Abstract
Purpose Person-centered care focuses on the whole person as a unique individual whose perspective, as well as their family’s perspective, is integrated into the provision of care. The purpose of this study was to describe the perspectives of patients regarding the influence of dental hygienist providers’ Social Intelligence on self-care and to create a Social Intelligence Self-care Conceptual Model.
Methods An investigator-designed questionnaire was administered to patients who received care at a dental hygiene program clinic following a minimum of one 15-minute self-care education session. Five open-ended items relating to patients’ perspectives of the dental hygienist providers’ Social Intelligence on self-care included: 1) commitment 2) partnering 3) responsibility, 4) positive social qualities and 5) negative social qualities. Responses were analyzed and themes developed for the first three items. Social Intelligence capabilities were used to analyze the last two items.
Results A total of 103 participants responded to the questionnaire. Themes for the first three items were: 1) interactions promoting encouragement and that are educational and individualized, 2) personal and shared responsibility, and 3) helpful, collaborative, and negative partners. Analysis of the last two items regarding influential positive and negative qualities yielded adapted Social Intelligence capabilities definitions. A Social Intelligence Self-care Conceptual Model was created by combining the study’s results, the concepts of the Client Self-care Commitment Model, and the philosophy of person-centered care.
Conclusion Social Intelligence was apparent in participants’ interpersonal interactions with dental hygiene care providers that were encouraging, educational, and individualized. Other influential interactions in relationship building were revealed in the themes of shared responsibility, helpful and collaborative partnerships and positive qualities demonstrated by dental hygienists. The Social Intelligence conceptual model may be valuable to implement into education and practice with the goal of improving person-centered care and the client’s oral health.
- social intelligence
- person-centered care
- patient-centered care
- client self-care commitment model
- social Intelligence self-care conceptual model
INTRODUCTION
Three aspects of patient care were interwoven to study Social Intelligence (SI) and develop a conceptual model. First, person-centered care (PCC) was investigated to understand its origin and differentiation from patient-centered care as well as its relationship to SI. Second, the Client Self-care Commitment Model (CSCCM)1 was reviewed for its relevance to PCC and SI. Lastly, SI was studied from patients’ perspectives as related to self-care education.
Person-centered care
Understanding the historical perspective of patient-centered care and its evolution into person-centered care (PCC) is needed as the literature on PCC is limited. In 1993, Gerteis et al. identified patient-centered care as respect for the values, preferences, and expressed needs of patients; coordination and integration of health care; information, communication, and education; physical comfort; emotional support including relieving fear and anxiety; and involvement of family and friends.2 These dimensions were highlighted in the Institute of Medicine’s (IOM) 2001 report calling for improving health care quality in the United States (US) by altering ways that patients and their families, clinicians, and others interact with the healthcare system.3 An intent of this change was to move the health care system towards being safe, effective, patient-centered, timely, efficient, and equitable. Patient-centered care encompassed compassion, empathy, and responsiveness to needs, values, and preferences of the individual person.3
Much has been published about patient-centered care and PCC since the IOM report. Epstein and Street commented that patient-centered care should change physician dominated dialogues to discussions that engage patients in active participation in their care.4 Physicians should be educated to be more mindful, informative, and empathetic to transform their role from an authority to a partner, with solidarity, empathy, and collaboration.4 A patient-centered approach should invite the individual to participate in the care process.4
In 2015, a review assessed PCC’s relationship to improving coordination and successful health care and services.5 Unsurprisingly, a universal definition of PCC was not found. Findings indicate that providers and organizations need to promote PCC by engaging persons in partnerships, shared decision making and meaningful participation in health care improvement.5 Mills et al. explored patients’ perspectives of PCC in dentistry and found that PCC was important in the delivery of high-quality care and should be a focus of the dental team.6 Five relational aspects of care emerged: connection, attitude, communication, empowerment and being valued. Subsequently, a dental model of PCC from the patient’s perspective was developed.6
In 2017, Walji et al. shared perspectives about PCC along with the opportunities and challenges for academic dental programs.7 Opportunities when changing to a PCC educational model include under-scoring social determinants of health, shared decision making, collaborative practice, preventive care, precision care, value-based payment and internet and connected devices. Challenges include changing mission and value statements, competencies, external curricular assessments, and infrastructure.7
In 2018 Lee et al. commented that dental systems should change from treating diseases to promoting health and that individuals and their social well-being should be placed at the center of decision making, including factors outside of the dental office.8 Person-centered care offers an opportunity for dentistry to improve quality of care and health outcomes, encourages change from surgery and treatment to health promotion and improvement, and focuses on oral health as integral to overall health. Thus, a proposed PCC model was presented with three key players: person, provider and care designer.8 This model is unlike others in dentistry that have focused solely on the provider within the clinical setting.6, 9,10.
