Clinical Decision Making for a Tooth with Apical Periodontitis: The Patients' Preferred Level of Participation

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• 作者：Amir Azarpazhooh ; DDS ; MSc ; PhD^&lowast ; ; ^&dagger ; ; ^&Dagger ; ; ^§ ; ; ^{amir.azarpazhooh@dentistry.utoronto.ca" class="auth_mail" title="E-mail the corresponding author} ; Thuan Dao ; DMD ; MSc ; PhD^‖ ; Wendy J. Ungar ; PhD^&Dagger ; ; ^¶ ; ; Faiza Chaudry ; DDS^&dagger ; ; Rafael Figueiredo ; DDS ; MSc^&dagger ; ; Murray Krahn ; MD ; MSc^&Dagger ; ; ^§ ; ; Shimon Friedman ; DDS ; MSc^&lowast ;
• 关键词：Apical periodontitis ; dentist-patient relations ; patient preference ; personal autonomy ; principle-based ethics ; shared decision making
• 刊名：Journal of Endodontics
• 出版年：2014
• 出版时间：June 2014
• 年：2014
• 卷：40
• 期：6
• 页码：784-789
• 全文大小：835 K

文摘

To effectively engage patients in clinical decisions regarding the management of teeth with apical periodontitis (AP), there is a need to explore patients' perspectives on the decision-making process. This study surveyed patients for their preferred level of participation in making treatment decisions for a tooth with AP.

Methods

Data were collected through a mail-out survey of 800 University of Toronto Faculty of Dentistry patients, complemented by a convenience sample of 200 patients from 10 community practices. The Control Preferences Scale was used to evaluate the patients' preferences for active, collaborative, or passive participation in treatment decisions for a tooth with AP. Using bivariate and logistic regression analyses, the Gelberg-Andersen Behavioral Model for Vulnerable Populations was applied to the Control Preferences Scale questions to understand the influential factors (P ≤ .05).

Results

Among 434 of 1,000 respondents, 44%, 40%, and 16% preferred an active, collaborative, and passive participation, respectively. Logistic regression showed a significant association (P ≤ .025) between participants' higher education and preference for active participation compared with a collaborative role. Also, immigrant status was significantly associated with preference for passive participation (P = .025).

Conclusions

The majority of patients valued an active or collaborative participation in deciding treatment for a tooth with AP. This pattern implied a preference for a patient-centered practice mode that emphasizes patient autonomy in decision making.