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A multilevel analysis of factors affecting the difference in dental patients' and caregivers' evaluation of oral quality of life
Malmö högskola, Faculty of Odontology (OD).
Malmö högskola, Faculty of Odontology (OD).
Malmö högskola, Faculty of Odontology (OD).
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2008 (English)In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 116, no 6, p. 531-537Article in journal (Refereed) Published
Abstract [en]

In a previous study, we observed that the concordance between patients' and caregivers' evaluation of oral health-related quality of life (OHRQoL) was low. The aim of this study was to use multilevel analysis to investigate the possible determinants of the low concordance, taking into account different patients' demographic and clinical variables, the financial system used by patients to pay for dental treatment, and the role of the different caregivers and clinics. The OHRQoL of patients was assessed both by the patients and by their caregivers, using the Oral Health Impact Profile (OHIP)-14. Data were collected in four clinics, and patients were evaluated by one of 27 caregivers. We tested eight multilevel models, using the difference (caregivers OHIP - patients OHIP) as the dependent variable. Data were complete for 432 patients. The mean difference was 4.4 (standard deviation = 8.2; higher scores indicated a higher impact on OHRQoL). The variance due to patients was partly explained by their age, gender, and number of teeth, with a greater OHIP difference for older vs. younger patients, for women than for men, and in patients with fewer teeth. Almost 30% of the variance was due to caregivers, while the effect of clinics was not significant. It is important to study the possible causes of the different judgments concerning patients' OHRQoL by patients and caregivers, in order to improve the patients' satisfaction with care.

Place, publisher, year, edition, pages
2008. Vol. 116, no 6, p. 531-537
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-6643DOI: 10.1111/j.1600-0722.2008.00578.xISI: 000261122300006PubMedID: 19049523Scopus ID: 2-s2.0-56749107668Local ID: 7384OAI: oai:DiVA.org:mau-6643DiVA, id: diva2:1403588
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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Johansson, VeronicaAxtelius, BjörnSöderfeldt, Björn

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