Article Data

  • Views 388
  • Dowloads 55

Original Research

Open Access

Facilitating Care of Children with Juvenile Idiopathic Arthritis, Orofacial Pain, and Dysfunction: An Interview Study of Specialized Health Professionals

  • Eva Leksell1,*,
  • Catharina Eriksson2
  • Malin Ernberg3,4
  • Britt Hedenberg-Magnusson5

1Department of Paediatric Dentistry, Umeå University Hospital, Umeå, Sweden

2Department of Clinical Sciences Paediatrics, Umeå University Hospital, Umeå, Sweden

3Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden

4Scandinavian Centre for Orofacial Neuroscience (SCON), Huddinge, Sweden

5Department of Orofacial Pain and Jaw Function, Eastman Dental Institute, Folktandvården Stockholm, Stockholm, Sweden

DOI: 10.11607/ofph.2850 Vol.35,Issue 4,December 2021 pp.278-287

Submitted: 02 October 2020 Accepted: 26 June 2021

Published: 30 December 2021

*Corresponding Author(s): Eva Leksell E-mail: eva.leksell@umu.se

Abstract

Aims: (1) To deepen knowledge on how specialized health care professionals (HCPs) reflect on encounters with children diagnosed with juvenile idiopathic arthritis (JIA) and (2) to outline a theory for orofacial care. Methods: Grounded theory was used to discover the psychosocial processes involved in communication between HCPs, children, and parents, and this information was used to develop a theory about these processes. Using classic grounded theory, a total of 20 interviews with HCPs were analyzed. Results: One main concern, “secure health and biopsychosocial development,” permeated all care. A core category was identified as “create a responsive interaction with the child and family.” The data that supported this core category helped to explain how the HCP responded to a patient to promote orofacial health. Based on the dentist’s responses to the child, eight subcategories were identified: (1) secure confidential relationships; (2) convey disease-specific knowledge; (3) communicate healthy findings and form mutual insights at examination; (4) encourage health-promoting behaviors;(5) ensure follow-up; (6) share perspectives; (7) guide parenting; and (8) improve knowledge and networks. Conclusion: How the dentist shall best understand the needs of a child diagnosed with JIA requires further evaluation. To promote oral health, the child must feel safe, confirmed, and supported with knowledge. Also, further studies are needed on the dentist’s collaboration with the pediatrician and the physiotherapist for contributing to overall health.

Keywords

interdisciplinary network; juvenile idiopathic arthritis; oral health; professional care; qualitative


Cite and Share

Eva Leksell,Catharina Eriksson,Malin Ernberg,Britt Hedenberg-Magnusson. Facilitating Care of Children with Juvenile Idiopathic Arthritis, Orofacial Pain, and Dysfunction: An Interview Study of Specialized Health Professionals. Journal of Oral & Facial Pain and Headache. 2021. 35(4);278-287.

References

1. Petty RE, Laxer RM, Lindsley CB, Wedderburn L. Textbook of Pediatric Rheumatology [e-book]. London: Elsevier Health Sciences, 2015.

2. Harrison LE, Pate JW, Richardson PA, Ickmans K, Wicksell RK, Simons LE. Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain. J Clin Med 2019;8:1267.

3. Backström M, Tynjälä P, Aalto K, et al. Validating 10-joint juvenile arthritis disease activity score cutoffs for disease activity levels in non-systemic juvenile idiopathic arthritis. RMD Open 2019;5:e000888.

4. Nordal E, Rypdal V, Arnstad ED, et al. Participation in school and physical education in juvenile idiopathic arthritis in a Nordic long-term cohort study. Pediatr Rheumatol Online J 2019;17:44.

5. Arnstad ED, Rypdal V, Peltoniemi S, et al. Early self-reported pain in juvenile idiopathic arthritis as related to long-term outcomes: Results from the Nordic juvenile idiopathic arthritis cohort study. Arthritis Care Res (Hoboken) 2019;71:961–969.

6. Barbosa TS, Gavião MB, Leme MS, Castelo PM. Oral health-related quality of life in children and preadolescents with caries, malocclusions or temporomandibular disorders. Oral Health Prev Dent 2016;14:389.

7. Halfon N, Forrest CB, Lerner RM, Faustman EM. Handbook of Life Course Health Development. Cham: Springer International Publishing, 2018.

8. Leksell E, Ernberg M, Magnusson B, Hedenberg-Magnusson B. Orofacial pain and dysfunction in children with juvenile idiopathic arthritis: A case-control study. Scand J Rheumatol 2012;41:375–378.

9. Fischer J, Skeie MS, Rosendahl K, et al. Prevalence of temporomandibular disorder in children and adolescents with juvenile idiopathic arthritis - a Norwegian cross- sectional mul-ticentre study. BMC Oral Health 2020;20:282.

10. Glerup M, Stoustrup P, Matzen LH, et al. Long-term outcomes of temporomandibular joints in juvenile idiopathic arthritis: 17 years of followup of a Nordic juvenile idiopathic arthritis cohort. J Rheumatol 2020;47:730–738.

11. Leksell E, Hallberg U, Magnusson B, Ernberg M, Hedenberg-Magnusson B. Perceived oral health and care of children with juvenile idiopathic arthritis: A qualitative study. J Oral Facial Pain Headache 2015;29:223–230.

12. Stinson JN, Toomey PC, Stevens BJ, et al. Asking the experts: exploring the self-management needs of adolescents with arthritis. Arthritis Rheum 2008;59:65–72.

13. Isola G, Perillo L, Migliorati M, et al. The impact of temporo-mandibular joint arthritis on functional disability and global health in patients with juvenile idiopathic arthritis. Eur J Orthod 2019;41:117–124.

