| 1. |
- Ayala-Luis, Joselyn, et al.
(författare)
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A multivariable analysis of patient dental satisfaction and oral health-related quality-of-life : A cross-sectional study based on DVSS and OHIP-14
- 2014
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Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 72:3, s. 187-193
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The aim of this paper was to study the association between dental satisfaction and oral health-related quality-of-life (OHRQoL) when controlling for individual, clinical and psychological factors. Materials. Secondary analysis was conducted using data from a large study carried out in the Swedish region of Varmland in 2004. The questionnaire included demographic variables, clinical assessment and the following instruments: the Dental Visit Satisfaction Scale (DVSS), the short version of Oral Health Impact Profile (OHIP-14) and a modified version of the revised helping alliance questionnaire. Internal consistency analysis was undertaken on the instruments to assess reliability; bivariate comparisons were assessed to compare DVSS scores with individual factors (age, gender and education). In addition, a three step hierarchical multiple regression analysis was performed with DVSS as a dependent variable. Results. Data were completed for 485 randomly selected patients. The mean age of participants was 43.5 years, 54.6% were women, and 41.2% had high education. The median DVSS score was 48 (range 10-50) and the median OHIP was 3.0 (range 0-56). All the instruments showed good reliability. Bivariate analysis showed that females were more satisfied than males (p <= 0.01) and patients of 50 years or older were more satisfied than the younger ones (p <= 0.05). Finally, the following variables explained 31% of the variance of being very satisfied with dental visit: a good OHRQoL and patients' positive perceptions of the relationship with their care provider. Conclusion. This study showed positive associations between dental satisfaction and OHRQoL when controlling for related factors. The result suggests that care providers should take into account the various dimensions of OHRQoL rather than use only clinical measurements when they evaluate patient satisfaction.
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| 2. |
- Chernyshov, P. V., et al.
(författare)
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Quality of life measurement in acne. Position Paper of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa
- 2018
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959. ; 32:2, s. 194-208
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Forskningsöversikt (refereegranskat)abstract
- Acne causes profound negative psychological and social effects on the quality of life (QoL) of patients. The European Dermatology Forum S3-Guideline for the Treatment of Acne recommended adopting a QoL measure as an integral part of acne management. Because of constantly growing interest in health-related QoL assessment in acne and because of the high impact of acne on patients' lives, the European Academy of Dermatology and Venereology Task Force on QoL and Patient Oriented Outcomes and the Task Force on Acne, Rosacea and Hidradenitis Suppurativa have documented the QoL instruments that have been used in acne patients, with information on validation, purposes of their usage, description of common limitations and mistakes in their usage and overall recommendations.
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| 3. |
- Dalgard, Florence J., et al.
(författare)
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Itch and Mental Health in Dermatological Patients across Europe : A Cross-Sectional Study in 13 Countries
- 2020
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Ingår i: Journal of Investigative Dermatology. - : Elsevier BV. - 0022-202X. ; 140:3, s. 568-573
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Tidskriftsartikel (refereegranskat)abstract
- Itch is a highly prevalent and multidimensional symptom. We aimed to analyze the association between itch and mental health in dermatological patients. This multicenter study is observational and cross-sectional and was conducted in dermatological clinics across 13 European countries. A total of 3,530 patients and 1,094 healthy controls were included. Patients were examined clinically. Outcome measures were itch (presence, chronicity, and intensity), the Hospital Anxiety and Depression Scale, EQ-5D visual analogue scale, sociodemographics, suicidal ideation, and stress (negative life events and economic difficulties). Ethical approval was obtained. Results showed significant association between the presence of itch in patients and clinical depression (odds ratio, 1.53; 95% confidence interval, 1.15–2.02), suicidal ideation (odds ratio, 1.27; 95% confidence interval, 1.01–1.60), and economic difficulties (odds ratio, 1.24; 95% confidence interval, 1.10–1.50). The mean score of reported generic health status assessed by the EQ-5D visual analogue scale was 65.9 (standard deviation = 20.1) in patients with itch, compared with 74.7 (standard deviation = 18.0) in patients without itch (P < 0.001) and 74.9 (standard deviation = 15.7) in controls with itch compared with 82.9 (standard deviation = 15.6) in controls without itch (P < 0.001). Itch contributes substantially to the psychological disease burden in dermatological patients, and the management of patients should include access to multidisciplinary care.
