Biomedical subjects

J Hoogstraten

Publications and source records attributed to J Hoogstraten.

At least 19 recordsLinked to original sources

PubMed2001

A career counseling program for dentists: effects on burnout.

The effects on burnout of a career counseling program were measured among general dental practitioners. Out of a group of 171 dentists, identified with unfavorable scores on the Maslach Burnout Inventory - Dutch version (MBI-NL), nineteen chose to participate in the program. It consisted of individual counseling and group sessions, using cognitive and behavioral intervention techniques, over a 6-month period. One month after the last session, both program participants (N=17) and invited, but not participating, dentists (N=66) again filled in the MBI-NL. Comparison of participants' pre- and post-test scores showed significant statistical improvement on the MBI-NL scales emotional exhaustion (EE), and personal accomplishment (PA). Among the control group, a distinction was made between dentists who had self-initiated preventive measures (N=35) and those who had not (N=31). Self-prevention also appeared to have an effect on EE and PA. Among dentists who reported not to have undertaken preventive action, no change in burnout levels was found. With reservations, it can be concluded that the prevention program does have a positive effect on burnout scores among dentists, while different forms of self-initiated prevention activities also appeared to be effective.

Analysis of Variance↗

PubMed2001

Informed consent in Dutch dental practice: knowledge, attitudes and self-efficacy of dentists.

The introduction of the 'Medical Treatment Contract Act' in the Netherlands 5 years ago, established some major rights and duties of both patients and members of the medical profession. The aim of this study was to assess Dutch dentists' knowledge, attitudes and self-efficacy with regard to several topics of this act. A questionnaire was sent to 806 dental practitioners; 41.6% of them responded. Results show that dentists are well informed about some of the most important topics of this law, such as the requirement to obtain the patient's consent to major dental treatments. The results concerning their attitude and self-efficacy, however, are less positive. A majority of the respondents believe that the principle of informed consent will lead to a commercialization of the dentist-patient relation. Also, fear for legal procedures and difficulty with what patients must be informed about appears present. It is concluded that improvement of the implementation of the requirements of this legislation in dental practice requires both a change in attitude and an enhancement of the communicative skills of dentists.

Adult↗

PubMed2001

Burnout intervention among Dutch dentists: long-term effects.

The aim of the present study was to determine the long-term effects of a burnout-intervention program among Dutch dentists using a longitudinal design. Using the Maslach Burnout Inventory (Dutch version: MBI-NL), at the initial measurement in 1997 a 'burnout risk group' (n = 171) was identified. This group received feedback on their scores and was invited to participate in an intervention program. Of the total group. 19 dentists participated in an intervention program. After the end of the intervention program, 92 dentists (the 19 participants and a control group) responded to a post-intervention survey in 1998. These dentists were approached once more 1 yr later, and this time 78 dentists (84.8%) returned a questionnaire. While demonstrating an improvement on all subscales of the MBI-NL at the first post-test, results show that the program participants showed a relapse at the second post-test. Controls who took action on their own initiative, on the other hand, reported a beneficial effect in the long run. Finally, controls that did not take any preventive action showed little or no progress. Possible causes for these findings are discussed, including the influence of coping style. perceived control, confounding factors, demand characteristics, and the necessity of post-intervention follow-up.

Burnout, Professional↗

PubMed2001

Substance use among Dutch dental students.

OBJECTIVES: The objectives were to assess the prevalence of substance use among Dutch dental students and to determine their attitudes about substance use and its consequences. METHODS: In association with a national study of drug use among US dental students, a questionnaire was translated from English into Dutch and administered to dental students at two dental schools in The Netherlands. Students received an anonymous 115-item questionnaire in the fall of 1996. RESULTS: Alcohol was the students' drug of choice for lifetime (95%), past year (94%) and past month (88%) use. No significant correlations were found between alcohol use and gender, schools, and years in dental education. In the past month, 58% of students reported drinking on 5 or more days; 53% had 5 or more drinks on the same occasion, 20% had 5 or more drinks on the same occasion on 5 or more days; and 17% reported getting drunk at least monthly. Prevalence rates for past month use of tobacco was 24% and marijuana, 4%. Male students smoked twice as much as females, with significant differences found for all three periods of use (X2>19.00, P<0.01). When asked whether their schools offered policies and education programs on alcohol and other drugs, 52% of students reported that these were not available. CONCLUSIONS: Dental schools should develop effective programmes to educate students about responsible use of alcohol and other licit and illicit drugs. Schools should also inform students about their susceptibilities to substance abuse and dependency.

