Dental Hygiene: Evidence-Based Practice - Research Proposal Example

Running head: DENTAL HYGIENE: EBP Dental Hygiene: Evidence-Based Practice Name: University: Course: Tutor: Date: Research Plan Title: Dental hygiene: evidence-based practice Aim: To identify whether dental hygienists are aware of new research findings in the dental hygiene field and whether they put new knowledge into practice. Literature Review Dental hygiene is part of oral hygiene and this is the practice of keeping the mouth clean so as to preclude dental problems as well as bad breadth. Dental hygiene calls for an increase in the number of intervention studies which clearly outline key advances in clients’ oral health outcomes. There is a concern of whether dental hygienists are adequately informed about new knowledge in the field of dental hygiene. In cases where dental hygienists are aware of new evidence-based dental hygiene practices the application of such knowledge is often lacking (Wilder et al., 2008). This is despite the fact that evidence-based practice (EBP) can only become operational if the knowledge obtained from current research is put into practice (Cobban, 2004). Oral hygiene specialists, specifically dental hygienists, work towards ensuring that health care services lead to the specialists’ clients’ optimal oral health results. The use of evidence-based methodology aims at making sure that research evidence is exploited (Cobban, Edgington & Clovis, 2008). Roger’s Theory of Diffusion of Innovations (RTDI) (Rogers, 2003) which has been applied to examine research application in several other fields may be used in dental hygiene analysis, as well, to offer insights. This is possible because research use is a significant constituent of EBP, while diffusion of research cognition is a crucial action in enforcing EBP. RTDI has some prognosticate for building up a discernment of cognition transfer in dental hygiene, and has so far been applied in studying the information-seeking conducts among dental hygienists (Rogers, 2003). According to Berwick (2003), many correlational and descriptive studies have depicted the dissemination of modification as debuts have disseminated within specific populations. These surveys have analysed relations amongst the innovation’s elements, the channel applied to disseminate the innovation’s cognition, the social system’s features of prospective adopters, as well as the duration for the innovation’s effectuation to take place. Among the identified oral illnesses and disorders, oral cancer happens to be the only disease that oftentimes leads to death, and frequently results to severe deformity (Clovis, Horowitz & Poel, 2003). Clovis, Horowitz and Poel affirmed that dental hygienists can take part in the cutting down of morbidity and mortality linked to oral cancers. This therefore highlights the need to have dental hygienists who have up-to-date information improvement of dental hygiene. Syme, Drury and Horowitz (2001) analysed Maryland dental hygienists’ roles in relation to evaluation of the oral cancer’s danger on patients. These authors noted that most hygienists examined for current tobacco use, a smaller number examined for previous tobacco habit and even a smaller number of hygienists examined for current or previous alcohol usage. The hygienists who conducted more inclusive screenings were more likely to be convinced of the need to provide tobacco stoppage teaching. According to Horwitz et al. (2002), dental hygienists alleged that their employers hardly expected them to carry out oral cancer tests hence dental hygienists did not find need to carry out the tests. A study by Clovis, Horowitz and Poel (2003) on Canadian dental hygienists in British Columbia and Nova Scotia identified gaps between knowledge and enforcement of the knowledge as far as oral cancer checkups are concerned. Dental specialists and researchers acknowledge that EBP will close the gap amongst dental hygiene practitioners in their endeavour to adopt the latest innovations for application. The main challenge however lies in identifying how the new knowledge can be translated from research into practice in a timely manner than presently going (Rogers, 2003). Since the application of new knowledge is mainly mandated on dental hygienists, it becomes worth enquiring whether dental hygienist are aware of new approaches in dental hygiene as well as the extent of application of the innovations. Research Question: How far are dental practitioners keeping their knowledge and practices current? Research Methodology: This study will take a qualitative approach since the main aim is to collect the views of dental hygienists concerning their awareness of new approaches in dental hygiene and their application. According to Golafshani (2003), qualitative research is used where the researcher seeks “illumination, understanding and exploration” (p. 600) of various situations thus a qualitative approach in this study will lead to illumination on evidence-based practice in dental hygiene. Since the researcher does not have a prior hypothesis on EBP in dental hygiene but rather seeks to understand dental hygienists’ EBP, a qualitative methodology emerges the most appropriate approach (Family Health International, n.d). Research Design: Sample selection: Qualitative research requires the researcher to select a subset of the entire population thus a suitable sampling method is required (Rubin & Babbie, 2007). This study will use quota sampling where the choice of participants is determined by selecting persons with certain characteristics such as members of a certain profession. In this study, the sample will be selected from a population of practicing dental hygienists in Central Auckland, New Zealand. Practising dental hygienists will be best versed with the views of interest (EBP in dental hygiene) in this study thus the information that will be collected will be highly accurate. A total of 20 practising dental hygienists in Central Auckland will be recruited for this study. It is important to note that qualitative research methods do not necessarily rely on sample size to derive important conclusions (Pope, Ziebland and Mays, 2000). As such, a sample size of 20 hygienists is expected to provide informative conclusions and at the same time enable an easy and cost effective study. The research team members will be responsible for recruiting prospective participants using quota sampling. In specific, research representatives will seek written consent from the New Zealand Dental Association for purposes of identifying licensed dental hygienists and their contacts. To ensure that the hygienists’ autonomy is maintained, the identified dental hygienists will be contacted via telephone to allow them to provide a written informed consent. Informed consent is one way of making sure that study participants understand the reasons behind participating in a particular study, the risk or benefits involved and the subsequent self-will to participate or not to participate in a study (Family Health International, n.d). The first 20 dental hygienists who will consent to participate in this study will be recruited and informed of their expected roles as interviewees. This will ensure that the participants will easily set time for interviews that will be administered in the study. Lack of rigour is one of the most critical issues in qualitative research (Marnie, Leybourne & Arnott, 2000). These authors however cite that rigour can be attained through use of measures that ensure that the study is dependable and trustworthy. The researcher intends to make the interviews less formal to ensure that participants will speak with as much freedom as possible. To ensure credibility in this study, the participants will be provided with drafts of the research outcomes and the research findings will not be hidden from the participants. This study will also maintain rigour by ensuring that the procedures and conclusions of this study are easily understood by other authors especially in the field of dental hygiene. Utilizing recruitment strategies that fit a study population in terms of culture as well as location is an important aspect of quota sampling (Family Health International, n.d). Since this study will take place in New Zealand, it will be important to adhere to the Treaty of Waitangi and the Principles thereof. There are generally three principles in the Treaty of Waitangi: partnership, protection and participation (Hudson, 2009). Since partnership encompasses the involvement of all persons (the Crown, Iwi and Maori) in order to achieve oral health benefits, this research will not discriminate participants during sampling. It is expected that forming partnerships with the department of health or the New Zealand Dental Association will be easy as noted by Durie (1998). Durie (1998) identifies that partnership is realised through formation of agreements between government agencies and different tribes in New Zealand. The principle of protection details rules regarding the protection of the interests of the people of Maori. This study will adhere to this principle by ensuring that autonomy, privacy and confidentiality of all the participants are maintained throughout and after the study. The findings of this study as well as any progress in the study will only be released to authorised persons and used for purposes of this study. This will certainly enhance the partnership and cooperation in the successful administration of this study. The principle of participation in the Treaty of Waitangi entails the involvement of Maori peoples’ in health care services (Hudson, 2009). It is therefore the intention of the researcher to involve the participants in the entire process of the study (including communicating the outcomes to the participants as necessary) as a way of increasing the participation of the Maori people in health care services. The involvement of the Maori dental hygienists will be a boost in the participation of the Maori in clinical studies. Instruments: Self-administered interviews will be conducted among dental hygiene practitioners to allow an in-depth understanding of the question at hand (a sample of the interview questions to be administered is attached in the appendix). Reis and Judd (2000) argue that self-administered interviews are suitable in research since they allow face-to-face interaction with the respondent. Furthermore, self-administered interviews can be conducted using telephone thus they may not require a lot of facilities. In addition to taking notes during the interviews, the researcher will also record the interviews on an audio tape for later exploration and note taking. Data collection methods: In-depth semi-structured interviews will be conducted among dental hygiene practitioners. Family Health International (n.d) mentions that in-depth interviews are useful in qualitative studies since they help in gathering data on individual’s perspectives or experiences regarding a certain topic. In this study, the experiences and views of dental hygienists as regards familiarity with and application of current research-based knowledge will be identified through the self-administered interviews. Identified dental hygienists will be requested to volunteer to stay an extra 40 minutes in the evening or any other time they are free to participate in the interviews. Cooperation from the participants is expected since they will have communicated their consent to participate in the interviews. In cases where it will not be possible to reach hygienists face-to-face, the participants will be interviewed through the telephone. However, the researcher will make every effort to conduct face-to-face interviews to ease costs of interview instruments and to maintain uniformity of interviews. Use of interviews is a flexible research design since it is possible to change the wording of the interview questions as well as include or exclude certain questions as it may seem appropriate (Robson, 2002). This study will therefore not only rely on the structured interview questions (in the appendix) but the researcher will exploit the principle of flexibility as will seem appropriate. This will enable collection of as much and relevant information as possible regarding EBP in dental hygiene among