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| 4. |
- Johansson, Veronica, et al.
(författare)
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Contract and fee-for-service care - regression modelling of oral health-related quality of life
- 2007
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In 1999, the public dental health service (PDHS) in the county of Värmland, Sweden, implemented contract care alongside the traditional patient financial system of fee-for-service care. In contract care, the patient pays a fixed sum annually for dental care and then receives basic dental care without additional costs. Aim The aim was to study the relation between patient financial system and oral health-related quality of life (OHRQoL). Methods In 2003, a questionnaire was sent to 2,400 consecutively selected patients in the PDHS in Värmland, 1,200 from each patient financial system. The questionnaire was answered by 1,324 participants (57% of those who could be reached). The questionnaire contained questions about willingness to pay for dental care, how much one had paid for dental care the previous year, OHRQoL (measured with the OHIP-14), dental anxiety, humanism of caregiver, general health (measured with the SF-36), multidimensional health locus of control, sense of coherence, self-esteem and demographics. Data on patient financial system, gender and age were obtained from the sampling frame. The data were analysed with a block method of multiple linear regression, adding blocks of variables in six steps: financial system, economic factors, individual factors, social factors, psychological factors and health factors. The threshold for statistical significance was set at p≤0.05. Results OHRQoL was affected by the financial system of the respondent: those in fee-for-service care had a worse OHRQoL than those in contract care. OHRQoL was also affected by health, sense of coherence and to some extent by psychological and economical factors. Of the social variables, only being foreign born had a significant effect on OHRQoL. Conclusions OHRQoL was found to be affected by patient financial system. Acknowledgements The study was financed by the Swedish Research Council.
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| 5. |
- Johansson, Veronica, et al.
(författare)
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Financial systems' impact on dental care : a review of fee-for-service and capitation systems
- 2007
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Ingår i: Community Dental Health. - 0265-539X. ; 24:1, s. 12-20
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Tidskriftsartikel (refereegranskat)abstract
- Objective This review covers the impact of financial systems on dental care. Background Remuneration in fee-for-service (FFS) is done per service provided and in capitation (CAP) per patient enrolled. It may be expected that dentists’ incentive in CAP is to keep the number of services provided at a minimum, while in FFS it is to keep the number of services at a maximum. This should lead to a different impact on care, with the dentists in CAP focusing more on prevention and dentists in FFS more on restorative treatment. Six questions were put: Does CAP increase or decrease caries incidence? Does CAP increase or decrease restorative treatments? Does CAP increase preventive care? Does CAP increase or decrease productivity? Does CAP increase or decrease the dentist’s satisfaction with his/her work? Does CAP increase or decrease the patients’ satisfaction with the oral care provided? Methods Literature was obtained through searches in databases. A format was developed to define the literature of interest. Results CAP decreases restorative treatment and there is a tendency of decreased caries incidence. “Supervised neglect” cannot be established. CAP increases preventive care. A conclusion regarding productivity was not possible. The results on dentist’s satisfaction with work were inconclusive, as were the results regarding patient satisfaction. Conclusions CAP has a different impact on provided care than FFS. More research is needed in this area and focus on efficiency is of importance. This review was funded by the Swedish Research Council.
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| 6. |
- Johansson, Veronica, et al.
