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- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Ambivalence in Coping with Dental Fear and Avoidance: A Qualitative Study
- 2002
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Ingår i: Journal of Health Psychology. - : SAGE Publications. - 1359-1053 .- 1461-7277. ; 7:6, s. 653-664
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Tidskriftsartikel (refereegranskat)abstract
- Dental phobia is a widespread problem, which can have significant impact on the individual's health and daily life. This grounded theory study aims to explore the situation of dental phobic patients: how dental phobia interferes with their normal routines and functioning, social activities and relationships, what factors contribute to the maintenance of dental fear and how they cope with their fear. In the qualitative analysis of thematized in-depth interviews four main categories were developed: threat to self-respect and well-being, avoidance, readiness to act and ambivalence in coping. The results show that several psychological and social factors interact in determining how dental phobic individuals cope with their fear, and demonstrate in what way dental fear affects their daily lives.
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| 2. |
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| 3. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Dental phobic patients' view of dental anxiety and experiences in dental care: a qualitative study.
- 2002
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Ingår i: Scandinavian journal of caring sciences. - 0283-9318. ; 16:2, s. 188-96
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Tidskriftsartikel (refereegranskat)abstract
- Dental phobic patients' view of dental anxiety and experiences in dental care: a qualitative study The aim of this study was to explore and describe dental phobic patients' perceptions of their dental fear and experiences in dental care. The study sample consisted of 18 participants (12 women), with a mean age of 39.4 years, selected consecutively from patients applying for treatment at a specialized dental fear clinic in G?teborg, Sweden. Dental fear, assessed by the Dental Anxiety Scale, showed score levels well over established levels for severe dental fear. The method for sampling and analysis was inspired by the constant comparative method for Grounded Theory (GT). The thematized in-depth interviews took place outside the clinic and lasted for 1-1.5 h. All the interviews were conducted by the first author (KHA), audiotaped and transcribed verbatim. Three higher-order categories were developed and labelled existential threat, vulnerability and unsupportive dentist. Existential threat was identified as the core category, describing the central meaning of the subjects' experiences in dental care. The core category included two dimensions, labelled threat of violation and threat of loss of autonomy and independence. The core category and the descriptive categories are integrated in a model framing the process of dental fear, as described by the informants. In conclusion, the onset of dental fear was commonly related to individual vulnerability and to traumatic dental care experiences, where perceived negative dentist behaviour played a significant role. The patient was caught in a 'vicious circle' that was difficult to break, and where fear and anxiety were maintained by negative expectations about treatment and about patient's own ability to cope in dental care situations.
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| 4. |
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| 5. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Phobic avoidance and regular dental care in fearful dental patients: a comparative study.
- 2001
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Ingår i: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 16, s. 188-196
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Tidskriftsartikel (refereegranskat)abstract
- The present investigation was a comparative study of 169 highly fearful dental patients, some of whom received regular dental care (n = 28) and some who never, or only when absolutely necessary, utilized dental care (n = 141). It was hypothesized that phobic avoidance is related to anticipatory stress and anxiety reactions, negative oral health effects, psychological distress, and negative social consequences. Background factors (sex, age, education, and dental attendance pattern), dental anxiety, general fears, general state and trait anxiety, mood states, depression, and quality of life effects were studied. Data were analyzed with descriptive statistics and with exploratory factor and multiple logistic regression analysis. It was shown that dental anxiety is significantly higher among the avoiders and this is in particular evident for anticipatory dental anxiety. Oral health differed between the groups, and it was shown that avoiders had significantly more missing teeth, whereas regular attenders had significantly more filled teeth. The avoiders reported a stronger negative impact on their daily life, whereas there were no significant differences between the groups with regard to general emotions. The logistic regression analysis showed that phobic avoidance was predicted only by anticipated dental anxiety and missing teeth. It was concluded that differences between high dental fear patients with regular dental care and phobic avoidance were mainly related to anticipated fear and anxiety, oral health effects, and concomitant negative life consequences. These results are discussed in terms of subjective stress, negative cognitions, social support, and coping-strategies.
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| 6. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Psychosocial aspects of dental and general fears in dental phobic patients.