In 2019 Håkansson Eklund et al. concluded that patient-centered care and PCC were superficially similar in shared decision making, relationships, communication, empathy, respect, engagement, holistic focus, individualized focus, and coordinated care.11 However, when further analyzed, empathy, communication, and holistic focus differed.11 In person-centered care, empathy is defined as understanding the person’s feelings in the present and considering how these feelings relate to life. Person-centered care communication is multifaceted with dialogue and narrative clarifying what is important to the individual. Person-centered care holistic perspective underscores the interdependence of the psychological, social and biological dimensions. Therefore, patient-centered care focuses on a functional life, whereas PCC focuses on a meaningful life.11
Palatta noted that while dental care was focused on the disease of a patient, PCC focuses on the whole person.12 Person-centered care also encourages dentistry to embrace the social determinants of health as defined by the World Health Organization and are defined as the conditions into which people were born, grow, work, live and age.13 Social determinants shape daily life and account for 70% of all health outcomes. Therefore, with a disease-centric versus a person-centered model the provider loses 70% of the data needed to improve health outcomes.12 The PCC model reconnects the mouth and body, reassesses perceptions of who oral health educators and providers are, and reevaluates educators’ and providers’ roles in assessing health outcomes for all people.12 These fundamental changes require alterations in the education of health care students,12 as echoed by Walji et al.7
Professional organizations have incorporated patient-centered care and PCC into their defined standards. The American Dental Hygienists’ Association defined patient-centered care as: “approaching services from the perspective that the client is the main focus of attention, interest, and activity. The client’s values, beliefs, and needs are of utmost importance in providing evidence-based care.”14 The Commission on Dental Accreditation identified patient-centered care within the standards for oral health care programs.15-17 These standards focus on communication, interpersonal skills, collaboration, and cultural diversity that relate to PCC. In 2021, the American Dental Education Association stated that outcomes for master’s and doctoral level graduates are to design and/or lead health care teams to deliver person-centered services and improve health care delivery systems.18 In conclusion, the newer concept, PCC, differs from patient-centered care in that PCC focuses on the whole person as a unique individual whose perspective, as well as their family’s perspective, is integrated into the provision of care.
Client Self-Care Commitment Model
Person-centered care concepts are evident in the Client Self-Care Commitment Model (CSCCM).1 The CSCCM unites concepts from the Explanatory, Client Empowerment, and the Human Needs Conceptual Models with the purpose of empowering clients as decision makers to enhance their oral health through commitment and adherence.1 Another goal was to involve patients or clients as co-therapists and incorporate not only “scientific data,” but also social or cultural information into self-care education.1
The CSCCM outlines five domains of exchange to facilitate the reciprocation of information between co-therapists (provider and client).1 The first domain, “initiation,” is the earliest opportunity for the clinician to begin building rapport with the client. By the third domain, the client and provider become co-therapists after verbalizing views utilizing the Explanatory model. In the fifth domain “evaluation” occurs and the cycle continues with a co-therapist approach. This model relates to PCC because the patient or client is cared for with new information learned in the context of daily living rather than through “formal” instruction. Dental hygienists “evolve from experts who select the client’s self-care behaviors to co-therapists who facilitate clients’ decisions.”1 This model clearly reflects PCC in that it addresses the client’s beliefs, values and priorities (Table I).