(författare)
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Multivariate analyses of patient financial systems and oral health-related quality of life
- 2010
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 38:5, s. 436-444
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Since 1999, the public dental health service (PDHS) in the county of Värmland, Sweden, has two co-existing patient financial systems, i.e. ways for the patient to pay for dental care services. Alongside the traditional system of fee-for-service payment, i.e. paying afterwards for provided services, a new system of contract care is offered. In this system, dental care is covered by a contractual agreement, for which the patient pays an annual fee and receives care covered by the contract without additional costs. The aim of this article was to study whether patient financial system was associated with oral health-related quality of life (OHRQoL). Methods: A questionnaire was answered by 1324 randomly selected patients, 52% from contract care and 48% from fee-for-service. The questionnaire contained questions about how much one was prepared to pay for dental care, how much one paid for dental care the previous year, OHIP-14 (measured OHRQoL), dental anxiety, humanism of caregiver, SF-36 (measured general health), multidimensional health locus of control, sense of coherence (SOC), self-esteem and demographics. Data on patient financial system, gender and age were obtained from the sampling frame. The material was analysed with a hierarchical block method of multiple regression analysis. Results: When controlling for all other variables, patient financial system was one of the strongest associations with OHRQoL: patients in fee-for-service had worse OHRQoL than those in contract care. OHRQoL was also associated with general health, SOC and to some extent also with psychological and economic factors. Of the social variables, only being foreign born was significant: it was associated with worse OHRQoL. Conclusions: Patient financial system was associated with OHRQoL when controlling for confounding factors: patients in contract care had better OHRQoL than those in fee-for-service care.
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| 7. |
- Johansson, Veronica, et al.
(författare)
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Patients' health in contract and fee-for-service care : I. A descriptive comparison
- 2007
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Ingår i: Swedish Dental Journal. - : Swedish dental association. - 0347-9994. ; 31:1, s. 27-34
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Tidskriftsartikel (refereegranskat)abstract
- Fee-for-service care, paying afterwards for services provided, is the traditional adult patient financial system in dentistry in Sweden. The public dental health service (PDHS) in the county of Värmland has since 1999 also an alternative system, contract care. There, a fixed sum of money is paid annually for dental care, which then is received without additional costs. This study compares the demographics, general health and oral health-related quality of life (OHRQoL) in the patient financial systems fee-for-service and contract care in the PDHS in Värmland. A questionnaire was answered by 1,324 patients, response rate 57%. A non-response analysis was undertaken. The non-response analysis showed that the likelihood for answering the questionnaire was higher for women, for respondents in contract care and for increasing age. Further analyses revealed that the non-respondents were healthier than the respondents and that experience of pain in the mouth was the only variable increasing the likelihood of response. General health was studied with the SF-36 and OHRQoL with the OHIP-14. The demographics studied were gender, age, birth country, marital status, education and social network. The results showed that there were differences in patients' health between the patient financial systems. Respondents in contract care had better OHRQoL than those in fee-for-service care. They also had better general health in four of the dimensions of SF-36, were younger, better educated, born in Sweden and were married/living with somebody to a larger extent than fee-for-service care respondents. Fee-for-service care respondents experienced higher social affinity with their housing area. In conclusion, patients in contract care had better general health and OHRQoL than patients in fee-for-service care. There were social differences in choice of financial system and biased non-response.
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| 8. |
- Johansson, Veronica, et al.
