Dental professionals’ role perceptions in relation to periodontal (gum) disease explanations
A thematic discourse analysis approach
DOI:
https://doi.org/10.1558/cam.20929Keywords:
behaviour change, dental communication, dental hygienists / dental therapists, dentists, periodontal (gum) disease, thematic discourse analysisAbstract
Objective: To use a discourse analysis approach to identify salient features in the lived experiences of dental professionals in relation to explaining periodontal (gum) disease to patients.
Methods: Interview data from 13 UK-trained and three internationally-trained dental professionals was examined using thematic discourse analysis. The first stage (discourse analysis) focused on the identification of language patterns in the interview data. This stage forms the focus of this paper.
Findings: Six discourse categories (Clinician, Mentor, Educator, Collaborator, Rapport Builder, Professional) were identified that related to the participants’ perceived professional roles. The categories were associated with differing worldviews and language use patterns, but with some overlap. All interviewees used a variety of discourse categories in their accounts, but a few relied predominantly on one category, e.g., Clinician or Mentor.
Conclusions: The local discourse categories identified in this study reflect broader discourses in healthcare relating to the roles of providers and patients, which have evolved through time.
Practice implications: Practising dental professionals are faced with a diverse range of patients who have different communication preferences. A suite of discourse categories can act as a ‘toolbox’ that dental professionals can flexibly draw on when needing to adopt a role that could predispose a particular patient to positive oral health behaviour change.
References
Ahmed, Hafeez (2017) Oral health: What is gum disease? British Dental Journal 222 (5): 323. https://doi.org/10.1038/sj.bdj.2017.196
Alexander, Karyn, Bianca Brijnath and Danielle Mazza (2014) Barriers and enablers to delivery of the Health Kids Check: An analysis informed by the Theoretical Domains Framework and COM-B model. Implementation Science 9: Article 60. https://doi.org/10.1186/1748-5908-9-60
Alrawiai, Sumaiah, Koula Asimakopoulou and Sasha Scambler (2019) Dentists’ perceptions of a practical model of patient-centred care: Providing information and choice in a dental consultation. Psychology, Health and Medicine 24 (9): 1090–1099. https://doi.org/10.1080/13548506.2019.1595682
Apelian, Nareg, Jean-Noel Vergnes and Christophe Bedos (2020) Is the dental profession ready for person-centred care? British Dental Journal 229 (2): 133–137. https://doi.org/10.1038/s41415-020-1650-3
Asimakopoulou, Koula, Matthew Nolan, Claire McCarthy and Jonathan Newton (2019) The effect of risk communication on periodontal treatment outcomes: A randomized controlled trial. Journal of Periodontology 90 (9): 948–956. https://doi.org/10.1002/JPER.18-0385
Atkins, Lou, Jill Francis, Rafat Islam, Denise O’Connor, Andrea Patey, Noah Ivers, Robbie Foy, Eilidh Duncan et al. (2017) A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. Implementation Science 21: Article 77. https://doi.org/10.1186/s13012-017-0605-9
Barrat, M. Christine (2015) Untitled comment added 2 August to article ‘Periodontal monitoring’. Dental Protection, 27 August 2014. Online: https://web.archive.org/web/20170609200029/https://www.dentalprotection.org/new-zealand/publications-resources/clinical-audit-tools/clinical-audit-tools-display/2014/08/27/periodontal-monitoring
Batchelor, Paul (2014) Is periodontal disease a public health problem? British Dental Journal 217 (8): 405–409. https://doi.org/10.1038/sj.bdj.2014.912
Barnes, Rebecca (2019) Conversation analysis of communication in medical care: Description and beyond. Research on Language and Social Interaction 52 (3): 300–315. https://doi.org/10.1080/08351813.2019.1631056
Boiko, Olga V. (2010) Dentist-patient communication: How do the models correspond? Social Science and Dentistry 1 (2): 57–67.
