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Patients’ perspectives on integrated oral healthcare in a northern Quebec Indigenous primary health care organisation: a qualitative study
  1. Richa Shrivastava1,
  2. Yves Couturier2,
  3. Naomi Kadoch1,
  4. Felix Girard1,
  5. Christophe Bedos3,
  6. Mary Ellen Macdonald3,
  7. Jill Torrie4,
  8. Elham Emami3
  1. 1 Faculty of Dentistry, Université de Montréal, Montréal, Québec, Canada
  2. 2 School of Social Work, Université de Sherbrooke, Sherbrooke, Québec, Canada
  3. 3 Faculty of Dentistry, McGill University, Montréal, Québec, Canada
  4. 4 Public Health Department, Cree Board of Health and Social Services of James Bay, Mistissini, Québec, Canada
  1. Correspondence to Elham Emami; elham.emami{at}mcgill.ca

Abstract

Objective Patient-centred care is considered to be an important element in the evaluation of integrated healthcare and has been effective in addressing oral health disparities. This study explored the patients’ perspectives of patient-centred integrated care in oral health services integrated into a primary healthcare organisation serving a northern Quebec Cree population.

Design This study used a multiple case study design within a qualitative approach and developmental evaluation methodology. Two theoretical models, Picker’s Principles of Patient-Centred Care and Valentijn’s Rainbow Model of Integrated Care, guided data collection and data analysis. The thematic analysis included transcription, debriefing, codification, data display and interpretation.

Setting This study was conducted in purposefully selected four Cree communities of Northern Quebec.

Participants Adult patients in need of oral healthcare and who attended the local dental clinic were identified and recruited by maximum variation sampling and snowball techniques.

Outcome measures Patients’ perspectives of patient-centred integrated oral healthcare.

Results Data analysis generated six major themes: enhanced accessibility, creating supportive environment, building trust through shared decision making, appreciation of public health programmes, raising oral health awareness and growing cultural humility among healthcare providers. Patients identified the integration of dental care into primary healthcare with respect to co-location, provision of free oral healthcare services, care coordination and continuity of care, referral services, developing supportive environment, shared decision making, oral health promotion and culturally competent care.

Conclusion These results confirmed that patient-centred care is an important element of integrated care. Patients valued the use of this concept in all domains and levels of integration. They recommended to further strengthen the clinical integration by involving parents in oral health promotion as well as optimising care coordination and empowering a supportive environment in organisational integration.

  • primary care
  • organisation of health services
  • quality in healthcare

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors RS contributed to study concept and design, acquisition, data collection, reviewing transcripts, coding, analysis and interpretation of data; drafting and critical revision of the manuscript. YC contributed to acquisition, data collection, revising analysis and critical revision of the manuscript. NK contributed to study concept and design, acquisition, reviewing transcripts, coding, analysis and interpretation of data, and drafting the manuscript . FG contributed to acquisition, data collection, revising analysis and critical revision of the manuscript. CB contributed to acquisition, revising analysis and critical revision of the manuscript. MEM contributed to acquisition, revising analysis and critical revision of the manuscript. JT contributed to study concept and design, acquisition, revising analysis and critical revision of the manuscript. EE contributed to study concept and design, acquisition, data collection, revising analysis and critical revision of the manuscript.

  • Funding We received funds from funding agencies including Canadian Institutes of Health Research, Quebec Population Health Research Network, Institut de recherche en santé publique de l’Université de Montréal, Fondation de l’Ordre des dentistes du Québec, the Network for Canadian Oral Health Research, and the Network for Oral and Bone Health Research (CIHR grant number: GI1-145123).

  • Competing interests None declared.

  • Ethics approval Ethics approval for this study was obtained from the Institutional Review Board of the Université de Montréal, McGill University and permission from the Research Committee of the Cree Board of Health and Social Services of James Bay.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

  • Patient consent for publication Not required.

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