Key Points
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Describes the effects of occupational stress on dentists.
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Describes the coping strategies used by dentists in difficult clinical situations.
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Discusses the implications of dentists' psychological well-being.
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Describes dentists' self report effects of emotions on their decision-making.
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Discusses the impact on patient care.
Abstract
Background and aims Dentistry is widely reported to be a stressful profession. There is a limited body of research relating to the coping strategies used by dentists whilst in clinical situations. This study aims to use qualitative methods to explore the full extent of the coping strategies associated with stressful events in primary dental practice.
Method Semi-structured interviews were conducted with 20 dentists within a 50 mile radius of Lincoln. A thematic analysis was conducted on verbatim transcriptions thereby identifying six themes and 35 codes.
Results Participants described both problem-focused and emotion-focused strategies. The strategies used had a variety of outcomes in the context of use. Most dentists denied that their emotions affected their decision-making, but then proceeded to describe how they were influential.
Discussion and conclusion Dentists use a wide variety of coping strategies some of which are maladaptive. Training in the development and recognition of appropriate coping decisions would be appropriate as they would, potentially, improve practitioner decision-making and well-being.
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References
Lazarus R S, Folkman S . Stress, Appraisal, and Coping. New York: Springer Publishing Company, 1984.
Carver C S, Scheier M F, Weintraub J K . Assessing coping strategies: A theoretically based approach. J Pers Soc Psychol 1989; 56: 267–283.
Aldao A, Nolen-Hoeksema S. The influence of context on the implementation of adaptive emotion regulation strategies. Behav Res Ther 2012; 50: 493–501.
Folkman S, Moskowitz J T . Stress, positive emotion, and coping. Curr Direct Psychol Sci 2000; 9: 115–118.
Folkman S, Lazarus R S . Coping as a mediator of emotion. J Pers Soc Psychol 1988; 54: 466–475.
Tugade M M, Fredrickson B L . Resilient individuals use positive emotions to bounce back from negative emotional experiences. J Pers Soc Psychol 2004; 86: 320–333.
Gorter R C, Albrecht G, Hoogstraten J, Eijkman M A . Measuring work stress among Dutch dentists. Int Dent J 1999; 49: 144–152.
Ayers K M, Thomson W M, Newton J T, Rich A M . Job stressors of New Zealand dentists and their coping strategies. Occup Med (Lond) 2008; 58: 275–281.
Moller A T, Spangenberg J J . Stress and coping amongst South African dentists in private practice. J Dent Assoc S Afr 1996; 51: 347–357.
Elani H W, Allison P J, Kumar R A, Mancini L, Lambrou A, Bedos C . A Systematic Review of Stress in Dental Students. J Dent Edu 2014; 78: 226–242.
Shankarapillai R, Nair M A, George R . The effect of yoga in stress reduction for dental students performing their first periodontal surgery: A randomized controlled study. Int J Yoga 2012; 5: 48–51.
Lester N, Smart L, Baum A . Measuring coping flexibility. Psychol Health 1994; 9: 409–424.
Doolittle B R, Windish D M, Seelig C B . Burnout, coping, and spirituality among internal medicine resident physicians. J Grad Med Educ 2013; 5: 257–261.
Tsutsumi A, Umehara K, Ono H, Kawakami N . Types of psychosocial job demands and adverse events due to dental mismanagement: a cross sectional study. BMC Oral Health 2007; 7: 3.
Legare F, Ratte S, Stacey D et al. Interventions for improving the adoption of shared decision making by healthcare professionals. Cochrane Database Syst Rev 2010; 5: CD006732.
Taris T W, Bakker A B, Schaufeli W B, Stoffelsen J, van Dierendonck D . Job control and burnout across occupations. Psychol Rep 2005; 97: 955–961.
Lazarus R S, Folkman S . Transactional theory and research on emotions and coping. Euro J Personality 1987; 1: 141–169.
Folkman S, Moskowitz J T . Coping: Pitfalls and promise. Annu Rev Psychol 2004; 55: 745–774.
Folkman S, Lazarus R S, Dunkel-Schetter C, DeLongis A, Gruen R J . Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. J Pers Soc Psychol 1986; 50: 992–1003.
Braun V, Clarke V . Using thematic analysis in psychology. Qual Res Psychol 2006; 3: 77–101.
Chipchase S Y, Chapman H R, Bretherton R . Dentists' decision-making style and anxiety about clinical decision-making. Br Dent J 2015; In preparation.
Chapman H R, Chipchase S Y, Bretherton R . Emotions in primary dental practice: a thematic analysis 1. clinical situations and accompanying emotions. Br Dent J 2014; 219: 401–409.
Chapman H R, Chipchase S Y, Bretherton R . Understanding emotionally relevant situations in primary dental care practice. 3. Developing narratives. Br Dent J 2015; In press.
Goodman LA . Snowball sampling. Ann Math Stat 1961; 1: 148–163.
Paulhus DL . Two-component models of socially desirable responding. J Pers Soc Psychol 1984; 46: 598–609.
