Either you Break or Brighten up: Exploring Dental Professionals' Experiences of Dealing with Emotional Distress during Dental Practice. A Qualitative Description

Authors

  • Sobia Akram
  • Karen Mc'Ardle

DOI:

https://doi.org/10.47672/ejhs.576

Keywords:

distress, emotional distress AND dentists, quality oral care, stress AND coping mechanisms, dentist AND resilience

Abstract

Purpose: The study purpose was to provide qualitative description of distress, its manifestations and role of resilience as perceived by practicing dentists in the Kingdom of Saudi Arabia (KSA). The goal was to provide fresh insights into the topic of distress and required coping skills in order to inform the development of future stress management programs.

Methodology: This study was designed qualitatively to determine the causes and impacts of stress among practicing dentists in KSA. Purposive sampling of dentists having not less than 5 years of practice and an average of 54 working hours per week (SD= 6) was done based on convenience approach. Twelve semi structured individual interviews with the help of an interview guide, were conducted and audiotaped to collect the data. After analysis of descriptive data, a coding scheme with four categories was generated by continuous adjustments. The categories originated as; stressful situations, impacts of distress, coping strategies and need of future interventions, were then applied to every single interview. This had identified many codes/themes and sub codes/subthemes related to the topic. The codes emerged were also double checked with the supervisor to have an inter-coder agreement. The participants were contacted again to validate the given information in the transcribed interview to increase the credibility of the study.

Findings: Work load, different kind of patients and financial pressure were reported as major cause of distress for dentists during practice. The cognitive reactions to distress came out to be some physical and many emotional disturbances affecting both the professional and family lives of dentists.

Regarding the experiences to cope, they implemented personal strategies to be resilient instead of compromising the quality of care they deliver. Also, they emphasized on the need of following interventions; Continued dental education with training courses to improve resilience amongst dentists and modified dental curriculum for dental students to face positively, the distressful situations in future practical part of their profession.

Unique contribution to theory, practice and policy: This study provided deep understandings of already developed concepts regarding stress and coping. The study findings proposed that individuals should focus on delivering high quality care by utilizing positive stress coping strategies. They should learn to adopt strategies that are easily accessible and sustainable within the context of a busy dental practice. Interventions to improve skills like motivation, self-determination and decision making should be implemented. Thus the study calls for imperative steps to be taken by stakeholders in dental institutes and at dental practices.

Downloads

Download data is not yet available.

Author Biographies

Sobia Akram

 

Post Graduate Student: Centre of Medical Education

Dundee University

 

Karen Mc'Ardle

 

Professor, Centre of Medical Education

Dundee University

References

Abduljabbar, T. A. (2008). Musculoskeletal disorders among dentists in Saudi Arabia. Pakistan Oral & Dental Journal, 28(1), 135-144.

Ahola, K., & Hakanen, J. (2007). Job strain, burnout, and depressive symptoms: A prospective study among dentists. Journal of Affective Disorders, 104(1-3), 103-110.

Allen, R., Judkins-Cohn, T., deVelasco, R., Forges, E., Lee, R., Clark, L., & Procunier, M. (2013). Moral distress among healthcare professionals at a health system. JONA's Healthcare Law, Ethics and Regulation, 15(3), 111-118.

Al-Omari, W. M. (2005). Perceived sources of stress within a dental educational environment. The Journal of Contemporary Dental Practice, 6(4), 64-74.

Al-Sowygh, Z. H. (2013). Academic distress, perceived stress and coping strategies among dental students in Saudi Arabia. Saudi Dental Journal, 25(3), 97-105.

Alzahem, A. M., Van der Molen, H. T., Alaujan, A. H., Schmidt, H. G., & Zamakhshary, M. H. (2011). Stress amongst dental students: a systematic review. European Journal of Dental Education, 15(1), 8-18.

