Patients' perspectives on integrated oral healthcare in a northern Quebec Indigenous primary health care organisation: a qualitative study.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
30 07 2019
Historique:
entrez: 2 8 2019
pubmed: 2 8 2019
medline: 6 8 2020
Statut: epublish

Résumé

Patient-centred care is considered to be an important element in the evaluation of integrated healthcare and has been effective in addressing oral health disparities. This study explored the patients' perspectives of patient-centred integrated care in oral health services integrated into a primary healthcare organisation serving a northern Quebec Cree population. This study used a multiple case study design within a qualitative approach and developmental evaluation methodology. Two theoretical models, Picker's Principles of Patient-Centred Care and Valentijn's Rainbow Model of Integrated Care, guided data collection and data analysis. The thematic analysis included transcription, debriefing, codification, data display and interpretation. This study was conducted in purposefully selected four Cree communities of Northern Quebec. Adult patients in need of oral healthcare and who attended the local dental clinic were identified and recruited by maximum variation sampling and snowball techniques. Patients' perspectives of patient-centred integrated oral healthcare. Data analysis generated six major themes: enhanced accessibility, creating supportive environment, building trust through shared decision making, appreciation of public health programmes, raising oral health awareness and growing cultural humility among healthcare providers. Patients identified the integration of dental care into primary healthcare with respect to co-location, provision of free oral healthcare services, care coordination and continuity of care, referral services, developing supportive environment, shared decision making, oral health promotion and culturally competent care. These results confirmed that patient-centred care is an important element of integrated care. Patients valued the use of this concept in all domains and levels of integration. They recommended to further strengthen the clinical integration by involving parents in oral health promotion as well as optimising care coordination and empowering a supportive environment in organisational integration.

Identifiants

pubmed: 31366663
pii: bmjopen-2019-030005
doi: 10.1136/bmjopen-2019-030005
pmc: PMC6677955
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e030005

Subventions

Organisme : CIHR
ID : GI1-145123
Pays : Canada

Informations de copyright

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Richa Shrivastava (R)

Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada.

Yves Couturier (Y)

School of Social Work, Université de Sherbrooke, Sherbrooke, Québec, Canada.

Naomi Kadoch (N)

Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada.

Felix Girard (F)

Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada.

Christophe Bedos (C)

Faculty of Dentistry, McGill University, Montréal, Québec, Canada.

Mary Ellen Macdonald (ME)

Faculty of Dentistry, McGill University, Montréal, Québec, Canada.

Jill Torrie (J)

Public Health Department, Cree Board of Health and Social Services of James Bay, Mistissini, Québec, Canada.

Elham Emami (E)

Faculty of Dentistry, McGill University, Montréal, Québec, Canada.

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