Interpersonal Skills in the Dentist-Patient Relationship: the art of dentistry

Sammanfattning: The concept of interpersonal skills and its relevance in the dentist-patient relationship wasinvestigated. In Study I, general dentists responding to a mailed questionnaire reported thatthe ideal characteristics of a good dentist can be divided into three categories: 1)interpersonal skills; 2) clinical skills; and 3) other skills. The relative importance of anumber of listed attributes in dentistry were: contact with patients, communication skills,empathy, manual skills and theoretical knowledge, in that order.In Studies II and III, dentists specialized in the treatment of dental phobia wereinterviewed. The analysis of the transcribed interviews was influenced by the principles ofGrounded Theory. In Study II, characteristics of the patient-centered dental consultation wereidentified, including categories of 'Holistic perception and understanding of the patient';'The dentist's positive outlook on people'; and 'The dentist's positive view of patientcontact'. In study III, the following categories described the dynamics of interpersonalprocesses in the dentist-patient encounter: 'Relatedness, based on affective resonance andconcordant roles'; 'The dental phobic patient's emotions'; 'The patient's verbal and nonverbalcues'; 'The dentist's role as a clinician: professional interpersonal skills'; and 'Thedentist's role as a fellow-being: general interpersonal skills'. The results of studies II andIII have a theoretical implication and are supported by previous models of patient-centeredmedicine and the dynamics of the doctor-patient consultation. In Study IV the factor structure of the Swedish version of the Getz's Dental Beliefs Surveywas investigated based on a dental phobic patient population. An exploratory factor analysis(EFA) indicated two solutions: a one-factor (scree plot) solution 'Communication'; and athree-factor (eigenvalues) solution: 'Communication', 'Trust', and 'Fear of NegativeInformation'. A confirmatory factor analysis (CFA), however, suggested a five-factor solution:'Communication', 'Trust', 'Fear of Negative Information', 'Lack of Control' and 'SocialInteraction Distress in Dental Treatment (SIDDT)'. Neither the EFA nor the CFA confirmed thefour-factor structure suggested by the constructors of the DBS. Moreover, the items includedin the dimensions were also partly different from the original version of the DBS. The resultsfrom the two factor analyses indicated that the factor structure of the DBS is ambiguous.Finally, it was concluded that the DBS measures a complex phenomenon with the help of only afew items. The results from the four studies contribute to a better understanding of the concept ofinterpersonal skills in dentistry from the perspective of the dentist, and indirectly of thepatient. Concepts and categories that were identified in Studies I, II and III were inaccordance with the contents of the items and the labels of the DBS factors, investigated inStudy IV. The significance of dentists' interpersonal skills when treating patients,particularly with dental phobia, was confirmed both quantitatively and qualitatively.