A qualitative exploration of motivation to self-manage and styles of self-management amongst people living with type 2 diabetes

The study examined the motives that people living with type 2 diabetes (T2D) had for self-managing their condition and ways they used to assess the success of their self-management efforts. Using semistructured interviews (), focus groups (3 × participants), and open-ended questionnaires (), people living with and self-managing T2D were recruited from a community-based T2D participation group. Most participants were older (aged 60+) and lived in a socioeconomically deprived area in the United Kingdom. Data were analysed thematically using framework analysis. Patients’ motives for self-management included (i) concern about the anticipative effects of T2D; (ii) wishing to “stay well”; (iii) maintaining independence; (iv) reducing the need for healthcare professionals; and (v) improving quality of life. Six self-management styles were found and pertained to self-managing: (i) through routinisation; (ii) as a burden; (iii) as maintenance; (iv) through delegation; (v) through comanagement; and (vi) through autonomy. Motivators for self-management shaped the criteria people used to judge the success of their self-management practices and influenced their self-management style. The findings show that styles of T2D self-management are mediated and moderated by sociocontextual issues. Healthcare professionals should take these into account when supporting people living with T2D

‘You have to treat the person, not the mouth only’: UK dentists’ perceptions of communication in patient consultations

Effective communication between patients and health professionals is a key component of patient-centred care. Although there is a large body of literature focusing on doctor-patient communication, there has been limited research related to dentist-patient communication, especially presented from the dentists’ perspective. The aim of our study was to explore UK dentists’ perceptions of communication in their consultations, and the factors they perceive may influence this. We conducted semi-structured interviews with eight dentists in UK dental NHS practices. Thematic analysis revealed three themes (‘Treating the whole person’, ‘Barriers to patient-centred communication’ and ‘Mutuality of communication’), which reflected the dentists’ perceptions of their own communication during consultations, the patients’ interaction skills, attitudes (and characteristics that may affect them), and external factors, such as time constraints, that can influence dentist-patients’ encounters. These in-depth accounts are valuable, in that we see what dentists perceive is important, obstructive and facilitative. They report using a patient-centred approach in their everyday dental practice; however this is often difficult due to factors such as time constraints. Although they emphasized that the patient has an active role to play in the communication process, it may be the case that they also need to play their part in facilitating this

The impact of priming on dentally induced social judgements: An experimental study

ObjectiveTo ascertain the effects of priming to consider tooth appearance (i.e. exposure to a ‘tooth whitening television advert’) versus control (a ‘non-dental’ television advert) on social judgements of tooth colour in a group of Caucasians.MethodsTwo groups of Caucasians randomly assigned to watch either a tooth-whitening advert (experimental, N = 67) or a bread advert (control, N = 62). All rated the measures of social perceptions: friendliness, popularity, social life, success, intelligence, graduation, introversion/extroversion, happiness, self-confidence, attractiveness, age-estimation and satisfaction, after watching either of the adverts and viewing three digitally modified photographs (Darkened, natural and whitened teeth) of different Caucasian adults (males and females) separately.ResultsThere were no statistically significant differences for all the measures of social perception between the groups. Nevertheless, the questions that inquired about popularity, friendliness, success, intelligence, happiness, self-confidence, attractiveness and satisfaction were consistently rated higher for all three tooth shades in the experimental than the control groups. Further, within the experimental and control groups, higher ratings were given to the faces with whitened teeth than the natural and darkened teeth.ConclusionsPriming has little impact on dentally induced social judgements as this study failed to demonstrate statistically significant differences. Nevertheless, both groups gave the highest subjective ratings for the faces with whitened teeth and the tooth-whitening advert group associated the faces in the photographs with higher subjective ratings than the non-dental advert group irrespective of the tooth shade. One reason for this could be the way media affects the psychological well-being.Clinical significance statementThe almost universal exposure to idealised tooth appearance in the media may increase demand for aesthetic treatments. Standardising the colour of the tooth plays a huge impact and making individuals to view a tooth whitening advert just prior to a procedure might influence patient choices.</p

Comparative Optimism, Self-Superiority, Egocentric Impact Perception and Health Information Seeking: A COVID-19 Study

We examined perceived self-other differences (self-uniqueness) in appraisals of one’s risk of an infectious disease (COVID-19), one’s adherence to behavioural precautionary measures against the disease, and the impact of these measures on one’s life. We also examined the relationship of self-uniqueness with information seeking and trust in sources of information about the disease. We administered an online survey to a community sample (N= 8696) of Dutch-speaking individuals, mainly in Belgium and The Netherlands, during the first lockdown (late April-Mid June 2020). As a group, participants reported that they were less likely to get infected or infect others or to suffer severe outcomes than average (unrealistic optimism) and that they adhered better than average to behavioural precautionary measures (illusory superiority). Except for participants below 25, who reported that they were affected more than average by these measures (egocentric impact bias), participants also generally reported that they were less affected than average (allocentric impact bias). Individual differences in selfuniqueness were associated with differences in the number of information sources being used and trust on these sources. Higher comparative optimism for infection, selfsuperiority, and allocentric impact perception were associated with information being sought from fewer sources; higher self-superiority and egocentric impact perception were associated with lower trust. We discuss implications for health communication

Patients' and dentists' perceptions of tele-dentistry at the time of COVID-19. A questionnaire-based study.