(författare)
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Patients' health in contract and fee-for-service care : a descriptive analysis
- 2006
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Ingår i: Community Dental Health. - 0265-539X. ; 23:3, s. 187-188
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- AIM Fee-for-service, paying afterwards for services provided, is the traditional patient financial system in dentistry in Sweden. The public dental health service (PDHS) in Värmland has since 1999 also an alternative system: contract care, where a fixed sum of money is paid annually for dental care, which is then received without additional cost. This study describes demographic as well as general and oral health-related characteristics among patients in a service study comparing the two patient financial systems, fee-for-service and contract care, in the PDHS in Värmland. METHODS A questionnaire was answered by 1,324 patients (response rate 57%). Of the respondents, 52% were in contract care and 48% in fee-for-service. A non-response analysis and a special study of the non-respondents were undertaken. General health was studied with SF-36, measuring health in eight dimensions: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. Oral health was studied with OHIP-14, measuring oral health in seven dimensions (functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability and handicap) and as an index. The demographic factors included gender, age, birth country, marital status, education, and social affinity with neighbourhood and housing area. The data were analysed with contingency tables, Chi-square tests, t-tests, Mann-Whitney non-parametric tests and logistic regression analyses. RESULTS The non-response analysis revealed that the likelihood for answering the questionnaire was higher for women (OR=1.27), for respondents in contract care (OR=1.43) and for each year of life (OR=1.02). A short telephone interview with 40 non-respondents in each financial system indicated that the non-respondents had better oral health than the respondents. The non-respondents had experienced less pain in the mouth, less difficulties doing their usual jobs and had found life more satisfying than the respondents. There were no significant differences in gender or age. In the study population, differences in health were observed between the financial systems. Respondents in contract care had better oral health than those in fee-for-service (p=0.019). They had also better general health in half of the dimensions of SF-36 (physical functioning: p<0.001; role-physical: p=0.002; general health: p<0.001; social functioning: p=0.045), were younger (p<0.001), better educated (p< 0.001), were born in Sweden more often (p<0.001) and were more often married/living with somebody (p=0.011) than were the fee-for-service respondents. The fee-for-service respondents experienced higher social affinity with their housing area (p=0.049). CONCLUSION There was bias in nonresponse. Contract care patients had better general and oral health than patients in fee-for-service. Acknowledgement: The study was financed by the Swedish Research Council.
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| 9. |
- Misery, Laurent, et al.
(författare)
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White paper on psychodermatology in Europe : A position paper from the EADV Psychodermatology Task Force and the European Society for Dermatology and Psychiatry (ESDaP)
- 2023
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - 0926-9959. ; 37:12, s. 2419-2427
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Tidskriftsartikel (refereegranskat)abstract
- Psychodermatology is a subspecialty of dermatology that is of increasing interest to dermatologists and patients. The case for the provision of at least regional psychodermatology services across Europe is robust. Psychodermatology services have been shown to have better, quicker and more cost-efficient clinical outcomes for patients with psychodermatological conditions. Despite this, psychodermatology services are not uniformly available across Europe. In fact many countries have yet to establish dedicated psychodermatology services. In other countries psychodermatology services are in development. Even in countries where psychodermatolgy units have been established, the services are not available across the whole country. This is especially true for the provision of paediatric psychodermatology services. Also whilst most states across Europe are keen to develop psychodermatology services, the rate at which this development is being implemented is very slow. Our paper maps the current provision of psychodermatology services across Europe and indicates that there is still very much more work to be done in order to develop the comprehensive psychodermatology services across Europe, which are so crucial for our patients.
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| 10. |
- Sampogna, Francesca, et al.
(författare)
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A multilevel analysis of factors affecting the difference in dental patients' and caregivers' evaluation of oral quality of life
- 2008
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 116:6, s. 531-537
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Tidskriftsartikel (refereegranskat)abstract
- In a previous study, we observed that the concordance between patients' and caregivers' evaluation of oral health-related quality of life (OHRQoL) was low. The aim of this study was to use multilevel analysis to investigate the possible determinants of the low concordance, taking into account different patients' demographic and clinical variables, the financial system used by patients to pay for dental treatment, and the role of the different caregivers and clinics. The OHRQoL of patients was assessed both by the patients and by their caregivers, using the Oral Health Impact Profile (OHIP)-14. Data were collected in four clinics, and patients were evaluated by one of 27 caregivers. We tested eight multilevel models, using the difference (caregivers OHIP - patients OHIP) as the dependent variable. Data were complete for 432 patients. The mean difference was 4.4 (standard deviation = 8.2; higher scores indicated a higher impact on OHRQoL). The variance due to patients was partly explained by their age, gender, and number of teeth, with a greater OHIP difference for older vs. younger patients, for women than for men, and in patients with fewer teeth. Almost 30% of the variance was due to caregivers, while the effect of clinics was not significant. It is important to study the possible causes of the different judgments concerning patients' OHRQoL by patients and caregivers, in order to improve the patients' satisfaction with care.
