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J Endod. 2014 Jun;40(6):784-9. doi: 10.1016/j.joen.2014.01.045. Epub 2014 Mar 29.

Clinical decision making for a tooth with apical periodontitis: the patients' preferred level of participation.

Author information

  • 1Discipline of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative, University of Toronto, Toronto, Ontario, Canada. Electronic address: amir.azarpazhooh@dentistry.utoronto.ca.
  • 2Discipline of Prosthodontics, Faculty of Dentistry, University of Toronto, Ontario, Canada.
  • 3Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Program of Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
  • 4Discipline of Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
  • 5Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment Collaborative, University of Toronto, Toronto, Ontario, Canada.
  • 6Discipline of Endodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.

Abstract

INTRODUCTION:

To effectively engage patients in clinical decisions regarding the management of teeth with apical periodontitis (AP), there is a need to explore patients' perspectives on the decision-making process. This study surveyed patients for their preferred level of participation in making treatment decisions for a tooth with AP.

METHODS:

Data were collected through a mail-out survey of 800 University of Toronto Faculty of Dentistry patients, complemented by a convenience sample of 200 patients from 10 community practices. The Control Preferences Scale was used to evaluate the patients' preferences for active, collaborative, or passive participation in treatment decisions for a tooth with AP. Using bivariate and logistic regression analyses, the Gelberg-Andersen Behavioral Model for Vulnerable Populations was applied to the Control Preferences Scale questions to understand the influential factors (P ≤ .05).

RESULTS:

Among 434 of 1,000 respondents, 44%, 40%, and 16% preferred an active, collaborative, and passive participation, respectively. Logistic regression showed a significant association (P ≤ .025) between participants' higher education and preference for active participation compared with a collaborative role. Also, immigrant status was significantly associated with preference for passive participation (P = .025).

CONCLUSIONS:

The majority of patients valued an active or collaborative participation in deciding treatment for a tooth with AP. This pattern implied a preference for a patient-centered practice mode that emphasizes patient autonomy in decision making.

KEYWORDS:

Apical periodontitis; dentist-patient relations; patient preference; personal autonomy; principle-based ethics; shared decision making

PMID:
24862704
DOI:
10.1016/j.joen.2014.01.045
[PubMed - indexed for MEDLINE]
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