Anxiety State Clinical Trial
Official title:
An Investigation Into Patients' State Anxiety Reduction Following the Administration of a Dental Anxiety Questionnaire in the Dental Treatment Setting
Dental anxiety is a significant barrier to the acceptance of regular dental care, and has
many negative consequences. A study by Dailey et al. (2002) found that providing the dentist
with information of the high level of a patient's dental anxiety prior to treatment using
the Modified Dental Anxiety Scale (MDAS, Humphris et al., 1995), lead to a significant
reduction in state anxiety from pre- to post- dental consultation compared to a control
group. The current study aimed to replicate the study by Dailey et al. (2002), and to
further explore whether the reduction in state anxiety associated with the MDAS could be
explained by a change in dentist behaviour on receiving it, or a change in patient
expectancy about the treatment session, or both.
The design was a randomised control trial involving three groups, which aimed to manipulate
possible changes in dentist behaviour and patient expectancy. In Group 1, the MDAS was left
at reception, as expected by the patient. In Group 2, the dentist received the MDAS,
although the patient did not expect this. In Group 3 the dentist received the MDAS and the
patient did expect this. The sample (N=182) was taken from two dental access centres, and
included participants obtaining a score of 19 or above, or 5 on any one item of the MDAS.
Pre- and post-dental consultation measures of state anxiety were taken using the six-item
short-form of the state scale of the Spielberger State-Trait Anxiety Inventory (STAI-S,
Marteau & Bekker, 1992).
The aim of the current study was to compare the degree of anxiety reduction in dentally
anxious patients attending a Dental Access Center where the dentist did or did not receive
the patients' assessment of dental anxiety.
METHODS Design of study A three group pre-and post-test design was adopted, a control group
(Group1: patient completed the MDAS (Modified Dental Anxiety Scale) questionnaire and handed
it to the receptionist) and the experimental group where the patient handed the MDAS to the
dentist (Group 3). An additional group was included (Group 2). Patients completed the MDAS
and handed it to the receptionist whereupon it was given to the dentist contrary to patient
expectation. The dental staff were kept blind to the actual design of the study. The Local
Research and Ethics Committee approved the study.
Test the hypothesis that patients sharing assessment information about their dental anxiety
to members of the dental team has beneficial effects on their state anxiety.
Randomisation A block randomisation schedule was computer generated by University of
Manchester statistician (BT). Pre-sealed opaque envelopes that contained questionnaires
specific to the three groups were prepared by a colleague to minimise selection bias. All
materials were pre-coded with the participant number.
Sample
Dental Access Centers provide: general dental services to those who are not registered with
a NHS dentist, NHS patient charges and receipt of easily available treatment and advice
(appointment not always necessary). The study was conducted at two Greater Manchester Dental
Access Centers. These sites offered treatment to emergency dental patients who were more
likely to become dentally anxious than regular attenders (Maggirias and Locker, 2002) .
Participants were volunteers recruited, from October 2003 to April 2004.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Health Services Research
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