Tehran dentists' knowledge and attitudes towards hepatitis B and their willingness to treat simulated hepatitis B positive patients

Abstract

The dental profession has a high risk of hepatitis B virus (HBV) contamination and can play a crucial role in controlling HBV cross-contamination. In this cross-sectional study we used unique methods to assess Tehran dentists' knowledge, attitude and behaviour regarding HBV. Two simulated HBV-positive patients visited 300 general/specialist dentists in their offices and recorded dentists' willingness to treat them. Later, the dentists were interviewed regarding their knowledge about hepatitis B and attitude to HBV-positive patients. The mean knowledge score of dentists was 14.3 (SD 6.9) out of 44 and the mean attitude score was 20.0 (SD 3.6) out of 39. A majority of dentists (55.6%) were willing to treat a patient with HBV, unconditionally or with conditions. Some individual attitude items correlated with knowledge items concerning transmission of the virus and its prevention. Dentists' willingness to treat patients did not correlate with knowledge or attitude, except for the attitude item on concern about becoming infected. RÉSUMÉ La profession dentaire est à haut risque de contamination par le virus de l'hépatite B et peut jouer un rôle crucial dans la lutte contre la contamination croisée par ce virus. Dans cette présente étude transversale, des méthodes uniques ont été adoptée pour évaluer les connaissances, les attitudes et les comportements des dentistes de Téhéran vis-à-vis du virus de l'hépatite B. Deux patients déclarant une infection fictive par le virus de l'hépatite B ont rendu visite à 300 dentistes spécialistes ou généralistes sur leur lieu d'exercice et ont pris note de leur disposition à les traiter. Dans un deuxième temps, les dentistes ont été interrogés sur leurs connaissances en matière d'hépatite B et leur attitude vis-à-vis des patients infectés par le virus. Le score moyen des dentistes pour les connaissances était de 14,3 (ET 6,9) sur 44 tandis que le score moyen pour l'attitude était de 20,0 (ET 3,6) sur 39. La majorité des dentistes (55,6 %) étaient disposés à traiter un patient infecté par le virus de l'hépatite B, avec ou sans conditions. Certains items concernant l'attitude individuelle étaient corrélés aux items concernant les connaissances relatives à la transmission du virus et sa prévention. La disposition des dentistes à traiter des patients infectés n'était pas corrélée aux connaissances ni à l'attitude, à l'exception de l'item concernant l'attitude relative à la crainte de contracter l'infection. ‫له‬ ‫اإلجيابيني‬ ‫حياكون‬ ‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫العرشون‬ ‫املجلد‬ ‫الثامن‬ ‫العدد‬ 499

Risk factors influencing dentists’ hepatitis B-related knowledge and attitudes and their willingness to treat hepatitis B positive patients

“…Each included dentist (n = 300) participated in both phases of the study. More details about the sampling are given in our earlier report (7).…”

“…In a previous report of the same research, we described Tehran dentists' knowledge about hepatitis and HBV, their self-reported attitudes towards people with HBV and their actual behaviour towards treating simulated HBV-positive patients (7). In this paper, we report the demographic, educational and office factors influencing dentists' knowledge, attitudes and behaviour.…”

“…The maximum obtainable score was 44. Some questions had a score of 1 and some had higher scores (different weights) (7). The attitude-oriented questionnaire included 13 questions with 4 Likert-scale answers, (scored from 3 to 0 for each question) which represented the extent of dentists' attitudes towards and willingness to participate in treating HBV-positive patients (7,9).…”

“…The hepatitis B virus (HBV) is about 50 to 100 times more infectious than HIV (6). This might deter clinicians from treating HBV-positive patients (7), even though it is unethical and in some countries illegal to refuse treatment to HBV patients (1,8). Clinicians' reluctance to treat infected patients could also have serious implications for public health (9); for example, there is a greater risk of cross-contamination if patients conceal their disease status (1,3,9,10).…”

“…Despite these issues, many dentists still refuse to treat patients suffering from bloodborne diseases (8) due to dentists' higher exposure risks than the general public and even other healthcare professionals (1,2,4,5,7,9,(11)(12)(13)(14). Dentists' unwillingness cannot be tackled by legal penalties (8) but by improvements in attitude (9,15,16), which might be a reflection of improved knowledge and confidence (9,10,15,16).…”