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| 11. |
- Sampogna, Francesca, et al.
(författare)
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A multilevel analysis of factors affecting the difference in patients’ and providers’ evaluation of oral quality of life
- 2008
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Konferensbidrag (refereegranskat)abstract
- Background It is important for dentists and hygienists to evaluate the oral health-related quality of life (OHRQoL) of patients, in order to depict with accuracy the burden of the disease on them, and thus to reach their specific needs. In a previous study, we observed that caregivers tended to overestimate the burden of dental conditions on patients’ life. Aim of the study In the present study, we further analysed those data using multilevel analysis, to investigate the possible determinants of the low concordance between patients’ and caregivers’ evaluation of OHRQoL, taking into account the role of the different caregivers and clinics. Methods This study consisted of a simultaneous assessment of patients’ oral quality of life, performed both by patients themselves and by their caregivers. Data were collected in four clinics, and patients were evaluated by 27 caregivers (15 dentists and 12 hygienists). OHRQoL was measured using the OHIP-14, that contains measures of physical, psychological and social abilities, general physical function, ability of speech and eating, symptoms of pain and discomfort, and appearance and social embarrassment. We tested eight multilevel models, using the OHIP difference as the dependent variable. In each model, the variance for the fixed effect (i.e., the levels) and the random effects (i.e., the intercept and other variables) was estimated. Results Data were complete for 432 patients. The mean difference between the caregivers’ OHIP and the patients’ OHIP was 4.4 (SD=8.2). The variance due to patients was partly explained by their age (higher OHIP difference in elderly vs young patients), gender (higher OHIP difference in women vs men), and number of teeth (higher OHIP difference in patients with less teeth). Almost 30% of variance was due to caregivers, while the effect of clinics was not significant. Conclusions The differences in caregivers’ evaluation could depend on the different caregivers’ experience, or their personal ability to empathize with the patient, or at least in part descend from different conceptual models of dental disease among caregivers. It is important to study the possible causes of the different judgments concerning patients’ OHRQoL by patients and caregivers, in order to improve the patients’ satisfaction of care, and to help patients to reach a well-informed decision about the treatment. Acknowledgement. The study was supported by the Swedish Research Council. DA is supported, in part, by funds from the "Progetto Ricerca Corrente" of the Italian Ministry of Health, Rome, Italy.
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| 12. |
- Sampogna, Francesca, et al.
(författare)
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Comparison of patients' and providers' severity evaluation of oral mucosal conditions
- 2011
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Ingår i: The Journal of American Academy of Dermatology. - : Elsevier. - 0190-9622 .- 1097-6787. ; 65:1, s. 69-76
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In dental diseases, significant discrepancies were observed in the oral health-related quality of life evaluation between patients and providers. Few studies have been performed specifically on the impact of oral mucosal diseases on patients' health. OBJECTIVE: We sought to compare the evaluation of the severity of oral mucosal conditions in providers and patients. METHODS: Patients with an oral mucosal condition were recruited at the oral health care unit of a dermatologic hospital. Severity was evaluated both by the physician and by the patient, using a global severity assessment score on a 5-point scale. The 14-item Oral Health Impact Profile was used to evaluate oral health-related quality of life, the 12-item General Health Questionnaire for psychologic problems, and the 20-item Toronto Alexithymia Scale for alexithymia (ie, the difficulty in identifying and expressing feelings). RESULTS: Data were complete for 206 patients. The agreement between patients' and providers' evaluation was very low (Cohen κ = 0.18). Severity was particularly underestimated by the physician in patients with alexithymia (43% compared with 25% of patients with no alexithymia) and with psychologic problems (44% vs 25%). LIMITATIONS: Because of the high number of different conditions, and thus the small figures in each group, it was not possible to analyze the concordance between patient and provider in each single condition. CONCLUSION: Even in the severity assessment of his or her own disease, it is plausible that a patient does not provide a simple clinical evaluation, but includes subjective aspects. It is important for the physician to take into account the severity the patient perceives in making treatment decisions, and in evaluating clinical improvement
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| 13. |
- Sampogna, Francesca, et al.
