Using qualitative synthesis to develop a metatheory that explains how patients manage complete tooth loss (2020)
Complete tooth loss is a leading cause of oral disability, and is among the mostdifficult treatment challenges in dentistry. Tooth loss, like the loss of other body parts,can generate profound emotional and social responses, but there is no comprehensivetheory to explain how people psychologically manage loss of a part of their body. Giventhe complexity of the phenomena surrounding these issues, the purpose of thisdissertation was to conduct a systematic review of the literature to search for andsynthesize the psychosocial theories commonly related to the loss of anatomical parts,such as breasts, limb, or teeth, and to explain the beliefs and behaviours of peopleresponding to such losses. The methodological challenges encountered whenconducting the systematic search and qualitative synthesis of theories are alsopresented with proposed solutions and considerations to overcome such challenges.Finally, I explore how theories from this qualitative synthesis explain the beliefs,concerns, and responses of people who experience complete tooth loss. The findings ofthe search yielded 2,540 citations that referenced 288 articles referring to 89 primarytheories containing 586 constructs. Through the synthesis of seven constructcategories, a metatheory with essential contributions from theories related tocommunications, developmental regulation, emotions, resources, and social cognitionwas integrated to explain responses to loss. Different approaches of searching werenecessary, for example, both electronic and manual searches were used, includingsearching of the reference list of selected articles to better understand the sources ofrelevant theories. Inclusion criteria were refined using iterative and inductive processesto ensure the inclusion of all relevant literature. The qualitative synthesis presented inthis study was a useful approach for developing a metatheory that provided aconceptual foundation, which was used to explain how people manage the loss ofanatomical parts. A metatheory synthesized from five dominant theories addressingcommunication, personal background, emotions, resources, and social awarenessoffers a comprehensive and plausible explanation of how people respondpsychologically and socially to the loss of their teeth, and it expands the scope ofinformation needed to help people manage their loss and subsequent treatment.
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