scholarly journals More than just a dental practitioner: A realist evaluation of a dental anxiety service in Norway

Author(s):  
Emilie Bryne ◽  
Sarah Hean ◽  
Kjersti Evensen ◽  
Vibeke Bull
2021 ◽  
Author(s):  
Emilie Bryne ◽  
Sarah Catherine Patricia Duff Hean ◽  
Kjersti Berge Evensen ◽  
Vibeke Hervik Bull

Abstract Background: Torture, abuse and dental phobia are often precursors to developing a pathological relationship with dental care due to elevated anxiety and the risk for re-traumatisation. Consequently, this patient group tends to avoid dental services, leaving them with severe tooth decay that affects both their general and psychosocial health. Norwegian dental services have implemented a specific dental service targeting this patient group, aiming to both alleviate their dental anxiety and restore their oral health. The outcomes of this service have been positive, but for this model to be transferrable to other national contexts, it is necessary not just to understand whether the service works, but also how and why it works. Therefore, this study developed theories on how the structure of the service alleviates dental anxiety and restores patients’ oral health. Although developed specifically in a Norwegian context, these theories may be applicable to other national and international contexts. Methods: This realist evaluation comprised sequential, multiple methods encompassing a review of service and policy documentation (n=12), followed by realist interviews with service developers and deliverers (n=12). Guided by a retroductive approach consisting of coding, cataloguing and configuring through content analyses and context-mechanism-outcome (CMO) heuristics, the analyses generated four programme theories.Results: First, the state-subsidised dental service affects service access and service uptake. Second, this service can be adapted and tailored to regional resources to meet the needs of the heterogenous patient group. Third, regional service teams are cohesive because of a lack of national communication and cooperative practice. Fourth, the complexity of migration processes and poor dissemination practices leads to poor recruitment of torture survivors to the service. Conclusions: The service follows a hybrid bottom-up, top-down approach, allowing teams to practise discretion and tailor their approach to meet individual needs. With its bi-dimensional structure, the service reaches a patient population that would otherwise avoid dental services. Service uptake is beneficial as patients report experiencing improved quality of life. However, the service is struggling to reach torture survivors, which may be attributable to multiple contextual factors. More research is therefore required to understand the lack of service uptake among torture survivors.


2012 ◽  
Vol 3 (3) ◽  
pp. 295-298
Author(s):  
Ema Aleksic ◽  
◽  
jasmina milic ◽  
Maja Lalic ◽  
Adam Malesevic ◽  
...  

Author(s):  
Yagoub Alyami ◽  
Khames Alzahrani ◽  
Amal Masmali ◽  
Alaa Abulaban ◽  
Jameel Qahwaji ◽  
...  
Keyword(s):  

Author(s):  
Yasmine Ahmed ◽  
Reem Alhokair ◽  
Rana Babsail ◽  
Sarah Albabtain ◽  
Khames Alzahrani
Keyword(s):  

Relay Journal ◽  
2019 ◽  
pp. 271-291
Author(s):  
Huw Davies

This study is an evaluation of the professional development (PD) programme for learning advisors employed in the self-access centre at Kanda University of International Studies in Japan. The research issue investigated was whether the PD activities of advisors allow them to provide appropriate support to students at the University. The implementation of policies, the people and the setting were all considered in building an understanding of what may make the programme work. The framework used to understand this programme is realist evaluation (Pawson & Tilley, 1997), in which theories related to the initial research issue were refined and developed to offer new perspectives. Results suggest that initial training aids advisors in supporting students, but that future implementation decisions are needed for the mentoring element of the programme and on whether more peer observation should take place. The implication that informal discussion among the workgroup and the freedom to choose personal PD journeys are fundamental drivers of effective practice is a finding that may be applied to other teacher and advisor education settings.


Sign in / Sign up

Export Citation Format

Share Document