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Comparison of patients' and providers' severity evaluation of oral mucosal conditions
Malmö högskola, Faculty of Odontology (OD).
Malmö högskola, Faculty of Odontology (OD).
Malmö högskola, Faculty of Odontology (OD).
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2011 (English)In: The Journal of American Academy of Dermatology, ISSN 0190-9622, E-ISSN 1097-6787, Vol. 65, no 1, p. 69-76Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In dental diseases, significant discrepancies were observed in the oral health-related quality of life evaluation between patients and providers. Few studies have been performed specifically on the impact of oral mucosal diseases on patients' health. OBJECTIVE: We sought to compare the evaluation of the severity of oral mucosal conditions in providers and patients. METHODS: Patients with an oral mucosal condition were recruited at the oral health care unit of a dermatologic hospital. Severity was evaluated both by the physician and by the patient, using a global severity assessment score on a 5-point scale. The 14-item Oral Health Impact Profile was used to evaluate oral health-related quality of life, the 12-item General Health Questionnaire for psychologic problems, and the 20-item Toronto Alexithymia Scale for alexithymia (ie, the difficulty in identifying and expressing feelings). RESULTS: Data were complete for 206 patients. The agreement between patients' and providers' evaluation was very low (Cohen κ = 0.18). Severity was particularly underestimated by the physician in patients with alexithymia (43% compared with 25% of patients with no alexithymia) and with psychologic problems (44% vs 25%). LIMITATIONS: Because of the high number of different conditions, and thus the small figures in each group, it was not possible to analyze the concordance between patient and provider in each single condition. CONCLUSION: Even in the severity assessment of his or her own disease, it is plausible that a patient does not provide a simple clinical evaluation, but includes subjective aspects. It is important for the physician to take into account the severity the patient perceives in making treatment decisions, and in evaluating clinical improvement

Place, publisher, year, edition, pages
Elsevier, 2011. Vol. 65, no 1, p. 69-76
Keywords [en]
alexithymia, communication patient-provider, 14-item Oral Health Impact Profile, oral mucosal conditions, Physician Global Assessment, quality of life, severity
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-6746DOI: 10.1016/j.jaad.2010.05.001ISI: 000292222200009PubMedID: 21458105Scopus ID: 2-s2.0-79958840650Local ID: 13029OAI: oai:DiVA.org:mau-6746DiVA, id: diva2:1403696
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
In thesis
1. Quality of life and severity assessment by provider and patient in oral and skin conditions
Open this publication in new window or tab >>Quality of life and severity assessment by provider and patient in oral and skin conditions
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A good communication between patient and provider has the aimto understand the patient’s problems, to establish and maintain acaring relation, and to inform about disease. The quality of communicationmay have an influence on different important aspects, suchas satisfaction and adherence to treatment.In this thesis, the overairching aim was to evaluate the effects ofthe communication between patient and provider, by comparing theirevaluation of either the health-related quality of life of patients, or theseverity of the disease.It was chosen to focus on oral and dermatological conditions, sinceskin and teeth are some of the most important components of the appearanceof a person, and conditions which affect them can have deeppsychosocial implications on patients’ life.Paper I concerns skin conditions. Dermatologists’ opinions on skinhealth-related quality of life and psychological problems in patientswere compared to the patients’ reports.Papers II and III concern oral conditions. The evaluation of oralhealth-related quality of life problems in patients by the caregivers wascompared to the evaluation given by patients.In Paper IV, about oral mucosal conditions, the comparison wasmade between the evaluation of the severity of the disease by patientsand providers.Paper I: as regards quality of life, physicians tended to overestimateimpairment in several conditions, particularly in alopecia. In many diagnosticcategories, an underestimation of the frequency of depressionand anxiety by dermatologists was observed. Paper II and III: the correlation between patients’ and caregivers’evaluation of oral health-related quality of life was low. In general, caregiverstended to overestimate the quality of life impairment of their patients,particularly for women, for elderly people, and for patients witha low number of teeth. The difference between patient and caregiverevaluation did not depend on the professional status of the caregiver(dentist or hygienist), nor on the clinics.Paper IV: in oral mucosal conditions, the agreement between patients’and providers’ evaluation of severity was very low. Physicians tended tounderestimate severity more in older than in younger patients, and inpatients with a higher quality of life impairment compared to the others.The underestimation by the physician was also positively associatedto psychological problems and the presence of alexithymia.This thesis showed a low agreement between patient and provider inthe evaluation of quality of life and psychological problems of patients,and of the disease severity, both in dental and dermatological conditions.The discrepancies were both in the direction of an underestimationand an overestimation by the caregiver.

Place, publisher, year, edition, pages
Malmö University, Faculty of Odontology, Department of Oral Public Health, 2010
Series
Doctoral Dissertation in Odontology
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-7656 (URN)10168 (Local ID)91-7104-310-1 (ISBN)10168 (Archive number)10168 (OAI)
Note

Note: The papers are not included in the fulltext online.

Paper IV in dissertation as manuscript with title "Comparison of patients’ and providers’ severity evaluation of oral mucosal diseases".

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-04Bibliographically approved

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Söderfeldt, BjörnAxtelius, Björn

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