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| Name | Class |
|---|---|
| Yeditepe University | OTHER |
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In the present study, we aimed to assess children's anxiety levels by using different dental anxiety scales and children's drawings evaluated according to two different scoring systems: Child Drawing: Hospital (CD: H) and Emotional indicators of Human Figure Drawings (HFD).
Background: Drawings can be used as a method of communication that represents an individual's self-concept, anxiety, attitude, or conflict.
Aim: The purpose of this study was to evaluate children's drawing as a measure of dental anxiety in a dental setting.
Design: Seventy- eight children, aged 6-12 years, were enrolled in this study. Pulp therapy and/or restorative treatment was performed during the first therapeutic session for all participants. Sound, Eye, and Motor (SEM) and Frankl scales were used as an objective assessment of dental anxiety during treatment. After the treatment session, the children were instructed to draw a picture of a person at a dental clinic. Children's drawings were scored by a paediatric dentist and a psychologist using Child Drawing: Hospital (CD: H) scale and emotional indicators of Human Figure Drawings (HFD). The findings were compared with Frankl and SEM scores.
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| Measure | Description | Time Frame |
|---|---|---|
| Child Drawing: Hospital (CD: H) scale | Children's drawings were scored by a paediatric dentist and a psychologist using Child Drawing: Hospital (CD: H) scale.CD: H Scoring Guide, Rating Scale and the CD: H score sheet was used for the scoring of the drawings.A manual has been established to aid in scoring the drawing, which consists of specific directions and examples to assist in scoring the drawing. Raters were directed to read and understand the CD: H manual carefully, which includes the CD: H Scoring Guide and Rating Scale and the CD: H Score Sheet.The scoring of the drawing consists of three sections. Level of anxiety according to CD: H score sheet was as follows.27 <43: very low stress, 44-83: low stress, 84-129: average stress, 130-167: above average; and 168 and over: very high stress. | 1 hour |
| Human Figure Drawings (HFD) | Children's drawings were scored by a paediatric dentist and a psychologist usingemotional indicators of Human Figure Drawings (HFD).Thirty clinically valid emotional indicators (EIs) consisting of 9 quality signs, 13 special features, and eight omissions.Drawings are analyzed by the presence or absence of EIs. Score EIs as 1 = present or 0 = absent, and a total score is achieved by adding all scores that can be used in statistical analysis. Drawings can be quickly evaluated for evidence of EIs which are signs on HFDs that are associated with specific traits, anxieties.For instance, insecure and anxious children prefer to draw small figures. Moreover, children with anxiety tend to shade parts of the figure.Two or more EIs imply possible emotional difficulties exhibited by the child that warrant further investigation. | 1 hour |
| Frankl Scale | Frankl scale was used as an objective assessment of behaviour during treatment.The Frankl scale is rated according to the following criteria: Rating score 1: definitely negative: Refusal of treatment, crying forcefully, fearful or any other overt evidence of extreme negativism; Rating score 2: negative: Reluctant to accept treatment, uncooperative, some evidence of negative attitude but not pronounced, that is sullen, withdrawn; Rating score 3: positive: acceptance of treatment; at times cautious, willingness to comply with the dentist, at times with reservation but patient follows the dentist's direction cooperatively; Rating score 4: definitely positive: good rapport with the dentist, interested in dental procedures, laughing and enjoying the situation. |
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Inclusion Criteria:
Exclusion Criteria:
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Number of patients required was calculated on the basis of a micro-sample at an accepted level of significance(p<0.05) and a maximum permissible error α<0.05 and β<0.2. A total of 78 children were enrolled in this study. The participants of this study included children referred to, Paediatric Dentistry Department for their dental treatment on primary teeth. Once admitted to the Paediatric Dental Clinic children are examined by a paediatric dentist and each child is appointed for their dental therapeutic session. Comprehensive treatment plans of 571 children were examined and eligible 78 subjects who matched the inclusion criteria were randomly selected from children who were appointed for their first dental treatment session.
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| 1 hour |
| Sound, Eye, and Motor (SEM) scale | Sound, Eye, and Motor (SEM) and Frankl scales were used as an objective assessment of behaviour during treatment.The slightest manifestation of the eyes, sound or motion of the patient is graded in four levels: comfort, slight discomfort, moderate pain, and pain. Rating scores range from 1 to 4. Lowest score represent comfort whereas high score indicate pain. | 1 hour |