PubMed · 12715607
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Camille Pavy Claibourne. 2003. Hope and transformation.. https://pubmed.ncbi.nlm.nih.gov/12715607/
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AIM: To test the effectiveness of dental health educators in general dental practice. OBJECTIVE: To evaluate the effectiveness and cost of primary care trusts seconding dental health educators free of charge to suitable general dental practices to provide dental health counselling to mothers of regularly attending pre-school children at risk to caries. METHOD: Two-cell, parallel group, cluster randomised, controlled clinical trial of two years' duration. CLINICAL SETTING: 30 general dental practices in North-West England. PARTICIPANTS: 269 mothers of 334 pre-school children. INTERVENTIONS: Those in the test group were given visits to a dental health educator over a 2-year period to counsel mothers of at-risk, pre-school children. The rest were held as a control. MAIN OUTCOME MEASURES: Caries prevalence of the children and dental health knowledge, attitudes and toothbrushing skills of the parents. The full costs of the exercise were kept throughout. The statistical analysis controlled for the clustering of children within practices. RESULTS: After 2 years, 271 (81%) children and 248 (92%) mothers remained in the study. There was an 18% difference in mean dmft between the groups in favour of the test group children but this was not statistically significant. At the end of the study there was an 18% difference in mean dmft between the groups in favour of the test group children but this was not statistically significant. No difference in plaque levels was found. The mothers in the test group were more knowledgeable, had better attitudes towards the dental health of their offspring and better toothbrushing skills than those in the control. Each 2-hour session to counsel ten parents cost pound 40. CONCLUSION: Primary care trusts should carefully consider the cost value of seconding dental health educators to counsel parents of regularly attending, at-risk, pre-school children when considering such an option.
OBJECTIVE: To examine attitudes towards drug use among middle aged respondents with high levels of chronic morbidity. DESIGN: Qualitative study with detailed interviews. SETTING: West of Scotland. PARTICIPANTS: 23 men and women aged about 50 years with four or more chronic illnesses. MAIN OUTCOME MEASURE: Participants' feelings about long term use of drugs to manage chronic multiple morbidity. RESULTS: Drugs occupied a central place in the way people managed their comorbidities. Respondents expressed an aversion to taking drugs, despite acknowledging that they depended on drugs to live as "normal" a life as possible. Respondents expressed ambivalence to their drugs in various ways. Firstly, they adopted both regular and more flexible regimens and might adhere to a regular regimen in treating one condition (such as hypertension) while adopting a flexible regimen in relation to others, in response to their experience of symptoms or varying demands of their daily life. Secondly, they expressed reluctance to take drugs, but an inability to be free of them. Thirdly, drugs both facilitated performance of social roles and served as evidence of an inability to perform such roles. CONCLUSIONS: Insight into the considerable tension experienced by people managing complex drug regimens to manage multiple chronic illness may help medical carers to support self care practices among patients and to optimise concordance in their use of prescribed drugs.
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