| 1. |
- Arnrup, K, et al.
(författare)
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Classification of dental behavior management problems among children.
- 2007
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Ingår i: Poster presentation at the 85th General Session & Exhibition of the IADR, New Orleans, LA, USA, March 21-24, 2007..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: This study aimed to further investigate the heterogeneity within the group of children referred for specialist treatment because of dental behavior management problems (DBMP). A specific aim was to evaluate the validity of a previously reported cluster structure in another DBMP study group. Methods: 177 child dental patients, aged 4 to 12 at referral to a specialist pediatric dental clinic in Göteborg, Sweden, were classified into subgroups according to their personal characteristics. Cluster structure was described and compared to previously reported findings in a DBMP study group of same-aged child dental patients in Örebro, Sweden (n=74). Parental assessments of children's dental and general fear, temperament and behavior were made pre-treatment. The children also performed a vocabulary test. Data were analyzed mainly with a person-based approach using sequences of cluster analyses. Results: Classification into five different subgroups was judged the best representation of the Göteborg study group data, while four groups had been defined in Örebro. The new clusters partly paralleled the previous and were labeled (I) Extrovert, outgoing, (II) Highly fearful, multiple problems, (III) Highly fearful, (IV) Moderately fearful, externalizing, impulsive and (V) Moderately fearful, inhibited. Cluster profile II describes severe dental fear and general temperamental and behavioral problems of internalizing as well as externalizing character. Such combined problems were not clearly revealed in the Örebro cluster structure. Conclusion: The contention that children with dental behavior management problems (DBMP) comprise a heterogeneous group was strengthened. Similar, although not identical, clusters of children showing DBMP were identified in this replication study. Apart from different levels of dental fear, varying temperamental and behavioral characteristics need to be taken into consideration to better match treatment for these patients
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| 2. |
- Bernson, Jenny M, et al.
(författare)
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Adaptive coping strategies among adults with dental fear. Further development of a new version of the Dental Coping Strategy Questionnaire
- 2012
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Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 70:5, s. 414-420
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The aim of this study was to further develop and investigate a newly constructed 15-item questionnaire on strategies for coping with dental treatment, used by fearful adult patients undergoing regular dental care and those with phobic avoidance. Materials and Methods. The dental coping strategy questionnaire (DCSQ-15) was distributed to 77 individuals with dental phobic avoidance and 94 fearful patients undergoing regular dental care. Previous analyses of a 20-item coping questionnaire (DCSQ-20) revealed that 2 of 4 identified factors predicted regularity or phobic avoidance of dental care. However, one of these factors was considered related to catastrophizing thoughts and not to coping strategies and it was therefore removed in the present study. Results. The reduced 15-item questionnaire was analyzed to identify its factor structure and a 5-factor solution was found. The five factors were labeled (i) ‘self-efficacy’, (ii) ‘self-distraction’, (iii) ‘distancing’, (iv) ‘praying’ and (v) ‘optimism’. The factors of ‘praying’ and ‘optimism’ correlated significantly with dental anxiety and were assessed significantly higher and lower respectively, among individuals with phobic avoidance. A logistic regression analysis revealed that ‘optimism’, together with gender and dental anxiety, was predictive of the regularity or phobic avoidance of dental care.
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| 3. |
- Bernson, Jenny M, et al.
(författare)
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Dental coping strategies, general anxiety, and depression among adult patients with dental anxiety but with different dental-attendance patterns
- 2013
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 121:3, s. 270-276
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To describe the differences in characteristics and outcome between two consecutive series of patients admitted to hospital with chest pain in a 20-year perspective. Particular emphasis is placed on changes in outcome in relation to the initial electrocardiogram (ECG). SUBJECTS: In the two periods, 1986-1987 and 2008, all patients with chest pain admitted to the study hospitals in Gothenburg, Sweden, were included. RESULTS: Five thousand and sixteen patients were registered in a period of 21 months in 1986-1987 and 2287 patients were registered during 3 months in 2008. In a comparison of the two time periods, the age of chest pain patients was not significantly different (mean age 60.1 ± 17.8 years in 1986-1987 and 59.8 ± 19.1 years in 2008, p=0.50). There was a lower prevalence of previous angina pectoris, congestive heart failure and current smoking in the second period, whereas a history of acute myocardial infarction, hypertension and diabetes mellitus had become more prevalent. The use of cardio-protective drugs increased and ECG changes indicating acute myocardial ischemia on admission to hospital decreased. Length of hospitalisation was reduced from a median of 5 days to 3 days (p<0.0001). A significant decrease in 30-day and 1-year mortality was found (3.8% in 1986-1987 vs 2.0% in 2008 and 9.9% vs 6.3% respectively, p<0.0001 for both comparisons). CONCLUSIONS: During a period of 20 years, the characteristics and outcome of patients admitted to hospital with chest pain changed. The most important changes were a lower prevalence of ECG signs indicating acute myocardial ischemia on admission, shorter hospitalisation time and a lower 30-day and 1-year mortality.
