
Advances in Dental Research Medicine-Medicine (all)
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