Five domains of information exchange of the Client Self-care Commitment Model (CSCCM)
Since its creation in 2000, the CSCCM has been incorporated into oral health research. The new model was found to enhance client participation in the periodontal disease treatment process, improve adherence to oral self-care behaviors, and ultimately contribute to a reduction in periodontal probe depths.19 This model was also found to empower clients to commit to a self-care plan.20
Social Intelligence
In the late 1990s Goleman identified SI as the capacity to recognize the feelings of others and motivate and manage others’ emotions effectively.21 Social Intelligence refers to an interpersonal, or others-focused relationship, whereas Emotional intelligence (EI) is an intrapersonal, or self-focused relationship. Social Intelligence pertains to the intelligence required to navigate human relationships, a set of abilities separate from classic intelligence, or intelligence quotient. Some theorists and studies consider SI to be a subcategory of EI, whereas others consider EI and SI to be related, but separate. The current study has subscribed to the Emotional Competence Framework that considered SI and EI to be defined separately.22 This framework includes Social Awareness and Social Skills as defined by 13 capabilities (Table II).
Social Awareness and Social Skills Capabilities Definitions
Rogo et al. described the quantitative results of the 13 capabilities related to Social Awareness and Social Skills.23 Study participants (n=103) rated 26 items, 2 pertaining to each capability, on a 7-point Likert scale (strongly disagree=1 to strongly agree=7). Data revealed that participants “agreed” (6) or “strongly agreed” (7) that each SI capability had a positive influence on self-care. The mean values for all capabilities ranged from 6.0 to 6.6 edifying each SI capability’s importance from the patients’ perspectives.23
The rank order of the Social Awareness capabilities was: Service Orientation (mean=6.6), Empathy (mean=6.45), Developing Others (mean=6.45), Political Awareness (mean=6.45) and Leveraging Diversity (mean=6.4).23 Further, the rank order of the Social Skills capabilities was: Leadership (mean=6.55), Influence (mean=6.55), Collaboration and Cooperation (mean=6.45), Teamwork (mean=6.4), Building Bonds (mean=6.4), Change Catalyst (mean=6.35), Communication (mean=6.15) and Conflict Management (mean=6.0).23 While there was no statistically significant difference in capabilities based on recare interval or age, gender had a statistically significant effect (p=0.013); women were more positively influenced by dental hygienists’ SI than men.23 The researchers speculated this finding could be related to literature indicating women have higher EI and SI,24-26 and could be more aware of, or influenced by, others’ SI. Patient perspectives about the influence of their oral health care provider’s SI had on self-care were as follows: 1) very positive, 2) ratings of all thirteen SI capabilities were very high, 3) Social Awareness capabilities were ranked somewhat higher than Social Skills capabilities, and 4) gender influenced patients’ perspectives. Oral health care providers and dental hygiene educators may consider building SI concepts into dental hygiene care and student learning experiences.23
The purpose of this study was to further describe patients’ perspectives regarding the influence of dental hygienist providers’ SI on self-care by analyzing qualitative responses to five research items focused on commitment, responsibility, partnership, and positive and negative social qualities. A second aim of this study was to develop a conceptual model interweaving the findings of this SI research with PCC and the CSCCM. Conceptual models provide a framework for guiding clinical practice.
METHODS
This descriptive study was approved by the Idaho State University Human Subjects Committee through an expedited review. A self-designed questionnaire about SI included five open-ended items related to SI that were derived from the Emotional Competence Framework.22 The validity and reliability of the questionnaire had been established previously.23 The items included: 1) My commitment to improving my daily oral self-care is influenced by interactions with a dental hygienist, 2) Whose responsibility is your commitment to your oral-self-care?, 3) Do you want to be a partner with a dental hygienist in planning your oral self-care?, 4) What social qualities about your dental hygienist(s) have positively influenced your oral self-care?, and 5) What social qualities about your dental hygienist(s) have negatively influenced your oral self-care? The first three items asked respondents to explain their answers. The questionnaire also included nine demographic items and the informed consent.