Awa, W. L., Plaumann, M., & Walter, U. (2010). Burnout prevention: A review of intervention programs. Patient Education and Counseling, 78(2), 184-190.

Basson, R. A. (2013). Management and prevention of burnout in the dental practitioner. Dentistry Journal, 3(168), 2161-1122.

Bhugra, D., Bhui, K.S., and Gupta, K.R. (2008). Burnout and stress among doctors and dentists in North India. International Journal of Culture and Mental Health, 1(1), 24-29.

Bradberry, T. (2014). How successful people stay calm. Forbes. Retrieved January 20, 2020, from https://www.forbes.com/sites/travisbradberry/2014/02/06/how-successful-people-stay-calm/

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101.

Brooks, S.K., Gerada, C., & Chalder, T. (2013). Doctors and dentists with mental ill health and addictions: Outcomes of treatment from the Practitioner Health Programme. Journal of Mental Health, 22 (3), pp. 237-245.

Brown, J., Burke, F. J., Macdonald, E. B., Gilmour, H., Hill, K. B., Morris, A. J., . . . Murray, K. (2010). Dental practitioners and ill health retirement: causes, outcomes and re-employment. Br Dent J, 209(5), 813.

Bickford, M. (2005). Stress in the Workplace: A General Overview of the Causes, the Effects, and the Solutions. Canadian Mental Health Association Newfoundland and Labrador Division, 8(1), 1-3.

Balgiu, B. (2017). Self-esteem, personality and resilience. Study of a students' emerging adults group. Journal of Educational Science and Psychology, VII (LXIX), 93-99.

Chapman, H., Chipchase, S. & Bretherton, R. (2017). The evaluation of a continuing professional development package for primary care dentists designed to reduce stress, build resilience and improve clinical decision-making. Br Dent J, 223, 261-271 https://doi.org/10.1038/sj.bdj.2017.712

Chiovitti, R. F., & Piran, N. (2003). Rigour and grounded theory research. Journal of Advanced Nursing, 44(4), 427-435.

Chipchase, A., Cordrey, D., Floyd, D., Grubbs, L., Miller, S., & Tyre, B. (2012). Stress: perceptions, manifestations, and coping mechanisms of student registered nurse anesthetists. American Association of Nurse Anesthetists Journal, 80(4), S49-55.

Corbin, J., & Strauss, A. L. (2008). Basics of qualitative research: Techniques and procedures for developing grounded theory (3rd ed.). Thousand Oaks, CA: SAGE Publications

Corley, M. C., Minick, P., Elswick, R. K., & Jacobs, M. (2005). Nurse moral distress and ethical work environment. Nursing Ethics, 12(4), 381-390.

Cote, L., & Turgeon, J. (2005). Appraising qualitative research articles in medicine and medical education. Medical Teacher, 27(1), 71-75.

Creswell, J. W. (2014). The selection of a research approach. Research Design: Qualitative, Quantitative, and Mixed methods Approaches (4th ed., pp. 3-24).Thousand Oaks, CA: Sage.

Curtin, M., & Fossey, E. (2007). Appraising the trustworthiness of qualitative studies: Guidelines for occupational therapists. Australian Occupational Therapy Journal, 54(2), 88-94.

Daly, B., Batchelor, P., Treasure, E., & Watt, R. (2013). Essential dental public health (2nd ed.). Oxford, England, UK: Oxford University Press.

Denton, D.A., Newton, J.T., and Bower, E.J. (2008). Occupational burnout and work engagement: A national survey of dentists in the United Kingdom. Br Dent J 205(13), 382-383.

DiCicco-Bloom, B., & Crabtree, B. F. (2006). The qualitative research interview. Medical Education, 40(4), 314-321.

Domínguez-García, E., & Fernández-Berrocal, P. (2018). The association between emotional intelligence and suicidal behavior: A systematic review. Frontiers in Psychology, 9, 2380. doi:10.3389/fpsyg.2018.02380

Dyrbye, L. N., Thomas, M. R., & Shanafelt, T. D. (2005,). Medical student distress: causes, consequences, and proposed solutions. In Mayo Clinic Proceedings, 80(12), 1613-1622.