- 2000
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Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 58:1, s. 37-43
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Tidskriftsartikel (refereegranskat)abstract
- Phobic reactions can often be a significant health problem for fearful dental patients. This is true in particular for individuals with long-time avoidance and elevated general psychological distress. The aim of this study was to investigate the expression of dental fear among 67 dental phobic individuals with a low versus high degree of general fear. Reported etiologic background factors, avoidance time, general psychological distress and psychosocial manifestations and consequences of dental phobia were studied. No significant difference in dental anxiety level between individuals with low versus high general fear was found, and both groups reported high frequencies of negative dental experiences. The low-fear group reported a longer (though not statistically significant) average avoidance time than the high-fear group. However, patients with a high level of general fear showed a significantly higher degree of psychological distress, and also reported stronger negative social consequences from their dental anxiety. These results indicate that the character of dental fear might be different between different groups of fearful patients, which makes the condition psychologically handicapping. Such aspects should be assessed in the diagnostic analysis of patients with severe dental anxiety. In particular, assessments of signs of general psychological distress are warranted.
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| 7. |
- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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The importance of dental beliefs for the outcome of dental-fear treatment.
- 2003
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Ingår i: European journal of oral sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 111:2, s. 99-105
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the importance of dental beliefs and the predictive value of the Dental Belief Survey (DBS) in dental-fear treatment. The sample comprised 117 adult patients seeking treatment at a dental-fear clinic. Pretreatment data were collected during a screening procedure, including two visits to the dentist. Outcome measurements were completed after treatment. The dentist rated successful/unsuccessful treatment outcome. Patients unsuccessful in treatment (n = 48) reported more initial negative dental beliefs, while patients successful in treatment (n = 69) showed a larger decrease in negative beliefs between the first and second visit to the dentist. However, these differences were small. There was a significant difference between the groups at visit two. Thus, patients unsuccessful in treatment reported more negative beliefs about how dentists communicate. Regression analyses showed that improved dental beliefs during the first two visits to the dentist predicted dental-fear reduction, while longer avoidance time, female gender, low engagement in treatment, and depressed mood increased the risk of unsuccessful treatment outcome. Our results suggest that the DBS provides valuable information, and that patients' subjective perceptions about how dentists communicate are important for treatment outcome. However, initial dental beliefs were not found to predict clinical treatment outcome.
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| 9. |
- Berggren, Ulf, 1948, et al.
(författare)
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Assessment of patients with direct conditioned and indirect cognitive reported origin of dental fear.
- 1997
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Ingår i: European journal of oral sciences. - 0909-8836 .- 1600-0722. ; 105:3, s. 213-20
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the reported conditioned or cognitive origin of dental phobia in 100 adult patients at a specialized dental phobia clinic. It was shown that a majority of patients reported a conditioned background to their dental fear. Patients' avoidance time and level of dental anxiety corresponded to previously reported data for fearful groups. Individuals with an arousal conditioning etiology of dental fear reported significantly longer avoidance time as compared to individuals with a cognitively learned reaction. With the exception of an elevated level of general fears, most psychometrically assessed emotional reactions were well within normal ranges. However, patients with a non-conditioned, cognitive etiology reported significantly higher levels of trait anxiety and fear of embarrassment. In addition, a separate analysis among women revealed a greater fear of physical injuries among patients with cognitive etiology.
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| 10. |
- Berggren, Ulf, 1948, et al.
(författare)
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Assessment of patients with phobic dental anxiety.
- 1997
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Ingår i: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 55:4, s. 217-22
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated a screening procedure for psychologic distress in adult patients with dental phobia before treatment of dental fear. The screening procedure was performed among 191 individuals in consecutive steps and included a medical/dental history, psychologic interviewing, and testing. Data collected during this process were analyzed and compared with SCL-90(R) data. The screening process was successful in selecting individuals without major psychologic distress problems. Among the excluded patients 91% had general symptoms scores on the SCL-90(R) exceeding a normative population mean, and 95% of included patients had a mean lower than an average for psychiatric outpatients. There were statistically significant differences between included and excluded patients on all subdimensions of the SCL-90. Thus, excluded patients had higher levels of psychologic distress, poorer psychosocial background, and more psychosomatic symptoms. This was accompanied by higher levels of negative attitudes toward dentists and their performance of dentistry, whereas no significant differences were found among the dental fear measures used.
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