The nonprobability convenience sample was solicited from patients who were receiving care at a student dental hygiene clinic in the spring of 2019. The eligibility criteria included patients who volunteered, were at least 18 years old and had experienced a minimum of one fifteen-minute self-care education session with a student dental hygienist provider. Students, faculty, and staff of the dental hygiene program were excluded. Participants completed the questionnaire in the reception area and were asked to base their responses on all past and present interactions with dental hygienists, not just the interaction with the student dental hygienist.
Two members of the research team independently analyzed the qualitative data. When the analysis differed, differences were reconciled through discussion. The open-ended responses to the first three items were coded based on the content of the written comments and similar codes were grouped together to form a theme. The responses to the two items regarding the qualities of dental hygienists were coded using the SI capabilities from the Emotional Competence Framework.22
RESULTS
Sample demographics
A total of 103 patients volunteered to participate. The majority identified as women (60%) and white (84%), were between the ages of 18-21 years (36%) and had completed high school (51%). Most did not have dental insurance (49%), received care from a dental hygienist two times a year (44%), had two or more dental hygienists provide care over the last 5 years (79%) and received dental hygiene care in a university clinic and private practice (45%). Detailed demographic data have been published previously.23
Commitment
The analysis revealed two themes: Interactions promoting encouragement and Interactions that are educational and individualized. The Interactions promoting encouragement was supported by responses such as, “Hygienists have been very encouraging and have helped do a better job of brushing” and “They are like having a coach to help both with the encouragement they provide.” The second theme, Interactions that are educational and individualized, was confirmed by the statement, “The hygienist has given me a treatment plan, preventive alternative, and nutrition - all ideas to improve my health. She has given me references to get more help as well. She has given me extra information on flossing, toothpaste and fluoride treatments. I can apply this information to improve my daily oral care.”
Comments supporting both themes were “I hit a time in life where I just didn’t care about my teeth. The dental hygienist’s encouragement and teaching me have helped me to care and to pay attention to my teeth” and “They have been very helpful in education, motivation, and inspiration with regards to dental care.” One participant highlighted interactions being educational and addressing the needs of the patient, as well as building relationships between the person and practitioner. “Dental hygienists play a huge role in dental care. They educate their patients on the needs they need, and they grow relationships with their patients.” Additional comments are shown in Table III.
Themes and Representative Statements Related to Commitment, Responsibility and Partnership
Responsibility
Comments were analyzed and categorized into two themes: Personal responsibility and Shared responsibility. Personal responsibility from the clients’ perspectives is “The only person responsible for my health is me; 30 min exercise... brush, floss, teeth, etc.” and “I need to take charge of the self-care and make sure I go to the hygienist and dentist for checkups to stay on top of everything.” A comment supporting Shared responsibility for self-care was: “My dentist and dental hygienist are there to give me the best education on how to keep my oral health better and new things that will make it easier. It is my job to stay up on it and to practice it religiously at home. It’s not their mouth, it’s mine, but they do want the best for me. If I don’t want the best, then there’s not much they can do for me.”
Partnership
Responses were analyzed into three themes: Helpful partner, Collaborative partner and Negative partner. A Helpful partner is evident in this comment, “My hygienist was well informed about my oral self-care, had very good ideas; was very helpful and had up-to-date information to help me with my oral self-care plan.” A Collaborative partner was supported by the statements: ”I would like to work with them to develop tips for keeping good habits” and “I would like to be a part of the decision-making process for my health.” A Negative partner is represented by undesirable interactions such as, “Do not pressure or guilt me.”
Positive and Negative Social Qualities
The responses to these two open-ended questions were analyzed using the SI capabilities. The Social Awareness capabilities represent the dental hygienists’ ability to recognize and understand clients’ emotions, needs, and perspectives.24 For instance, Empathy is revealed as having a positive influence on self-care, “Positive attitude and nonjudgmental. She understood my difficulties and didn’t belittle me.” A statement indicating a negative influence is “In the past when a hygienist made me feel as though I am not doing enough, I feel that this has had a negative influence.”
