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The ' Clinical Humanities & Wellbeing programme'- sustainable healthcare education for an era of uncertainty. Int Rev Psychiatry 2023; 35:636-644. [PMID: 38461386 DOI: 10.1080/09540261.2023.2262026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/12/2023] [Indexed: 03/11/2024]
Abstract
This article presents a case study where integration of arts and humanities into a clinical programme is being implemented at scale, as core mandatory learning for all students within a UK dental, undergraduate context. The cross-disciplinary programme described, that integrates the Humanities with Clinical Sciences, is a longitudinal professional identity formation curriculum for sustainable oral healthcare which aligns with the UK dental regulator's proposals for a 'safe practitioner' framework for new graduates. The Clinical Humanities & Wellbeing modules embrace the emotional and attitudinal aspects of learning and educate clinical students for the practical wisdom (phronesis) required to deliver 21st century oral healthcare in an era of uncertainty. The overarching aim of the curriculum and its accompanying assessment is to promote critical reflection, student insight and development of integrity, reflexivity, and responsibility. Enabling the subjectification of professional identity formation in this cross-disciplinary way aims to develop students as 'safe practitioners', with increased professional autonomy, responsible for their own actions, and who are better equipped for the uncertainties and phronesis of clinical practice. At present, the programme is being evaluated, employing illuminative evaluation methodology and we present some tentative initial findings. The authors believe that this unique approach and signature pedagogy is, with careful curation, transferrable to other health professions' contexts.
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Mental health, psychological distress and burnout in Australian dental practitioners. Aust Dent J 2023; 68:160-170. [PMID: 37199455 DOI: 10.1111/adj.12961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Dental practitioners are known to experience a high level of stress, but little is known about the mental health of Australian dental practitioners. The aim of this study was to investigate the prevalence of mental health conditions among Australian dental practitioners. METHODS A cross sectional survey of 1483 Australian dental practitioners was carried out from October to December 2021. Participants reported aspects of mental health including depression, anxiety disorder, burnout (Sydney Burnout Measure) and psychological distress (Kessler Psychological Distress Scale and General Health Questionnaire 12). RESULTS Self-reported psychological distress was high, with 32.0% rated as having moderate or severe psychological distress and 59.4% a high likelihood of minor (or more severe) psychological distress. One in four participants (24.8%) were classified as likely to be experiencing burnout, with 25.9% reporting ever having a diagnosis of depression, 11.4% a current diagnosis of depression, 23.1% ever having a diagnosis of anxiety disorder and 12.9% a current diagnosis of anxiety disorder. CONCLUSION Australian dental practitioners reported a high burden of psychological distress, burnout and mental health issues, suggesting a need for education and programmes to support their mental health and wellbeing. © 2023 Australian Dental Association.
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Australian dental practitioners experience of burnout. J Public Health Dent 2023; 83:397-407. [PMID: 38018025 DOI: 10.1111/jphd.12594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 07/27/2023] [Accepted: 11/03/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND The aim of this study was to investigate factors associated with burnout in Australian dental practitioners. METHODS A cross-sectional survey of 1483 Australian dental practitioners was conducted from Oct to Dec 2021. Participants reported burnout using the Sydney Burnout Measure, and aspects of mental health including psychological distress, depression, and anxiety disorders. Predictors of burnout were explored using a generalized linear model with a stepped approach including demographic, health and risk factor variables. RESULTS One in four participants were classified as likely to be experiencing burnout. Burnout was associated with working in a regional/rural location (β = 2.82, p < 0.001), an academic/non-clinical role (β = 5.01, p = 0.037), more years of experience as a dental practitioner (β = 0.08, p = 0.022), a current diagnosis of depression (β = 2.38, p = 0.049), moderate/severe psychological distress (β = 7.16, p < 0.001), poor self-rated physical health (β = 5.84, p < 0.001) and increasing alcohol consumption (β = 0.17, p = 0.020). Participants who scored high on resilience (β = -0.23, p = 0.002) or perfectionism (β = -0.24, p < 0.001) had lower burnout scores. CONCLUSION Australian dental practitioners appear to be at high risk of burnout which may impact on their health and wellbeing and ability to deliver patient care. There is a need for support services to manage burnout and education to address workplace and environmental factors that may contribute to burnout.