Adult↗

PubMed2001

Differential effects of active versus passive coping on secretory immunity.

This study examined the acute immunological effects of two laboratory stressors, expected to evoke distinct patterns of cardiac autonomic activity; namely an "active coping" time-paced memory test, and a "passive coping" stressful video showing surgical operations. We measured salivary S-IgA, IgA-subclasses (IgA1, IgA2), and secretory component (SC). SC is responsible for the transport of S-IgA across the epithelium, and thus a rate-determining step in S-IgA secretion. Thirty-two male undergraduates were subjected to both stressors and a control video (a didactic television program). The memory test induced a typical "fight-flight" response, characterized by increases in heart rate and blood pressure in association with a decrease in cardiac preejection period (PEP) and vagal tone. The surgical video produced a "conservation-withdrawal"-like response, characterized by an enhanced vagal tone, a decrease in heart rate, and a moderate sympathetic coactivation (as indicated by a shortened PEP and an increased systolic pressure). The memory test induced an increase in the concentration and, to a lesser extent, in the output of S-IgA, IgA], and SC. The output of IgA2 was not significantly affected. For the surgical video, a different pattern emerged: During stressor exposure S-IgA remained unaffected, against the background of a small increase in SC output. However, 10 min after the surgical video S-IgA levels had decreased. This decrease in S-IgA was paralleled by a decrease in IgA1, but not IgA2. We conclude that acute stress can have both enhancing and suppressive effects on secretory immunity, the IgA1 subclass in particular. The mechanisms that underlie these divergent responses may include stressor-specific patterns of autonomic activation.

Adaptation, Psychological↗

PubMed2000

Dental anxiety reduction and dental attendance after treatment in a dental fear clinic: a follow-up study.

OBJECTIVES: The aim of the present study was to assess treatment outcome in terms of dental anxiety reduction at a post-treatment assessment and dental anxiety reduction and dental attendance one year later. Furthermore, it was determined to what extent psychopathological characteristics were related to treatment outcome. METHODS: Questionnaires were sent to 280 patients treated with one of three treatment modes (i.e., behavioral management (BM), nitrous oxide sedation (NOS), and intravenous sedation (IVS)) at a dental fear clinic in The Netherlands. Dental anxiety before (T1) and after (T2) treatment was assessed using the Dental Anxiety Scale (DAS) and the Short version of the Dental Anxiety Inventory (S-DAI); the Symptom Checklist 90 (SCL-90) was used to assess general psychopathology. Dental anxiety was assessed again a year later and patients were questioned about their dental attendance pattern (T3). RESULTS: ANOVA showed that the DAS and S-DAI scores at T2 and T3 were statistically significant lower than the initial scores. In addition, IVS patients showed less anxiety reduction than BM patients at both T2 and T3. Of the 145 patients whose last visit to the clinic was at least one year ago, 62% had visited a GDP at T3. A regression analysis revealed that, beside treatment mode, somatization, number of visits to clinic for dental treatment, and number of months between first and last visit to the clinic predicted dental anxiety at follow-up. CONCLUSIONS: It is concluded that, although a reduction in dental anxiety level was present, a relatively large proportion of patients did not improve, in terms of both dental anxiety and dental attendance.

Adolescent↗

PubMed2000

Burnout and health among Dutch dentists.

In this study, it was hypothesised that dentists with a high burnout risk would experience more health complaints and show more unhealthy behaviour when compared with dentists with a low burnout risk. With a response rate of 75%, a representative group of 709 actively practising dentists responded to a questionnaire containing the Dutch version of the Maslach Burnout Inventory (MBI-NL), a health complaints measure (VOEG), and items on health behaviour. Results showed that dentists with a high burnout risk reported health complaints to a greater extent than dentists with a low burnout risk. They also reported more unhealthy behaviour in some aspects (physical exercise/sporting, increase in alcohol consumption, unhealthy diet), but not in others. It also appeared that one out of ten dentists reported having poor general health, and that three out of ten reported to have poor physical condition. In general, dentists' self-reports appeared favourable in comparison with the Dutch population. It is concluded from this study that among dentists burnout and poor health are strongly related. It is discussed that in order to deal preventively with burnout in dentistry, attention to physical health, including ergonomics, is essential.

