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Biomedical subjects

M A Eijkman

Publications and source records attributed to M A Eijkman.

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

[Complaints against dentists].

To get an impression of the claim-behaviour of patients of Dutch dentists, a qualitative survey was completed amongst eight out of the nine dental consultants of dental liability insurers in the Netherlands. After a literature-study and a test-interview, 11 questions were composed to get the information. It became apparent that the accused dentist is either the young, (too) enthusiastic dentist or the older one, who has lost interest in his job and follows no post academic education. Like in most western countries, according to literature, the most frequent topics patients complain about in the Netherlands are oral surgery, followed by fixed prosthetics, endodontology and recently periodontology. The main cause of the complaints is, according to the interviewed advisors, the lack of communication between the dentist and his patient. Moreover it became clear that dentists misuse their malpractice liability insurance as a second patient-insurance.

Adult↗
PubMed2001

[Job stress and health in dentists].

This study aimed at monitoring stressful work factors as indicated by Dutch general dental practitioners. Special attention was given to gender differences. Apart from mental pressure also physical pressure was studied. It appeared that among all dentists patient related aspects were considered stressful, als well as external interference by government, insurance company, etc. Male dentists also felt pressure from a lack of career perspective and dental office management, whereas female dentists felt pressure from unexpected or uncertain professional situations. Dentists appeared to have a good physical health, when compared with Dutch reference scores, although some job specific physical complaints could be detected. In the discussion the importance of early career planning is emphasized.

Adult↗
PubMed2001

[Satisfied patients?].

This paper examines the difficult question how satisfied patients are with dental services. Scientific research shows that this is hard to measure. Five issues affect dental satisfaction, of which interpersonal and psychosocial factors are reported as being among the most important factors. Two case reports of dissatisfied patients are presented. It is emphasized that adequate counseling skills of the dentist, his evaluation of the expectations and wishes of the patient at the beginning of the treatment, and a sound dental, medical and psychosocial anamnesis are crucial for preventing dental dissatisfaction among patients.

Dentist-Patient Relations↗
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

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

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↗
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

Quality assurance in dentistry: the Dutch approach.

PURPOSE: To describe the definition of quality, as used in the Dutch literature, and to discuss the policy concerning quality assurance of dental care of both the Dutch government and the Dutch Dental Association. DATA SOURCE: Study of relevant literature. RESULTS: Quality is described as the degree to which the entire set of characteristics of a product, process or service satisfies established or obvious needs. With respect to quality assurance, the government merely tends to frame the setting, through legislation and stimulation, whereas the professional organization supports the responsibility of individual dentists by developing a quality, assurance system and by delivering tools for quality assessment. Possible activities within such a quality assurance system are continuing education, peer review, the use of practice guidelines and horizontal referral. CONCLUSION: In Dutch dentistry a start has been made with the development of a quality assurance policy, which is aimed at the improvement of oral health and the increase of patient satisfaction. However, further research should still be focused on quality of dental care and its assessment in practice.

Dental Health Services↗
PubMed1997

Defensive dental behaviour: illusion or reality?

Defensive medicine or defensive behaviour of physicians is considered a major problem in contemporary health care. It seems reasonable to assume that defensive behaviour also occurs in dental practice, although so far very little has been published in the dental literature on this subject. The main objective of this study was to investigate whether defensive behaviour occurs in dentistry. As a survey study 38 dentists were interviewed: 30 men and 8 women, mainly general dental practitioners with an average of 20.9 years in practice. The results of this pilot-study indicate that it is very likely that defensive behaviour occurs in dental practice, despite the fact that there is hardly any evidence of fear for malpractice claims and lawsuits among the respondents. The majority of the dentists interviewed stated that they carried out some treatments at their patient's request although they did not believe the treatment to be necessary from a professional point of view. A motive for deliberately refraining from treatment is lack of dental motivation by the patient and poor oral hygiene. According to some respondents patients are sometimes referred unnecessarily to specialists. Also 'difficult' patients run the risk of unwarranted referral to specialists, and, moreover referrals because of insurance reasons are mentioned. The financial situation of the patient and the defensive behaviour of dental practitioners seem to be closely connected.