The Social Skills capabilities involve dental hygienists applying the understandings gained through Social Awareness during interactions with clients.21, 24 For example, Communication, is demonstrated in the quality of having a positive influence, “When they discuss openly what’s going on and explain things thoroughly.” A negative influence is “Giving me instructions but not explaining to me why they are important.” Social quality themes and representative responses are shown in Tables IVa and b.
Social Qualities Themes Regarding Dental Hygienists and Representative Responses
Social Qualities Themes Regarding Dental Hygienists and Representative Responses
The adapted SI definitions were based on the analysis of the qualities of dental hygienists having a positive or negative influence on self-care (Table II). The conceptual model blends the concepts of PCC with the adapted definitions of the SI capabilities and the philosophy of the CSSCM (Figure 1).
Social Intelligence Self-care Conceptual Model
DISCUSSION
The findings of this study present the unique perspectives of persons who present for dental hygiene care. The themes, adapted SI definitions, and a conceptual model are based on these person-centered perspectives. Conceptual models provide a framework for guiding clinical practice. The new model created from this inquiry could offer recommendations for interacting with clients during self-care education as viewed from clients’ perspective.
Commitment
The first theme was Interactions promoting encouragement. Representative participant statements about commitment used the words “helping” and “coaching.” A systematic review discovered that formal decision coaching might aid in making decisions about healthcare treatments.27 Jull et al. posited that quality discussions occur when individuals know the best available evidence and can share what matters most to them. Decision coaching is only one type of formal coaching in healthcare; much informal coaching probably occurs, particularly in relation to self-care.27 The conclusions of Jull et al. relate to the findings of this study and to the principles of PCC and SI.27 Assumedly, students and practicing clinicians implemented informal coaching to promote self-care and behavior change while practicing PCC and SI.
Additionally, both “helping” and “coaching” align with key elements of the adapted definition from the qualitative analysis of Developing Others (Table II) “displaying an encouraging attitude” and “acting as a coach by providing suggestions for improving self-care.” “Helping” is also summarized in the Leadership adapted definition: displaying genuine interest in helping improve oral health. Additionally, Influence includes a key phrase “encouraging improvements” and Teamwork involves “helping patients improve oral health.” Another capability, Change Catalyst, includes this phrase “offers suggestions for change to improve oral health.”
The second theme is Interactions that are educational and individualized. ”Educational” and “individualized” are strongly associated with principles of PCC.2,3,5,6,11 Individualization is the core of PCC where one’s values, preferences, and needs for care are a focus and information, communication and education are integral to providing patients with PCC.2,3
Service Orientation’s adapted definition echoes this sentiment by being sensitive to the client’s oral conditions and needs, provides personalized care, and explains information (Table II). Also, Change Catalyst includes the key phrase “recognizes and explains oral health problems” and Communication involves “taking time to thoroughly explain and openly discuss oral conditions.”
The findings relating to commitment seem to also relate to the CSCCM in the assessment phase where an explanation of the disease processes and prevention strategies is provided by the clinician. The client shares behaviors, knowledge, and illness experiences while the provider uses questioning and models sincerity, attentiveness, and respectfulness. If differences are not agreed upon, the provider defaults to the client’s priorities.1
Responsibility
Two themes emerged in the responsibility category: Personal and Shared responsibility. The two themes, however, do not seem mutually exclusive. Shared responsibility is very evident in the literature in relation to PCC, SI and the CSCCM. Authors concluded that providers and organizations need to engage in partnerships and shared decision making with patients.5,7,11 Scrambler et al. also found shared decision making to be integral to delivering PCC, although these concepts were not assessed in relation to patient satisfaction or treatment outcomes.10 Bedos et al. found that shared decision making is what people expect from dental visits and that treatment planning development is an important part of shared decision making.28
Shared decision making or responsibility is also evident in Collaboration and cooperation which states “Involves patients in decision making. Collaborates with patients to reach common goals.” This capability is evident in the CSCCM negotiation domain where self-care behaviors, treatment, and recare intervals are negotiated and alternate treatments and self-care strategies are explored.1 The clinician acts as a resource person and an honest collaborator.1
Partnership
As a Helpful partner, participants commented on “helpful,” “good ideas,” and “providing options.” Partnership is closely related to power.28 The balance of power should be chosen by the patient and professionals should support this level of power. Power for partnership should be together, cooperative, and trustworthy. The role of the patient is not to obey the professional, but to have a balanced relationship; therefore, patients play an active role in their health.28 Epstein and Street noted that keeping patients more involved in consultation changes the physician dominant intervention to engaging patients as active participants.4 Being helpful with good ideas and options for patients aids in balancing power.28 These concepts directly relate to PCC.
