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Background and literature of review
Background
Hypnosis is considered a commonly used therapy option in case of dentistry and medicine for the patients in order to reduce their fear and pain while getting treatment. This specific phobia of dental treatment along with dental anxiety are considered prevalent conditions which are capable of causing impairment in oral health of an individual (Ncbi.nlm.nih.gov, 2023a). Good cooperation is necessary here with a dentist who is accountable to carry out procedures under sedation and general anaesthesia in order to achieve proper treatment conditions in case of both doctor and patients. This is followed by enhancement of the overall patient comfort along with reducing fear and anxiety. More than 10 million people in adult age have dental anxiety and an estimate of approximately 6 million people suffering from dental phobia in the UK (Wolf et al. 2022). In addition, it can also be addressed that approximately 53% of the overall population in the UK are facing phobia in regards to dental treatment (Bsch.org.uk, 2023). These populations are scared to visit their dentists along with an estimation of 17% of the population that have explained their excessive fear of visiting dentists and refused to complete their essential dental work (Publishing.rcseng.ac.uk, 2023). In the case of the identified country, the use of hypnotherapy does not require specific training and law and that emphasises on its implementation by the people who are not necessarily professional. In the UK, more than 3000 people are currently practising hypnotherapy as well as consisting of individual practitioners and working together with registered therapists for maintaining professional associations (Ncbi.nlm.nih.gov, 2023a).
Importance and justification
There are a great variety of methods that have been used in hypnotic intervention while treating dental issues and causing districting assessment in the form of powerful and successful methods while reducing anxiety among passions. On the other hand, dental anxiety or dental phobia is considered the severity of the psychological and physiological symptoms while triggering fears in the form of a perception of the visuals, olfactory and sensory stimulus during dental treatment (Ncbi.nlm.nih.gov, 2023a). It includes inclusion of visualisation, suggestion as well as hypnosis strategies with the aim of training the patient to put themselves on a level while focusing on the consciousness of the patient during the treatment which improves the overall treatment outcome.
Current knowledge gap
Even though the use of hypnosis is common in treating dental phobia among patients while receiving treatment, approximately 20% of the population shows a proper response to the hypnotherapy (Bsch.org.uk, 2023). On the other hand, approximately 50 to 60% of patients land somewhere else in terms of responding to or declining the therapeutic aspects of hypnotherapy in the case of receiving dental treatment (Publishing.rcseng.ac.uk, 2023). This factor requires in-depth research while understanding the proper use of hypnotherapy with the aim of increasing its effectiveness alongside identifying the adverse impact on patients while getting treatment. This is followed by identifying the gap of the adverse impact while receiving treatment from this intervention process in comparison to the other available option while reducing anxiety and pain of the patient (Ncbi.nlm.nih.gov, 2023a). It also requires shedding light on the dentist's perspective to choose specific intervention in terms of improving beneficial outcomes for both the patient and dentist.
SPICE framework
This model is used in order to generate qualitative research questions. Here, "S" stands for the setting which explains the word "Where". For the following context, it refers to the NHS sedation clinics situated in Essex in the UK. The "P" stands for perspectives and addresses "for whom" or the identified population. For the following context of the research proposal, it explains dental phobic patients from NHS sedation clinics situated in Essex. "I" stands for Intervention that refers to the use of hypnotherapy for reducing a patient's anxiousness and pain while getting treatment. “C” stands for comparison factor that refers to patients receiving other therapy in comparison with hypnosis and “E” for evaluation that will focus on the positive side of receiving this treatment.
Research question
The potential research question for this proposal refers to "How do dental phobic patients from NHS sedation clinics in Essex react to hypnotherapy?”
Aim and objectives
Aim of this proposal revolves around the identification of the impact of hypnotherapy for the dental phobic patients from NHS sedation clinics in Essex and the objectives focusing on the identification of study design to collect qualitative information for the following context.
