Arora, A, Baâdoudi, F, van Exel, JNA, Ali, FM, Maskrey, N, van der Heijden, GJMG and 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). e0219931.

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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.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Public Library of Science at https://doi.org/10.1371/journal.pone.0219931 - please refer to any applicable terms of use of the publisher.
Subjects: R Medicine > RK Dentistry
Divisions: Faculty of Medicine and Health Sciences > School of Pharmacy and Bioengineering
Depositing User: Mr Scott McGowan
Date Deposited: 30 Sep 2019 09:35
Last Modified: 04 Oct 2019 11:19
URI: http://eprints.keele.ac.uk/id/eprint/6901

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