| 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. |
- 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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| 3. |
- 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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| 4. |
- 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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| 5. |
- Axelsson, Malin, 1964-, et al.
(författare)
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Motivational foci and asthma medication tactics directed towards a functional day
- 2011
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 11, s. 809-
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Tidskriftsartikel (refereegranskat)abstract
- Background:There appears to be an obvious gap between a medical and patient adherence perspective.Deviating from a medication prescription could be regarded as fairly irrational, but with respect to patients' goals and/or concerns it could be seen as understandable. Thus, the aim was to elucidate adherence reasoning in relation to asthma medication.Methods:This was a qualitative study; data collection and analysis procedures were conducted according to Grounded Theory methodology. Eighteen persons, aged 22 with asthma and regular asthma medication treatment, were interviewed.Results:The emerged theoretical model illustrated that adherence to asthma medication was motivated by three foci, all directed towards a desired outcome in terms of a functional day as desired by the patient. Apromotive focus was associated with the ambition to achieve a positive asthma outcome by being adherent either to the received prescription or to a self-adjusted dosage. A preventive focuswas intended to ensure avoidance of a negative asthma outcome either by sticking to the prescription or by preventively overusing the medication. A permissive focus was associated with unstructured adherence behaviour in which medication intake was primarily triggered by asthma symptoms.Conclusions:As all participants had consciously adopted functioning medication tactics that directed themtowards the desired goal of a functional day. In an effort to bridge the gap between a patient- and a medical adherence perspective, patients need support in defining their desired functionality and guidance in developing a person-based medication tactic.
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| 6. |
- Axelsson, Malin, 1964-, et al.
(författare)
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Personality, adherence, asthma control and health-related quality of life in young adult asthmatics
- 2009
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Ingår i: Respiratory Medicine. - : Elsevier. - 0954-6111 .- 1532-3064. ; 103:7, s. 1033-1040
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundStriving for improved adherence and asthma control is of vital concern in today's asthma management. Several influential factors have been identified, but the importance of personality traits has been insufficiently explored. The aim was first to determine whether personality traits in young adult asthmatics are related to asthma control and health-related quality of life (HRQL), and second to examine the influences of personality traits on adherence to regular asthma medication treatment.MethodsYoung adult asthmatics, 22 years of age (n = 268) completed questionnaires. Statistical analyses were performed.ResultsThe personality traits Negative Affectivity and Impulsivity correlated negatively with asthma control, whereas in women Hedonic Capacity correlated positively with asthma control. Negative Affectivity, Impulsivity, Hedonic Capacity, Alexithymia and asthma control predicted the mental dimension of HRQL. Asthma control and physical activity predicted the physical dimension of HRQL. Among respondents with regular asthma medication (n = 109), Impulsivity correlated negatively with adherence. In men, Antagonism and Alexithymia were associated with low adherence. Additionally, Alexithymia, Hedonic Capacity and Negative Affectivity showed non-linear relationships with adherence, meaning that initially increased scores on these personality traits scales were associated with increased adherence but higher scores did not increase adherence. Respondents who were prescribed a single inhaler combining ICS and LABA reported higher adherence than those with monotherapies.ConclusionThese data suggest that personality can influence how asthma patients adhere to asthma medication treatment, and report their control and HRQL. Tools determining personality traits may be useful in the future in individualizing management of asthma patients.
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| 7. |
- Axelsson, Malin, 1964, et al.
(författare)
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Self-efficacy and adherence as mediating factors between personality traits and health-related quality of life.
