Patient-centred care in general dental practice - a systematic review of the literature

Abstract

BackgroundDelivering improvements in quality is a key objective within most healthcare systems, and a view which has been widely embraced within the NHS in the United Kingdom. Within the NHS, quality is evaluated across three key dimensions: clinical effectiveness, safety and patient experience, with the latter modelled on the Picker Principles of Patient-Centred Care (PCC). Quality improvement is an important feature of the current dental contract reforms in England, with “patient experience” likely to have a central role in the evaluation of quality. An understanding and appreciation of the evidence underpinning PCC within dentistry is highly relevant if we are to use this as a measure of quality in general dental practice.MethodsA systematic review of the literature was undertaken to identify the features of PCC relevant to dentistry and ascertain the current research evidence base underpinning its use as a measure of quality within general dental practice.ResultsThree papers were identified which met the inclusion criteria and demonstrated the use of primary research to provide an understanding of the key features of PCC within dentistry. None of the papers identified were based in general dental practice and none of the three studies sought the views of patients. Some distinct differences were noted between the key features of PCC reported within the dental literature and those developed within the NHS Patient Experience Framework.ConclusionsThis systematic review reveals a lack of understanding of PCC within dentistry, and in particular general dental practice. There is currently a poor evidence base to support the use of the current patient reported outcome measures as indicators of patient-centredness. Further research is necessary to understand the important features of PCC in dentistry and patients’ views should be central to this research.

Person-centred care in dentistry - the patients' perspective

“…Research into PCC within dentistry is limited, 15 and primary research has tended to focus on the views of dental staff. [12][13][14][15][16] Such research is valuable but only provides an understanding of PCC from a clinician's perspective.…”

“…[12][13][14][15][16] Such research is valuable but only provides an understanding of PCC from a clinician's perspective. To our knowledge, this is the first study to explore the attitudes of patients towards PCC in relation to dentistry.…”

“…12 Application of this generic framework in dentistry has been questioned 15 and the need for further research into PCC in dentistry highlighted. 16 A recent systematic literature review 15 identified three papers which contributed to an understanding of PCC in dentistry, [17][18][19] based on the views of dental care professionals and managers. Further research has recently been published by Scambler et al 16 who explore the understanding and practise of PCC in dentistry with a group of dentists.…”

Impact of Prominent Themes in Clinician-Patient Conversations on Caregiver’s Perceived Quality of Communication with Paediatric Dental Visits

“…The empathy approach is a key element in patient-centered care, and it has been found to be significantly related to the success of the patients’ treatment [26]. Children who perceive more empathy from positive reinforcement and reassurance of clinicians will likely to have fewer fear-related behaviors [27] and dental anxiety.…”

Comparing patients’ perspectives of “good care” in Dutch outpatient psychiatric services with academic perspectives of patient-centred care

“…According to medical ethics, the autonomy of patients should be respected and they should be treated with respect and dignity (Epstein et al, 2010). Second, the delivery of PCC is associated with improved health outcomes, satisfaction with care and reduced healthcare costs (Epstein, 2000;Greene et al, 2012;Hudon et al, 2011;Mills et al, 2014;Robinson et al, 2008;Storm & Edwards, 2013).…”