Methodology
Study design
The following research proposal is based on the dental phobic patients from the NHS sedative cleanings in Essex and their perception in regards to hypnotherapy while reducing their anxiety and pain. The primary starting design of this proposal is based on the identification of relevant information on the study subject by using qualitative research methods while applying proper study design. This factor also implicates the potential start design in the form of an interview process for the following context which is associated with a prior representation of potential questionnaires for the identified group to estimating study outcome (Silva et al. 2022). In addition, it can also be stated that designing an elevated and rapid research process on the basis of different patient perceptions towards the effectiveness of hypnotherapy in order to reduce their anxiety and pain during dental treatment shades light on the availability of different research articles while presenting the effectiveness of identified intervention. As the role of qualitative research method is considered a significance tape that highlights the identified research subject by providing naturalistic reviews on the subject, it also addresses an in-depth understanding of the context while using existing information for a proper outcome (Borusyak et al. 2022). On the other hand, the interview process is an important attempt that helps with follow up questions and is conducted in a discussion manner while focusing on the selected group (Wolf et al. 2022) and for the following it refers to the dental phobic patients from NHS sedation clinics in Essex. This has the aim of providing a comprehensive description of the identified research question and assessing the influence of hypnotherapy intervention on the findings in terms of addressing the role of hypnotherapy for successful dental treatment by reducing a patient's anxiety.
It can also be justified that the implementation of qualitative study is effective for the following context while addressing new and integrative interpretation of findings that are already existing with the aim of shading light on the overall substances in comparison with addressing findings of individual studies alone (Borusyak et al. 2022). This also includes providing effective robust outcomes for researchers while understanding the magnitude of impact of the identified intervention in terms of continuing treatment for dental phobia among the identified population. The role of interview also helps with identifying proper conclusions by using potential open-ended questions suitable for identifying research questions and traits that helps to influence the future research on hypnotherapy alongside making decisions on treatment policies and improving the care approach for dental phobic patients while dealing with the overall treatment aspect (Hossain et al. 2022).
Setting/Sample
The sample will be collected from the NHS and private patients from Essex who have obtained the dental treatment procedures and then the overall sample size will be generated by using a sample size calculator. For the following context, approximately 10 people will be contacted from the same ground in the UK with the aim of collecting information for the overall research proposal and those will be collected by using open-ended questionnaires [Refers to appendix 1]. The sample also includes people from the private hypnotherapy clinic in Essex who have already done the therapeutic process and have the fear of going through the process. On the other hand, those people require to be associated with a regular visit in a dental clinic and have anxiety while going through the overall process. However, the collection process will also use the inclusion and exclusion criteria while contacting people for the conduction of the interview process.
Inclusion and exclusion
The use of inclusion and exclusion criteria in case of the following research proposal helps with pointing out the primary in-study population in a consistent and reliable manner (Willems et al. 2022). It also includes uniformly and objectively addressing the identification of specific types of information which will be justified for the following research proposal while conducting the order study alongside meeting the formed research question. While the exclusion criteria share light on the specific characteristics of information that are not required for the following research proposal and suitable for the identified population, the inclusion criteria highlight the opposite by addressing the preferability of collected information. These techniques are effective while focusing on suitable information to conduct the overall qualitative study context for the identified subject (Bao and Roubaud, 2022).
The inclusion criteria adults who are 18 years and above with the presence of dental issues and dental treatment. They also have natural teeth present for at least 24. This is followed by the people who do not smoke or chew tobacco and have not undergone any orthodontic treatment. This is followed by including people who are not diabetic or pregnant or suffering from any chronic disease alongside not taking "Amlodipine as well as Nifedipine, Phenytoin along with Cyclosporine or any type of anticoagulant group of medication. This is followed by the population who have been through dental treatment and have gone through sedation for reducing pain and their anxiety.
The exclusion criteria refer to the people under the 18 years of age alongside those diagnosed with periodontal disease conditions. This is followed by excluding people who have less than 24 natural teeth present alongside a chain smoker or chew tobacco regularly. This is followed by excluding people who have undergone orthodontic treatment and consist of chronic disease conditions such as diabetes or pregnancy. These are followed by the people who consume "Amlodipine as well as Nifedipine, Phenytoin along with Cyclosporine or any type of anticoagulant group of medication.
