Little is known about how community-dwelling people with dementia, as well as their carers, look after their oral health and use dental care. This exploratory study aimed to explore the beliefs, experiences and practices about oral health of people living with dementia and their carers. We used an ethnographic qualitative approach conducting face-to-face interviews at home with people living with dementia and/or carers. Interview data and field notes were analysed thematically using framework methods. We approached volunteers registered with the online UK. Join Dementia Research network from whom a total of 17 participants were recruited in 2018. Five interviews were conducted with carers alone, two with a person living with dementia alone, and five with a carer and person with dementia jointly. Three main themes emerged: oral health is not prioritised; access to dental care is shaped by increasing disability; and the importance of continuity of care. While people living with dementia and their carers may view oral health important once prompted, many reported difficulties in undertaking or assisting with daily self-care and accessing dental services, particularly as dementia progresses. We draw out implications for the organisation and delivery of public and private dental services.
Aim To investigate the roles and relationships of registered Clinical Dental Technicians (CDTs) in the dental team and healthcare systems, and their perspective as a professional group in the United Kingdom (UK). Methods This qualitative study was conducted following a national questionnaire survey of CDTs, 18 of whom participated in semi‐structured interviews; they were purposively sampled to represent the diversity and demography of CDTs. A topic guide, informed by the literature and survey findings, guided discussions which were recorded and transcribed verbatim. Drawing upon phenomenological and cultural relativistic theories, thematic analysis was conducted, thus enabling an “analytic story” of the lived experience to emerge. Results Clinical dental technicians expressed pride, passion and satisfaction in their work yet feel misunderstood in their role. Experiences of being accepted and incorporated into the wider dental profession are strained. Ultimately, there is a complex web of inter‐dependence between all actors—a triadic relationship—bounded by policymakers and regulators which directly impacts on best practice and the balance between collaboration and autonomy. Looking to the future, Ideal practice may involve different models of care, with examples of good practice emerging. Conclusion This paper provides a unique examination of the lived experience, feelings and relationships of CDTs. The perceptions of their role, their inter‐professional relations and the progression as a professional group must be addressed, and their potential to work collaboratively actively engaged to serve our ageing population.
BackgroundThe patient’s interpretation of the events and decisions leading up to consultation with a healthcare professional for symptoms of brain cancer is under researched. The aim of this study was to document responses to noticing the changes preceding a diagnosis of brain cancer and living with them, focusing on appraisal of changes and the decision to seek (and re-seek) help, with attention to the psychological processes underpinning the appraisal and help-seeking intervals.MethodIn this qualitative study set in Eastern and NW England, in-depth interviews with adult patients recently diagnosed with primary brain cancer and their family members were analysed thematically, using the Model of Pathways to Treatment as a conceptual framework.Results39 adult patients were interviewed. Regarding the appraisal interval, cognitive heuristics were found to underpin explanations of changes/symptoms. The subtlety and normality of changes often suggested nothing serious was wrong. Common explanations included stress or being busy at work, or age and these did not seem to warrant a visit to a doctor. Explanations and the decision to seek help were made within the social context, with friends, family and work colleagues contributing to appraisal and help-seeking decisions.Regarding the help-seeking interval, barriers to seeking help reflected components of Social Cognitive Theory, and included having other priorities, outcome expectations (e.g. ‘feeling silly’, not sure much can be done about it, not wanting to waste doctors’ time) and accessibility of a preferred healthcare professional.ConclusionApplication of psychological theory facilitated understanding of the influences on cognition and behaviour. The study highlights implications for theory, awareness campaigns and potential opportunities promoting more timely help-seeking.
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