Clinical Decision Making for a Tooth with Apical Periodontitis: The Patients' Preferred Level of Participation |
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Authors: | Amir Azarpazhooh Thuan Dao Wendy J. Ungar Faiza Chaudry Rafael Figueiredo Murray Krahn Shimon Friedman |
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Affiliation: | ∗ Discipline 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;‖ Discipline of Prosthodontics, Faculty of Dentistry, University of Toronto, Ontario, Canada;¶ Program of Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada |
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Abstract: | IntroductionTo 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.MethodsData 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).ResultsAmong 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).ConclusionsThe 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. |
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Keywords: | Apical periodontitis dentist-patient relations patient preference personal autonomy principle-based ethics shared decision making |
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