Gerry Humphris | University of St Andrews (original) (raw)

Papers by Gerry Humphris

Clinical oncology (Royal College of Radiologists (Great Britain)), 2003

International journal of paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children, 2009

Background. The development of dental anxiety in children is poorly understood.Aims. The aims o... more Background. The development of dental anxiety in children is poorly understood.Aims. The aims of this study were to measure changes in dental anxiety over time and to examine the relationship between anxiety, dental care, and other factors.Design. A prospective cohort study of children in the north-west of England followed from 5 to 9 years of age. The participants were clinically examined and their parents completed the same questionnaire at 5 and 9 years.Results. The majority (54.3%N = 38) of participants who were anxious at 5 years were no longer anxious at 9 years, but a large proportion of children who were anxious at 5 remained anxious at 9 years of age (45.7%N = 32). During the follow-up period, a larger proportion of children developed anxiety (11.7%N = 85) than the proportion of children who were reported as being anxious at baseline (8.8%N = 70). At 9 years of age, dental anxiety was significantly associated with girls; parental anxiety; a history of extraction; and irregular, asymptomatic dental visiting. These factors were also significantly associated with dental anxiety at 5 years old.Conclusions. Dental anxiety was cumulative in the study population over time, and its development influenced by multiple variables. Results suggest that adverse conditioning and vicarious learning are both important in the development of this condition.

Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2013

Background The effect of reassurance in managing distress among children who receive procedures o... more 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).

Critical care medicine, 2003

To evaluate the effectiveness of a rehabilitation program following critical illness to aid physi... more To evaluate the effectiveness of a rehabilitation program following critical illness to aid physical and psychological recovery.

Community dental health, 2013

To test a theoretical model based on Cohen's dental profession factors (training; practit... more To test a theoretical model based on Cohen's dental profession factors (training; practitioner attitudes; geography) to investigate practitioners' willingness to treat adolescents with learning disabilities (LD) in primary dental care. A sample of all 537 primary care dentists working in a mainly urban area of Northern Ireland and a more rural area of Scotland. Willingness to treat adolescents with LD. Questionnaire survey of demographic profile, undergraduate education, current knowledge, attitudes towards individuals with LD and willingness to treat this patient group. A path analytical approach (multiple meditational model) was used. Three hundred dentists participated giving a valid response rate of 61%. Undergraduate education and current knowledge (training) strengthened a social model perspective promoting positive attitudes and willingness to treat adolescents with LD. Undergraduate education and current knowledge about disability did not significantly contribute to dentists whose attitudes were underpinned by the medical model of disability. Therefore geography (rural or urban location) was not an influential factor in willingness to treat adolescents with LD. This does not exclude the possibility that area of work may have an influence as a consequence of undergraduate university attended. This model identifies the importance of undergraduate and continuing dental education with regard to modifying professional attitudes (social and clinical factors) to assist practitioners treat adolescents with LD and provide them with inclusive dental services in primary dental care.

Psycho-oncology, 2009

Background: Fear of recurrence (FOR) has been increasingly recognised as an issue of significant ... more Background: Fear of recurrence (FOR) has been increasingly recognised as an issue of significant burden for most cancer patients, and has been associated with psychological morbidity and reduced quality of life. More recently, the impact of recurrence fears has been indicated in the families of cancer patients. However, there has been a lack of prospective research.Aim: To systematically examine distress and illness concerns among patient–carer dyads.Methods: A multi-centre prospective study of head and neck cancer patients and their carers (patients, n=101; carers, n=101), surveyed at two time-points following diagnosis.Results: Carers recorded higher recurrence concerns on average than the patient group (p<0.001). A predictive path model of patient and carer self-reports of distress and FORs was explored, with an excellent overall fit of the final model (χ2=15.4, df=12, p=0.22, Comparative Fit Index (CFI)=0.994, Root Mean Square Estimate of Approximation (RMSEA)=0.053).Conclusions: The preliminary results establish that early fears and distress within individuals govern later reports on these same attributes, but that there is some weak evidence of influence from one attribute to another within and across individuals in the dyad. Future prospective dyadic research is warranted to ascertain the level of these fears over an extended time and their relationship to patient and carer adaptation. Intervention may be needed to reduce this disease concern to a manageable level at an early stage of the illness trajectory. Copyright © 2008 John Wiley & Sons, Ltd.

Community dental health, 2007

Résumé/Abstract Dental anxiety assessment can be achieved by using brief multi-item scales. Corah... more Résumé/Abstract Dental anxiety assessment can be achieved by using brief multi-item scales. Corah's Dental Anxiety Scale has been used extensively since the 1970s. However the scale has some flaws which led to the design of the Modified Dental Anxiety Scale ...

British dental journal, 2012

Extended duties dental nurses (EDDNs) have been trained to deliver fluoride varnish applications ... more Extended duties dental nurses (EDDNs) have been trained to deliver fluoride varnish applications to preschool children as part of the Childsmile initiative in Scotland. To determine a detailed behavioural profile of the EDDNs during the administration of the fluoride varnish to confirm professional manner and identify differences in nurse behaviours between successful and unsuccessful application sessions. Nurse-child interactions were video recorded and nurse behaviours coded and analysed using a specially developed coding scheme (SABICS). Behaviour frequency and duration were measured and correlations were calculated. Differences in behaviour were examined between successful and unsuccessful application sessions. Three hundred and three interactions were coded out of 456 recorded application sessions. No incident occurred where nurses threatened or placed undue stress on a child. In unsuccessful, compared with successful, application sessions, nurses demonstrated higher frequency and duration of the following behaviours: &amp;amp;amp;#39;permission seeking&amp;amp;amp;#39;, &amp;amp;amp;#39;offer of task alternative&amp;amp;amp;#39;, &amp;amp;amp;#39;information seeking&amp;amp;amp;#39; and &amp;amp;amp;#39;reassurance&amp;amp;amp;#39;, controlling for length of procedure. Whereas with successful applications, &amp;amp;amp;#39;praise&amp;amp;amp;#39;, &amp;amp;amp;#39;instruction&amp;amp;amp;#39; and &amp;amp;amp;#39;information-giving&amp;amp;amp;#39; were used more frequently and for a longer duration, compared with unsuccessful applications. The EDDNs demonstrated a professional manner working with preschool children. They behaved differently between successful and unsuccessful application sessions. Sequential analysis is needed to examine causal effects of behaviours and its effects on delivery outcomes.

