Community Dental Health

cover art

Cover Date:
June 2010
Print ISSN:
0265 539X
Vol:
27
Issue:
2

Editorial - Use of qualitative data in oral health research

Qualitative research encapsulates a broad range of methodological approaches which complement quantitative methods by providing, “an in-depth and interpreted understanding of the social world, by learning about people’s social and material circumstances, their experiences, perspectives and histories” (Richie & Lewis 2003). The uses of qualitative data are fourfold:

which immigrants adopted the behaviours of their adopted country – in this case a greater intake of sugar containing food and drinks which were not so easy to access in their home country. The qualitative method allowed respondents to discuss their perceptions of the process through which their behaviour had changed and the many influences on this.

Describing a process or phenomenon or mapping the features of a phenomenon
Where little is known about a phenomenon or the features have not previously been clearly delineated, qualitative methods can provide a rich level of data to map such key features. For example Travess et al (2004) analysed themes emerging from focus group interviews with patients who had undergone combined orthodontic and orthognathic treatment. The data revealed that patients’ experience of such treatment was disproportionately focussed on the surgical aspects of treatment, and highlighted themes (in particular post-operative pain relief) which were especially important to patients, but which would not necessarily take prominence in clinical descriptions of the treatment.

Generating new ways of perceiving or understanding a social phenomenon
In-depth qualitative research can provide a startling new perspective on a phenomenon, even one as well researched as tooth decay. Nations & Nuto Sde (2002) describe beliefs about tooth decay and dental care amongst individuals in Brazil. They contrasted the views of university-trained dentists who had a disease-orientated, microbiological, technology-rational model of dental health, with a lay model in which tooth worms burrow from tooth to tooth and cannot be eradicated by placement of a filling. According to the latter model faith in God was as important for soothing pain as visiting the dentist. The authors suggest that the lay explanatory model shaped the experience of dental pain, the timing and sequencing of help-seeking behaviours, and contributed to the lack of acceptance of caries prevention advice. Understanding the patients’ perspective has clear implications for health promotion, the provision of preventive advice and treatment.

Explaining social phenomena
Beyond description of a process or phenomenon, qualitative methods can be used to produce theoretical explanations of social behaviours through a combination of inductive and deductive inferences. As an example of this, Bedos et al (2009) conducted focus group and individual interviews with people in receipt of social assistance, a group who despite benefitting from free access to dental care, do not routinely use dental services. These researchers report that participants defined oral health in a social manner, placing great value on dental appearance, yet felt powerless to improve their oral health. Thus their non-attendance is interpreted not as ignorance or lack of motivation, but as the result of a feeling of being powerless to access services. This paper is remarkable for its place as the first study using qualitative methods to be published in Journal of Dental Research. Here the qualitative research provides information to explain a quantitative observation through understanding the meaning of the behaviour to participants.

The role of qualitative methods in health research
Qualitative research provides a way of getting beyond the general to the specific and enables us to understand the minutiae of people’s lives and the role of oral health and oral health related behaviours within them. This benefits health service research in five specific ways. Firstly, quantitative, positivist research produces generalisable knowledge, however as clinical practitioners we need to know when generalities end and individual factors become important. Further, we need to know how individuals interact with their environments. There are clear implications for the practice of evidence based dentistry. Under what circumstances should guidelines be considered inappropriate for a particular individual ? Second, the positivist paradigm is based on the belief that phenomena can be reduced to their constituent parts, measured, and then causal relationships deduced. Such an approach is linear as opposed to the holistic and context dependent nature of the social world in which we live. The third benefit for health services research of the qualitative approach relates to the move from equating health with the absence of disease and towards a state of complete physical social and mental wellbeing. This has promoted lay-conceptions of health which need to be understood if we want to be able to treat our patients and influence their oral health related behaviours.

Understanding perspectives, motivations and frames of reference
Similarly the perspectives of particular groups on their oral health, their motivation for engaging in oral health related behaviours (or behaviours which are harmful to oral health) can all be explored through qualitative research. Bower & Newton (2007) conducted interviews with Albanian speaking individuals living in London. They were able to place oral health within a wide context of acculturation, by

Article Price
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Page Start
66
Page End
67
Authors
Professor J. T. Newton, Dr. S. Scambler

Articles from this issue

  • Title
  • Pg. Start
  • Pg. End

  1. Editorial - Use of qualitative data in oral health research
  2. 66
  3. 67

  1. A health equity methodology for auditing oral health and NHS General Dental Services in Sheffield, England.
  2. 68
  3. 73

  1. Effectiveness of structured comprehensive paediatric oral health education for parents of children less than two years of age in Germany
  2. 74
  3. 80

  1. An assessment of nutritional information in oral health education leaflets
  2. 81
  3. 88

  1. Reliability analysis of visual examinations carried out by schoolteachers and a dental assistant in the detection of dental caries.
  2. 89
  3. 93

  1. Oral health in children in Denmark under different public dental health care schemes
  2. 94
  3. 101

  1. Caries experience and oral health behaviour among 11 – 13-year-olds: an ecological study of data from 27 European countries, Israel, Canada and USA
  2. 102
  3. 108

  1. Caries prevalence and intra-oral pattern among young children in Ajman.
  2. 109
  3. 113

  1. Endodontic treatment completion following emergency pulpectomy
  2. 114
  3. 117

  1. Prevalence of cleft lip and palate in births from 2003 – 2006 in Iran.
  2. 118
  3. 121

  1. Development of a measure of childhood information learning experiences related to dental anxiety
  2. 122
  3. 128