Psychosocial impacts of oral epithelial dysplasia

BACKGROUND: The psychosocial impact of receiving the diagnosis of oral epithelial dysplasia, which presents up to 3.5% increased annual risk of mouth cancer, remain unknown. Using validated instruments, the present study aimed to investigate the prevalence and existing correlations between anxiety, depression and dental anxiety symptoms and burden on oral health-related quality of life. METHODS: A clinical cohort of 82 patients with oral dysplasia was asked to complete the Hospital Anxiety and Depression Scale, the Modified Dental Anxiety Scale and the shortened version of the Oral Health Impact Profile. Spearman's correlation coefficient and regression analyses were performed. RESULTS: The participants' scores were in keeping with the presence of anxiety, depression and emotional distress symptoms in 30%, 16%, and 26%, respectively. However, 69% experienced anxiety related to procedures that may be required as part of long-term management of oral dysplasia (e.g. local anaesthetic injection). The oral-health related quality of life scores showed 41.5% reporting a recent daily problem due to their oral or dental health. Significant correlations [p > 0.05] were found among and between all of the used instruments. Being a female with oral dysplasia also predicted increased odds of indicating higher anxiety and dental anxiety scores than males [p > 0.05]. CONCLUSION: Oral dysplasia can adversely impact on the psychosocial well-being of affected persons. Establishing a causal relationship between the measured variables may, however, be challenging and would need further longitudinal studies

Carol Porter, DNP, RN, FAAN, Oral History Interview, January 25, 2018

Major Topics Covered: Personal background and education Vision for evolution in the Division of Nursing Leadership issues in nursing Emergency management: training and experience prior to MD Anderson, 9/11; importance of emergency management training to a nursing career; leadership in emergency managementhttps://openworks.mdanderson.org/mchv_interviewsessions/1173/thumbnail.jp

Carol Porter, DNP, RN, FAAN, Oral History Interview, January 4, 2018

Major Topics Covered: Personal background and education Vision for evolution in the Division of Nursing Leadership issues in nursing Emergency management: training and experience prior to MD Anderson, 9/11; importance of emergency management training to a nursing career; leadership in emergency managementhttps://openworks.mdanderson.org/mchv_interviewsessions/1172/thumbnail.jp

Carol Porter, DNP, RN, FAAN, Oral History Interview, July 6, 2018

Major Topics Covered: Personal background and education Vision for evolution in the Division of Nursing Leadership issues in nursing Emergency management: training and experience prior to MD Anderson, 9/11; importance of emergency management training to a nursing career; leadership in emergency managementhttps://openworks.mdanderson.org/mchv_interviewsessions/1174/thumbnail.jp

Information needs and oral epithelial dysplasia: development and psychometric evaluation of a novel instrument

Objectives: Oral epithelial dysplasia (OED) can lead to significant information needs (IN) related to the risk of cancer development, the need for long‐term monitoring and potential intervention. The present study aimed to develop and perform preliminary psychometric testing for a novel IN instrument specific to OED. / Subjects and methods: Patients diagnosed with OED were invited to complete the Oral Epithelial Dysplasia Informational Needs Questionnaire (ODIN‐Q), which was developed based on a known theoretical framework and with items generated via expert input and the literature. Face validity and content validity were initially assessed prior to finalisation of the tool. ODIN‐Q was tested for internal consistency and test–retest reliability along with construct validity. / Results: ODIN‐Q consists of 35 items, categorised under six domains, and rated by dual 4‐point Likert scales (amount of information received and degree of importance). Internal consistency (Cronbach's alpha) was rated “excellent” for the scale (0.93) and both subscales (0.92/0.94). For test–retest reliability, moderate agreement was found (κ = 0.49–0.53). Regarding construct validity, a significant but limited relationship was found between ODIN‐Q and the Krantz Health Opinion Survey. / Conclusion: ODIN‐Q showed adequate psychometric properties of reliability and validity. Further validation is, however, needed to assess its structural validity and responsiveness