Flick, U., Von Kardoff, E., & Steinke, I. (2004). What Is Qualitative Research? An Introduction to the Field. In: U. Flick, E. Von Kardoff, & I. Steinke (Eds.), a Companion to Qualitative Research (pp. 3-12). London: Sage.

Fox, C. (2010): Evidence summary: Does dentists' fear have an adverse effect on clinical decision-making? Br Dent J, 209,181-182.

Galan, F., Rios-Santos, J. V., Polo, J., Rios-Carrasco, B., & Bullon, P. (2014). Burnout, depression and suicidal ideation in dental students. Med Oral Patol Oral Cir Bucal, 19(3), 19281.

Gale, N. K., Heath, G., Cameron, E., Rashid, S., & Redwood, S. (2013). Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology, 13(1), 117.

Gaudiano B. A. (2008). Cognitive-behavioural therapies: achievements and challenges. Evidence-based mental health, 11(1), 5-7. https://doi.org/10.1136/ebmh.11.1.5

Gilmour, J., Stewardson, D. A., Shugars, D. A., & Burke, F. J. T. (2005). An assessment of career satisfaction among a group of general dental practitioners in Staffordshire. Br Dent J, 198(11), 701.

Gorter, R. C., Albrecht, G., Hoogstraten, J., & Eijkman, M. A. (1998). Work place characteristics, work stress and burnout among Dutch dentists. European Journal of Oral Sciences, 106(6), 999-1005.

Gorter, R. C., Eijkman, M. A., & Hoogstraten, J. (2000). Burnout and health among Dutch dentists. European Journal of Oral Sciences, 108(4), 261-267.

Grant, L., & Kinman, G. (2014). Emotional Resilience in the Helping Professions and how it can be enhanced. Health and Social Care Education, 3(1), 23-34. doi: 10.11120/hsce.2014.00040

Hancocks, S. (2014). Defensive dentistry. British Dental Journal, 217 (7), 327. doi: 10.1038/sj.bdj.2014.863.

Hatch, J. A. (2002). Doing Qualitative Research in Education Settings. Retrieved from http://site.ebrary.com/id/10587283

Hawton, K., Agerbo, E., Simkin, S., Platt, B., & Mellanby, R.J. (2011). Risk of suicide in medical and related occupational groups: A national study based on Danish case population-based registers. Journal of Affective Disorders, 134(1-3), 320-6.

Hill, K. B., Burke, F. J. T., Brown, J., Macdonald, E. B., Morris, A. J., White, D. A., & Murray, K. (2010). Dental practitioners and ill health retirement: A qualitative investigation into the causes and effects. Br Dent J, 209(5), E8. https://doi.org/10.1038/sj.bdj.2010.814

Humphris, G. M., & Cooper, C. L. (1998). New stressors for GDPs in the past ten years: a qualitative study. Br Dent J, 185(8), 404.

Jain, A., & Bansal, R. (2012). Stress among medical and dental students: a global issue. IOSR Journal of Dental and Medical Sciences, 1(5), 5-7.

Kemp, M., & Edwards, H. (2014). "Stressing out: Sources of Work-related Stress among Salaried Primary Care Dentists in the UK". Dentistry, 62-63.

Khankeh, H., Ranjbar, M., Khorasani-Zavareh, D., Zargham-Boroujeni, A., & Johansson, E. (2015). Challenges in conducting qualitative research in health: A conceptual paper. Iranian Journal of Nursing and Midwifery Research, 20(6), 635.

Kinsella, E. A. (2001). Reflections on reflective practice. Canadian Journal of Occupational Therapy, 68(3), 195-198.

