How to reduce the stress of general dental practice: The need for research into the effectiveness of multifaceted interventions

Newton, Tim; Allen, Charlotte; Coates, Jonathan; Turner, Ann; Prior, J.

doi:10.1038/sj.bdj.4813463

Cited by 48 publications

(42 citation statements)

References 23 publications

(18 reference statements)

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“…This will be the focus of further research. These gains were largely maintained at 6-month follow-up, unlike the previous studies where a long-term follow-up was either not undertaken, 54 or the gains made were not maintained. 52,53 Also, a tendency to relapse at the end of a course of CBT treatment for clinical problems is common and clinical treatment packages taper, include booster sessions and incorporate relapse prevention skills in order to minimise this.…”

Section: Discussioncontrasting

confidence: 38%

“…The 2 significant programmes reported to date [52][53][54] which address stress in dentists appear, from the published details, to have focused on improving (apparently mainly behavioural) coping skills for dealing with stress once it has arisen. They were demanding of time resources including, for example, visits to therapists and weekend stays.…”

Section: Discussionmentioning

confidence: 99%

“…This difference in approach may explain the lower dropout rates in this intervention (83% of the SH and 89% completed the 6 week follow-up and 78% and 79%, respectively, completed the 6 month follow-up) which is comparable to the intervention with Dutch dentists 53 and significantly better than the evaluation return rate (45%) in the British study. 54 Dropout rates for self-help CBT can be as high as 50%. 73 Dropouts increase the perceived effect of any intervention.…”

Section: Discussionmentioning

confidence: 99%

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The evaluation of a continuing professional development package for primary care dentists designed to reduce stress, build resilience and improve clinical decision-making

2017

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Introduction: Stress and burnout are widely accepted as a problem for primary care dental practitioners. Previous programmes to address this issue have met with some success. Burnout is associated with poor coping skills and emotion regulation, and increased rates of clinical errors. Anxiety is associated with poor decision-making and is thought to be associated with poor clinical decision-making. Attempts to improve decision-making use increasing meta-awareness and review of thinking processes. Bibliotherapy is an effective method of delivering cognitive behavioural therapy as self-help or guided self-help (with some therapist input) formats. Objective: To evaluate the efficacy of a specially designed CPD package which was designed to improve coping skills, build resilience and reduce the impact of anxiety on dentists' clinical decision-making. Design: A multi-centred quasi-experiment Setting: Lincolnshire and Nottinghamshire (England) 2014 Materials and methods: Thirty-five volunteer primary care dentists used two versions (selfhelp [SH] and guided self-help [GSH], which included a 3 hour workshop) of a specially written cognitive-behavioural-therapy bibliotherapy programme designed to improve wellbeing and decision-making. Main Outcome Measures:The main outcome measures were dentists' burnout, depression, anxiety, stress and decision-making style. Data were also collected on use and evaluation of the programme. Results: At 6 weeks there was a clinically and statistically significant reduction in depression, anxiety and stress levels, a statistically significant reduction in burnout (emotional exhaustion) and hypervigilant decision-making and an increase in personal achievement (burnout). The improvements in depression, stress, emotional exhaustion and hypervigilant decision-making were maintained at 6 months. Dentists were overwhelmingly positive in their evaluation of the project and used most of its contents. Conclusion: With the caveat of small numbers and the lack of a no-treatment control, this project demonstrated that a self-help package can be highly acceptable to dentists and, in the short-to-medium term, improve dentists' well-being and decision-making with implications for patient safety.

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Section: Discussioncontrasting

confidence: 38%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The evaluation of a continuing professional development package for primary care dentists designed to reduce stress, build resilience and improve clinical decision-making

2017

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“…Two comparatively time-intensive interventions based in the Netherlands 10;11 and the UK, 12 have been reported and demonstrated some improvements in wellbeing. The former resulted in short-term benefits (reduction in burnout) which were lost at longer follow-up; the individuals who had the best outcome were those who, once notified of their high burnout scores, acted independently to improve their wellbeing.…”

Section: Introductionmentioning

confidence: 99%

A study to explore specific stressors and coping strategies in primary dental care practice

Bretherton

Chapman

Chipchase³

2016

Br Dent J

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Background and Aims: It is widely acknowledged that dentists experience occupational stress. This qualitative study aimed to explore previously identified specific stressors in more detail in order to inform the development of a future stress management programme. Method: Two focus groups of dentists (N: 7 & 6) were conducted to explore, in more detail, nine specific stressors and concepts; being out of one's comfort zone, zoning out from the patient, celebrating the positive aspects of work, thinking aloud, the effect of hurting patients, the impact of perfectionism, responsibility for patient's self-care, the emotional impact of difficult situations as a foundation dentist. Participants were also asked for their views on the structure and contents of the proposed stress management package. Verbatim transcripts were subjected to thematic analysis. Results and Discussion: Dentists described the impact of these stressors and their current coping methods; thematic analysis revealed 9 themes which covered the above concepts and a further overall theme of need for control. The findings are elaborated in connection to their relevant stress, coping and emotion psychological theory. Their implications for personal well-being and clinical outcomes are discussed. Conclusion: Dentists' stressful and coping experiences are complex and it is essential that any stress management programme reflects this and that the skills are easily accessible and sustainable within the context of a busy dental practice.

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“…9 Such disorders may also be a common cause of early retirement in the dental profession, and workrelated stress has been shown to relate to job dissatisfaction and poor working relationships. 10 Osborne and Croucher 11 have assessed levels of burnout among dental practitioners in South East England, concluding that general dental practice had characteristics which were likely to produce high levels of job-related stress, with 11% of practitioners exhibiting high overall burnout levels. The incidence of musculoskeletal problems among dentists and their impact has also been reported.…”

Section: Introductionmentioning

confidence: 99%

Dental practitioners and ill health retirement: a qualitative investigation into the causes and effects

et al. 2010

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How to reduce the stress of general dental practice: The need for research into the effectiveness of multifaceted interventions

Cited by 48 publications

References 23 publications

The evaluation of a continuing professional development package for primary care dentists designed to reduce stress, build resilience and improve clinical decision-making

The evaluation of a continuing professional development package for primary care dentists designed to reduce stress, build resilience and improve clinical decision-making

A study to explore specific stressors and coping strategies in primary dental care practice

Dental practitioners and ill health retirement: a qualitative investigation into the causes and effects

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