STANCES AND KNOWLEDGE OF DENTAL MEDICINE STUDENTS ABOUT ONCOLOGY PATIENTS’ DENTAL CARE

Cilj: Glavni cilj ovog istraživanja bio je utvrditi kakvi su stavovi i znanja studenata dentalne medicine iz Splita, Rijeke, Zagreba, Ljubljane i Sarajeva o dentalnoj skrbi onkoloških pacijenata te postoji li potreba za uvođenjem dodatnih edukacija na navedenu temu za vrijeme njihovog studiranja. Materijali i metode: U ovom je istraživanju sudjelovalo ukupno 140 ispitanika. Istraživanje je provedeno među studentima 4., 5. i 6. godine studija dentalne medicine u Splitu, Zagrebu, Rijeci, Sarajevu i Ljubljani. Znanja i stavove studenata o dentalnoj skrbi onkoloških pacijenata ispitali smo u obliku anonimnog online upitnika sastavljenog od 36 specifičnih pitanja. Nakon prikupljanja svih ispunjenih upitnika napravljena je statistička analiza dobivenih podataka. Rezultati: Studenti su učili o pružanju dentalne skrbi onkološkim pacijentima, ali samo 16,4% ispitanika misli da može pružiti adekvatnu pomoć onkološkim pacijentima. Teorijsko znanje o incidenciji i najčešćoj vrsti tumora glave i vrata je zadovoljavajuće. Nešto slabije je znanje o nuspojavama radio/kemoterapije u usnoj šupljini, posebno o promjeni okusa tijekom terapije (48,6% ispitanika ponudilo je netočan odgovor na pitanje o promjeni okusa, a 25% odgovorilo je Niti se slažem, niti se ne slažem). Studenti svih fakulteta nisu pokazali zadovoljavajuće znanje o ORN, koja je najozbiljnija nuspojava radioterapije, i znanje baš o ovoj nuspojavi bi trebalo biti najveće. Na tvrdnju “ORN je u početku bezbolna.” najveći postotak odgovora Ne slažem se i U potpunosti se ne slažem ponudili su studenti iz Rijeke (31,3%), a velik postotak odgovora Niti se slažem, niti se ne slažem zabilježen je na svim fakultetima, najviše u Ljubljani i Rijeci (37,5%). Također, na tvrdnju “Ukupna doza zračenja veća od 40 Gy predstavlja rizik za ORN.” 47,9% studenata odgovorilo je Niti se slažem, niti se ne slažem. Nesigurnost kod studenata svih pet fakulteta se pokazala na pitanja o potrebnom broju trombocita i granulocita kod hitnog invazivnog zahvata i antibiotske profilakse. Na tvrdnje o broju trombocita i granulocita, 27,1% ispitanika, odnosno njih 32,9%, odgovorilo je Niti se slažem, niti se ne slažem. Također, nisu bili sigurni ni u vremenski period prije početka onkološke terapije unutar kojega je moguće ekstrahirat zube i endodontski ih liječiti (34,3% ispitanika nije ponudilo točan odgovor na pitanje o ekstrakciji). Studenti su upoznati s uputama u oralnu higijenu i balansiranu prehranu pacijenata na onkološkoj terapiji. Iako su uočene određene razlike u stupnju znanja između fakulteta, iste nisu bile dovoljne da bi se pokazale i statistički značajnim primjenom Kruskal-Wallis ANOVA testa. Primjenom generalnog regresijskog modela potvrđeno je da fakultet na kojem studiraju ima jedino statistički značajan utjecaj na tvrdnju „Nije dokazana veća incidencija karijesa kod onkoloških pacijenata“. Zaključak: Studenti su učili o onkološkoj terapiji, ali su svjesni da nisu dovoljno educirani o pružanju odgovarajuće dentalne skrbi onkološkim pacijentima i 100% ispitanika želi naučiti više o pružanju iste. Budući da fakultetsko obrazovanje treba studentu pružiti što više potrebnog znanja za daljnju karijeru doktora dentalne medicine, dodatna edukacija o dentalnoj skrbi onkoloških pacijenata je nužna.Goal: Main goal of this research was to establish stances and knowledge of dental medicine students from Split, Rijeka, Zagreb, Ljubljana and Sarajevo about oncology patients’ dental care, and if there is a need for introduction of additional instructions on the subject during their education. Material and methods: A total of 140 subjects took part in this research. Said research was conducted amongst students of 4., 5. and 6. year of dental medicine studies in Split, Zagreb, Rijeka, Sarajevo and Ljubljana. Knowledge and stances of students on the subject of dental care for oncology patients was tested in the form of an anonymous online survey composed of 36 specific questions. After gathering all completed surveys, a statistical analysis of acquired data was conducted. Results: Students have learned about providing dental care to oncology patients, but only 16.4% of them thinks that they can provide adequate dental care to oncology patients. Theoretical knowledge about the incidence and the most common type of head and neck tumors is satisfactory. Knowledge is poor about the side effects of radio/chemotherapy in oral cavity, especially about the change in taste during therapy (48.6% of respondents offered an incorrect answer to the question about the change in taste, 25% answered Neither agree, nor disagree). Students of all faculties did not show satisfactory knowledge about ORN, which is the most serious side effect of radiotherapy, and knowledge about this side effect should be the greatest. To the statement "ORN is initially painless." the highest percentage of answers I disagree and I completely disagree offered students from Rijeka (31.3%), and a great percentage of answers Neither agree, nor disagree was recorded at all faculties, mostly in Ljubljana and Rijeka (37.5%). Also, to the claim "A total radiation dose greater than 40 Gy poses a risk to ORN." 47.9% of students answered Neither agree, nor disagree. Insecurity in knowledge of students at all five faculties was shown by questions about the required number of platelets and granulocytes in emergency invasive surgery and antibiotic prophylaxis. When asked about the number of platelets and granulocytes, 27.1% of respondents, actually the 32.9% of them, answered Neither agree, nor disagree. Also, they were unsure in the time period before the start of oncology therapy within which is possible to extract the teeth and endodontically treat them (34.3% of respondents did not offer an accurate answer to the question about extraction). Students are familiar with the instructions in oral hygiene and balanced diet of patients during an oncology therapy. Using Kruskal-Wallis (ANOVA) test, differences observed in degree of knowledge on the subject between universities were proven not statistically relevant. General regression model used in the study confirmed that the university which students attend has statistically relevant impact on the claim “No higher incidence of dental caries was proven in oncology patients”. Conclusion: Students learned about oncological therapy, but are aware they don’t have sufficient knowledge to provide adequate dental care to oncology patients and 100% of subjects want to learn more on the subject of dental care for oncology patients. Since college education is supposed to provide the student with as much as possible knowledge for future career of a dental practitioner, additional education on the subject of dental care for oncology patients is necessary