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| 4. |
- Lundgren Elfström, Magnus, 1971, et al.
(författare)
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Methodological assessment of behavioural problem dimensions in adults with dental fear.
- 2007
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Ingår i: Community Dent Oral Epidemiol. - : Wiley. - 0301-5661 .- 1600-0528. ; 35:3, s. 186-194
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: In the assessment and treatment of persons with dental fear, there may be other psychological/behavioural factors than fear itself and traditional measures of psychopathology that should be considered. Longitudinal natural history studies are needed to find such variables. The present study investigated whether the same behavioural problem dimensions (internalizing, externalizing, attention) found among children and adolescents with behaviour management problems and/or dental fear could also be found among severely fearful adult patients. METHODS: The participants were 230 consecutive adult patients applying for treatment for severe dental anxiety at a specialized clinic. Patients completed a version of the Rutter behaviour questionnaire that was adapted for adults. Comparison data were the Hospital Anxiety and Depression scale and self-rated anger evoked by dental fear. Background data, including dental fear, were also collected. Descriptive statistics, principal components analyses, group comparisons and correlations were calculated. RESULTS: Of the three behaviour problems scales we adapted for adults, two (Internalizing and Attention) had acceptable psychometric properties and meaningful relations with the comparison variables. In contrast, the third problem scale (Externalizing) proved to have less satisfactory properties and relations, especially for men. Patients with severe phobia had higher levels of problem behaviours than patients with less severe phobia. CONCLUSIONS: Internalizing and Attention scales for adults seem promising for use in future prospective studies of the natural history of dental fear. The Externalizing scale, however, needs to be studied with a wider range of comparison variables and measures of social desirability.
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| 5. |
- Lundgren, Jesper, 1970, et al.
(författare)
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The relationship between temperament and fearfulness in adult dental phobic patients.
- 2007
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Ingår i: Int J Paediatr Dent. - 0960-7439 .- 1365-263X. ; 17:6, s. 460-468
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Temperament has been associated with dental fear (DF) and dental behavioural management problems (DBMP) in children, but little is known about what role temperament plays in the aetiology of DF. Thus, measures of temperament suitable for use among children, adolescents, and adults would be of value for longitudinal and family studies of DF, where relations between children's and parent's ratings are investigated. AIM: Our aim was to explore the adapted EASI (emotionality, activity, sociability, and impulsivity) in adult patients, and to evaluate the instrument in comparison with established measures of DF and general emotional reactions in adults. DESIGN: The subjects were 230 adult patients applying for treatment for DF and 41 nonfearful patients (reference group). Questionnaires investigated temperament (general and DF) and general anxiety and depression. RESULTS: The previously described factor structure of the EASI among children was confirmed and the adapted EASI had acceptable psychometric qualities. Emotionality correlated with DF and with measures of general psychological distress. No differences were found in mean scores of EASI dimensions between DF group and the reference group, which was in contrast with studies in children. CONCLUSIONS: The adapted EASI seem promising for use in future longitudinal and familial studies of development of DF and DBMP.
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| 6. |
- Wide Boman, Ulla, 1964, et al.
(författare)
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Common use of a Fear Survey Schedule for assessment of dental fear among children and adults.
- 2008
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Ingår i: International journal of paediatric dentistry. - 0960-7439 .- 1365-263X. ; 18:1, s. 70-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Little is known about children with dental fear (DF) in a long-term perspective. Measures of DF suitable for use among children, adolescents, and adults would be of value for longitudinal and family studies. AIM: Our aim was to explore the DF subscale of the Children's Fear Survey Schedule (CFSS-DS) in highly fearful adult dental patients. DESIGN: The subjects were 230 adult patients applying for treatment for severe DF at a specialized DF clinic. Questionnaires investigated background data, general fear and DF, and general anxiety and depression. Reference data were obtained from 36 nonfearful patients on a subset of questionnaires. RESULTS: The fearful group reported high levels of DF on all measures and at a level similar to children with severe DF. The DF measures clearly differed between the fearful and reference groups. A factor analysis revealed a three-factor structure (fear of dental treatment, medical treatment, and of strangers and choking), which explained 68% of the variance. CONCLUSION: The CFSS-DS appears suitable for use in studies of adult populations. The results indicated that some areas of DF (physiology, avoidant behaviour, anticipatory anxiety), areas of importance among adult patients, are not assessed by the CFSS-DS. Studies of adults should therefore also include established adult measures of DF.
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| 7. |
- Bernson, Jenny M, et al.
(författare)
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Self-reported dental coping strategies among fearful adult patients: preliminary enquiry explorations.
