Combine or Separate Future Pain? The Impact of Current Pain on Decisions about Future Dental Treatments

Andrade, Eduardo B.; Bianchini, Marco Aurélio; Lucchiari, Newton

doi:10.1371/journal.pone.0064057

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…The factor pain was identified fifty-eight times in n=49 articles, but forty-nine times (n=45 articles) it was not addressed where the pain resulted from. In nine cases, pain was differentiated in terms of its origin, e.g., reduction of prior pain (USA) [120] and relief (Syria) [163], pain during treatment (Brazil) [146], and the chance of experiencing pain after treatment (Canada) [92]. Overall, pain is identified as a factor of choice in articles from almost all countries considered (n=34 countries, including articles focusing on different countries).…”

Section: Discussionmentioning

confidence: 99%

Decision-making regarding dental treatments – What factors matter from patients’ perspective and does Covid-19 influence patients’ behavior? A systematic review

Felgner,

Handrock,

Schroll

et al. 2023

Preprint

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Background Achieving dental health for the population should be a concern of a public health care system, as it may affect its expenditures in the long term. Patients often face individual challenges in dental health care. Why patients decide for or against dental treatments can be determined by many factors, e.g., own financial resources, preferences, and external circumstances. The study’s aim is to identify these factors with an international perspective. Methods We systematically searched for literature in three biomedical databases. Factors of choice were extracted from relevant publications. We used a qualitative approach for analysis, and the MMAT (Mixed Methods Appraisal Tool) for quality assessment. Results After multistage screening of n = 4,226 publications by two reviewers, n = 233 relevant articles of different study types [qualitative (n = 42), quantitative (n = 177), and mixed methods (n = 14)] were included in the analysis. Data collection was realized across different settings [e.g., practice (n = 18)] and approaches (e.g., interviews) in n = 49 countries. Included articles focused on specific treatments (e.g., caries treatment) or treatments in general (e.g., dental tourism). Across countries, various factors of choice (n = 101) were identified, divided into three categories: (I) "dentist & dental institution" (e.g., communication), (II) "patient" (e.g., dental fear), and (III) "treatment" (e.g., durability). The factors out-of-pocket payment and dental fear were mentioned most frequently (n = 148, n = 73). In countries with most articles [UK (n = 28), Saudi Arabia (n = 23), USA (n = 22), India (n = 19), and Brazil (n = 14)], out-of-pocket payment was identified most often [e.g., India: in 68%, and the UK: in 56% of articles]. Frequency of the factor dental fear varied by country. One publication addressed the Covid-19 pandemic reporting that treatment appointments were cancelled by patients due to their fear of infection with SARS-CoV-2. Study quality is highly variable. Conclusions A variety of factors influence patients' choice regarding dental treatments. There is little research on impact of the Covid-19 pandemic. Knowing patients’ reasons for seeking dental care can help to inform decisions about interventions to improve dental health. Regulatory measures and information efforts should be adapted to reduce patients’ access barriers to dental care, and to reduce expenditures of health care systems in the long term.

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Section: Discussionmentioning

confidence: 99%

Decision-making regarding dental treatments – What factors matter from patients’ perspective and does Covid-19 influence patients’ behavior? A systematic review

Felgner,

Handrock,

Schroll

et al. 2023

Preprint

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“…32−35 With specific reference to treatment choices, Bono et al determined that the intensity of pain is the most influential factor affecting a patient's decision to accept surgical complications when considering lumbar spine fusion, 25 and Andrade et al found that recent pain influenced decisions concerning the scheduling of future treatments. 36 These considerations suggested assessing impulsivity and pain in vascular disease patients making treatment decisions. The present study is the first to attempt to investigate the proportional contribution of (i) pain, (ii) impulsivity, (iii) patients' perception of the benefits of surgery, (iv) patients' perception of peri-operative risk and (v) predicted peri-operative risk on acceptance of peri-operative risk by a surgical population.…”

Section: Discussionmentioning

confidence: 99%

Predictors of peri-operative risk acceptance by South African vascular surgery patients at a tertiary level hospital