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Effect of the COVID-19 pandemic on depression, perceived stress and hypochondria of frontline dental staff (FDS): A cohort study. Work 2023:WOR220370. [PMID: 36710707 DOI: 10.3233/wor-220370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The coronavirus 2019 (COVID-19) pandemic had several mental effects on medical staff. OBJECTIVE This study intended to evaluate deviations in Frontline Dental Staff (FDS) depression, perceived stress and hypochondria during the COVID-19 outbreak, and to assess whether the existence of potential risk-factors influenced these symptoms over time. METHODS This prospective cohort study surveyed FDS three periods from February 1, 2021 to April 8, 2022. FDSs' mental health was assessed through Beck Depression Inventory, Cohen Perceived Stress and the Evans Self-Illness Questionnaires; multivariate linear regression were used to identify potential factors associated with changes on each outcome (depression, perceived stress and hypochondria) over time. All analyses were performed in STATA ver.14. RESULTS In a total of 635 FDS, about 69%, 83%, and 71% reported relative depression, 77%, 87%, and 64% reported moderate to high stress level, and 60%, 76% and 74% reported moderate hypochondriac from first, second, and third survives, respectively. The mean and standard deviation of the variables increased dramatically at second survive (July 17 to October 21, 2021) and decreased again at third survive significantly. Being female, working in public sector, and low socioeconomic level were main predictors of higher levels of depression (p < 0.001) and perceived stress (p < 0.001). Perceived stress was a strong predictor of high-level depression (t = 7.79, p < 0.001). CONCLUSION FDSs' depression, stress and hypochondria were high and positively associated with being female, working in public-sector, and low socioeconomic level. To increase the effectiveness and decrease work burnout, psychological support should be provided.
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Mental health and wellbeing interventions in the dental sector: a systematic review. Evid Based Dent 2022:10.1038/s41432-022-0831-0. [PMID: 36477677 PMCID: PMC9735078 DOI: 10.1038/s41432-022-0831-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/30/2022] [Indexed: 12/13/2022]
Abstract
Introduction UK dentists experience high levels of stress, anxiety and burnout. Poor mental health can lead practitioners to exit the profession, contributing to workforce and service loss. Therefore, there is a need to focus on interventions to protect the mental health and wellbeing of dental teams. Three levels of intervention can be deployed in the workplace to support mental health and wellbeing: primary prevention, secondary prevention, and tertiary prevention.Aim The aim of this systematic review was to identify evidence on interventions used to prevent, improve or tackle mental health issues among dental team members and dental profession students in countries of very high development.Methods This systematic review was conducted according to a predefined protocol and reported according to PRISMA guidelines. The MEDLINE, Embase CINAHL, DOSS, Scopus, and PsycINFO databases were searched. Prospective empirical studies were considered for inclusion. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) was used to assess the methodological quality of the included studies. The identified interventions were categorised according to level of prevention.Results The search yielded 12,919 results. Eight studies met the inclusion criteria. All of the studies concerned dentists or dental students. There were no studies for other groups of dental professionals. No primary prevention-level studies were identified. Secondary prevention-level studies (n = 4) included various psychoeducational interventions aiming to raise awareness and improve coping skills and led to significant improvements in stress levels and burnout of dentists and dental students. Tertiary prevention-level studies (n = 4) mainly employed counselling which was shown to be beneficial for dentists and students experiencing psychological ill-health.Conclusions Mental wellbeing awareness should be put at the centre of dental education and the workplace. Leadership and innovation are required to design primary-level interventions which can be implemented in the UK dental sector, with its distinct organisational and service characteristics.
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Moving on. BDJ IN PRACTICE 2022. [PMCID: PMC9168634 DOI: 10.1038/s41404-022-1164-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Analysis of occupational stress, burnout, and job satisfaction among dental practitioners. Work 2022; 72:323-331. [DOI: 10.3233/wor-210555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Dental practitioners can be prone to stress because of the long working hours, high patient expectations, and work environment. OBJECTIVE: To investigate dimensions of occupational stress among dental practitioners leading to burnout and to model its causality with job satisfaction. METHODS: An analytical cross-sectional study was conducted for five months. A sample of 302 practicing dental practitioners was selected using the consecutive sample technique. This sample included dental practitioners working in clinical and non-clinical departments of public and private sector universities as well as those doing private general practice. A self-administered structured questionnaire based on the Work Stress Questionnaire was sent using Survey Monkey. Descriptive statistics were calculated. Spearman correlation was applied between stress scores and job satisfaction. A Chi-square test was applied to look into the association between stress levels and different categories. Univariate and multivariate analysis was performed. RESULT: The prevalence of overall occupational stress was high among dental practitioners (83.4%). Occupational stress was greatest in females (55.8%), dental practitioners in the private sector (55.7%), and general dental practitioners (GDPs) (47%). The overall prevalence of job satisfaction among dental professionals was 30%. Occupational stress was significantly associated with burnout and job dissatisfaction in dentistry. Stress levels and working hours were statistically and positively associated, whereas the association between stress levels and job satisfaction was inversely and significantly associated. CONCLUSION: The prevalence of occupational stress among dental practitioners was high and the level of job satisfaction was moderate. The model between these variables was well-fitted.