- 2007
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Ingår i: European journal of oral sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 115:6, s. 484-90
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Tidskriftsartikel (refereegranskat)abstract
- This investigation explored strategies to cope with dental treatment used by fearful adult patients undergoing regular dental care and those with phobic avoidance. A newly constructed 20-item questionnaire entitled The Dental Coping Strategy Questionnaire (DCSQ-20) was distributed consecutively to 171 individuals with self- and dentist-reported high dental fear, of whom 77 had dental phobic avoidance and were attending a dental fear clinic and 94 were undergoing regular care at one of three different public dental clinics. The level of dental fear was high in both groups, but significantly higher among avoidant individuals. Several of the DCSQ-20 items showed statistically significant differences between groups. Factor analysis of the DCSQ-20 yielded a four-factor solution explaining 52% of the total variance. The factors were labelled (i) 'self-efficacy statements', (ii) 'self distraction and distancing', (iii) 'catastrophizing', and (iv) 'praying and despair'. The DCSQ-20 displayed sound psychometric properties, and the reliability (Cronbach's alpha) for the factors was between 0.68-0.78. Factors (iii) and (iv) correlated significantly with dental anxiety and were rated significantly higher among individuals with phobic avoidance. In a logistic regression analysis, gender, dental anxiety, and three of the four factors (i, iii, iv) were predictive of regularity vs. phobic avoidance of dental care.
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| 8. |
- Elfström, Magnus, 1971-, et al.
(författare)
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Temperamental and behavioural characteristics of adults seeking treatment for severe dental fear
- 2009
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Ingår i: Psychology and Health. - : Informa UK Limited. - 0887-0446 .- 1476-8321. ; 24:sup. 1, s. 162-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Other psychological/behavioral factors in addition to fear and traditional measures of psychopathology should possibly be considered in the assessment and treatment of dental fear. The present study investigated fear and personality profiles among severely fearful adult patients. Participants were 230 consecutive adults applying for treatment of severe dental anxiety at a specialized clinic. Background data included dental treatment and dental fear history, general anxiety and depression assessments. Cluster analyses were performed. Four different fear and personality subgroups were judged to best represent data: (I) Fearful, extrovert, outgoing, (II) Highly fearful, extrovert, outgoing, (III) Fearful, inhibited, and (IV) Highly fearful, multiple problems. The view that adults with dental fear comprise a heterogeneous group was strengthened. Apart from different levels of dental fear, there seems to be varying temperamental and behavioral characteristics that need to be further studied and that may lead to a better match of treatment for these patients.
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| 9. |
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| 10. |
- Lundgren Elfström, Magnus, 1971
(författare)
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Coping strategies and health-related quality of life in persons with traumatic spinal cord lesion
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims: The overall aims of the thesis were to investigate coping strategies employed by persons with traumatic spinal cord lesion (SCL) to cope with the lesion and its consequences, and to study the relations between coping strategies and health-related quality of life (HRQL). Further, specific contributions to SCL-related scale development were given.Methods: Participants were recruited among community-residing persons with SCL from a typical rural/urban Swedish area. Characteristics of the participants were comparable to the general Swedish SCL population. In a cross-sectional design, items in a pool derived from in-depth interviews, literature reviews and the transactional theory of stress and coping were tested. Standardised instruments were used to assess general coping strategies, social support, and HRQL. A rigorous psychometric procedure was used. First, 274 persons participated in the development of SCL-related coping strategies and emotional well-being measures. Second, a subsample of 256 persons participated in studies of relations between SCL-related coping strategies and a wide range of HRQL domains. Third, a further subsample of 181 persons participated in a comparison of SCL-related and general coping strategies. Three reference groups were used: 167 persons with SCL from the same catchment area, 110 age- and sex-matched persons from the Swedish norm group (SF-36), and a general population sample of 264 persons.Results: The SCL-related Coping Strategies Questionnaire (SCL CSQ) and SCL-related Emotional Well-being Questionnaire (SCL EWQ) both met basic psychometric standards for reliability and validity. The SCL CSQ comprises three factors: Acceptance (i.e. revaluation of life values); Fighting spirit (i.e. efforts to minimise the effects of the lesion); Social reliance (i.e. a tendency towards dependent behaviour). The SCL EWQ included three factors: Helplessness (i.e. feeling perplexed, out of control and low self-esteem); Intrusion (i.e. bitterness and brooding); Personal growth (i.e. positive outcomes of life crisis). There were clear limitations in participants' generic HRQL compared to age- and sex-matched references. Two SCL-related coping factors were clearly associated with all HRQL domains when social support and a wide range of sociodemographic and disability-related variables were controlled for. Persons scoring high on Acceptance reported better HRQL whereas high scores on Social reliance were related to decreased HRQL. SCL-related coping strategies were psychometrically more stable and stronger related to overall quality of life than general coping strategies.Conclusion: SCL-related coping strategies are distinct correlates of HRQL. Revaluation of life values is associated with better HRQL whereas unconditional reliance on other people is linked to unsatisfying HRQL. The results suggest the importance of coping strategies in further research studying factors that may mediate the effect of stress on HRQL among persons with SCL. Continued and emphasised focus on individuals coping strategies and evaluation of HRQL outcome in rehabilitation and follow-up is proposed.
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