Healthcare avoidance: a qualitative study of dental care avoidance in Germany in terms of emergent behaviours and characteristics

Abstract Background The treatment of acute pain is part of everyday dental practice. Often, these symptoms result from years of patients' inadequate or missing dental routines and lead to a reduction in the quality of life or health of the patients and to high costs for the health care system....

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Autores principales:	Isabell Gragoll, Lukas Schumann, Monique Neubauer, Christina Westphal, Hermann Lang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Healthcare avoidance Dental care avoidance Avoidance of the dentist Avoidant behavior Qualitative study Typology Dentistry RK1-715
Acceso en línea:	https://doaj.org/article/70dacbca53d24ee2960ba923143491f6
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spelling	oai:doaj.org-article:70dacbca53d24ee2960ba923143491f62021-11-14T12:32:03ZHealthcare avoidance: a qualitative study of dental care avoidance in Germany in terms of emergent behaviours and characteristics10.1186/s12903-021-01933-11472-6831https://doaj.org/article/70dacbca53d24ee2960ba923143491f62021-11-01T00:00:00Zhttps://doi.org/10.1186/s12903-021-01933-1https://doaj.org/toc/1472-6831Abstract Background The treatment of acute pain is part of everyday dental practice. Often, these symptoms result from years of patients' inadequate or missing dental routines and lead to a reduction in the quality of life or health of the patients and to high costs for the health care system. Despite the enormous advantages of modern dentistry, many patients avoid going to the dentist. Therefore, the study aimed to determine the reasons and behaviours that cause patients to avoid visits to the dentist. Methods We conducted semi-structured interviews with patients who had an above-average DMFT index and had been going to the dentist only irregularly for years. The sample participants were recruited from the northern German region of Mecklenburg-Western Pomerania. 20 individual interviews were recorded, transcribed verbatim and coded. We used a qualitative framework approach to code the transcripts in order to establish a consensus among the researchers. Ultimately, through discussions and reviews of the attributes and meaning of the topics, a typology could be established. Results A typology of patients who avoid the dentist was developed. Four independent characteristic patterns of dentist avoidance could be developed: avoiding the dentist due to "distance" (type A; includes subtype A1 "avoiding the dentist due to negligence" and subtype A2 "dental avoidance due to neutralization"), "disappointment" (type B), "shame" (type C), and "fear" (type D). Using the typology as a generalised tool to determine the minimum and maximum contrasts, it was possible to capture the diversity and multidimensionality of the reasons and behaviours for avoidance. All patients had negative dental experiences, which had led to different avoidance patterns and strategies. Conclusions The identified avoidance characteristics represent a spectrum of patients from Northern Germany who avoid going to the dentist. This is the first comprehensive study in Germany representing avoidance behaviour of dentist patients in the form of a typology. The results suggest that dentistry also needs qualitative research to better understand patient characteristics and provide direct access to patients who avoid regular dental visits. Thus, the results make a potentially fundamental contribution to the improvement of dental care and enrich its understanding.Isabell GragollLukas SchumannMonique NeubauerChristina WestphalHermann LangBMCarticleHealthcare avoidanceDental care avoidanceAvoidance of the dentistAvoidant behaviorQualitative studyTypologyDentistryRK1-715ENBMC Oral Health, Vol 21, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Healthcare avoidance Dental care avoidance Avoidance of the dentist Avoidant behavior Qualitative study Typology Dentistry RK1-715
spellingShingle	Healthcare avoidance Dental care avoidance Avoidance of the dentist Avoidant behavior Qualitative study Typology Dentistry RK1-715 Isabell Gragoll Lukas Schumann Monique Neubauer Christina Westphal Hermann Lang Healthcare avoidance: a qualitative study of dental care avoidance in Germany in terms of emergent behaviours and characteristics
description	Abstract Background The treatment of acute pain is part of everyday dental practice. Often, these symptoms result from years of patients' inadequate or missing dental routines and lead to a reduction in the quality of life or health of the patients and to high costs for the health care system. Despite the enormous advantages of modern dentistry, many patients avoid going to the dentist. Therefore, the study aimed to determine the reasons and behaviours that cause patients to avoid visits to the dentist. Methods We conducted semi-structured interviews with patients who had an above-average DMFT index and had been going to the dentist only irregularly for years. The sample participants were recruited from the northern German region of Mecklenburg-Western Pomerania. 20 individual interviews were recorded, transcribed verbatim and coded. We used a qualitative framework approach to code the transcripts in order to establish a consensus among the researchers. Ultimately, through discussions and reviews of the attributes and meaning of the topics, a typology could be established. Results A typology of patients who avoid the dentist was developed. Four independent characteristic patterns of dentist avoidance could be developed: avoiding the dentist due to "distance" (type A; includes subtype A1 "avoiding the dentist due to negligence" and subtype A2 "dental avoidance due to neutralization"), "disappointment" (type B), "shame" (type C), and "fear" (type D). Using the typology as a generalised tool to determine the minimum and maximum contrasts, it was possible to capture the diversity and multidimensionality of the reasons and behaviours for avoidance. All patients had negative dental experiences, which had led to different avoidance patterns and strategies. Conclusions The identified avoidance characteristics represent a spectrum of patients from Northern Germany who avoid going to the dentist. This is the first comprehensive study in Germany representing avoidance behaviour of dentist patients in the form of a typology. The results suggest that dentistry also needs qualitative research to better understand patient characteristics and provide direct access to patients who avoid regular dental visits. Thus, the results make a potentially fundamental contribution to the improvement of dental care and enrich its understanding.
format	article
author	Isabell Gragoll Lukas Schumann Monique Neubauer Christina Westphal Hermann Lang
author_facet	Isabell Gragoll Lukas Schumann Monique Neubauer Christina Westphal Hermann Lang
author_sort	Isabell Gragoll
title	Healthcare avoidance: a qualitative study of dental care avoidance in Germany in terms of emergent behaviours and characteristics
title_short	Healthcare avoidance: a qualitative study of dental care avoidance in Germany in terms of emergent behaviours and characteristics
title_full	Healthcare avoidance: a qualitative study of dental care avoidance in Germany in terms of emergent behaviours and characteristics
title_fullStr	Healthcare avoidance: a qualitative study of dental care avoidance in Germany in terms of emergent behaviours and characteristics
title_full_unstemmed	Healthcare avoidance: a qualitative study of dental care avoidance in Germany in terms of emergent behaviours and characteristics
title_sort	healthcare avoidance: a qualitative study of dental care avoidance in germany in terms of emergent behaviours and characteristics
publisher	BMC
publishDate	2021
url	https://doaj.org/article/70dacbca53d24ee2960ba923143491f6
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Healthcare avoidance: a qualitative study of dental care avoidance in Germany in terms of emergent behaviours and characteristics

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