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Uncertainty and Fears Around Sustainability: A Qualitative Exploration of the Emotional Reactions of Dental Practitioners and Dental Care Professionals During COVID-19. FRONTIERS IN ORAL HEALTH 2022; 2:799158. [PMID: 35128524 PMCID: PMC8813960 DOI: 10.3389/froh.2021.799158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/20/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Recent cross-sectional surveys have shown the detrimental impact of COVID-19 on the health and well-being of dental practitioners and dental care professionals. This qualitative study complements the growing quantitative evidence base with an in-depth exploration of the lived experiences of those working in primary care dental teams in Scotland. METHODS Focus groups were carried out with primary care dental team members and trainees between July and October 2020. Olsen's tripartite framework of health service sustainability was operationalised to explore how participants experienced uncertainty and their attempts to sustain dental services. RESULTS Analysis revealed significant concerns surrounding the sustainability of dental services and dental training programmes as a consequence of the emergency level response to the pandemic. Restrictions on dentistry were seen to be severely impeding desirable clinical outcomes, particularly for the most vulnerable groups. Participants experienced being unable to deliver high quality care to their patients as both confusing and distressing. The capability of the dental health care system to meet a growing backlog of dental need and manage this effectively in a pandemic era was called in to serious question. Ongoing uncertainties were affecting how participants were thinking about their professional futures, with stress about income and employment, along with heightened experiences of professional isolation during the pandemic, resulting in some looking at possibilities for retraining or even considering leaving their profession altogether. DISCUSSION The impact of the pandemic has produced considerable uncertainty regarding the sustainability of dental services in the medium to longer term. It has also served to expose the uncertainties practitioners grapple with routinely as they attempt to sustain their NHS dental service delivery. CONCLUSION This study brings in to sharp focus the diversity of challenges, confusions and uncertainties experienced by dental practitioners and dental care professionals during the COVID-19 pandemic and the need for suitable and ongoing measures to be put in place to support their mental well-being.
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Exploring the Effect of the COVID-19 Pandemic on the Dental Team: Preparedness, Psychological Impacts and Emotional Reactions. FRONTIERS IN ORAL HEALTH 2022; 2:669752. [PMID: 35048012 PMCID: PMC8757713 DOI: 10.3389/froh.2021.669752] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/31/2021] [Indexed: 12/03/2022] Open
Abstract
Background: The COVID-19 pandemic has placed increased demands on clinical staff in primary dental care due to a variety of uncertainties. Current reports on staff responses have tended to be brief enquiries without some theoretical explanation supported by developed measurement systems. Aim: To investigate features of health and well-being as an outcome of the uncertainties surrounding COVID-19 for dentists and dental health professionals in primary dental care and for those in training. In addition, the study examined the well-being indices with reference to normative values. Finally a theoretical model was explored to explain depressive symptoms and investigate its generalisability across dentists and dental health professionals in primary dental care and those in postgraduate training. Methods: A cross-sectional survey of dental trainees and primary dental care staff in Scotland was conducted in June to October 2020. Assessment was through “Portal,” an online tool used for course bookings/management administered by NHS Education for Scotland. A non-probability convenience sample was employed to recruit participants. The questionnaire consisted of four multi-item scales including: preparedness (14 items of the DPPPS), burnout (the 9 item emotional exhaustion subscale and 5 items of the depersonalisation subscale of the MBI), the 22 item Impact of Event Scale-Revised, and depressive symptomatology using the Patient Health Questionnaire-2. Analysis was performed to compare the levels of these assessments between trainees and primary dental care staff and a theoretically based path model to explain depressive symptomology, utilising structural equation modelling. Results: Approximately, 27% of all 329 respondents reported significant depressive symptomology and 55% of primary care staff rated themselves as emotionally exhausted. Primary care staff (n = 218) felt less prepared for managing their health, coping with uncertainty and financial insecurity compared with their trainee (n = 111) counterparts (all p's < 0.05). Depressive symptomology was rated higher than reported community samples (p < 0.05) The overall fit of the raw data applied to the theoretical model confirmed that preparedness (negative association) and trauma associated with COVID-19 (positive association) were significant factors predicting lowered mood (chi-square = 46.7, df = 21, p = 0.001; CFI = 0.98, RMSEA = 0.06, SRMR = 0.03). Burnout was indirectly implicated and a major path from trauma to burnout was found to be significant in primary care staff but absent in trainees (p < 0.002). Conclusion: These initial findings demonstrate the possible benefit of resourcing staff support and interventions to assist dental staff to prepare during periods of high uncertainty resulting from the recent COVID-19 pandemic.