practitioners. The interviews will be based on open-ended questions to allow dental hygienists feel free to respond using their preferred words and in an in-depth manner. It is expected that the respondents will provide information with easiness due to the informal approach of qualitative design which the researcher will maintain during the interviews (Patton, 2002). Data analysis: This study will utilize content analysis as the principle data analysis technique. Pope, Ziebland and Mays (2000) highlight that textual data collected during interviews is best explored via content analysis and simple counts in rare cases where specific aspects of the study are to be analyzed. In this study, the various aspects of the study collected via note taking will be analyzed and coded to generate analytical categories as well as provide explanations. It is important to note that the recorded interviews will be re-listened and notes will be taken concerning the important aspects of the study. A grounded theory approach will be utilized, where analytical categories will be identified as they emerge from the exploration of the data (Thorne, 2003). The indexed data will then be analysed using appropriate statistical packages (SPSS in this study) to provide further description of the data and to enable derivation of conclusion. Ethical issues: Since this research will involve human subjects, ethical guidelines will be followed accordingly. It is however notable that the participants will be exposed to very low risk. However, this study will adhere to principles of beneficence, autonomy and respect for communities (Family Health International, n.d). The researcher will ensure that the participants give a written informed consent and the participants will be informed that they could choose not to participate in the study. The Auckland University of Technology Ethics Knowledge Base will be consulted to approve this study. It is expected that the Auckland University of Technology Ethics Committee (AUTEC) will consider whether all ethical issue in biomedical research are adhered to more so in maintaining the safety of the participants. Any necessary recommendations from the Ethics Committee will be adhered to and implemented before or during the study. Expected outcome: The participants (dental hygienists) will be more knowledgeable on the availability of current knowledge in dental hygiene. Eventually, participants will be able to gauge their level of evidence-based practice in dental hygiene specifically in Central Auckland. Overall, this study will enable dental hygienists to keep their knowledge and practice current. References Berwick, M. (2003). Disseminating innovations in health care. Journal of American Medical Association, 289(15): 1969-1975. Clovis, B., Horowitz, B., & Poel, H. (2003). Oral and pharyngeal cancer: knowledge, opinions and practices of dental hygienists in British Columbia and Nova Scotia. Canadian Dental Hygiene Association Journal Probe Scientific, 37(3): 109-122. Cobban, S. J. (2004). Evidence-based practice and professionalization of dental hygiene. International Journal of Dental Hygiene, 2(4): 152-160. Cobban, S. J., Edgington, E. M. and Clovis, J. B. (2008). Moving research knowledge into dental hygiene practice. Journal of Dental Hygiene, 82(2): 1-11. Crawford, H. K., Leybourne, M. L. and Arnott, A. (2000). How we ensured rigour in a multi-site, multi-discipline, multi-researcher study. Forum Qualitative Sozialforschung / Forum: Qualitative Social Research, 1(1), Art. 12, Retrieved 6, Oct. 2010 from http://nbn-resolving.de/urn:nbn:de:0114-fqs0001125. Durie, M. (1998). Whaiora: Māori health development. Auckland: Oxford University Press. Family Health International. (n.d). Qualitative research methods overview. Qualitative Research Methods: A Data Collector's Field Guide. Golafshani, N. (2003). Understanding reliability and validity in qualitative research. The Qualitative Report, 8(4): 597-607. Hudson, M. L. (2009). The Treaty of Waitangi and research ethics in Aotearoa. Journal of Bioethical Inquiry, 6(1), 61-68. doi: 10.1007/s11673-008-9127-0 Patton, M. Q. (2002). Qualitative research and evaluation methods (3rd Ed.). California, CA: Sage. Pope, C., Ziebland, S. and Mays, N. (2000). Qualitative research in health care: Analysing qualitative data. British Medical Journal, 320(7227): 114-116 doi: 10.1136/bmj.320.7227.114 Reis, H. T. and Judd, C. M. (2000). Handbook of research methods in social and personality psychology. New York, NY: Cambridge University Press. Robson, C. (2002). Real world research: a resource for social scientists and practitioner-researchers. 2nd Ed. Oxford, UK: Blackwell Publishing. Rogers, M. E. (2003). Diffusion of innovations. 5th Ed. New York, NY: Free Press. Rubin, A. and Babbie, E. R. (2007). Essential research methods for social work (2nd Ed.). California, CA: Brook/Cole, Cengage Learning. Syme, E., Drury, F., & Horowitz, M. (2001). Maryland dental hygienists' assessment of patients’ risk behaviours for oral cancer. Journal of Dental Hygiene, 75(1): 25-38. Thorne, S. (2003). Data analysis in qualitative research. Evidence Based Nursing, 3: 68-70. doi:10.1136/ebn.3.3.68 Wilder, R. C., O'Donnel, J. A., Barry, J. M., Galli, D. M. and Hakim, F. F. et al. (2008). Is Dentistry at risk? A case for interprofessional education. Dental Education, 72(11): 1231-1237. Appendix 1. How many years have you been in dental hygiene practice? 2. Please elaborate your understanding of evidence-based practice in dental hygiene. 3. Are you aware of any new research findings concerning the practice of oral health? 4. Do you have access to recent publications in the field of dental health practice particularly in New Zealand? If yes, where do you access the information from? 5. How often do you apply new research findings in dental health practice? 6. What is your general view about acquisition, dissemination and application of novel research-based knowledge in the field of oral health more so in New Zealand? 7. Do you think that evidence-based practice and use of up-to-date methods in dental health would improve oral health outcomes in patients? Read More