What Should Dental Services for People with Disabilities Be Like? Results of an Irish Delphi Panel Survey

Abstract

BackgroundThis study aimed to generate prioritised goals for oral health services for people with disabilities as a first step in meeting the need for evidence based oral health services for people with disabilities in Ireland.MethodsThe study used a three round modified e-Delphi method, involving dental service professionals and people with disabilities or their representatives, in Ireland. Three rounds were completed online using SurveyMonkey. Round 1 asked: “List what you think dental services for people with disabilities in Ireland should be like.” Items for subsequent rounds were generated from responses to Round 1. Round 2 and Round 3 used 5 point Likert scales to rank these items by priority: from No Priority (1) to Top Priority (5). Consensus was achieved on each item where at least 80% of respondents considered an item either High or Top Priority. A consensus meeting concluded the process.ResultsSixty-one panelists started and 48 completed the survey. The Delphi panel agreed on level of priority for 69 items and generated 16 consensus statements. These statements covered a range of topics such as access to care, availability of information and training, quality of care, dental treatment and cost. A recurrent theme relating to the appropriateness of care to individual need arose across topics suggesting a need to match service delivery according to the individual's needs, wants and expectations rather than the disability type/diagnosis based service which predominates today.ConclusionsThis process produced a list of prioritised goals for dental services for people with disabilities. This creates a foundation for building evidence-based service models for people with disabilities in Ireland.

Obstacles to comprehensive dental care in patients with sustained limitations of their decision‐making abilities: findings from a Delphi study

“…Finally, the fact that our findings are close to those of Mac Giolla Phadraig et al . suggests good transferability.…”

“…This was largely in agreement with the findings of the study conducted by Mac Giolla Phadraig et al . and could explain why it was difficult for panellists to give a definition of patients with sustained limitations of their decision‐making abilities. The definition depended on the difficulties encountered by each person.…”

What should dental services for people with disabilities in Ireland be like? Agreed priorities from a focus group of people with learning disabilities

“…This study aimed to test the feasibility of the methods used. It is based on a single focus group, which enabled a group of people with communication and cognitive impairments to build on the results of an online National Delphi Process, which by design excluded them (Mac Giolla Phadraig et al ., ). This study confirms the importance of including those with learning disabilities when setting goals for services.…”

“…Twenty‐one Focus Group Statements were developed specifically for this study from 16 Delphi Statements that emerged from a related Delphi study (Mac Giolla Phadraig et al ., ). Before the focus group, each Delphi Statement was reviewed and reworded by the lead researcher and communication experts, to produce sensible, clear and unambiguous Focus Group Statements .…”

“…So far, the preferences and expectations of people with learning disabilities have not routinely been considered in designing such oral health services (Mac Giolla Phadraig et al, 2014b). This is despite the National Disability Authority's long-held assertion that people with disabilities should be supported to be active participants in oral health care (Elliot et al, 2005).…”