The adapted definitions relating to a Helpful partner are Leadership which involves projecting enthusiasm and interest and Influence which includes encouragement or helpfulness. Collaboration and cooperation align with the Collaborative partner theme as does Teamwork.
The other two themes are Collaborative and Negative partners. Collaboration as a partner and disagreement are mentioned in Bedos et al.’s discussion as relating to having power and being a partner.28 Not only does a Negative partner relate to inappropriate power or balance in the PCC relationship, but also to the comfort level during care. Lack of comfort can create fear and patient expectations about this fear should be considered.28 Clinicians should be mindful of the person’s comfort and fear level during care by engaging the person in communication to determine verbal and nonverbal cues indicating negative emotions. Yuan et al. found anxiety was related to patient trust and communication, and shame was related to anxiety.29 Effective communication was deemed to be essential for PCC and a trusting relationship was the cornerstone for providing effective communication. Patients’ psychosocial needs are central in PCC to alleviate fear and anxiety. Certainly, these psychosocial needs relate to the characteristics of SI found in this study and the previous study.23
In relation to a Negative partner, comfort level has been associated to negativity.28,29 In fact, the adapted definition of Empathy is concern for the person’s comfort level and well-being and avoiding being judgmental during client interactions. Developing others mentions being positive, supportive and encouraging which all relate to comfort and should help alleviate negativity. Relating well to people from various backgrounds is critical as defined by Leveraging diversity. Literature supports the view that diverse groups of people are especially challenged to receive PCC and perhaps including SI characteristics in these interactions can enhance relationships, respect, autonomy, quality of care, partnership and outcomes.30,31 Conflict management was defined as listening to concerns and handling situations to make patients feel confident which relates to being able to overcome a negative partnership.
The CSCCM definitely supports a helpful and collaborative partnership because the premise in each domain is to have the provider assist, question, negotiate, establish, support and document needs, values and beliefs.1 During the assessment domain the provider is encouraged to default to the client’s priorities should differences between the client and provider arise supporting PCC and eliminating the outcome of a negative partner.1
Positive and Negative Social Qualities
Responses to these items were enlightening. For example, Service Orientation contains participants’ verbiage related to PCC and SI such as “sensitive” and “best quality care.”3,5,6,30 The negative comment about being “annoyed” when education did not begin with questions supports the significant role of questioning in assessing the client’s knowledge level prior to education. Questioning strategy is paramount in PCC and CSCCM,1,6,28 and is a function of effective communication.
The capability of Collaboration and Cooperation includes participants’ words about positive influences such as “inclusion in decisions” and “reaching common goals.” These words certainly reflect traits of PCC, SI and CSCCM.1,6,11 Comments having a negative influence were about not listening and being worried about time. Of course, bidirectional relationships between provider and client are essential to reach the goals of PCC and SI capabilities are implemented to do so. Epstein and Street noted that providers must be educated to be more mindful, informative, and empathetic to transform “authority” to partnership and invite persons to participate in decision making.4 Mills et al. concluded that connections, attitude, and empowerment are important in PCC.6 Additional key words about positive qualities related to PCC, SI, and the CSCCM are highlighted from participants’ comments including: caring, informative, open, less judged, positive, listens, talk to anyone, inspirational, honest, genuine concern, and active listening.
The adapted SI capabilities were developed from the analysis of the social qualities of dental hygienists having a positive or negative influence on self-care; therefore, the new definitions suggest changes directly related to dental hygiene and self-care education. These definitions could be used when teaching students or licensed professionals about SI and concepts of PCC and the CSCCM. As reviewed, organizations have incorporated concepts of patient-centered care and PCC into their documents.14-18 Also, a call for change to move oral health care education to a PCC model has been discussed.7,12 A review about patient-centered approaches in clinical consultations found that teaching providers to share control with patients was successful and could be accomplished with short-term training versus longer education.32 Although this review focused on consultations, the point might be made that teaching these concepts might not involve significant curricular changes.
