Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 32

 

Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
     


 
 Table of Contents    
ORIGINAL ARTICLE  
Year : 2012  |  Volume : 2  |  Issue : 2  |  Page : 80-84
Dental student's knowledge, beliefs and attitudes toward obese patients at one dental college in India


1 Population Social Health and Research Group, Griffith Health Institute and School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia; Department of Public Health Dentistry, Darshan Dental College and Hospital, Udaipur, Rajasthan, India
2 Department of Public Health Dentistry, Vidarbha Youth Welfare Society's Dental College, Amravathi, Maharashtra; Department of Public Health Dentistry, Darshan Dental College and Hospital, Udaipur, Rajasthan, India
3 Department of Public Health Dentistry, SRM Dental College, Chennai, Tamil Nadu; Department of Public Health Dentistry, Darshan Dental College and Hospital, Udaipur, Rajasthan, India
4 Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Andhra Pradesh; Department of Public Health Dentistry, Darshan Dental College and Hospital, Udaipur, Rajasthan, India

Click here for correspondence address and email

Date of Web Publication13-Nov-2013
 

   Abstract 

Aim: To assess the knowledge, attitudes and beliefs toward obesity among clinical and preclinical dental undergraduate students of a private dental school in India.
Materials and Methods: The total sample size in the present study accounted to 247. In order to assess knowledge, attitudes and beliefs of study subjects toward obesity, a questionnaire was adapted from a previous survey, which consisted of questions related to the student's perception of responsibilities toward obese patients, their knowledge and attitudes toward obese patients and each question had answers on a Likert scale.
Results: More than half (56.3%) of the clinical students strongly agreed and 40.6% of the preclinical students agreed that obesity is a chronic disease. Less than half (45.6%) of the participants differed that they will need to make accommodations in equipment and office furniture. More than half the subjects (60.6%) were interested in learning about obesity in dental school. Significantly greater number of clinical students agreed "they feel uncomfortable when examining an obese patient" and "it is difficult for them to feel empathy for the obese patient"; in addition, they believed that overweight people lack will-power and are lazier.
Conclusions: There were no differences between the genders for any of the statements. Many of the students in clinical years had negative attitudes toward obese patients than preclinical students.

Keywords: Attitudes, beliefs, dental students, knowledge, obesity

How to cite this article:
Kumar S, Tadakamadla J, Tibdewal H, Duraiswamy P, Kulkarni S. Dental student's knowledge, beliefs and attitudes toward obese patients at one dental college in India. J Educ Ethics Dent 2012;2:80-4

How to cite this URL:
Kumar S, Tadakamadla J, Tibdewal H, Duraiswamy P, Kulkarni S. Dental student's knowledge, beliefs and attitudes toward obese patients at one dental college in India. J Educ Ethics Dent [serial online] 2012 [cited 2021 Oct 25];2:80-4. Available from: https://www.jeed.in/text.asp?2012/2/2/80/121264



   Introduction Top


Obesity is defined by the World Health Organization as a condition of abnormal or excess fat accumulation in adipose tissue, to the extent that health may be impaired. [1] The pandemic of overweight and obesity in developed and developing countries presents a challenge to public health and requires medical intervention, modifications of individual behavior and environmental changes. [2] In addition, obesity is associated with many health risks, which include hypertension, diabetes, ischemic heart disease, gallstones, osteoarthritis and malignancy. [3]

Along with the numerous medical problems that are associated with obesity, obese patients are also exposed to public disapproval and negative attitudes that have been documented to exist in education, the workplace and the mass media as well as in the health-care profession. [4]

Most of the previous surveys in India revealed an obesity prevalence of more than 25% among various Indian populations. [5] This suggests that dentists can expect one obese patient among every four patients in their routine dental practice, which warrants dental students to be well-equipped with obesity education.

Though it is essential to integrate obesity education in dental curricula, it has not been implemented in India and there is literally no literature available regarding the knowledge, attitudes and beliefs of dental undergraduate students toward obese patients. Thus, aim of this study was to assess the knowledge, attitudes and beliefs towards obesity among clinical and pre-clinical dental undergraduate students of a private dental school in India.


   Materials and Methods Top


All the undergraduate students (pre-clinical and clinical) pursuing their career at a private dental institution in India were invited to participate in the study. The total sample size in the present study accounted to 247, students present on the days of the survey were included and those unwilling constituted exclusion criterion. Ethical approval was obtained from the ethics committee of Darshan Dental College and Hospital and informed consent was taken from all the participants.

No effort was performed to trace the pupils absent on the days of the survey and no incentives were provided for the participants.

In order to assess the Knowledge, attitudes and beliefs of study subjects toward obesity, a questionnaire was adapted from a previous survey by Magliocca et al. [4] The original questionnaire consisted of 16 statements while only 14 statements were considered for inclusion in the questionnaire for its use in the present survey. Two questions on knowledge related to obesity ("I have taken other courses prior to dental school that educated me about obesity and "I can correctly identify the World Health Organization definitions of overweight, obese, and morbidly obese patients") were excluded from the original questionnaire because we presumed that none of the study participants would agree to those statements as there are neither such courses on obesity in India nor are the dental students taught about the definitions related to obesity in their curriculum.