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The impact of the COVID-19 pandemic on the mental health of dentists in Wales. Br Dent J 2022; 232:44-54. [PMID: 35031746 PMCID: PMC8758985 DOI: 10.1038/s41415-021-3756-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/30/2021] [Indexed: 01/21/2023]
Abstract
Introduction The COVID-19 pandemic has had a large impact on dentistry across Wales. Dentists were facing significant levels of psychological distress prior to the pandemic, so it was important to monitor dentists' mental health during this unprecedented challenge. Aims To gain both an understanding of the impact that the COVID-19 pandemic has been having on the mental health of dentists working in Wales, as well as understanding the levels of stress the pandemic has caused. We also aimed to understand the specific causes of stress. Results High levels of stress were found, with 82% of respondents saying stress levels in the dental team have increased noticeably. Three-quarters of respondents have gone to work despite not feeling mentally well enough. Working conditions and financial pressures caused by the pandemic have directly impacted the mental health of many dentists. As a result, they have been using both adaptive and maladaptive coping methods to cope with the stress of the pandemic, with over one-third of respondents drinking alcohol more frequently than before the pandemic. Conclusions The pandemic has had a profound impact on the professional lives of dentists working in Wales. Their interactions with patients and colleagues have been greatly affected, as well as their work and working conditions. These have all substantially contributed to increased stress levels. Without significant improvements to the working conditions of dentists, as well as continued psychological support, large-scale burnout in the future is not only possible, but likely. Provides detailed information of the stressors dentists dealt with during the pandemic and looks at how many dentists cannot cope with the stress of their job during the pandemic. Looks at the maladaptive coping methods dentists have used over the course of the pandemic, such as alcohol and nicotine products, as well as the adaptive coping methods dentists have used, such as walks and mindfulness. Discusses how many dentists went to work despite not feeling mentally well enough to do so, plus looks at the impact the pandemic has had on dentists' sleep. Looks at the working conditions dentists in Wales are facing due to the pandemic and the way different aspects of dentistry have been affected.
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Burnout, lifestyle and relaxation among dentists in Lithuania: a cross-sectional study. BMC Health Serv Res 2021; 21:1098. [PMID: 34654421 PMCID: PMC8520307 DOI: 10.1186/s12913-021-07074-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/22/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The aim of this study was to estimate the association of burnout level with lifestyle and relaxation among dentists in Lithuania. A better understanding of this association could help in the development of targeted interventions to prevent burnout among these professionals. METHODS The survey was conducted among practising dentists (N = 380) using the Maslach Burnout Inventory (MBI) and an authors' proposed scale to measure lifestyle and relaxation. Poisson regression was applied to examine the association between variables. RESULTS Regular cigarette smoking among dentists in Lithuania was 16.8 % and alcohol consumption was 31.3 %. Some forms of active relaxation were also common: regular playing sports (57.9 %), and spending time in nature (61.4 %). Emotional exhaustion (EE) and depersonalization (DP) burnout dimensions were negatively related to the regular use of illegal substances, alcohol, medication and smoking, while personal achievement (PA) was negatively related to smoking only. Dentists who regularly exercised had significantly lower EE and DP sum scores, and better assessments of PA. There were also positive relationships of EE, DP and PA sum scores with the variables of relaxation (e.g., spending time with family or friends, visiting a theatre, engaging in art, listening to music). CONCLUSIONS It was concluded that the burnout dimensions are negatively associated with unhealthy lifestyle factors and positively associated with active relaxation among dentists in Lithuania. Therefore, burnout prevention should target specific lifestyle and relaxation improvement strategies.