Defensive Medicine↗
PubMed1997

Communication skills training courses in dental education.

In this article, some reasons for teaching communication skills in dental schools are discussed. An overview of 3 courses at the Amsterdam dental school is presented, along with the results of a student evaluation. Students evaluated these courses as useful and relevant for dental practice. It is concluded that this is especially so when the students recognize direct applicability of the courses to dental practice.

Communication↗
PubMed1997

On the assessment of dental health care attitudes in 1986 and 1995, using the dental attitude questionnaire.

OBJECTIVE: To re-establish and update the empirical data obtained in 1986 with the Dental Attitude Questionnaire. DESIGN: In 1995 this questionnaire, presented earlier by Hoogstraten and Broers (1986), was completed in a similar setting using similar subjects as in 1985, to make a comparison between 1986 and 1995 possible. SUBJECTS: 375 persons, all first grade psychology students who participated for additional course credit. Mean age was 21.7 years, 65 per cent were female. RESULTS: Data show a change in oral health care attitudes and a change in the internal consistency of the DAQ subscales, making the present version of the questionnaire inadequate for measuring present oral health care attitudes. CONCLUSION: This study has shown once more the importance of conducting replication studies after relatively long periods of time in order to update the psychometric characteristics of questionnaires.

Adult↗
PubMed1996

Opinions of Dutch dentists on the introduction of new legislation in the field of informed consent. A pilot study.

This article describes the results of four group discussions held with 34 Dutch dentists to examine their opinion on the introduction of new legislation in the field of some patient rights, particularly the duty to inform patients and the patient's authorization of a dental treatment procedure. From all the discussions it appears that most are ignorant of the contents of the legislation. A number of important consequences for the practice are mentioned. Amongst the negative consequences which are often named are: loss of income, a greater time investment per patient, the selection of patients, more insurance claims and an increase in administration and keeping dossiers. The positive remarks that emerge are working with protocols, an increase in the quality of care and a better education of the patient. The discussion draws attention to the legal framework of the dentist-patient relationship, although it is not yet clear how certain aspects will take shape in the daily dental practice.

Adult↗
PubMed1996

Quality of dental care: the view of regular attenders.

Patients' perceptions play an important role in assessing the quality of dental treatment. This study investigated 56 possible quality aspects on their importance as judged by regular attenders. A nationwide sample of 5000 Dutch people was contracted, 1328 persons meeting our selection criteria filled out the questionnaire and responded. The results show that hygiene of instruments and the availability of the dentist in case of emergency were considered the most important. It was concluded that in general these patients judged technical and functional aspects of dental care to be of more importance than communicative and informative aspects. Differences in perceptions were found according to sex and, to a lesser extent, to education, means of insurance and place of residence. But, on the whole, response patterns were homogeneous.

Adult↗
PubMed1996

Dutch dentists' conceptions of dental silver amalgam.

A sample of 468 dentists completed a questionnaire on their conceptions of amalgam. A minority (1-3%) reported that amalgam often causes toxic, galvanic and/or allergic side-effects. A considerably larger number (10-30%) stated that such side-effects 'sometimes' occur, while less respondents (6-11%) said they did not know. 60-80% said that such side-effects do not exist, or rarely. If a patient requested the removal of amalgam, one-third of dentists would do so often for cosmetic or toxic reasons, but only one-fifth in the case of a proven allergy. A very substantial percentage would not remove amalgam except for cosmetic reason. Substantial minorities thought that amalgam should not be used for pregnant women or children, or admitted that they did not know. The use of amalgam was rejected by 5%, while 9% could not decide whether they were for or against its use. Multivariate analysis reveals the existence of two dimensions in the data. The first dimension, referred to as "acceptance-of-amalgam", makes it possible to distinguish a subsample (about 9%) consisting of "rejectors-of-amalgam". On the second dimension, referred to as "conviction", a subsample (almost 20%) of "doubters" can be discerned, alongside "convinced adversaries" (about 4%) and "convinced advocates" (some 25%). The majority of the respondents are thought to be more or less in favour of the use of amalgam.

Attitude of Health Personnel↗