patients' experiance about the impact of periodontitis
TRANSCRIPT
Patient’s Experience About the Impact Of Periodontitis
Submitted By, Arya.V.Devi CRRIRajas Dental College
Introduction
Traditionally, research focus on the clinico-pathological mechanisms of the disease rather than its impact on the patient.
This is in line with the historical biomedical approach to disease and illness.
Periodontal disease can exert more than simply biological effects and can affect both the sufferers’ psychology and social functioning.
It is more appropriate to take a biopsychological approach to disease and illness
Clinical relevance Scientific Rationale for the
study
• Investigation of the biopsychosocial effects of periodontitis to improve our understanding of patient perceptions of the impact of periodontal disease
Principle Findings
• Impairment, functional limitation, discomfort(physical &psychological)disability(psychological, social & physical)
• Stigma (negative associations and impressions of periodontal disease for the patient)
Practical implicati
ons
• A central tenet of successful periodontal therapy is behavior change and improved understanding of patients experiences regarding their disease is therefore relevant to help effect such change
Interviews of patients with periodontal conditions were
conducted
Data were organized in a framework and recurrent themes
identified
Interviews occurred until it was felt that no new themes or ideas were being expressed by respondents
(N=14)
MATERIAL
&
METHODS
Results
Impairment
Functional
Limitatio
n
Discomfort
Disabilit
y
Effects Of Periodontal Disease On Patients' Daily Lives
Relevant to the domains of locker's conceptual model of oral health
periodontal
disease
periodontal
disease
Locker's model
Locker's model
Death
Stigma And Retrospective Regret
Definitions Of Domains Of Locker's Model
Domain/ concept Subdivision Definition
Death Mortality rates, life expectancy, potential years of life lost
Impairment Extent of anatomical loss or structural abnormality
Functional limitation Extent of loss of function of body parts or systems
DiscomfortSelf reported physical and psychological distress,
including pain and other feeling states not directly observable
Disability
Physical 1.Activity restriction 2.Social limitation
Psychological 1.Affective states 2.Cognitive states
Social 1.Integrative 2.Social contacts 3.Intimacy
Handicap
Inequality Lack of access to social opportunities
Deprivation Inequality of outcomes in terms of income, self image, self esteem
Dissatisfaction With health and/or overall quality of life
Domain of oral health• Impairment
Periodontal disease • Tooth mobility• Sensitivity of
teeth
Representative quotation• I cannot bite into
an apple and eat it that way, I have got to chop it up.
• On cold days, cold air and things like that, if you breathed in you’d be like “Aargh”, like you were eating an ice cream
Impairment & functional limitation
Domain of oral health • Functional
limitation
As a result of tooth mobility
As a result of sensitivity of teeth
Representative quotation• I have to cut the
apple and eat it from the side of my mouth. I cannot eat a crust or french bread because I felt teeth would fall out
• If I am eating a lolly, I wont bite it. I will bite it at the back of my teeth
I have to bite hard foods at the back of my teeth
Domain of oral health
Discomfort
Discomfort
I’m an person who likes hoootttt coffee… Yummieeee….
One morning it makes sensitivity…Argh…
SENSITIVITY
As its ma favourite… I have to wait till it cools down
And we know
how a cool
coffee
tastes….Awww..
Its no longer ma
favourite
Domain of oral health
Discomfort
HALITOSIS
Domain of oral health
Discomfort
It was easy to eat a full apple before
But later a small bite makes my gums bleed. Aargh….
TOOTH MOBILITY
I have to chop the apple…This makes me awkward…and so I wouldn’t eat with anybody at all
I know I cant eat an apple…it makes me feel my teeth are gonna fall…especially the lower….
Disability
Psychological Disability It’s embarrassing, I don’t say I’ve got gum disease, I’ll say its because my bone is crumbling…it sounds better to say gum
disease. gum disease..people with rotten teeth and all and don’t look after them
Social DisabilityI wouldn’t eat with anybody at all. if there was only me and
husband, I didn’t bother. I was just like “Oh no, we’ll just stop in because its too much of a hassle and I don’t want anything
Physical DisabilityI couldn’t go out and eat a sandwich in a restaurant or anything
like that you just hadn’t got the capacity to bite. That was one of the things, you had to go somewhere where you had knife and
fork and you could cut things.
Domain of oral health
Periodontal disease
Representative quotation
Disability
Aww...people with rotten teeth and all..
PSYCHOLOGICAL DISABILITY
I wont say its Gum diseaseIts embarrassing….
I couldn’t go out and eat a sandwich in a restaurant or anything like that you just hadn’t got the capacity to bite
PHYSICAL DISABILITY
Handicap was not widely reported by interviewees.
Handicap is A result of very high level impacts on patient's lives
Handicap were reported as the inability to participate in hobbies, enjoy time with family, socialize and enjoy holidays
Handicap
Quoteit is embarrassing because people naturally assume that it is because you have forgot your hygiene and
you have not looked after your teeth and it is not always the case
The least people know, the better
I was a pretty confident lad before but It has just affected my self
confidence in a big way
I think about it at least 25% of the day, if not more because I was very, very conscious of it and it depends on what day it is as to how many
people I have to talk to
Interpretation
Perception of being unclean, embarrassed
Doesn’t want people to know
Reduced self confidence
Impacting relationships
Stigma
Conclusion Health care systems tend to be consumer driven and
evidence demands that the clinician take a patient centered approach to management of disease and illness
Understand the biopsychosocial effects of the disease so that attempts can be made to minimize them
Plan periodontal care which addresses patient needs and key concerns and evaluate outcomes of periodontal
treatment from the patient’s perspective
Reference
• Journal of Clinical Periodontology 2010 Vol 37• Internet
Take Care Of your
Periodontium