Schwarz N, Strack F, Hippler H J, Bishop G . The impact of administration mode on response effects in survey measurement. Appl Cogn Psychol 1991; 5: 193–212.
Beck JS . Cognitive therapy: Basics and beyond. New York: Guilford Press, 1995.
Kimble M, Boxwala M, Bean W et al. The impact of hypervigilance: Evidence for a forward feedback loop. J Anx Dis 2014; 28: 241–245.
Richards H J, Benson V, Donnelly N, Hadwin J A . Exploring the function of selective attention and hypervigilance for threat in anxiety. Clin Psychol Rev 2014; 34: 1–13.
O'Doherty K M . The Little Book of Thinking Errors. London: Cognitive Therapy Books, 2009.
General Dental Council. Standards for the Dental Team. London: General Dental Council, 2013.
Janis I L, Mann L . Decision Making. New York: The Free Press, 1977.
Croskerry P, Abbass A, Wu A W . Emotional influences in patient safety. J Patient Saf 2010; 6: 199–205.
Bilodeau L P, Moody J M, Rathbun J D, Kraut R A . Evaluation of ECG changes in dentists treating awake patients. Anesth Prog 1983; 30: 193–196.
Cooper C L, Mallinger M, Kahn R . Identifying sources of occupational stress among dentists. J Occup Psychol 1978; 51: 227–234.
Michaud K, Matheson K, Kelly O, Anisman H . Impact of stressors in a natural context on release of cortisol in healthy adult humans: a meta-analysis. Stress (Amsterdam, Netherlands) 2008; 11: 177–197.
Aldao A, Nolen-Hoeksema S, Schweizer S . Emotion-regulation strategies across psychopathology: A meta-analytic review. Clin Psychol Rev 2010; 30: 217–237.
Zapf D, Vogt C, Seifert C, Mertini H, Isic A . Emotion work as a source of stress: The concept and development of an instrument. Euro J Work Organizational Psychol 1999; 8: 371–400.
Phillips B, Tan T T W, Julian C . The theoretical underpinnings of emotional dissonance: a framework and analysis of propositions. J Services Marketing 2006; 20: 471–478.
Zapf D, Seifert C, Schmutte B, Mertini H, Holz M . Emotion work and job stressors and their effects on burnout. Psychol Health 2001; 16: 527–545.
Richards J M, Gross J J . Composure at any cost? The cognitive consequences of emotion suppression. Personality Soc Psychol Bulletin 1999; 25: 1033–1044.
Hulsheger U R, Schewe A F . On the costs and benefits of emotional labor: A meta-analysis of three decades of research. J Occup Health Psychol 2011; 16: 361–389.
Gross J J, Levenson R W . Hiding feelings: the acute effects of inhibiting negative and positive emotion. J Abnorm Psychol 1997; 106: 95–103.
Jordan A H, Monin Bt, Dweck C S, Lovett B J, John O P, Gross J J . Misery has more company than people think: underestimating the prevalence of others' negative emotions. Personality Soc Psychol Bulletin 2011; 37: 120–135.
Ekman P . Emotions revealed understanding faces and feelings. London: Phoenix, 2004.
Hareli S, Hess U . What emotional reactions can tell us about the nature of others: An appraisal perspective on person perception. Cogn Emot 2010; 24: 128–140.
DiMatteo M R, Linn L S, Chang B L, Cope D W . Affect and neutrality in physician behavior: A study of patients' values and satisfaction. J Behav Med 1985; 8: 397–409.
Mauss I B, Shallcross A J, Troy A S et al. Don't hide your happiness! Positive emotion dissociation, social connectedness, and psychological functioning. J Pers Soc Psychol 2011; 100: 738–748.
Gloria C T, Faulk K E, Steinhardt M A . Positive affectivity predicts successful and unsuccessful adaptation to stress. Motivation Emot 2013; 37: 185–193.
Frese M . Social support as a moderator of the relationship between work stressors and psychological dysfunctioning: A longitudinal study with objective measures. J Occup Health Psychol 1999; 4: 179–192.
Lohr J M, Olatunji B O, Baumeister R F, Bushman B J . The psychology of anger venting and empirically supported alternatives that do no harm. Sci Rev Ment Health Pract 2007; 5: 53–64.
Chandarana P V, Hill K B . What makes a good dentist? A pilot study. Dent Update 2014; 41: 156–158.
Rankin J A, Harris M B . Comparison of stress and coping in male and female dentists. J Dent Pract Adm 1990; 7: 166–172.
Acknowledgements
The authors are indebted to the Shirley Glasstone Hughes Trust for funding this project and to the dentists who gave generously of their precious time. They would also like to thank Dr Nima Moghaddam and the anonymous peer reviewers for their helpful comments on earlier drafts of this paper.
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Chapman, H., Chipchase, S. & Bretherton, R. Understanding emotionally relevant situations in primary dental practice. 2. Reported effects of emotionally charged situations. Br Dent J 219, E8 (2015). https://doi.org/10.1038/sj.bdj.2015.852
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DOI: https://doi.org/10.1038/sj.bdj.2015.852
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