Boman, Ase, Ina Borup, Lene Povlsen and Elisabeth Dahlborg Lyckhage (2012) Parents’ discursive resources: Analysis of discourses in Swedish, Danish and Norwegian health care guidelines for children with Diabetes type 1. Scandinavian Journal of Caring Sciences 26 (2): 363–371. https://doi.org/10.1111/j.1471-6712.2011.00942.x
Bowman, Marion (2021) A framework for scaffolding academic reflective writing in dentistry. European Journal of Dental Education 25 (1): 35–49. https://doi.org/10.1111/eje.12575
Bowman, Marion, Ruth Payne, Karen Vinall-Collier and Aradhna Tugnait (2022) Conversation, discourse and linguistic analysis in dental communication: Valuable but under-used approaches. British Dental Journal 232 (12): 875–878. https://doi.org/10.1038/s41415-022-4348-x
Braun, Virginia and Victoria Clarke (2006) Using thematic analysis in Psychology. Qualitative Research in Psychology 3 (2): 77–101. https://doi.org/10.1191/1478088706qp063oa
Bridges, Susan M., Colman McGrath, Cythia K. Y. Yiu and Brenda S. S. Cheng (2010) ‘Reassuring’ during clinical examinations. Journal of Asian Pacific Communication. 20 (2): 85–206. https://doi.org/10.1075/japc.20.2.02bri
Cane, James, Denise O’Connor and Susan Michie (2012) Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation Science 7: Article 37. https://doi.org/10.1186/1748-5908-7-37
Carey, Jim A., Anna Madill and Michael Manogue (2010) Communication skills in dental education: A systematic review. European Journal of Dental Education 14: 69-78. https://doi.org/10.1111/j.1600-0579.2009.00586.x
Chapple, Ian L., Fridua Van der Weijden, Christof Doerfer, David Herrera, Lior Shapira, David Polak, Phoebus Madianos, Anna Louropoulou et al. (2015) Primary prevention of periodontitis: Managing gingivitis. Journal of Clinical Periodontology. 42 (16): S71–S76. https://doi.org/10.1111/jcpe.12366
Cheek, Julianne (2004) At the margins? Discourse analysis and qualitative research. Qualitative Health Research 14 (8): 1140–1150. https://doi.org/10.1177/1049732304266820
Cobban, Sandra J., Eunice M. Edgington, Florence Myrick and Louanne Keenan (2009) A discourse on the nature of dental hygiene knowledge and knowing. International Journal of Dental Hygiene 7: 10–16. https://doi.org/10.1111/j.1601-5037.2008.00315.x
Crawford, Tonia, Peter Roger and Sally Candlin (2017) The interactional consequences of ‘empowering discourse’ in intercultural patient education. Patient Education and Counseling 100 (3): 405–500. https://doi.org/10.1016/j.pec.2016.09.017
Croft, Phil, Deborah A. White, Connie M. D. Wiskin and Teresa F. Allan (2005) Evaluation by dental students of a communication skills course using professional role-players in a UK school of dentistry. European Journal of Dental Education 9 (1): 2–9. https://doi.org/10.1111/j.1600-0579.2004.00349.x
Cross, Duncan and Ann Smalldridge (2011) Improving written and verbal communication skills for international medical graduates: A linguistic and medical approach. Medical Teacher 33: e364–e367. https://doi.org/10.3109/0142159X.2011.577469
Dahm, Maria, Lynda Yates, Kathryn Ogden, Kim Rooney and Brooke Sheldon (2015) Enhancing international medical graduates’ communication: The contribution of applied linguistics. Medical Education 49 (8): 828–837. https://doi.org/10.1111/medu.12776
Davis, Karen (2011) Power words in periodontal communication. Online: https://www.rdhmag.com/patient-care/radiology/article/16408614/power-words-in-periodontal-communication
D’Cruz, Len (2010) Risk management in clinical practice. Part 1: Introduction. British Dental Journal 209 (1): 19–23. https://doi.org/10.1038/sj.bdj.2010.579
Dental Defence Union (2014) Probing deeper into periodontics claims. DDU Journal (April): 9–11.