Suffering as a Means to Enhance Experiential Learning

Abstract Background: There is a need for nursing curriculum to not only reflect content (the knowing) as an outcome but to also embrace the creation of safe places to foster dialogue (the being) as process; recognizing that both process and outcome are intertwined as pedagogical goals. Challenging students to think about how they would be (ontological), recognizing there are no right or wrong (black and white) answers, that life is often lived in the "grey" can be fostered through narratives as a learning strategy. Aim: The aim of this study was to examine the efficacy of a combined teaching and learning strategy (vodcast and narratives) to replace a traditional lecture to enhance experiential learning focusing on the concepts of caring, suffering, and ethical dilemmas. Results: Out of the 135 students enrolled in the course a total of 109 participated in the research study for a response rate of 80.7%. The plural teaching strategy (the vodcast, journal articles, and case studies) introduced for the research study was overwhelmingly beneficial for many students; the opportunity to review the content multiple times, peer inspired content, and convenience to balance school and life responsibilities were seen as advantages by participants. Conclusions: What began as an initial discussion between nursing students (who were struggling to ensure their practice was safe, ethical, and competent) and faculty initiated a journey which provided richness of practice, both education and clinical, to all who were involved. Increased awareness by faculty to intentionally integrate caring, suffering, and ethical dilemmas concepts into a classroom setting may enhance the student's future practice by preparing them as competent, conscientious, and compassionate nurses

The patient acceptable symptom state in oral lichen planus: identification of cut-off threshold scores in measures of pain and quality of life

Objectives: To establish thresholds of pain and quality of life scores corresponding to patient acceptable symptom state (PASS) in patients with oral lichen planus (OLP) and to assess demographic and clinical factors associated with achieving the PASS. / Methods: Prospective data from baseline and 4-month follow-up including Visual Analogue Scale (VAS), Numerical Rating Scale (NRS), 14-item Oral Health Impact Profile (OHIP-14) and 15-item and 26-item Chronic Oral Mucosal Disease Questionnaire (COMDQ-15; COMDQ-26) were collected from 281 patients with OLP. An anchoring approach based upon the patient’s opinion on acceptability of OLP status was applied. Associated factors for achieving the PASS were analysed using multivariate logistic regression. / Results: About two-thirds (68.7%) of participants rated their OLP status as acceptable. Cut-off thresholds for PASS were as follows: ≤ 28 mm for VAS, ≤ 3 for NRS, ≤ 18 for total OHIP-14, ≤ 26 for total COMDQ-15 and ≤ 48 for total COMDQ-26. Based upon results of multivariate logistic analysis, factors associated with being in PASS were lower pain intensity, lower depressive symptoms and lower disease activity of OLP. / Conclusion: The present study established PASS cut-off thresholds as a tool facilitating interpretation of pain and quality of life outcomes relevant to individuals with OLP. / Clinical relevance: Identified PASS estimates could be utilised as clinically important endpoints in clinical practice of OLP as well as eligibility criteria for recruiting participants in clinical trials assessing effectiveness of symptomatic intervention of OLP

Online Information on the Treatment of Burning Mouth Syndrome: Quality and Readability

Aims: the aims of this study were to evaluate the quality and readability of online information regarding the treatment of BMS. Methods: An Internet search using the phrase ‘burning mouth syndrome treatment’ was carried out on the Google search engine (www.google.co.uk) on June 8th 2015. The first 100 websites listed were then examined. Data collection included DISCERN score, the Journal of the American Medical Association (JAMA) benchmarks for website analysis score, the presence of the Health on the Net (HON) seal and the Flesch Reading Ease Score. Descriptive statistics were performed using Microsoft Office Excel. Results: The search strategy initially yielded 635,000 links and following the application of the exclusion criteria 53 sites remained for analysis. The overall DISCERN score varied between websites, with half of all websites achieving an overall score of 2 and none of these websites achieving the maximum score of 5 (2.4 ± 0.7). Only 18.9% (10) of the websites achieved the four JAMA benchmarks while 5.7% (3) of the websites had not achieve any of them. Nine of the 53 assessed websites (17%) displayed the HON seal. The Flesch Reading Ease scores (FRES) of the websites ranged between 32.4 and 82.2. The mean rating was 55.4 (±10.7), which is considered to reflect fairly difficult reading. Conclusion: In conclusion, the information available online regarding BMS is of questionable quality and content. Perhaps engaging patients in determining what type and format of information they desire when searching online for health information could guide clinicians and researchers alike in providing such reliable and readable information sources