Kondracki, N.L., Wellman, N.S. & Amundson, D.R. (2002). Content analysis: Review of methods and their applications in nutrition education. Journal of Nutritional Educational Behaviour, 34(4), 224-240. doi: 10.1016/S1499-4046(06)60097-3

Laschinger, H. K., Almost, J., Purdy, N., & Kim, J. (2004). Predictors of nurse managers' health in Canadian restructured healthcare settings. Nursing Leadership,17(4), 88-105.

Leventhal, H. O. R., & IAN, B. (Eds.). (2012). The common-sense model of self-regulation of health and illness. In: The Self-regulation of Health and Illness Behaviour (1st ed., pp. 56-79). New York: Routledge.

Lindholm, M. (2006). Working conditions, psychosocial resources and work stress in nurses and physicians in chief managers' positions. Journal of Nursing Management, 14(4), 300-309.

Luthar, S. S., Cicchetti, D., & Becker, B. (2000). The construct of resilience: A critical evaluation and guidelines for future work. Child Development, 71(3), 543-562.

Mankaka, C. O., Waeber, G., & Gachoud, D. (2014). Female residents experiencing medical errors in general internal medicine: a qualitative study. BMC Medical Education, 14(1), 140. doi: 10.1186/1472-6920-14-140

Meltzer, H., Griffiths, C., Brock, A., Rooney, C., & Jenkins, R. (2008). Patterns of suicide by occupation in England and Wales: 2001-2005. British Journal of Psychiatry, 193(1), 73-6.

Monrouxe, L. V., Rees, C. E., Dennis, I., & Wells, S. E. (2015). Professionalism dilemmas, moral distress and the healthcare student: Insights from two online UK-wide questionnaire studies. BMJ Open, 5(5), e007518. doi: 10.1136/bmjopen-2014-007518.

Moore, R., & Brodsgaard, I. (2001). Dentists' perceived stress and its relation to perceptions about anxious patients. Community Dentistry and Oral Epidemiology, 29(1), 73-80.

Morse, Z., & Dravo, U. (2007). Stress levels of dental students at the Fiji School of Medicine. European Journal of Dental Education, 11(2), 99-103.

Murphy, R. J., Gray, S. A., Sterling, G., Reeves, K., & DuCette, J. (2009). A comparative study of professional student stress. Journal of Dental Education, 73(3), 328-337.

Myers, H. L., & Myers, L. B. (2004). 'It's difficult being a dentist': stress and health in the general dental practitioner. Br Dent J, 197(2), 89-93.

Newbury-Birch, D., Lowry, R. J., & Kamali, F. (2002). The changing patterns of drinking, illicit drug use, stress, anxiety and depression in dental students in a UK dental school: a longitudinal study. Br Dent J, 192(11), 646.

Newton, J. T., Mistry, K., Patel, A., Patel, P., Perkins, M., Saeed, K., & Smith, C. (2002). Stress in dental specialists: a comparison of six clinical dental specialties. Primary Dental Care, 9(3), 100-104.

Orzechowska, A., Zajączkowska, M., Talarowska, M., & Gałecki, P. (2013). Depression and ways of coping with stress: A preliminary study. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 19, 1050.

Ousehal, L., Lazrak, L., & Hassani, K. (2011). Evaluation of stress among 100 Moroccan orthodontists. Open Journal of Stomatology, 1(01), 1.

Paulhus, D. L. (1984). Two-component models of socially desirable responding. Journal of Personality and Social Psychology, 46(3), 598.

Plessas, A., Delgado, M. B., Nasser, M., Hanoch, Y., & Moles, D. R. (2018). Impact of stress on dentists' clinical performance. A systematic review. Community Dent Health, 35(1), 9-15.

Pohlmann, K., Jonas, I., Ruf, S., & Harzer, W. (2005). Stress, burnout and health in the clinical period of dental education. European Journal of Dental Education, 9(2), 78-84.