Govender

Spurrett

Biccard

2015

Southern African Journal of Anaesthesia and Analgesia

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Background: Vascular surgical patients have an elevated cardiac risk following non-cardiac surgery. The decision whether to proceed with surgery is multidimensional. Patients must balance the considerations in favour of surgery with those favouring conservative treatment, which requires weighing peri-operative risk against morbidity associated with non-surgical treatment. Methods: The aim of this prospective correlational study was to determine the proportional contributions of (i) pain, (ii) impulsivity, (iii) patients' perception of the benefits of surgery, (iv) patients' perception of peri-operative risk and (v) the predicted peri-operative risk on acceptance of peri-operative risk by vascular surgical patients. Sixty patients were prospectively recruited by convenience sampling from the Inkosi Albert Luthuli Central Hospital vascular surgery clinic between April 2014 and June 2014. Written informed consent was obtained. Patients completed a questionnaire which documented demographics, pain assessment, impulsivity screen (Barratt Impulsiveness Scale 11), patients' perception of surgery, predicted peri-operative risk (South African Vascular Surgical Cardiac Risk Index) and acceptance of peri-operative risk. Data were analysed using descriptive statistics and linear regression (SPSS version 22). Results: The patients' perception of the benefits of surgery (β 0.36, 95% CI 0.14-0.70, p = 0.005) was the only predictor of peri-operative risk acceptance. The associations between the other potential predictors and the outcome were insignificant. Conclusion:The perceived benefit of surgery was the most important predictor of acceptance of peri-operative risk in this cohort.Keywords: pain, peri-operative risk, shared decision-making, vascular surgery There has been a global increase in the number of patients undergoing non-cardiac surgery with an estimated 500 000 to 900 000 patients experiencing peri-operative cardiac events annually. 1,2Vascular surgical patients have an increased cardiac risk following non-cardiac surgery and a high coexistent morbidity. The dilemma that these patients face involves balancing the risks and benefits associated with surgery against those of conservative management, which includes considering the peri-operative risk associated with the surgery (cardiac death, nonfatal myocardial infarction and nonfatal cardiac arrest) against the associated consequences without the surgery (intractable pain, limited mobility and death). 2−5Decision-making is a cognitive process that requires reflection on the consequences of a choice and deliberation on alternatives and contemplation of future outcomes. 6,7 Patient autonomy and readiness to give informed consent for surgery are affected by several factors. 8 The aim of this study was to determine the proportional contributions of (i) pain, (ii) impulsivity, (iii) patients' perception of the benefits of surgery, (iv) patients' perception of peri-operative risk and (v) predicted peri-operative risk on the acceptance of peri-operative risk by vascular sur...

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“…52 Notably, the pain experienced by patients during their current treatment may influence their future treatment decisions, depending on their personal endurance limits. 53 Other subjective pain-related outcomes that do not have dedicated outcome measurement tools include: 'flare-up' and need for medication, which can be recorded through a careful clinical history and be considered as "critical" outcomes. 22 A 'flare-up' is an unpleasant experience of severe pain and swelling following endodontic treatment that necessitates an unscheduled emergency visit to a clinician.…”

Section: Painmentioning

confidence: 99%

Dental Patient-Reported Outcomes in Endodontics - A Narrative Review

Nagendrababu

Vinothkumar

EL-KARIM

et al. 2023

Journal of Evidence-Based Dental Practice

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Combine or Separate Future Pain? The Impact of Current Pain on Decisions about Future Dental Treatments

Cited by 4 publications

References 20 publications

Decision-making regarding dental treatments – What factors matter from patients’ perspective and does Covid-19 influence patients’ behavior? A systematic review

Decision-making regarding dental treatments – What factors matter from patients’ perspective and does Covid-19 influence patients’ behavior? A systematic review

Predictors of peri-operative risk acceptance by South African vascular surgery patients at a tertiary level hospital

Dental Patient-Reported Outcomes in Endodontics - A Narrative Review

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