(författare)
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Measuring quality of life of patients with different clinical types of psoriasis using the SF-36
- 2006
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 0007-0963 .- 1365-2133. ; 154:5, s. 844-849
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Different specific and generic instruments are used to evaluate quality of life in dermatology, but their interrelationship is not well known. OBJECTIVES: To describe the quality of life in patients with different clinical types of psoriasis using the 36-item short form of the Medical Outcomes Study questionnaire (SF-36), and to study its correlation with dermatology-specific instruments. METHODS: We conducted a cross-sectional study of 380 inpatients with psoriasis. SF-36 mean scores were compared with the norms for medical and psychiatric disorders. Quality of life was also measured by both dermatology-specific (Skindex-29 and Dermatology Life Quality Index, DLQI) and psoriasis-specific instruments (Psoriasis Disability Index, PDI, and the Impact of Psoriasis Questionnaire, IPSO). A specific (Psoriasis Life Stress Inventory, PLSI) and a generic (12-item General Health Questionnaire, GHQ-12) measure of psychological distress was also used. A cluster analysis was performed to study the relationship among the different questionnaires. RESULTS: Our study population showed SF-36 physical health scores similar to minor medical conditions (e.g. physical functioning 79 for psoriasis, 80 for minor medical conditions, and 57 for severe medical conditions), but mental health scores quite similar to psychiatric illnesses (e.g. mental health 57 for psoriasis, 81 for minor medical conditions, 79 for severe medical conditions, and 53 for psychiatric conditions). The SF-36 showed two distinct patterns of impairment of quality of life, with a greater burden of disease for palmoplantar, pustular and arthropathic psoriasis. SF-36 scales tended to form separate clusters from the other dermatology-specific quality of life instruments. CONCLUSIONS: A generic quality of life instrument (e.g. the SF-36) provides information that is complementary to that derived from dermatological questionnaires, and may give further insight in the evaluation of the burden of psoriasis.
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| 14. |
- Sampogna, Francesca, et al.
(författare)
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Measuring the impact of dermatological conditions on family and caregivers : a review of dermatology-specific instruments
- 2017
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959. ; 31:9, s. 1429-1439
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Forskningsöversikt (refereegranskat)abstract
- The patient is the centre of a web of relationships, and the impact of his/her disease on family members and caregivers must be taken into account. The aim of this study was to identify the specific instruments that measure the impact of a dermatological disease on the quality of life (QoL) of family members, by performing a systematic search of the literature. Fifteen papers were identified, describing the creation and validation of nine instruments. Four of them concerned atopic dermatitis (Dermatitis Family Index, DFI; Parents’ Index QoL Atopic Dermatitis, PiQoL-AD; QoL in primary caregivers of children with atopic dermatitis, QPCAD; Childhood Atopic Dermatitis Impact Scale, CADIS), two measured the impact of psoriasis in family members (Psoriasis Family Index, PFI; FamilyPso), one the impact of epidermolysis bullosa (Epidermolysis Bullosa Burden of Disease, EB-BoD), one of ichthyosis (Family Burden Ichthyosis, FBI), and one was generic for dermatological conditions (Family Dermatology Life Quality Index, FDLQI). The European Academy of Dermatology and Venereology quality of life taskforce recommends that the impact of a skin disease on family and caregivers should be measured as part of any thorough evaluation of the burden of a disease. Guidelines are given to choose the most appropriate instruments.
