Involving patients in treatment decisions – a delicate balancing act for Swedish dentists

• Published in: Health expectations : an international journal of public participation in health care and health policy Vol. 17; no. 4; pp. 500 - 510
• Main Authors: Roing, Marta, Holmstrom, Inger Knutsson
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.08.2014; John Wiley & Sons, Inc
• Subjects: Adult; Aged; Attitude of Health Personnel; Balancing; Caring Sciences w. Medical Focus; Clinical decision making; consumer; Consumers; Content analysis; Decision analysis; Decision making; Dental service; Dental treatment; Dentists; Dentists - psychology; dentist’s professional role; Female; Health Knowledge, Attitudes, Practice; Humans; informed decision making; Male; Medical service; Middle Aged; Occupational roles; Omvårdnadsforskning med medicinsk inriktning; onsumer; Oral health; Oral health care; Original Research Papers; Patient participation; Patient Participation - methods; Patients; Professional Role; professionals-as-agents; Public welfare; Qualitative analysis; qualitative research approach; Random Allocation; shared decision making; Social policy; Social welfare; Sweden; Treatment preferences; Trust; Welfare state; Sweden; shared decision making; Sweden; content analysis; professionals-as-agents; qualitative research approach; dentist’s professional role; consumer; informed decision making; dentist's professional role
• ISSN: 1369-6513; 1369-7625; 1369-7625
• DOI: 10.1111/j.1369-7625.2012.00778.x

Background  This study focuses on patients’ participation in treatment decisions related to the delivery of oral health care in the social welfare state of Sweden. In 1985, the National Dental Service Act gave dental patients the right to take an active role in decisions regarding their treatment and, in doing so, strengthened them as consumers. Little is known how dentists in Sweden have adapted to this change. Objective  This study explores how dentists in Sweden perceive and experience involving patients in dental treatment decisions. Design  Data were collected from open‐ended interviews with nineteen dentists, and an inductive qualitative content analysis was chosen to analyse the transcribed interviews. Findings  Involving patients in treatment decisions appeared to be delicate balancing acts between the ideals of patient involvement and the reality of how it is practised in Sweden. These balancing acts in turn revealed obstacles to patient involvement and the role that economy can play on the decisions of some patients regarding their treatment. Conclusions  This study has given insight into a relationship in which some dentists in Sweden find it hard to adapt to and change their professional role with patients who appear to act more as consumers. For these dentists, better practice of patient involvement may require adoption of a more consumerist approach. However, in situations where economy influences patients’ treatment choices, the ideals of patient involvement may remain unattainable.