Polychronopoulou, A., & Divaris, K. (2005). Perceived sources of stress among Greek dental students. Journal of Dental Education, 69(6), 687-692.

Pouradeli, S., Shahravan, A., Eskandarizdeh, A., Rafie, F., & Hashemipour, M. A. (2016). Occupational stress and coping behaviours among dentists in Kerman, Iran. Sultan Qaboos University Medical Journal, 16(3), e341.

Radcliffe, C., & Lester, H. (2003). Perceived stress during undergraduate medical training: a qualitative study. Medical Education, 37(1), 32-38.

Rajab, L. D. (2001). Perceived sources of stress among dental students at the University of Jordan. Journal of Dental Education, 65(3), 232-241.

Schwappach, D.L., & Boluarte, T.A. (2009). The emotional impact of medical errorinvolvement on physicians: A call for leadership and organizational accountability. Swiss Medical Weekly, 139(1-2), 9-15.

Seidberg, B. H., & Sullivan, T. H. (2004). Dentists' use, misuse, abuse or dependence on mood-altering substances. New York State Dent Journal, 70(4), 30-33.

Shanafelt, T. D., Bradley, K. A., Wipf, J. E., & Back, A. L. (2002). Burnout and self-reported patient care in an internal medicine residency program. Annals of Internal Medicine, 136(5), 358-367.

Silverman, D. (2013). Doing Qualitative Research: A Practical Handbook (4th ed.). London: SAGE publications limited.

Skinner, E. A., Edge, K., Altman, J., & Sherwood, H. (2003). Searching for the structure of coping: a review and critique of category systems for classifying ways of coping. Psychological Bulletin, 129(2), 216.

Smith, B. W., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., & Bernard, J. (2008). The brief resilience scale: assessing the ability to bounce back. International Journal of Behavioral Medicine, 15(3), 194-200.

Sofola, O. O., & Jeboda, S. O. (2006). Perceived sources of stress in Nigerian dental students. European Journal of Dental Education, 10(1), 20-23.

Sparks, K., Faragher, B., & Cooper, C. L. (2001). Well"being and occupational health in the 21st century workplace. Journal of Occupational and Organizational Psychology, 74(4), 489-509.

Suen, L. J., Huang, H. M., & Lee, H. H. (2014). A comparison of convenience sampling and purposive sampling. Hu Li Za Zhi, 61(3), 105-111.

Thomas, D. R. (2017). Feedback from research participants: are member checks useful in qualitative research? Qualitative Research in Psychology, 14(1), 23-41.

Tsutsumi, A., Umehara, K., Ono, H., & Kawakami, N. (2007). Types of psychosocial job demands and adverse events due to dental mismanagement: A cross sectional study. BMC Oral Health, 7(1), 3.

Tyssen, R. & Vaglum, P. (2002).Mental health problems among young doctors: an updated review of prospective studies. Harvard Review of Psychiatry, 10, 154-65.

Wiederhold, B. K., Cipresso, P., Pizzioli, D., Wiederhold, M., & Riva, G. (2018). Intervention for physician burnout: A systematic review. Open Medicine, 13(1), 253-263.

Wright, E. B., Holcombe, C., & Salmon, P. (2004). Doctors' communication of trust, care, and respect in breast cancer: Qualitative study. BMJ, 328(7444), 864. doi:10.1136/bmj.38046.771308.7C

Zimmerman M. A. (2013). Resiliency theory: A strengths-based approach to research and practice for adolescent health. Health Education & Behavior, 40(4), 381-383. doi: 10.1177/1090198113493782

Downloads

Published

2020-09-22

How to Cite

Akram, S., & Mc'Ardle, K. (2020). Either you Break or Brighten up: Exploring Dental Professionals’ Experiences of Dealing with Emotional Distress during Dental Practice. A Qualitative Description. European Journal of Health Sciences, 5(2), 16–47. https://doi.org/10.47672/ejhs.576

Issue

Section

Articles