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Reassurance and Distress Behavior in Preschool Children Undergoing Dental Preventive Care Procedures in a Community Setting: a Multilevel Observational Study

Annals of Behavioral Medicine

Abstract

Background

The effect of reassurance in managing distress among children who receive procedures of a less aversive nature has not been fully investigated.

Purpose

This study aimed to investigate the relationship between reassurance by dental staff and distress behavior of preschool children receiving preventive procedures in a community setting.

Methods

Nurse–child interactions (n = 270) during fluoride varnish application were video recorded and coded. Multilevel logistic regression modeled the probability of the occurrence of child distress behavior as a function of reassurance provision, controlling for child-level and nurse-level variables.

Results

Child distress behavior was positively related to nurse verbal reassurance but negatively linked to the time that this reassurance occurred. Both child initial anxiety and nurse nonprocedural training increased the probability of observable distress behavior.

Conclusions

The use of verbal reassurance to promote reception of mild invasive procedures was counterindicated, especially when offered early in the intervention (ClinicalTrials.gov number: NCT00881790).

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Acknowledgments

We would like to acknowledge the National Health Service (NHS) Fife health board who funded the 1-year pilot study (2007–2008) and the Scottish government who provided financial support for the 3-year main study (2008–2011). In addition, we would like to acknowledge the support from the University Court of the University of St Andrews, who kindly acted as the sponsor for this study. We would also like to acknowledge the support from the Childsmile Evaluation Board, the Childsmile Evaluation and Research Team, and the Childsmile Directors Lorna Macpherson and Graham Ball. We thank all participants including the schools, dental nurses, parents, and children for their enthusiastic participation. We are grateful to Gillian Forbes for helping with collection and coding of the video data and to Jonathan Davidson for preparing the data file. We also gratefully acknowledge the valuable statistical advice provided by Dorothy Currie.

Conflict of Interest

The authors have no conflict of interest to disclose.

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The views expressed in this article are those of the authors and not necessarily those of the funders.

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Correspondence to Yuefang Zhou Ph.D..

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Zhou, Y., Humphris, G.M. Reassurance and Distress Behavior in Preschool Children Undergoing Dental Preventive Care Procedures in a Community Setting: a Multilevel Observational Study. ann. behav. med. 48, 100–111 (2014). https://doi.org/10.1007/s12160-013-9566-7

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  • DOI: https://doi.org/10.1007/s12160-013-9566-7

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