Dental Protection (2016) Dental Protection Horizons Roadshow 2015: How to avoid becoming a statistic. Online: http://www.dentalprotection.org/uk/about/media-centre/press-releases-display/2015/08/28/dental-protection-horizons-roadshow-2015-how-to-avoid-becoming-a-statistic
Francis, Jill, Denise O’Connor and Janet Curran (2012) Theories of behaviour change synthesised into a set of theoretical groupings: Introducing a thematic series on the theoretical domains framework. Implementation Science 7 (35): 7–35. https://doi.org/10.1186/1748-5908-7-35
General Dental Council (2013) Standards for the Dental Team. London: General Dental Council. Online: https://standards.gdc-uk.org/Assets/pdf/Standards%20for%20the%20Dental%20Team.pdf
General Dental Council (2015) Preparing for Practice: Dental Team Learning Outcomes for Registration (revised edition). London: General Dental Council. Online: https://www.gdc-uk.org/docs/default-source/quality-assurance/preparing-for-practice-(revised-2015).pdf
Heritage, John and Douglas W. Maynard (2006) Problems and prospects in the study of physician-patient interaction: 30 years of research. Annual Review of Sociology 32: 351–374. https://doi.org/10.1146/annurev.soc.32.082905.093959
Hodges, Brian D., Ayelet Kuper and Scott Reeves (2008) Discourse analysis. British Medical Journal 337 (7669): 570–572. https://doi.org/10.1136/bmj.a879
Holden, Alexander (2019) Dentistry and oral health in online media sources. Community Dental Health 36 (3): 221–228.
Holloway, Immy and Kathleen Galvin (2017) Qualitative Research in Nursing and Healthcare (4th edition). Chichester, UK: Wiley Blackwell.
Humphris, Gerry, John Crawford, Kirsty Hill, Angela Gilbert and Ruth Freeman (2013) UK population norms for the modified dental anxiety scale with percentile calculator: Adult dental health survey 2009 results. BMC Oral Health 13 (29): Article PMC3691614. https://doi.org/10.1186/1472-6831-13-29
Jahng, Kristina, Leslie Martin, Carol Golin and Robin DiMatteo (2005) Preferences for medical collaboration: Patient–physician congruence and patient outcomes. Patient Education and Counseling 57 (3): 308–314. https://doi.org/10.1016/j.pec.2004.08.006
Kelly, Aengus (2015) The Ceremonial (Dis)Order of the Clinic: Mapping Engagement in Dental Interactions. Unpublished doctoral dissertation, School of Linguistics, Speech and Communication Sciences University of Dublin, Ireland.
Lupton, Deborah (1992) Discourse analysis: A new methodology for understanding the ideologies of health and illness. Australian Journal of Public Health 16 (2): 145–150. https://doi.org/10.1111/j.1753-6405.1992.tb00043.x
McCrae, Niall and Edward Purssell (2016) Is it really theoretical? A review of sampling in grounded theory studies in nursing journals. Journal of Advanced Nursing 72 (10): 2284–2293. https://doi.org/10.1111/jan.12986
Mishler, Elliot G. (1984) The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex.
NHS Information Centre for Health and Social Care (2009) Adult Dental Health Survey 2009 – Summary Report and Thematic Series. Online: https://digital.nhs.uk/data-and-information/publications/statistical/adult-dental-health-survey/adult-dental-health-survey-2009-summary-report-and-thematic-series
Nowak, Marta, Heather Buchanan and Koula Asimakopoulou (2018) ‘You have to treat the person, not the mouth only’: UK dentists’ perceptions of communication in patient consultations. Psychology, Health & Medicine 23 (6): 752–761. https://doi.org/10.1080/13548506.2018.1457167
O’Neill [as O’Neil], Michaela (2016) The role of hygienists and therapists. Dentistry Online, 16 September. Online: https://www.dentistry.co.uk/2016/09/16/the-role-of-dental-hygienists-and-therapists/
Pearce, Mark, Steven J. Agius, Joan E. Macfarlane and Nicholas Taylor (2015) Supporting dental registrants in difficulty. British Dental Journal 218: Article E5. https://doi.org/10.1038/sj.bdj.2015.97
Potter, Jonathan and Margaret Wetherell (1987) Discourse and Social Psychology: Beyond Attitudes and Behaviour. London: Sage.