Intervention/controls or comparison
There will be two groups of participants and they will be randomly assigned while conducting the overall interview process. They will be asked questions on a face-to-face interview process and will be given their questionnaire before starting the process. Besides, they need to go through the oral treatment procedure before participating in the process and need to have prior experience while accepting sedation in terms of reducing pain for dental treatment. While the first group will be a control group who have gone through other intervention processes while receiving pain during dental treatment the comparison group will be receiving hypnotherapy for going through the treatment process.
Outcome
Hypnotherapy is considered a significant tool that is implied in terms of treating dental pain. It also helps patients to get rid of their phobia by muting all irrational thoughts as well as creating a feeling of calm confidence (Uziel and Eli, 2023). In addition, it can also be stated that this type of therapy is effective for continuing the non-pharmacologic treatment intervention for patients suffering from dental pain. Regardless of the overall progress of any treatment, the primary challenge of treating patients in case of dentistry refers to the management of free and intraoperative anxiety of the patient (Ncbi.nlm.nih.gov, 2023a). This also includes doctors to identify a proper option for treating patients with dental phobia.
Data extraction and analysis
This can be done by structuring the significant features of the identified information while understanding primary terms and characteristics to make the overall process more structured (Martins et al. 2022). Here, the data will be collected by going through interview answers and then followed by identifying codes from those answers. This also includes generation of themes on the basis of those codes and present in Microsoft office. Besides, the data extraction will be based on the use of Microsoft Excel while using those codes and the implementation of in-text citation while in the form of developing proper themes for the overall process. The themes will be focusing on the prevalence of dental anxiety and phobia among the identified group of people and is followed by the available option of intervention for treating dental issues. Here, the primary focus will be on the use of hypnotherapy in comparison with the usage of other intervention and treatment processes for dental treatment. This is followed by focusing on the effectiveness of the identified treatment process and the high-end use of this process in dentistry.
Result
The result will be focusing on the implementation of hypnosis therapy to reduce the dental phobia among the patients from NHS sedation clinics situated in Essex. This includes focusing on the percentage of population that relies on this identified therapeutic intervention as well as doctors’ perceptions while using this process and its effectiveness. From the overall discussion as it was identified that only a limited population are aware of the positive result from using this intervention the improving quality and awareness regarding this therapy is also necessary which needs to be focused and supported with. The overall research will also focus on the patient's perceptions while receiving dental treatment and their reason for feeling fears and anxiety for the treatment and their perceptions while using other intervention.
Ethical considerations
As the proposal is intended to use human participation for the conduction of the interview process, the ethical risk is high here while conducting the overall research process. However, qualitative health research is primarily focused on the experience of people in relation to health and illness (Sinkovi? and Towler, 2019). Therefore, the ethics includes sending consent forms for the identified people along with the copy of the questionnaire before starting with the interview process [Refers to appendix 2]. This is followed by keeping the participants' anonymity along with maintaining confidentiality in regards to their answer revealing identity and storing their answer after the conduction of the interview process. On the other hand, data confidentiality needs to be maintained while managing the purpose of the study and the interview process as well as the implementation of audio and video recording for the interview by informing the participants beforehand. However, there are some specific ethical rates that need to be addressed in the form of risk of bias along with the risk of harm as well as the power imbalance while conducting the overall interview process.
Relevance to practise
The use of any technique while doing treatment is effective to depend heavily on the dentist in terms of applying the process alongside empathic abilities in order to demonstrate the procedure to reduce the anxiety of the patient. The proper acceptance of hypnosis intervention helps with effectively reducing anxiety among patients with dental phobia and also reducing their fear and anxiety of getting treatment. It has a positive impact on improving the overall health outcome and avoiding lack of dental treatment, reducing the sensation of feeling pain and low bleeding during tooth extraction. Therefore, the identified research subject is important to carry out while focusing on the implementation of hypnosis intervention for a better outcome for both the dentist and patients.
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