Patient decision-making in relation to extensive restorative dental treatment. Part II: Evaluation of a patient decision-making model.

A theoretical model was proposed and tested to evaluate some of the factors involved in patients' decisions to undergo extensive restorative dental treatment. This model incorporates aspects of the environment within which the decision occurred (the patient/provider relationship, social influence and the role of cues in initiating treatment) and internal values held by the individual (perceptions of value of and barriers to treatment). Value of treatment was measured using aesthetics, function, health motivation and self-esteem. Barriers to treatment included fears and anxieties about treatment, the costs of treatment, the time involved in obtaining treatment and access to care. Data were collected by mailed questionnaire from 188 patients at a North American state university dental school who had received over $1,500 of restorative dental treatment during 1990/91. Data were analysed using path analysis multiple regression. The most important determinant in the decision to undergo treatment was patient/provider relationship. As expected, barriers exerted an inverse effect upon the outcome and had twice the influence compared with the patients' perceived value of treatment. Cues and social influence were not shown to play a significant role in initiating restorative dental treatment.