ObjectivesCOVID-19 has had a significant impact on dentistry in unforeseen ways, including a substantial rise in the development and implementation of video consultations. The research aimed to investigate dentists' and patients' attitudes towards dental video consultations (tele-dentistry) and to identify potential ways to improve the experience.MethodsA cross-sectional, pre-post design, online survey was carried out with patients' and dentists' before and after video consultations. A total of 249 participants accessed the survey and 228 of them consented to take part in the study and answered the online questions. Participants' attitudes towards video consultations were assessed using a questionnaire constructed by a multidisciplinary team of periodontists and psychologists. The measure assessed the perceived efficacy of the video consultations on patients and the dental team. Video consultations were performed to risk assess, triage and manage remotely via a video link out at (deleted name of institution as double blinded peer review) via NHS England's Attend Anywhere platform.ResultsThe majority of patients strongly agreed and were satisfied using tele-dentistry in the five domains which we explored: the ease, comprehensiveness and helpfulness of the video consultations and the anxiety and satisfaction levels of the patient. Dentists and students alike felt more confident and competent after having carried out a video consultation. The majority of clinicians found the tele-dentistry platform helpful and easy to perform. Just over 70% of patients strongly agreed that the video consultation ran smoothly and 75.7% strongly agreed that they were comfortable accessing the consultation from home rather than travelling in for the consultation. Just under 80% of patients stated that they would recommend the video consultation.ConclusionsThis study shows that tele-dentistry may be a valid option to help service providers and dental patients, as it seems to be well accepted by both patients and dentists. JM to typesetter.Clinical significancePatients' and dentists' perceptions of Tele-Dentistry at the time of COVID-19. A questionnaire-based study. To our knowledge this is one of the first studies evaluates perceptions of patients and clinicians before and after a tele-dentistry encounter in and across different dental departments. The majority of survey participants expressed positive views towards tele-dentistry across all domains including ease and comprehensiveness of the video consultation, perceived helpfulness and anxiety and satisfaction of the patient. Dentists appear to be competent and confident to carry out these video consultations and find them to be helpful and easy to complete. As a result, we suggest readers adopt tele-dentistry in their daily activities to help patients and clinicians alike

Labels and descriptions of dental behaviour support techniques: A scoping review of clinical practice guidelines

Introduction: There is no agreed taxonomy of the techniques used to support patients to receive professional oral healthcare. This lack of specification leads to imprecision in describing, understanding, teaching and implementing behaviour support techniques in dentistry (DBS). Methods: This review aims to identify the labels and associated descriptors used by practitioners to describe DBS techniques, as a first step in developing a shared terminology for DBS techniques. Following registration of a protocol, a scoping review limited to Clinical Practice Guidelines only was undertaken to identify the labels and descriptors used to refer to DBS techniques. Results: From 5317 screened records, 30 were included, generating a list of 51 distinct DBS techniques. General anaesthesia was the most commonly reported DBS (n = 21). This review also explores what term is given to DBS techniques as a group (Behaviour management was most commonly used (n = 8)) and how these techniques were categorized (mainly distinguishing between pharmacological and non‐pharmacological). Conclusions: This is the first attempt to generate a list of techniques that can be selected for patients and marks an initial step in future efforts at agreeing and categorizing these techniques into an accepted taxonomy, with all the benefits this brings to research, education, practice and patients

Comparative optimism about infection and recovery from COVID‐19; Implications for adherence with lockdown advice

Background Comparative optimism, the belief that negative events are more likely to happen to others rather than to oneself, is well established in health risk research. It is unknown, however, whether comparative optimism also permeates people’s health expectations and potentially behaviour during the COVID-19 pandemic. Objectives Data were collected through an international survey (N = 6485) exploring people’s thoughts and psychosocial behaviours relating to COVID‐19. This paper reports UK data on comparative optimism. In particular, we examine the belief that negative events surrounding risk and recovery from COVID-19 are perceived as more likely to happen to others rather than to oneself. Methods Using online snowball sampling through social media, anonymous UK survey data were collected from N = 645 adults during weeks 5-8 of the UK COVID-19 lockdown. The sample was normally distributed in terms of age and reflected the UK ethnic and disability profile. Findings Respondents demonstrated comparative optimism where they believed that as compared to others of the same age and gender, they were unlikely to experience a range of controllable (eg accidentally infect/ be infected) and uncontrollable (eg need hospitalization/ intensive care treatment if infected) COVID-19-related risks in the short term (P < .001). They were comparatively pessimistic (ie thinking they were more at risk than others for developing COVID-19-related infection or symptoms) when thinking about the next year. Discussion This is one of the first ever studies to report compelling comparative biases in UK adults’ thinking about COVID-19

Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management

Objectives: Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e-Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour. // Methods: Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action. // Results: The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied. // Discussion: Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care

Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management

Objectives: Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e‐Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour. Methods: Following a registered protocol, a modified e‐Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action. Results: The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied. Discussion: Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care