Validation and randomized control trial of the e-SAID, a computerized paediatric dental patient request form, to intervene in dental anxiety


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Abstract

BackgroundA rationale for, and pilot of a children's patient request form developed specifically for dental visits, has been previously reported. The SAID (survey of anxiety and information for dentists) is a questionnaire with three embedded subscales: dental anxiety, coping style and dental neglect. It includes children's requests for emotional support, information and treatment. The main, but not sole, response format is a facial image scale. A randomized control trial of a computer version is now reported. The aims were to validate items in the e-SAID, and to assess it as an intervention in dental anxiety.MethodA total of 168 children aged 10–13, attending for routine dental checks in a community dental clinic, were randomly assigned to intervention (83) or control (85) groups. The intervention group completed the e-SAID, in which the first and last questions measured anxiety; and printed a summary of their responses for the dentist. Control group children completed the same anxiety questions, but with a time-lapse.ResultsMeans and SD were summarized for the 11 items showing a generally positive skew on the seven point scale. After removing the two-item dental neglect subscale, the anxiety and coping subscales were shown to be relatively independent (r = 0.14) and factorially pure. The intervention group mean anxiety score decreased following completion of the e-SAID, while the control group mean anxiety score increased with a small significant interaction effect; however, much of the change occurred in the positive-affect end of the scale.ConclusionsTwo problems are discussed: defining anxiety as a bipolar score; and some children being so keen to be assigned to the intervention group that they circumvented the computer allocation process. Children wanted to actively engage in discussion of their dental treatment. The e-SAID was an effective tool for that, regardless of initial low anxiety levels.

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