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| 15. |
- Sampogna, Francesca
(författare)
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Quality of life and severity assessment by provider and patient in oral and skin conditions
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A good communication between patient and provider has the aimto understand the patient’s problems, to establish and maintain acaring relation, and to inform about disease. The quality of communicationmay have an influence on different important aspects, suchas satisfaction and adherence to treatment.In this thesis, the overairching aim was to evaluate the effects ofthe communication between patient and provider, by comparing theirevaluation of either the health-related quality of life of patients, or theseverity of the disease.It was chosen to focus on oral and dermatological conditions, sinceskin and teeth are some of the most important components of the appearanceof a person, and conditions which affect them can have deeppsychosocial implications on patients’ life.Paper I concerns skin conditions. Dermatologists’ opinions on skinhealth-related quality of life and psychological problems in patientswere compared to the patients’ reports.Papers II and III concern oral conditions. The evaluation of oralhealth-related quality of life problems in patients by the caregivers wascompared to the evaluation given by patients.In Paper IV, about oral mucosal conditions, the comparison wasmade between the evaluation of the severity of the disease by patientsand providers.Paper I: as regards quality of life, physicians tended to overestimateimpairment in several conditions, particularly in alopecia. In many diagnosticcategories, an underestimation of the frequency of depressionand anxiety by dermatologists was observed. Paper II and III: the correlation between patients’ and caregivers’evaluation of oral health-related quality of life was low. In general, caregiverstended to overestimate the quality of life impairment of their patients,particularly for women, for elderly people, and for patients witha low number of teeth. The difference between patient and caregiverevaluation did not depend on the professional status of the caregiver(dentist or hygienist), nor on the clinics.Paper IV: in oral mucosal conditions, the agreement between patients’and providers’ evaluation of severity was very low. Physicians tended tounderestimate severity more in older than in younger patients, and inpatients with a higher quality of life impairment compared to the others.The underestimation by the physician was also positively associatedto psychological problems and the presence of alexithymia.This thesis showed a low agreement between patient and provider inthe evaluation of quality of life and psychological problems of patients,and of the disease severity, both in dental and dermatological conditions.The discrepancies were both in the direction of an underestimationand an overestimation by the caregiver.
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| 16. |
- Sampogna, Francesca, et al.
(författare)
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Quality of life in patients with dental conditions : comparing patients' and providers' evaluation
- 2009
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Ingår i: Community Dental Health. - 0265-539X. ; 26:4, s. 234-238
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To measure the agreement between patients and their caregivers in evaluating patients’ oral quality of life. Basic research design. Cross-sectional study. Clinical setting. Data collected in four Swedish dental clinics in 2004. Participants. Consecutive patients. Data were completed for 444 patients. Fifteen dentists and 12 dental hygienists agreed to participate. Interventions. For each patient, the patient him/herself and his/her caregiver completed the 14-item Oral Health Impact Profile (OHIP-14), a specific instrument used to measure quality of life in oral conditions, with higher scores indicating a worse quality of life. Information on personal and clinical characteristics of patients were also collected. Main outcome measures. Median OHIP-14 scores given by caregivers and patients were calculated and compared in different subgroups of patients. Cohen’s kappa was calculated to measure the agreement between the evaluation of patients and caregivers. Results. OHIP-14 scores median values were 3.0 among patients and 9.0 among caregivers. Caregivers always gave a higher score than patients, especially in older patients and patients with lower education. The concordance between patients’ and caregivers’ evaluation was very low (for different OHIP-14 cutoffs: Cohen’s kappa from 0.10 to 0.15). Conclusions. In this study, great discrepancies were observed between patients and caregivers in the evaluation of patients’ oral quality of life, with caregivers overestimating the burden of dental conditions on patients. It is important to improve patient-caregiver communication, in order to increase patient satisfaction and provide better care. A good patient-caregiver relationship is essential for the patients’ well-being and their adherence to treatment.
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