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歯科診療における小児の心理状態と行動の把握 : CFSS-DS, Faces Rating Scalesおよび色選択法を用いた検討

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  • Relationship between the psychological condition and the behavior of children on the dental treatments using CFSS-DS, Faces Rating Scales and the color selection method

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Abstract

小児の歯科診療においては, 成人よりきめ細やかな対応が必要である。小児患者に対してどのような対応法をとるかについては, 対象となる小児によって異なるが小児の歯科診療に対する心理状態が把握できれば, 歯科的対応が容易になり, 歯科治療を円滑に進めることができると考えられる。そこで, 今回, 新潟大学医歯学総合病院小児歯科診療室を受診した, 歯科受診経験のある3歳1か月~7歳11か月の34名の健常小児を対象に, 歯科診療時の心理状態と行動を把握することを目的に, 心理的評価としてCFSS-DS, FS, 色選択法(心理的評価)を用いて歯科診療時の小児の態度(行動評価)を観察し検討を行った結果, 以下の知見を得た。1. CFSS-DS値と診療前のFS評価値, および年齢との間に正相関がみられたことから, 診療前の低年齢小児の心理状態は,歯科恐怖や不安と関連性があることが明らかになった。2. CFSS-DS値と診療中の態度との間に相関がみられたことから, 低年齢小児では歯科診療に対する歯科恐怖や不安がそのまま診療中の態度に表出されることが心理行動解析によって示された。3. 好きな色選択法は診療前後の心理的変化を, 診療前後での色選択法は次の歯科診療時の入室時行動を把握できる可能性が推察された。4. 色選択によって, CFSS-DSとFSでは捉えきれない小児患者の入室時の行動を把握できる可能性が示唆された。

More delicate care should be provided in dental treatments for children than for adults. Although the dentist-patient communication may differ in accordance with each child, dental correspondence may be made easier and dental treatments may be conducted more smoothly if the dentist is aware of the child's psychological condition regarding dental treatment. Therefore, for the purpose of foreseeing psychological condition and behavior during dental treatments, we used CFSS-DS (Dental Sub-scale of Children's Fear Survey Schedule), FS (Faces Rating Scales), and the color selection methods as psychological evaluations to assess the attitude of 34 examinees aged 3 years and 1 month to 7 years and 11 months who had experienced dental treatments. The results were as follows. 1) Fear and anxiety about an upcoming dental treatment were relevant to the psychological conditions of the lower age group children because a positive correlation was detected between the CFSS-DS and the FS values before the dental treatment and between the test values and the child's age. 2) Behavior analysis clarified that fear and anxiety about dental treatment in the lower age group infants was directly reflected in their attitude during dental treatment, because there was a correlation between the CFSS-DS value and the attitudes during dental treatment. 3) The psychological change between before and after the dental treatments might be understood using the favorite color selection method, and prospective behavior upon entering the treatment room for an appointment might be presumed by the color selection method prior to and after the dental treatment. 4) The color selection method was effective in predicting the children's behavior upon entering the treatment room, which CFSS-DS and FS could not foresee completely.

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