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The future of dentistry post-COVID-19: perspectives from Urgent Dental Care centre staff in England. Br Dent J 2021:10.1038/s41415-021-3405-1. [PMID: 34552211 PMCID: PMC8456399 DOI: 10.1038/s41415-021-3405-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/22/2021] [Indexed: 12/04/2022]
Abstract
Introduction While routine dentistry was suspended during the COVID-19 pandemic, Urgent Dental Care centres (UDCs) were established to support patients with urgent dental needs.Aim The study aimed to provide insights and recommendations on future dental reform based on the perspectives of frontline staff delivering dental care in UDCs.Method A qualitative research study using a phenomenological approach. A hybrid approach that incorporated both a deductive and an inductive approach to analysis was adopted.Results The sample included 29 dentists and nine dental nurses providing care at UDCs in England during the pandemic. The following predominant themes were identified: patient care and access, practice viability, workforce sustainability, identity of dentistry and contract reform.Conclusions The pandemic has highlighted the desire from the dental profession for urgent reform of the current NHS dental contract in England. This was directed towards a more resilient, responsive and equitable dental service that is better prepared for current and future challenges.
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Common Difficult Scenarios for The Newly Qualified Dental Professional. Prim Dent J 2021; 10:63-68. [PMID: 34353155 DOI: 10.1177/20501684211012582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dental complaints are at the forefront of many dental practitioners' thoughts, with most dentists likely to have a complaint against them during their practicing lifetime. Difficult clinical scenarios can be particularly challenging for the newly qualified dental professional to manage, with a lack of experience potentially leading to an increased likelihood of a complaint. This article highlights several common clinical scenarios which dental practitioners are likely to face, providing a framework for their management and assessing the impact that the coronavirus pandemic may have on patients presenting for routine dental care.
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Supporting dentists' health and wellbeing - a qualitative study of coping strategies in 'normal times'. Br Dent J 2021:10.1038/s41415-021-3205-7. [PMID: 34285386 PMCID: PMC8294212 DOI: 10.1038/s41415-021-3205-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/07/2020] [Indexed: 11/18/2022]
Abstract
Background Research has highlighted multiple determinants of dentists' health and wellbeing, and has raised concerns over workforce morale and retention. Limited research has been undertaken on possible solutions. Thus, the aim was to explore the coping strategies used or advocated by dentists to protect and support their health and wellbeing.Methods This qualitative study involved a purposive sample of dentists working in England taking account of age, gender, career stage, work sector, geographical area, position and route of entry to registration. Dentists were approached via gatekeepers across England to participate in semi-structured interviews. A topic guide, informed by past research, was used to guide the discourse. Informants' views were audio-recorded and field notes were made. Data were transcribed and analysed using an interpretative phenomenological approach to generate theory with the support of the framework methodology.Results Twenty dentists were interviewed from a range of backgrounds. Self-reported coping strategies included a range of strategies for 'taking control', including 'embracing self-care' and 'seeking professional support', while drawing on 'supportive personal and social networks'. Managing professional careers included diversifying through greater 'mixing' of NHS with private work, privatising, specialising, or combining dentistry with another role. Strengthening job security and facilitating diversity of experience remain important for supporting the health and wellbeing of dentists. Selling practices or, in the extreme, completely leaving the profession were considered practical options. At organisational level, building sustainable teams and transforming culture were advocated as important; while at systems level, reforming the NHS and bridging the gap between the profession and regulatory body were considered vital. Additionally, the need for strong professional leadership and wider societal debate was advocated as part of a whole systems approach to enable job satisfaction in delivering high-quality, patient-centred, evidence-based care in future.Conclusion While dentists demonstrated a range of coping mechanisms, multi-level action was advocated to enhance the health, wellbeing and retention of dentists. Systems reform at macro- and meso-levels is urgently advocated to enable fulfilling careers within dentistry, particularly for those at the front line of primary dental care in the public sector. Personal resilience alone will not suffice and recommendations for action are explored to avert a public health catastrophe. This is a time for reflection, debate and action.