Social Intelligence Self-Care Conceptual Model
The person who presents as a client for oral health care is at the center of the model (Figure 1). The premise of PCC is to incorporate the following aspects into care: the person’s needs, values, and preferences as well as outcomes that matter most to the individual/family.2,3 Additionally, clients are considered members of the oral health care team based on their expertise related to their needs, personal values and preferences.
The inner circle contains the Social Awareness capabilities (Figure 1). These capabilities seem to be a prerequisite to the Social Skills capabilities because the clinician/provider needs to understand the person’s social context when presenting for care. This understanding is the foundation for positive social interaction and relationship building necessary for engaging individuals as partners in care. The second circle represents the Social Skills capabilities that are necessary when involving the person in shared decision-making about self-care practices and treatment. Shared decision-making is defined as the “interpersonal, interdependent process in which health professionals, patients and their caregivers relate to and influence each other as they collaborate in making decisions about a patient’s health.”33 This approach requires clinicians to demonstrate effective Social Skill capabilities to engage patients as experts in their own health and collaborators in decision making about self-care practices. In a study about SI and social desirability conducted with oral health students, higher levels of SI had significant contributions to toothbrushing, flossing, and dental visit frequency; thus, having a significant association with positive oral health behaviors.34
The outer circle presents the domains of the CSCCM.1 This person-centered model is a framework for guiding dialogue between the clinician providers and clients to elicit their oral health perspectives and to promote the client’s role as a partner in determining oral health care needs.1 The clinician acts as a resource-person while the client engages in the decision-making process as an informed co-therapist; thereby, fostering autonomy and empowerment.1 While communicating throughout the five domains, the dental hygienist provider is able to promote PCC by guiding the interaction through a series of actions, during which the client is encouraged to share their needs, concerns, and beliefs.1 The SI capabilities are integrated during each domain in order to empower individuals to commit to the self-care practices in which they feel comfortable. Because of the relationships between SI, PCC, and the CSCCM, this model serves as a visual display of these concepts for clarity and discussion. For example, educators could discuss the relationship between the adapted SI definitions of Developing Others (Social Awareness) and Teamwork (Social Skills) with the negotiation domain of the CSCCM. Application of the findings of this study into oral health care provided by dental hygiene students and practitioners has the potential to improve PCC and support the CSCCM.
LIMITATIONS AND FUTURE RESEARCH
Limitations of this study include the sample size and lack of application to broader geographic locations and patient populations. Suggestions for future research include implementing this study in a wider range of health care settings with varying patient populations. Of further value would be studies assessing the teaching and learning outcomes of implementing the adapted SI definitions and conceptual model in educational curricula and oral health care settings. Investigating the relationship of SI to PCC and the CSCCM could further aid in understanding the relationships between these concepts. Additionally, the intent of creating a new conceptual model was to add to the scientific knowledge base of the discipline and to be used as the foundation for future investigations to verify the model.
CONCLUSION
This study provided a unique opportunity for persons who seek dental hygiene care to voice their perspectives on commitment, responsibility, partnership, and dental hygienists’ positive and negative social qualities related to self-care education. Social Intelligence was apparent in the interpersonal interactions with dental hygienists that participants reported as being encouraging, educational, and individualized. Additional influential interactions in relationship building were illustrated in the themes of shared responsibility, helpful and collaborative partnerships, as well as positive qualities care providers demonstrated during self-care education. The Social Intelligence Self-care Conceptual Model, including the adapted SI capabilities definitions, might be valuable to implement into dental hygiene education and practice to improve person-centered care and clients’ oral health.
Footnotes
NDHRA priority area, Client Level: Oral Health Care (health promotion: treatments, behaviors, products)
- Received February 1, 2023.
- Accepted April 3, 2023.
- Copyright © 2023 The American Dental Hygienists’ Association
