Implementation of Evidence-Based Pain Assessment in Pediatric Dentistry

项目摘要 牙科手术是儿童急性疼痛的最常见来源之一。痛童年牙科 经验是痛苦的。此外，它们与牙科恐惧的发展，未来的牙科护理有关 避免和相关的口腔健康问题。使用循证疼痛测量工具是一个不可或缺的 这是急性疼痛管理的一部分，并且此类工具可用于儿童牙科环境。这些 专业团体推荐工具作为常规临床实践的一部分。然而，牙医 不太可能坚持使用标准化的疼痛评估方案。K23项目旨在确定 在儿科牙科中进行循证疼痛评估的障碍和促进因素，并开发和试点一种 干预措施将提高牙医对疼痛管理循证指南的遵守程度。的 职业发展奖将提供培训，以促进候选人的研究计划，在行为 牙科.精心设计的培训计划将使候选人获得实施科学方面的专业知识， 定性研究方法，儿科疼痛和儿科牙科，以及其他经验， 多学科合作和赠款写作。培训目标将通过严格的指导来实现 从专家，研究生水平的课程，和先进的专业发展活动。拟议 研究项目与培训目标相一致。第一阶段将包括三项研究： 所有美国儿科牙科住院医师主任，以确定哪些方法来牙疼评估， 教，以及如何;（2）一个大的，全国代表性的调查牙医，以确定的障碍和促进者， 在临床实践中使用基于证据的急性儿科牙痛评估;（3）定性 与牙医进行访谈，以加深对这些障碍和促进因素的理解，并确定最终目标， 干预第二阶段将涉及制定针对障碍的执行干预措施 以及在第一阶段确定的促进者，以改进对评估建议的遵守情况。干预 将根据主要利益攸关方咨询小组的反馈意见制定， 随后，将与牙医一起对该策略的适当性、可接受性和可行性进行试点测试。的 这项研究的长期目标是改善儿童牙科的疼痛管理， 预防患者痛苦、牙科恐惧症的发展以及相关的健康后果。这项工作将需要 就读于一所研究密集型公立大学，在行为牙科方面具有显著优势， 执行科学和儿科疼痛。该奖项将补充候选人的现有优势， 提供新领域的培训，并将为他的独立研究生涯做好准备， 心理学改善口腔健康。

PROJECT SUMMARY Dental procedures are one of the most common sources of acute pain in children. Painful childhood dental experiences are distressing. Moreover, they are related to development of dental fear, future dental care avoidance, and associated oral health problems. Use of evidence-based pain measurement tools is an integral part of acute pain management, and such tools are available for use with children in the dental setting. These tools are recommended by professional groups as part of routine clinical practice. However, dentists are unlikely to consistently use standardized pain assessment protocols. This K23 project aims to identify the barriers to and facilitators of evidence-based pain assessment in pediatric dentistry and to develop and pilot an intervention that will increase dentists’ adherence to evidence-based guidelines on pain management. The career development award will provide training to advance the candidate’s research program in behavioral dentistry. A carefully devised training plan will allow the candidate to gain expertise in implementation science, qualitative research methods, pediatric pain, and pediatric dentistry, as well as additional experience in multidisciplinary collaboration and grant writing. Training goals will be achieved through rigorous mentorship from experts, graduate-level coursework, and advanced professional development activities. The proposed research project is congruent with the training goals. The first phase will include three studies: (1) a survey of all US pediatric dentistry residency directors to determine which approaches to dental pain assessment are taught, and how; (2) a large, nationally-representative survey of dentists to identify barriers to and facilitators of use of evidence-based assessment of acute pediatric dental pain in clinical practice; and, (3) qualitative interviews with dentists to refine the understanding of these barriers and facilitators and identify final targets for intervention. The second phase will involve development of an implementation intervention targeting barriers and facilitators identified in the first phase to improve adherence to assessment recommendations. Intervention development will be informed by feedback from an advisory group of key stakeholders, and the implementation strategy will subsequently be pilot tested with dentists for appropriateness, acceptability, and feasibility. The long-term objective of this research is to improve pain management in pediatric dentistry as a means to prevent patient distress, development of dental fear, and related health consequences. The work will take place at a research-intensive public university with noteworthy strengths in behavioral dentistry, implementation science, and pediatric pain. The award will complement the candidate’s existing strengths by providing training in new domains and will prepare him for an independent research career using health psychology to improve oral health.