Difficult dental patients: a grounded theory study of dental staff's experiences

Introduction: The "difficult" patient is a well-known and potentially negative character across care contexts. Objectives: To generate a conceptual framework explaining the main concerns about "difficult" dental patients and deepen understanding of their characteristics, their effects on dental staff, and how staff think and act to manage them. Methods: Ten semi-structured interviews with dentists, dental hygienists, and dental nurses were audio-recorded, transcribed, and analyzed using grounded theory. Results: The core category "balancing subjective difficulties" emerged, encompassing seven interrelated categories: showing interaction difficulties; having bio-psycho-social complexity; evoking negative emotions and behaviors; hampering self-esteem and job satisfaction; impairing life and health in general; activating internal and external resources; and creating adaptive treatment relations. Conclusions: Dental staff identify specific characteristics, effects, and handling strategies regarding "difficult" patients. The capacity to balance subjective difficulties depends on contextual conditions such as time and focus, indicating a need for further research on dental interactions and broader perspectives on "difficult" dental patients.

Adam Alvenfors, Mersiha Velic, Bertil Marklund, Sven Kylén, Peter Lingström, Jenny Bernson