Adult↗

PubMed1999

Treatment modalities in a dental fear clinic and the relation with general psychopathology and oral health variables.

OBJECTIVE: To assess differences among highly anxious dental patients assigned to different treatment modes (i.e. behavioural management (BM), nitrous oxide sedation (NOS), intravenous sedation (IVS). Patients were compared with regard to psychological and dental variables before treatment (e.g. number of decayed teeth), and dental variables after treatment (e.g. number of fillings made). DESIGN: Dentists experienced in the treatment of highly anxious patients allocated patients to a treatment mode based upon their clinical judgement. SETTING: Centre for Special Dental Care, Amsterdam, The Netherlands. SUBJECTS: 211 patients from this dental fear clinic. MEASURES: General psychopathology, as measured by the Symptom Checklist 90 (SCL-90), and dental anxiety (DAS, S-DAI, 10-point scale) were measured prior to treatment. From the panoramic radiograph the following pre-treatment dental variables were assessed: number of teeth, number of decayed teeth, number of retained roots, and number of root-filled teeth. After treatment, number of fillings, extractions, endodontically treated elements, number of visits, and treatment duration, were determined from the patients' records. RESULTS: Of the 144 patients who received dental treatment at the clinic, 46.5% was treated using a BM approach, 27.8% with NOS, 22.9% with IVS, and 2.8% under GA. No differences among the treatment groups were found with regard to SCL-90 and dental anxiety. The results showed that patients in the IVS group had statistically significant more decayed teeth than patients in the BM group. Furthermore, more fillings were made in the IVS group than in the BM group. CONCLUSION: Since it appeared possible to treat a large proportion of patients by BM alone, training dentists in the application of psychological methods for the treatment of anxious patients should be stimulated. In addition, future research should seek for variables that, besides oral health, are better able to discriminate between groups of highly anxious patients than measures of dental anxiety and psychopathology.

Adolescent↗

PubMed1999

Measuring work stress among Dutch dentists.

Individual differences among dentists determine to a large degree what is experienced as work stress, but assessment of specific areas is necessary to be able to act preventively. The aim of this study was to develop an instrument to be used to monitor the experience of work stress in detail, to measure its levels, and to relate those levels to job (dis-) satisfaction. A questionnaire was developed, the Dentists' Experienced Work Stress Scale (DEWSS), covering widespread aspects of dental work, which was completed by 709 dentists, forming a highly representative sample of Dutch general dental practitioners. Factorial, correlational, and reliability analyses were conducted, after which seven areas of stress emerged: Work Pressure, Financial Aspects, Patient Contacts, Work Contents, Career Aspects, Team Aspects, and Professional and Private Life. Of these, Patient Contacts and Work Contents showed highest mean scores, as did the specific items: 'defaulters', 'governmental instructions', and 'unreasonable or demanding patients'. A strong inverse relationship was found between work stress, in particular lack of career perspective, and job satisfaction. The questionnaire is a valuable instrument to monitor pressure at work as felt by Dutch general dental practitioners. Patient contacts, work pressure, and career perspective clearly need preventive attention in the Dutch situation.

Cohort Studies↗

PubMed1999

Determinants of dentists' decisions to initiate dental implant treatment: a judgment analysis.

STATEMENT OF PROBLEM: Do psychosocial patient characteristics influence the decision of a dentist in recommending implant treatment? PURPOSE: This study assessed the importance that dental general practitioners attach to psychosocial patient characteristics when judging the suitability of these patients for dental implant treatment. METHOD AND MATERIAL: The judgment strategy of 30 Dutch dental practitioners was studied by using 2 tasks. Dentists first judged a series of written scenarios representing fictitious patients, each patient being characterized by 4 psychosocial aspects to determine the patients' suitability for implant treatment. The second task involved rank ordering 14 patient characteristics according to their importance in implant treatment decisions. RESULTS: Dentists judged the personal appearance of the patient and, to a lesser degree, the patient's socioeconomic status to influence decisions to treat. However, these characteristics are ranked as quite unimportant in decision making, whereas motivation, oral hygiene, and level of neuroticism were the most important patient characteristics. CONCLUSIONS: The results on the 2 tasks were clearly not in agreement. There was a substantial disagreement between what dentists say to be important characteristics (rank order task) and the characteristics they actually use to judge the suitability for implant treatment (scenario task). Moreover, it appeared that agreement among the dentists is quite low, especially for the scenario task.