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Supporting dentists' health and wellbeing - workforce assets under stress: a qualitative study in England. Br Dent J 2021:10.1038/s41415-021-3130-9. [PMID: 34285387 PMCID: PMC8294242 DOI: 10.1038/s41415-021-3130-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/07/2020] [Indexed: 11/08/2022]
Abstract
Background Multiple determinants influence dentists' health and wellbeing. In light of recent concerns, the aim of this research was to explore contemporary influences on dentists' health and wellbeing in England, drawing on their lived experience.Methods Semi-structured interviews were conducted with a purposive sample of dentists working in England, taking into account age, gender, career stage, work sector, geographical area, position and route of entry to registration. A topic guide, informed by the literature, was used to guide the discourse. Dentists were approached via gatekeepers, supported by snowball sampling. Interviews were recorded and transcribed for analysis. Framework analysis was used, taking an interpretative phenomenological approach to develop theory.Results Twenty dentists, from a range of backgrounds, participated in this research. While health and wellbeing was reported to be more positive among dentists in their later career, those in their early career and/or with high NHS work commitments shared concerns about their physical, psychological and emotional health. Influences ranged from macro-level issues relating to professional regulation and health systems, through meso-level, notably their workplace and job specification, to micro-level issues relating to their professional careers, relationships and personal life. Dentists highlighted ethical concerns and feeling driven to deliver, together with being demoralised by a survival culture, all leading to perceived lack of control and reduced professional fulfilment. In contrast, being able to deliver quality care, innovate and effect change, as well as being valued for their delivery, were perceived to positively contribute to general health and wellbeing.Conclusion Dentists have a vital role in providing care for patients, so there are serious public health implications if urgent action is not taken to improve and sustain their health and wellbeing. This study confirms that dentists are affected by multiple contemporary influences, and although greater support is needed for individuals, organisational, system and policy changes may be required to fully address the challenges they face.
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Burnout and Its Relationship with Demographic and Job-Related Variables among Dentists in Lithuania: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083968. [PMID: 33918738 PMCID: PMC8069627 DOI: 10.3390/ijerph18083968] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 12/21/2022]
Abstract
Although burnout has been described as a serious hazard for personal and professional lives and has been surveyed among dentists in many countries, no study has been published regarding burnout among dentists in Lithuania. This study aimed to evaluate the burnout level among Lithuanian dentists and its association with demographic variables, job satisfaction, and other job-related variables. The data were collected among dentists online or during professional conferences while using an anonymous questionnaire (n = 380). The Maslach Burnout Inventory (MBI) was used to evaluate the burnout level. A Poisson regression was applied for the analysis of relationships between variables. We observed that 42.3% of the respondents had a high emotional exhaustion (EE) (95% confidence interval (CI): 37.4-42.3%), while 18.7% (95% CI: 15.0-22.9%) and 28,2% (95% CI: 23.4-32.6%) had high depersonalization (DP) and low personal accomplishment (PA), respectively. Nonetheless, 15.3% (95% CI: 11.8-18.9%) of the study population experienced a high level of overall burnout. An original job satisfaction index was elaborated. It was significantly associated with sum scores of all burnout dimensions: with the EE sum score (Ratio of Sum Score Means (RSSM) 1.54; 95% CI: 1.46-1.62), DP sum score (RSSM 1.59; 95% CI: 1.45-1.74), and PA sum score (RSSM 0.88; 95% CI: 0.84-0.92). It was concluded that Lithuanian dentists can be characterised by high burnout intensity and high prevalence of burnout, being especially evident in emotional exhaustion. The dentist with low job satisfaction appeared to be the most vulnerable to all burnout dimensions.