14. Bollhalder A, Patcas R, Eichenberger M, et al. Magnetic resonance imaging followup of temporomandibular joint inflammation, deformation, and mandibular growth in juvenile idiopathic arthritis patients receiving systemic treatment. J Rheumatol 2020;47:909–916.

15. Frid P, Nordal E, Bovis F, et al. Temporomandibular joint involvement in association with quality of life, disability, and high disease activity in juvenile idiopathic arthritis. Arthritis Care Res (Hoboken) 2017;69:677–686.

16. Skeie MS, Gil EG, Cetrelli L, et al. Oral health in children and adolescents with juvenile idiopathic arthritis - a systematic review and meta-analysis. BMC Oral Health 2019;19:285.

17. Kjellberg H. Juvenile chronic arthritis. Dentofacial morphology, growth, mandibular function and orthodontic treatment. Swed Dent J Suppl 1995;109:1–56.

18. Kirkhus E, Arvidsson LZ, Smith HJ, Flatø B, Hetlevik SO, Larheim TA. Disk abnormality coexists with any degree of synovial and osseous abnormality in the temporomandibular joints of children with juvenile idiopathic arthritis. Pediatr Radiol 2016;46:331–341.

19. Valentino R, Rongo R, Alessio M, et al. “Pressure pain threshold over masticatory muscles and temporomandibular joint in patients with juvenile idiopathic arthritis”. J Oral Rehabil 2020;47:944–950.

20. Resnick CM, Frid P, Norholt SE, et al. An algorithm for management of dentofacial deformity resulting from juvenile idiopathic arthritis: Results of a multinational consensus conference. J Oral Maxillofac Surg 2019;77:1152.e1–1152.e33.

21. Resnick CM, Dang R, Henderson LA, et al. Frequency and morbidity of temporomandibular joint involvement in adult patients with a history of juvenile idiopathic arthritis. J Oral Maxillofac Surg 2017;75:1191–1200.

22. Stoustrup P, Resnick CM, Pedersen TK, et al. Standardizing terminology and assessment for orofacial conditions in juvenile idiopathic arthritis: International, multidisciplinary consen-sus-based recommendations. J Rheumatol 2019;46:518–522.

23. Leksell E, Hallberg U, Horne A, Ernberg M, Hedenberg-Magnusson B. Parenting a child with juvenile idiopathic arthritis, orofacial pain, and dysfunction: A qualitative study. J Oral Facial Pain Headache 2017;31:353–361.

24. Glaser BG, Strauss AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. New York: Aldine de Gruyte,1967.

25. Blumer H. Symbolic Interactionism: Perspective and method. Englewood Cliffs, NJ: Prentice-Hall, 1969.

26. Dellve L, Nordiska hälsovårdshögskolan. Coping with childhood disability [thesis]. Göteborg: Nordic School of Public Health, 2000.

27. Strauss AL, Corbin JM. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory, ed 2. Thousand Oaks, CA: Sage, 1998.

28. Charmaz K. Grounded theory: Objectivist and constructivist methods. In: Denzin NK, Lincoln YS (eds). Handbook of Qualitative Research, ed 2. Thousand Oaks, CA: Sage, 2000: 509–536.

29. Lundberg V, Sandlund M, Eriksson C, Janols R, Lind T, Fjellman-Wiklund A. How children and adolescents with juvenile idiopathic arthritis participate in their healthcare: Health professionals’ views. Disabil Rehabil 2020:1–8.

30. Harder M, Söderbäck M, Ranheim A. Health care professionals’ perspective on children’s participation in health care situations: encounters in mutuality and alienation. Int J Qual Stud Health Well-being 2018;13:1555421.

31. Gilljam BM, Arvidsson S, Nygren JM, Svedberg P. Promoting participation in healthcare situations for children with JIA: A grounded theory study. Int J Qual Stud Health Well-being 2016; 11:30518.

32. Golsäter M, Johansson LO, Harder M. General practitioners’ accounts of how to facilitate consultations with toddlers - an interview study. Scand J Prim Health Care 2017;35:3–9.

33. Stivers T. Physician-child interaction: When children answer physicians’ questions in routine medical encounters. Patient Educ Couns 2012;87:3–9.

34. Petersson C, Huus K, Åkesson K, Enskär K. Children’s experiences about a structured assessment of health-related quality of life during a patient encounter. Child Care Health Dev 2016;42:424–432.

35. Rahimi H, Twilt M, Herlin T, et al. Orofacial symptoms and oral health-related quality of life in juvenile idiopathic arthritis: A two-year prospective observational study. Pediatr Rheumatol Online J 2018;16:47.

36. Bucci R, Rongo R, Amato A, Martina S, D’Anto V, Valletta R. The psychological impact of dental aesthetics in patients with juvenile idiopathic arthritis compared with healthy peers: A cross-sectional study. Dent J (Basel) 2019;7:98.

37. Myrlund R, Keski-Nisula K, Kerosuo H. Stability of orthodontic treatment outcomes after 1-year treatment with the eruption guidance appliance in the early mixed dentition: A follow-up study. Angle Orthod 2019;89:206–213.

38. Cirgic E, Kjellberg H, Hansen K, Lepp M. Adolescents’ experiences of using removable functional appliances. Orthod Craniofac Res 2015;18:165–174.

39. Storm Mienna C, Glas L, Magnusson M, Ilgunas A, Häggman-Henrikson B, Wänman A. Patients’ experiences of supervised jawneck exercise among patients with localized TMD pain or TMD pain associated with generalized pain. Acta Odontol Scand 2019;77:495–501.

Abstracted / indexed in

Science Citation Index (SCI)

Science Citation Index Expanded (SCIE)

BIOSIS Previews

Scopus

Cumulative Index to Nursing and Allied Health Literature (CINAHL)

Submission Turnaround Time

Conferences

Top