- 2013
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Ingår i: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. - : Springer Science and Business Media LLC. - 1573-2649 .- 0962-9343. ; 22:3, s. 567-575
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Personality traits are rather stable dispositions in adulthood, while self-efficacy and adherence may be modified through targeted interventions. Health-related quality of life (HRQL) serves as a vital outcome measure. The present aim was to explore the function of self-efficacy and adherence as mediators for the influencing effect of personality traits on HRQL in people with chronic disease. METHODS: An epidemiological sample of 786 persons completed questionnaires on personality, general self-efficacy, adherence behaviour and HRQL. Data were statistically analysed using descriptive statistics, correlation analyses and path models. RESULTS: Self-efficacy mediated the effect of Extraversion and Conscientiousness on mental HRQL. Neuroticism had a direct effect on both physical and mental HRQL. Adherence partially mediated the effect of both Agreeableness and Conscientiousness on mental HRQL. CONCLUSIONS: The mental HRQL in people scoring low on Extraversion or low on Conscientiousness could be improved by strengthening general self-efficacy. Increasing adherence in people scoring low on Agreeableness or Conscientiousness could improve their mental HRQL, but the improvement was small and may be of lesser clinical relevance. These results argue for personalized interventions intended to positively affect health outcomes in people with chronic disease.
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| 8. |
- Axelsson, Malin, 1964-, et al.
(författare)
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The influence of personality traits on reported adherence to medication in individuals with chronic disease : An Epidemiological study in West Sweden
- 2011
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 6:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Limited research exists exploring the influence of personality on adherence behaviour. Since non-adherence is a major obstacle in treating prevalent chronic diseases the aim was to determine whether personality traits are related to reported adherence to medication in individuals with chronic disease. Methodology/Principal Findings: Individuals with chronic disease (n = 749) were identified in a random population sample of 5000 inhabitants aged 30-70 in two municipalities in West Sweden. Data on five personality traits, Neuroticism, Extraversion, Openness to experiences, Agreeableness, and Conscientiousness, and medication adherence behaviour was collected by questionnaires. Statistical analyses resulted in a negative relationship between Neuroticism and medication adherence (P<0.001), while both Agreeableness (P<0.001) and Conscientiousness (P<0.001) were positively related to adherence. At high levels of Conscientiousness, low adherence was related to higher scores in Neuroticism. At high levels of Agreeableness, low adherence was related to low scores in Conscientiousness and high scores in Openness to experiences. Conclusions: This study demonstrated that multiple personality traits are of significant importance for adherence behaviour in individuals with chronic disease. The findings suggest that several personality traits may interact in influencing adherence behaviour. Personality traits could putatively be used to focus efforts to educate and support patients with high risk of low medical adherence. © 2011 Axelsson et al.
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| 9. |
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| 10. |
- Brahm, Carl-Otto, 1974, et al.
(författare)
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Dentists' skills with fearful patients: education and treatment.
- 2013
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Ingår i: European journal of oral sciences. - : Wiley. - 1600-0722 .- 0909-8836. ; 121:3 Pt 2, s. 283-291
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Tidskriftsartikel (refereegranskat)abstract
- The aims were to explore dentists' skills in dental fear, current strategies when treating fearful adult patients, and the possible need for additional education among dentists working in Sweden. A sample of 1,293 members of the Association of Public Health Dentists in Sweden were asked to respond to a Web survey concerning dental fear. The response rate was 69% (n = 889); 91% trained in Sweden and 9% trained in another country. The most frequently used pharmacological anxiety-reducing techniques were medication with a midazolame mixture (72%) and benzodiazepine tablets (77%), and the most commonly used psychological techniques were relaxation (68%), distraction (66%), and Tell-Show-Do (86%). A larger proportion of dentists trained in Sweden, compared with dentists who were trained in other countries, reported that they had received undergraduate training in dental fear. Dentists trained in Sweden more often reported competence in pharmacological and psychological anxiety-reducing techniques, compared with dentists who were trained in other countries. Higher levels of self-rated efficacy in treating fearful patients accompanied additional education in dental fear after graduation. In conclusion, Swedish dentists use a variety of techniques to meet the needs of fearful dental patients. Competence in anxiety-reducing techniques is associated with self-efficacy and the site of education.
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