Thus, the final questionnaire consisted of three questions related to the student's perception of responsibilities toward obese patients, four and seven statements related to their knowledge and attitudes toward obese patients respectively.

Each question had answers on a Likert scale with five categories ranging from strongly disagree = 1 to strongly agree = 5.

Questionnaires were distributed by the author (SK) to all the students during a lecture and objectives of the survey were explained to the subjects.

Data was analyzed using the SPSS software (SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc.)

Descriptive data is presented as percentages and Chi-square analysis to compare the responses between the genders and to analyze the difference between courses of study.


   Results Top


The total sample size in the present study was 247 with an overall response rate of 66%. [Table 1] depicts the response rates for each year according to the gender, 1 st year (males-72%, females-56%), 2 nd year (males-62%, females-81%), 3 rd year-(males-63%, females-65%) and final year (males-64%, females-64%).
Table 1: Response rate of the study population according to gender and year of study

Click here to view


There were no significant differences between the genders for any statements and thus those results are not tabulated.

[Table 2] demonstrates that more than half (56.3%) of the clinical students strongly agreed and 40.6% of the pre-clinical students agreed that obesity is a chronic disease in comparison with 5.9% and 3.1% of the clinical and preclinical students respectively who strongly disagreed. In total, 80.5% of subjects agreed that obesity is a chronic disease while 93.8% of subjects agreed that obesity is associated with serious medical conditions.
Table 2: Responses to knowledge based obesity questions in relation to course of study

Click here to view


Majority (87%) of the study subjects agreed that small weight losses can produce important benefits in obese patients. There was a significant difference for knowledge about obesity between the students based on the course of study with a greater proportion of clinical students agreeing the knowledge related questions.

It is evident from [Table 3] that less than half (45.6%) of the participants differed that they need to make accommodations in equipment and office furniture. Majority (90.6%) of the students had a positive attitude toward assessing a patient's dietary habits, however, more number of clinical students (95%) agreed with this situation than preclinical students (82%). More than half the subjects (60.6%) were interested in learning about obesity in dental school.
Table 3: Perception of professional responsibility

Click here to view


Approximately, one-fifth (19%) of the study subjects agreed that they have negative reactions to obese patients. In addition, more than half of the subjects (65.1%) disagreed that they have negative reactions toward the appearance of an obese patient [Table 4]. Significantly, greater proportions of clinical subjects had negative attitudes toward obese patients than pre-clinical students with a greater number of clinical students agreeing that they feel uncomfortable when examining an obese patient in addition to agreeing the statements "It is difficult for me to feel empathy for an obese patient," "overweight people tend to lazier than normal weight people" and "overweight people lack willpower and lack motivation in comparison with normal weight people."
Table 4: Attitudes toward obesity

Click here to view



   Discussion Top


Though the response rate was considerable in the current study, it is not free of limitations, the first limitation being the inclusion of dental students of only one private dental college of India so; the results cannot be generalized to whole dental student population of India. Moreover, it would have been interesting if direct comparisons were made between the perceptions of the current study sample and young general population of similar ages because the educational background of dental students would have influenced their attitudes toward obesity and thus their perceptions could not be generalized to the general population. Furthermore, the obesity status was not recorded in dental students as the responses of obese students might be different from those who are non-obese.However, a research on west Philadelphia adolescents observed that all the subjects had positive self-esteem, eating habits and health behavior knowledge regardless of their obesity status. [6]

In total, 80.5% subjects agreed that obesity is a chronic disease and 87% subjects agreed that small weight losses can produce important benefits in obese patients. These figures are in concurrence with 86.2% and 78.4% that has been reported by female dental students of Saudi Arabia. [7] Moreover, 88% of the Australian general practitioners believed that small weight loses can produce important benefits among obese patients. [8]

It was observed that 93.9% of the participants agreed of obesity being associated with serious medical conditions, which is in agreement with 94% of dental and dental hygiene students of university of Michigan who were aware of an association between obesity and serious medical conditions. [4] This could be attributed to the wide attention and publicity given to obesity and its ill-effects by the government of India.

There was a significant difference for knowledge about obesity between the students based on the course of study with a greater proportion of clinical students agreeing to the knowledge related questions. This difference could be due to the curriculum of the clinical students where general medicine is a subject in the 3 rd year of their course, during which they study about the medical conditions and diseases related to obesity.

Greater number of clinical students (95%) than pre-clinical students (82%) agreed that assessing dietary habits is important in dentistry. Clinical students are taught to assess dietary habits of the patients as a part of regular case history, which might have influenced this finding. More than half the subjects (60.6%) were interested in learning about obesity in dental school, which is a positive indication that many dental students welcome incorporation of obesity education in the dental curriculum.