Analysis of Variance↗

PubMed1999

Reliability and validity of the Dutch version of the Social Attributes of Dental Anxiety Scale.

The aim of the present study was to assess the reliability and (factorial) validity of the Dutch version of the Social Attributes of Dental Anxiety Scale (SADAS). A factor analysis using the English version of the SADAS revealed two separate scales. The first eight items involved unwanted psychological upsets when patients encounter dental care directly; the four remaining items were about social inhibitions or restrictions due to the perceived state of oral health. Psychometric properties of the Dutch version were assessed using a sample of 170 highly anxious dental patients of a dental fear clinic in Amsterdam, The Netherlands. The Dental Anxiety Scale (DAS) and the Short version of the Dental Anxiety Inventory (S-DAI) were used as measures of dental anxiety. Factor analysis revealed that four factors explained 72.8% of the variance, and two forcedly extracted factors explained 53.4% of the variance. Correlations indicated that the SADAS does measure a different concept than dental anxiety. In addition, t-tests indicated that the SADAS was able to discriminate between a group of non-anxious individuals and the present group of patients. In conclusion, the SADAS is a promising new questionnaire with moderate factorial, but with more than sufficient reliability, as well as construct and discriminant validity.

Adaptation, Psychological↗

PubMed1999

Professional burnout among Dutch dentists.

UNLABELLED: Professional burnout, a long-term consequence of occupational stress, is considered to be a factor that explains a substantial proportion of incapacity for work. Burnout is defined as emotional exhaustion, depersonalization, and diminished personal accomplishment. AIMS: To investigate levels of burnout among Dutch practising dentists, to compare dentists' scores with norm scores, and to determine the percentage of dentists "at risk". METHODS: The instrument used was the Dutch version of the Maslach Burnout Inventory (MBI-NL), a 20-item modified version of the original MBI. A highly representative group of Dutch dentists participated (n = 709, 75% response rate). RESULTS: Mean levels (and standard deviations) of burnout were: emotional exhaustion 13.7 (8.6); depersonalization 5.9 (3.9); personal accomplishment 30.8 (5.9). Dentists had more favourable means compared with standard scores, although in the 95th percentile dentists showed more emotional exhaustion than standards indicate. While no overall sex differences were found, male middle-aged dentists tended to show more burnout. Of the working Dutch dentists, 21% had a certain risk, 13% had high overall levels of burnout, and 2.5% were highly burned out. CONCLUSION: It is concluded that Dutch dentists have relatively favourable mean levels of burnout, but those who are exhausted are extremely exhausted. The male dentist in his forties appears to be most vulnerable to burnout.

Adult↗

PubMed1999

Behavioural and emotional problems in children referred to a centre for special dental care.

This study was conducted among 203 children (103 boys) referred to a centre for special dental care because of a high level of dental fear. It was undertaken to explore to what extent behavioural and emotional problems co-exist in these children compared with children of a Dutch norm group. The children's parents filled out the parental version of the Child Behaviour Checklist (CBCL), before their first appointment at the centre. The behavioural and emotional problems of the children were assessed by this CBCL, and the mean scores of the children in the study were compared with the mean scores of the norm group. The mean scores on all scales, except on the subscale 'sex problems', of the children with a high level of dental fear proved to be significantly higher than the mean scores of the norm group (P< or =0.001). The results indicated that children referred to a special dental care centre not only suffer from high dental fear but also have problems in several other behavioural and emotional areas. These problems appear to be heterogeneous; they were found in several specific problem areas, both external and internal.

Behavioral Symptoms↗

PubMed1998

Dental implants in the atrophic maxilla: measurements of patients' satisfaction and treatment experience.