Evidence-based dentistry, 2012

Medline and the Social Science Index Citation databases were searched. Studies had to have used m... more Medline and the Social Science Index Citation databases were searched. Studies had to have used measures of dental anxiety completed by children themselves (≤16 years), been published in English and reported primary data. Non-validated measures, those using proxy measures and non-dentally specific measures were excluded. Data were extracted independently using a standardised form. Validity and reliability of the questionnaires were assessed, and measures were evaluated against a theoretical framework of dental anxiety. A qualitative summary of the measures is presented. Sixty studies met the inclusion criteria. These covered seven &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;trait&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; and two &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;state&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; measures of dental anxiety used to assess children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s dental anxiety over the past decade. The findings from this systematic review can be used to help guide dental academics, clinicians, psychologists and epidemiologists to choose the most appropriate measure of dental anxiety for their intended use. Future work should involve evaluating the content and developmental validity of existing measures with further consideration given to the use of theoretical frameworks to develop this field.

The British journal of general practice : the journal of the Royal College of General Practitioners, 2004

Patients often present in primary care with physical symptoms that doctors cannot readily explain... more Patients often present in primary care with physical symptoms that doctors cannot readily explain. The process of reassuring these patients is challenging, complex and poorly understood. To construct a typology of general practitioners&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; (GPs&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;) normalising explanations, based on their effect on the process and outcome of consultations involving patients with medically unexplained symptoms. Qualitative analysis of audiotaped consultations between patients and GPs. Seven general practices in Merseyside, United Kingdom. Transcripts of audiotaped consultations between 21 GPs and 36 patients with medically unexplained symptoms were analysed inductively, to identify types of normalising speech used by GPs. Normalisation without explanation included rudimentary reassurance and the authority of a negative test result. Patients persisted in requesting explanation and elaborated or extended their symptoms, rendering somatic management more likely. Normalisation with ineffective explanation provided a tangible physical explanation for symptoms, unrelated to patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s expressed concerns. This was also counterproductive. Normalisation with effective explanation provided tangible mechanisms grounded in patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; concerns, often linking physical and psychological factors. These explanations were accepted by patients; those linking physical and psychological factors contributed to psychosocial management outcomes. The routine exercise of normalisation by GPs contains approaches that are ineffective and may exacerbate patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; presentation. However, it also contains types of explanation that may reduce the need for symptomatic investigation or treatment. These findings can inform the development of well-grounded educational interventions for GPs.

International journal of surgery (London, England), 2006

General hospital psychiatry

Oral oncology, 2008

The first aim of this study was to describe appearance issues in patients following surgery for o... more The first aim of this study was to describe appearance issues in patients following surgery for oral and oro-pharyngeal squamous cell carcinoma using the Derriford appearance scale (DAS24) and the University of Washington Quality of Life Questionnaire Version 4 appearance item (UWQOL v4). Another aim was to compare these two questionnaires and justify a cut-off in the UWQOL. Also the study compares the cancer group to reference data and explores associations with clinical factors. 383 alive and disease free patients and treated between 1992 and 2005 were sent the survey of which 252 (66%) responded. Age (younger patients), T stage 3 and 4 and adjuvant radiotherapy were key factors in patients reporting problems with appearance. There was excellent correlation between the two questionnaires. A cut-off of less than 75 in the UWQOLv4 appearance item captured most of the problems raised in the DAS24. The cancer cohort had similar DAS24 scores to the general population sample and had more positive scores than the clinical reference group (burns etc patient). In conclusion the UWQOL appearance domain appears to be a suitable means of screening for appearance issues in this cohort and could act as a trigger for further assessment and treatment.

British dental journal, 2003

To determine whether the influence of a leaflet on mouth cancer improves knowledge, related attit... more To determine whether the influence of a leaflet on mouth cancer improves knowledge, related attitudes and intention to accept a mouth screen. Randomized controlled trial. Dental and medical waiting rooms in the North West of England. Nine hundred and forty nine patients from 16 practices were invited to participate. Standardized multi-item scales of six outcome measures including knowledge, beliefs and intention to accept an oral cancer screen. A patient information leaflet was given to a randomized intervention group of patients. A single sheet questionnaire was completed by both groups of patients (immediately following leaflet administration in the intervention arm of study). t tests were used to compare outcome variables between patients with and without access to the leaflet with Boneferroni correction. Participation rate was high (91%). Knowledge (P <0.001) and intentions (P = 0.003) benefited from patient access to leaflet. Anxiety was not raised with leaflet exposure. Some beliefs about the screening procedure appeared to be slightly improved by reading the leaflet (p <0.05). This study supports previous findings of an immediate positive effect of an information leaflet on patients' knowledge of oral cancer and willingness to accept an oral cancer screen.