Roberts, Celia and Srikant Sarangi (2005) Theme-oriented discourse analysis of medical encounters. Medical Education 39 (6): 632–640. https://doi.org/10.1111/j.1365-2929.2005.02171.x
Roberts, Celia, Val Wass, Roger Jones, Srikant Sarangi and Annie Gillet (2003) A discourse analysis study of ‘good’ and ‘poor’ communication in an OSCE: A proposed new framework for teaching students. Medical Education 37 (3): 197–201. https://doi.org/10.1046/j.1365-2923.2003.01443.x
Sarangi, Srikant (2010) Reconfiguring self/identity/status/role: The case of professional role performance in healthcare encounters Journal of Applied Linguistics and Professional Practice 7 (1): 75–95. https://doi.org/10.1558/japl.v7i1.75
Sarnat, Haim, Pnina Arad, David Hanauer and Elana Shohami (2001) Communication strategies used during paediatric dental treatment: A pilot study. Paediatric Dentistry 23 (3): 337–341.
Smile Aider (2020) Smile Aider (Stakeholder Meaningful Involvement Engagement Aiding Dental Research). School of Dentistry, University of Leeds website. Online: https://medicinehealth.leeds.ac.uk/dir-record/research-projects/1243/smile-aider-stakeholder-meaningful-involvement-engagement-aiding-dental-research
Swenson, Sara L., Stephanie Buell, Patti Zettler, Martha White, Delaney C. Ruston and Bernard Lo (2004) Patient-centred communication: Do patients really prefer it? Journal General Internal Medicine 19 (11): 1069–1079. https://doi.org/10.1111/j.1525-1497.2004.30384.x
Talja, Sanna (1999) Analyzing qualitative interview data: The discourse analytic method. Library and Information Science Research 21 (4): 459–477. https://doi.org/10.1016/S0740-8188(99)00024-9
Taylor, Gary and Jane Ussher (2001) Making sense of S&M: A discourse analytic account. Sexualities 4 (3): 293–314. https://doi.org/10.1177/136346001004003002
Threlfall, Antony G., Carianne M. Hunt, Keith M. Milsom, Martin Tickle and Anthony S. Blinkhorn (2007) Exploring factors that influence general dental practitioners when providing advice to help prevent caries in children. British Dental Journal 202: Article E10. https://doi.org/10.1038/bdj.2007.143
Turner, Daniel (2020) Introducing discourse analysis for qualitative research. Quirkos, 29 September. Online: https://www.quirkos.com/blog/post/discourse-analysis-qualitative-research/
Varela-Centelles, Pablo, Pedro Diz-Iglesias, Ana Estany-Gestal, Juan Seoane-Romero, Rosendo Bugarin-Gonzalez and Juan Seoane (2016) Periodontitis awareness amongst the general public: A critical systematic review to identify gaps in knowledge. Journal of Periodontology 87 (4): 403–415. https://doi.org/10.1902/jop.2015.150458
Walker, Tom W. M., Carla Fleming, Ashwin Kerai, S. Hall, Dylan Rakhra, Jeremy P. Horwood, Andrea E. Waylen and S. J. Thomas (2018) Are dental students well-equipped to deal with difficult communication situations? British Dental Journal 224: 163–168. https://doi.org/10.1038/sj.bdj.2018.44
Waylen, Andrea E., Gregory Makoul and Y. Albeyatti (2015) Patient-clinician communication in a dental setting: A pilot study. British Dental Journal 218: 585–588. https://doi.org/10.1038/sj.bdj.2015.389
Weston, Cynthia, Terry Gandell, Jacinthe Beauchamp, Lynne McAlpine, Carol Wiseman and Cathy Beauchamp (2001) Analyzing interview data: The development of a coding system, Qualitative Sociology 24 (3): 381–400. https://doi.org/10.1023/A:1010690908200
Published
Issue
Section
License
copyright Equinox Publishing Ltd.