Maxillary bone reconstruction in combination with placement of dental implants is a treatment modality reported since 1980 for patients suffering from maxillary atrophy and difficulties with wearing removable prosthesis. This study reports on patient experience and satisfaction among 88 consecutive patients concerning surgical and prosthetic aspects of their treatment. A questionnaire was used to gather the data. Patient satisfaction was measured on a scale from 1 to 5 (1 = bad/few, 5 = very good/much). The satisfaction index with regard to the total treatment was 4.1 +/- 0.9. A total of 90% of the patients responded that they would go through the treatment again or recommend the treatment to a friend if necessary. The post-operative pain index scored 2.6 +/- 1.2. The acceptation of the post-operative pain at the crista iliaca was 86.1% and of the maxilla 89.9%. It is concluded that the results of measurements of patient satisfaction after maxillary bone reconstruction in combination with placement of dental implants were acceptable.

Adult↗

PubMed1998

Work place characteristics, work stress and burnout among Dutch dentists.

Work stress among dentists has been described several times, indicating a diversity of causes of stress. Professional burnout among dentists has been the subject of empirical study only occasionally. The aim of the present study was to investigate which occupational factors are related to levels of burnout among Dutch dentists. A distinction was made between actual work place characteristics and experienced pressure from specific aspects of dental work. With a response rate of 75%, a representative group of 709 Dutch general dental practitioners responded to a questionnaire containing a Dutch version of the Maslach Burnout Inventory (MBI-NL), the Dentists' Experienced Work Stress Scale (DEWSS), and a collection of items on work place conditions. No actual work place condition could be demonstrated to be correlated with high burnout levels. Lack of career perspective appeared to be the stress factor most strongly related to burnout. Mean burnout levels of all dentists were found to be favourable in comparison with Dutch norm scores: dentists showed less Emotional Exhaustion, less Depersonalization, and more Personal Accomplishment. It is concluded that the relation between lack of career perspective and burnout should stimulate serious attention for career planning among dentists.

Adult↗

PubMed1998

Satisfaction as a determinant of compliance.

In this study the relation between satisfaction and compliance is examined in terms of specificity and predictive value. Satisfaction is assumed to be a determinant of compliance, especially if both concepts are measured at the same level of specificity (i.e., a dental level). A total of 176 subjects reported their satisfaction with dental visits and the dental practice, their dental compliance and their general tendency to comply. The results show a relation between satisfaction and compliance and that compliance can be predicted by satisfaction. Surprisingly, the relation between dental satisfaction and general compliance is stronger than the relation between dental satisfaction and dental compliance. This finding can be explained by the possible relation between different levels of compliance and the complexity of the concept dental compliance.

Adult↗

PubMed1998

The Dental Subscale of the Children's Fear Survey Schedule: a factor analytic study in The Netherlands.

The Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS) is a well-known instrument for assessing dental fear in children. Previous studies have shown that the scale has acceptable reliability and validity. Factor analysis using scores of a group of Finnish schoolchildren resulted in three factors. No other data on the factor structure have been published. In order to report on the factor structure of the Dutch parental version of the CFSS-DS, the present study was undertaken. Factor analysis using scores from a group of Dutch children (n= 150) demonstrated a factor pattern fairly similar to the results found in the Finnish study. Three factors were found: 1) fear of highly invasive dental procedures, 2) fear of less invasive aspects of treatment and 3) fear of medical aspects. Considering that almost all items load substantially (> or =0.20) on more than one factor, it seems that one primary underlying dimension exists: fear of invasive treatment aspects. The CFSS-DS is proposed as a reliable, one-dimensional measure of dental fear.

Child↗

PubMed1998

Compliance in dentistry: general adherence, specific adherence and perceived dental health.

In this study it was attempted to replicate findings on the relationship between general and specific adherence and perceived health in the context of dental treatment. Furthermore the psychometric characteristics of a modified adherence scale for use in dental populations were investigated. A sample of 167 freshmen completed a questionnaire containing a general adherence scale (GAS) developed by DiMatteo et al. (Oncology 1992;6:50-7), a perceived health scale, a perceived dental health scale, and two items about adherence to recommendations on dental behaviour. The GAS showed adequate internal consistency. Positive correlations were found for general adherence on the one hand and for specific adherence, perceived health, and perceived dental health on the other. The results concerning the GAS and specific adherence do not correspond with the findings of DiMatteo et al. It is suggested that this discrepancy is due to the situation-specificity of adherence in combination with differences in the samples and the specific adherence measures used in both studies.

Adult↗