Ahmed et al. considered that sensitivity to the needs of obese patients may require attention to the parking, office entry, furniture, medical equipment, supplies and office reading material. In addition, they presume that the initial cost of upgrading the office may be offset by larger dividends in the long run due to a broader range of clientele. [9]

In the present study, significantly greater percentage of clinical students than pre-clinical subjects agreed that treating obese patients in dentistry means that they will need to make accommodations in equipment and office furniture, which might be due to the real life experience of clinical student's with obese patients in their routine clinics.

It was observed that nearly half (more than 40%) of the faculty members of a university medical school agreed that they have negative reactions toward obese patients. [10] In contrast, only 19% of the present study subjects agreed that they have negative reactions to obese patients. Significantly greater proportions of clinical subjects had negative attitudes toward obese patients than their pre-clinical counterparts. This might be due to negative experiences of the clinical students while treating obese patients during their clinical practice while among pre-clinical students their pre-existing attitudes could have contributed for this finding.

Weight stigma (treating obese individuals as if they are deficient) and society's demands for slenderness has been a concern to obese people. It has also been observed that teachers can hold negative anti-fat attitude that may affect perception of performance among obese students. [11] Negative attitudes toward obese people are observed both implicitly and explicitly and are even observed among obese people, children and even in health-care professionals. [12] Thus, dental students might hold negative attitudes toward obese patients, but it is also expected that their professional education would have influenced their attitudes. However, the influence of dental education of the student's attitudes toward obesity could be understood by future studies conducted to compare the perceptions of obesity and obese population of students from medical professions and comparable young adults from the general population belonging to similar cultural environment.


   Conclusions Top


There were no differences between the genders for any of the statements. Many clinical subjects had negative attitudes towards obese patients than preclinical students. Majority of the students were interested in learning about obesity in dental school which warrants inclusion of obesity education in the dental curriculum. Counseling should be conducted for these students who are future practitioners in order to instill positive attitudes in them toward obesity patients.

 
   References Top

1.World Health Organization. Obesity: Preventing and managing the global epidemic. Report of the WHO Consultation. WHO Technical Report Series No. 894. Geneva: WHO; 2000.  Back to cited text no. 1
    
2.World Health Organization. Obesity: Preventing and managing the global epidemic. Report of a WHO Consultation on Obesity. Geneva, Switzerland: World Health Organization; 1997.  Back to cited text no. 2
    
3.Allison DI, Saunders ES. Obesity in North America: An overview. Med Clin North Am 2000;84:309-13.  Back to cited text no. 3
    
4.Magliocca KR, Jabero MF, Alto DL, Magliocca JF. Knowledge, beliefs, and attitudes of dental and dental hygiene students toward obesity. J Dent Educ 2005;69:1332-9.  Back to cited text no. 4
[PUBMED]    
5.Yajnik CS. Obesity epidemic in India: Intrauterine origins? Proc Nutr Soc 2004;63:387-96.  Back to cited text no. 5
[PUBMED]    
6.Gordon-Larsen P. Obesity-related knowledge, attitudes, and behaviors in obese and non-obese urban Philadelphia female adolescents. Obes Res 2001;9:112-8.  Back to cited text no. 6
[PUBMED]    
7.Al-Zahrani MS. Obesity and physical inactivity among female dental students. Umm Al-Qura Univ Med J 2010;1:12-21.  Back to cited text no. 7
    
8.Campbell K, Engel H, Timperio A, Cooper C, Crawford D. Obesity management: Australian general practitioners' attitudes and practices. Obes Res 2000;8:459-66.  Back to cited text no. 8
[PUBMED]    
9.Ahmed SM, Lemkau JP, Birt SL. Toward sensitive treatment of obese patients. Fam Pract Manag 2002;9:25-8.  Back to cited text no. 9
    
10.Jay M, Kalet A, Ark T, McMacken M, Messito MJ, Richter R, et al. Physicians' attitudes about obesity and their associations with competency and specialty: A cross-sectional study. BMC Health Serv Res 2009;9:106.  Back to cited text no. 10
[PUBMED]    
11.Rashmi, Jaswal S. Attitude of parents, peers and teachers towards obese teenagers. J Psychol 2011;2:45-51.  Back to cited text no. 11
    
12.Vartanian LR. Disgust and perceived control in attitudes toward obese people. Int J Obes (Lond) 2010;34:1302-7.  Back to cited text no. 12
[PUBMED]    

Top
Correspondence Address:
Santhosh Kumar
Population Social Health and Research Group, Griffith Health Institute and School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia

Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-7761.121264

Rights and Permissions



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

Top
 
 
  Search
 
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  


    Abstract
   Introduction
    Materials and Me...
   Results
   Discussion
   Conclusions
    References
    Article Tables

 Article Access Statistics
    Viewed3047    
    Printed90    
    Emailed0    
    PDF Downloaded248    
    Comments [Add]    

Recommend this journal