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Survey of Mental Health of Dentists in the COVID-19 Pandemic in the UK. J Int Soc Prev Community Dent 2021; 11:104-108. [PMID: 33688480 PMCID: PMC7934820 DOI: 10.4103/jispcd.jispcd_401_20] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 11/04/2022] Open
Abstract
Aim To assess the impact of work-related changes on the mental health (MH) of dentists during the peak of COVID-19 pandemic in the UK. Materials and Methods Dentists involved in certain treatments, for example, high-speed drilling procedures, generate infectious aerosols. These Aerosol Generating Procedures (AGPs) are at the highest risk of transmission of coronavirus. During the COVID-19 pandemic, a significant number of dentists in the UK were restricted from providing treatments to reduce the risk of viral transmission. Some of the dentists providing urgent dental treatment were involved in AGPs. Significant and sudden changes in the delivery of dental care in the current pandemic may have impacted the MH of dentists. An online survey was conducted, using validated tools to measure the MH symptoms and stress. Pearson's chi-squared test of independence was used for statistical analysis. Results Overall, 123 dentists participated in the survey. The prevalence of anxiety-related symptoms was 71% (95% CI 0.62-0.78), depression-related symptoms was 60% (95% CI 0.51-0.68), and stress was 92% (95% CI 0.86-0.96). Dentists working in the independent sector had more psychological symptoms compared with those in the public sector (P = 0.014). Conclusions Working in the public sector appeared to have a protective effect. Almost all the dentists in this survey were experiencing MH symptoms and stress. Further research is needed to assess the long-term effect of the COVID-19 pandemic on dentists.
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The Role of Yoga in Treating Stress-Related Symptoms in Dental Hygiene Students. Int J Yoga 2020; 13:213-222. [PMID: 33343151 PMCID: PMC7735503 DOI: 10.4103/ijoy.ijoy_5_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 04/22/2020] [Accepted: 06/01/2020] [Indexed: 11/17/2022] Open
Abstract
Context: Research has provided evidence for yoga's effectiveness in the prevention and treatment of pain and stress, both of which have been implicated as significant negative moderators of student performance and experience. Aims: This study investigated the feasibility and preliminary impact of a 10-week yoga intervention with dental hygiene students to reduce perceptions of stress and stress-related symptoms. Settings and Design: Students self-selected into a yoga treatment versus control condition. They completed stress and pain measures at four time points during and after the intervention or control period of 10-weeks. Methods: Participants were students enrolled in a dental hygiene program. All 77 participants completed a 10-week study, self-selecting into an intervention or control group. They completed three self-report questionnaires assessing pain and stress, administered at baseline, mid-point, postintervention, and two follow-ups. The 10-week yoga intervention consisted of 10 90-min yoga sessions that provided check-ins, breathing exercises, sequences of postures, relaxation exercises, and closing meditations. Statistical Analysis Used: Independent samples t-tests were used to compare perceived stress levels of participants in the control versus treatment groups. Paired t-test was used to assess differences in stress-related symptom levels across time. Results: Results suggested that a yoga intervention is feasible for this group and that active yoga practice can lower perceived stress across multiple domains and across time. Conclusions: A specially adapted and designed 10-week yoga protocol appears to be an accessible option for dental hygiene programs that seek to support their students in improving overall wellbeing.
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Factorial Validity and Variance of the Maslach Burnout Inventory between Demographic and Workload Groups among Dentists of Lithuania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249154. [PMID: 33302386 PMCID: PMC7762601 DOI: 10.3390/ijerph17249154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/02/2020] [Accepted: 12/06/2020] [Indexed: 11/25/2022]
Abstract
There is a lack of evidence about burnout syndrome among Lithuanian dentists; as a reliable instrument to examine the syndrome in this professional group has not yet been tested. The study aimed to investigate the performance of the items and the subscales of the Maslach burnout inventory (MBI) by validating its factorial structure and analyzing its variance between demographic and workload groups of dental professionals in Lithuania. The survey was conducted among practicing dentists online or during the scientific conferences for dentists using an anonymous questionnaire. To evaluate the level of burnout the MBI was chosen. Reports of a total of 380 respondents were examined. Three-factor structure of the MBI with cross-loading of two items suggested a good fit to data (χ2/df = 1.67; CFI = 0.93; TLI = 0.93; IFI = 0.93; and RMSEA = 0.059) and was invariant across demographic and workload groups of dentists. Multigroup factorial analysis revealed that females as compared to males had higher average emotional exhaustion; and the respondents up to 30 years as compared to respondents over 30 years of age had higher averages of the emotional exhaustion and depersonalization components. Highly specialized dentists (oral surgeons, prosthodontists, orthodontists, endodontists and poedodontists) were particularly less prone to burnout syndrome than dentists of general practice. It was concluded that the MBI offers factorial validity and demonstrates its invariant structure and variance of burnout dimensions across demographic and workload groups. These findings are informative for burnout prevention and intervention programs among dentists in Lithuania. Such information may contribute to lessen professional burnout among dentists in Lithuania.
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