Stress and social support are associated with depressive symptoms among dental students.
Aim: To explore the factor structure, reliability, and potential usefulness of a patient safety climate questionnaire in UK health care. Setting: Four acute hospital trusts and nine primary care trusts in England. Methods: The questionnaire used was the 27 item Teamwork and Safety Climate Survey. Thirty three healthcare staff commented on the wording and relevance. The questionnaire was then sent to 3650 staff within the 13 NHS trusts, seeking to achieve at least 600 responses as the basis for the factor analysis. 1307 questionnaires were returned (36% response). Factor analyses and reliability analyses were carried out on 897 responses from staff involved in direct patient care, to explore how consistently the questions measured the underlying constructs of safety climate and teamwork. Results: Some questionnaire items related to multiple factors or did not relate strongly to any factor. Five items were discarded. Two teamwork factors were derived from the remaining 11 teamwork items and three safety climate factors were derived from the remaining 11 safety items. Internal consistency reliabilities were satisfactory to good (Cronbach's alpha >0.69 for all five factors). Conclusions: This is one of the few studies to undertake a detailed evaluation of a patient safety climate questionnaire in UK health care and possibly the first to do so in primary as well as secondary care. The results indicate that a 22 item version of this safety climate questionnaire is useable as a research instrument in both settings, but also demonstrates a more general need for thorough validation of safety climate questionnaires before widespread usage.A s health care comes to be seen as a potentially high risk environment, there is increasing pressure to assess the safety culture of healthcare organisations. Some authors promote the use of semi-structured or qualitative approaches to assessing culture, 1 while others suggest that culture can be assessed using a questionnaire approach. There is a real debate over how effectively culture can be assessed using climate questionnaires. As described by Denison, 4 culture refers to the ''deep structure of organisations'' (values, beliefs and behaviours) and is traditionally assessed through interviews or observation, whereas climate mainly concerns individuals' perceptions of their work environment (policies, practices and procedures) at a particular point in time [5][6][7][8] and is amenable to measurement by questionnaire.9 Despite this debate, safety climate questionnaires have been used to assess safety culture in many safety critical industries such as nuclear power, aviation 10 and petrochemicals.11 Some questionnaires for use in health care have been derived from work in other industries such as aviation 12 or have included several items validated in other settings-for example, the armed forces.13 Most of the available healthcare safety climate questionnaires have been developed in the United States.It has been suggested that safety climate questionnaire data may be used as an indicat...
This study sought to determine whether there was an association between sickle cell disease (SCD) and dental caries in African-American adults. A sample of 102 African-American adult patients with SCD from Washington, D.C., and Baltimore, Maryland, were matched to 103 African-American adult subjects, who did not have SCD. The match was by age, gender and recruitment location. Each subject underwent a standardized oral examination as well as an interview to ascertain risk factors for dental caries. For individuals with incomes of less than dollars 15,000, subjects with SCD had more decayed (10.36 versus 1.58) and fewer filled (2.86 versus 8.45) surfaces compared to subjects without SCD with both differences being statistically significant (p<0.05) after adjusting for age and gender. The results suggest that low-income African Americans with SCD may be at increased risk for dental caries and are less likely to receive treatment with a restoration.
The incidence of pneumococcal disease could be reduced by improving nutrition and taking steps to identify and rehabilitate those children whose weight is faltering or falling. Encouraging mothers to develop greater financial independence may also be beneficial. Reduced exposure to smoke should be promoted by improving ventilation in kitchens, introducing more efficient and less polluting stoves, keeping children away from smoky environments and discouraging parental smoking.
The purpose of this study was to adapt the twenty-six-item Communication Skills Attitude Scale (CSAS) developed for medical students for use among dental students and to test the psychometric properties of the modiied instrument. The sample consisted of 250 students (an 80.1 percent response rate) in years D1 to D4 at a dental school in Washington, DC. The mean age of participants was 26.6 years with a range from twenty-one to forty-two years. Slightly more than half of the participants were female (52.4 percent) and were African American or of African descent (51.7 percent). Principal components analysis was used to test the psychometric properties of the instrument. The index that resulted measured both positive and negative attitudes toward learning communications skills. The inal twenty-four-item scale had good internal consistency (Cronbach's alpha=0.87), and the study obtained four important factors-Learning, Importance, Quality, and Success-that explained a signiicant portion of the variance (49.1 percent). Stratiied analysis by demographic variables suggested that there may be gender and ethnic differences in the students' attitudes towards learning communication skills. The authors conclude that the CSAS modiied for dental students, or DCSAS, is a useful tool to assess attitudes towards learning communication skills among dental students. G ood communication skills are essential for effective clinical practice in dentistry. As Hannah et al. noted, "An ability to communicate effectively with patients-in particular, to use active listening skills, to gather and impart information effectively, to handle patient emotions sensitively, and to demonstrate empathy, rapport, ethical awareness, and professionalism-is crucial." 1 In addition, research has found that good communication skills can increase the health care providers' diagnostic eficiency and decision making ability, as well as lead to improved patient satisfaction, greater adherence to provider recommendations, decreased anxiety, and lower rates of complaints and malpractice claims. [2][3][4][5][6][7] Professional associations and governmental organizations, acknowledging the central role of communication in attaining improved quality dental health care for an increasingly diverse population, have established objectives for the profession and the nation. In 2008, the American Dental Education Association (ADEA) House of Delegates approved communication and interpersonal skills as one of the domains of competencies for new general dentists. 8
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