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 Table of Contents  
ORIGINAL ARTICLES
Year : 2015  |  Volume : 2  |  Issue : 3  |  Page : 130-133

Nature and prevalence of needle phobia among dental college patients


1 Department of Oral and Maxillofacial Surgery, College of Dental Sciences and Hospital, Amargadh, Bhavnagar, Gujarat, India
2 Department of Pedodontics and Preventive Dentistry, College of Dental Sciences and Hospital, Amargadh, Bhavnagar, Gujarat, India
3 Department of Oral and Maxillofacial Surgery, King Khalid University, Abha, Saudi Arabia

Date of Web Publication19-Nov-2015

Correspondence Address:
Fareedi Mukram Ali
Department of Oral and Maxillofacial Surgery, College of Dental Sciences and Hospital, Amargadh, Bhavnagar, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2348-2915.169826

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  Abstract 

Background: The extent of the needle phobia and its effect on the patients in the community is the topic which still remains largely unexplored. The presence of needle phobia may influence the future dental treatment by the patient. Thus, the present study was planned to check the nature and prevalence of needle phobia among dental college patients. Materials and Methods: The study was carried with the help of 16 questionnaires specially formulated for the present study. The study included 343 patients came to the outpatient department of the dental college, and the observation was recorded and analyzed. Results: Most of the male and female participants had the experience of the needle phobia due to the experience shared by parents, friends, or relatives in their previous life. Due to needle phobia the most of the patient becomes somewhat anxious, and needle phobia had little impact on the life of the patients. According to our study, 13.3% of male participants and 14.6% of the female participants had avoided dental treatment due to fear of needles. Conclusion: The procedure of needle injection is a routine procedure in the dental clinics and hospitals for giving anesthesia to the patient. Therefore, these types of studies calculating the prevalence of needle phobia help to know about the view of the patient and ultimately the community toward the needle phobia. Hence that necessary steps can be taken.

Keywords: Dental patients, medical treatment, needle phobia


How to cite this article:
Ali FM, Bai P, Dungrani H, Raju MV, Ustad F, Hassan I. Nature and prevalence of needle phobia among dental college patients. J Dent Res Rev 2015;2:130-3

How to cite this URL:
Ali FM, Bai P, Dungrani H, Raju MV, Ustad F, Hassan I. Nature and prevalence of needle phobia among dental college patients. J Dent Res Rev [serial online] 2015 [cited 2019 Oct 23];2:130-3. Available from: http://www.jdrr.org/text.asp?2015/2/3/130/169826


  Introduction Top


In healthcare settings, fear of injections are common finding and approximately 10% of patients report an excessive fear of needles resulting in significant avoidance, distress, and/or impairment. In case of some individuals, this fear may be severe enough to report a diagnosis of specific phobia, blood-injection-injury (BII) type, referred to as “needle phobia."[1] The needle phobia is an immense fear of a needle or injection that is not in proportion to the actual danger. Fear of needles is known as trypanophobia, and it is considered as an extreme fear of medical procedures.[2],[3] It is also referred to as aichmophobia, belonephobia, ornithophobia, names that are actually technically incorrect because they denote simply a “fear of pins/needles” and do not refer to the medical aspect of trypanophobia.[2] Needle phobia now being included under the diagnostic category of BII phobia in American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.[3],[4] The primary objective of this study was to estimate the prevalence of needle phobia among dental patients. Secondary objectives were to determine the extent of avoidance of dental health care by those with a fear of needles, therefore, bringing greater awareness of this condition to dental health professionals.


  Materials and Methods Top


The study was comprised 343 patients came to the outpatient department of the dental college and who were willing to participate in the study. Out of 343 patients, 203 were male patients, and 140 were female patients. The study was carried out over a period of 6 months, and the patients included in the age group of 15–55 years. Approval from the College Ethical Committee was taken before the start of the study, and informed consent was taken from each participant of the study. Personnel data of the patients were recorded, and the study was done with the help of the questionnaires.

Inclusion criteria

  • Age group of 15–55 years
  • Patients voluntarily participated in the study
  • Needle phobia in relation to the oral cavity
  • Patient coming for the dental treatment.


Exclusion criteria

  • Students related to any medical field study, i.e., nursing, dental, medicine, Homeopathy, Ayurveda, etc.


Questionnaires

The study was done with the help of well-structured questionnaires, which were validated through the pilot study. It consisted of 16 questionnaires. Some of the questions were of Yes/No type and other of multiple choice questions. The questionnaires consisted of experience of the fear of needle, symptoms of needle phobia, self-medication for needle phobia, parents or friend's experience of needle phobia, reasons for needle phobia, extent of needle phobia, extent of pain, extent of anxiety, and impact of needle phobia on life.

The questionnaires were given to the participant patients, whenever they came and a time of 30 min were given to them to read the questionnaires and tick the answer. The questionnaires were also printed in the Hindi language for the patients who cannot understand English. The data were collected and whenever indicated scores were given. The responses of all participants including males and females were summed up to get a total score, and the results were analyzed.


  Results Top


The scores of the entire participants were summed up for each questionnaire and the total scores for the male and female participants were calculated in the form of a percentage of the total score [Table 1]. Fifty-two percent of the male participants and 60.7% of the female had experience of the needle phobia in their life, and 62.6% of the male participants had a phobia related to other parts of the body. However this was reverse in case of the female participants, in which 62.4% had experience of needle phobia in relation to the oral cavity. Most commonly, the needle phobia may be due to the experience shared by friends, parents, or relatives.
Table 1: The percentage of the total scores of the questionnaire of the study

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  Discussion Top


Fear is a common feature of early development and is a normal emotional response to a perceived threatening stimulus.[4] A phobia is defined as “an irrational, intense fear of an object or situation that poses little or no actual danger.”[2] Developmental fears are typically transitory and may resolve in childhood, including fear of the dark, strangers, and loud noises. However in some cases, fear of the certain situations or objects may remain throughout adolescence and can be problematic into adulthood.[4] When the fear crosses the point which is justified by the external threat, it interferes with the individual's ability to function optimally.[4] In our study, the experience of fear of needle was agreed by 52.2% of total male participants, whereas 60.7% of female had experience of fear of a needle in their life. Out of these, most commonly the fear of needle was associated with the other parts of the body than the oral cavity in case of male participants (62.6%). However in the case of female participants, the needle phobia was present most commonly with oral cavity (62.4%). The symptoms of the needle phobia were little bad in male as well as in female participants (33.3% and 31.2%, respectively). When asked about self-medication for the needle phobia, about 73.8% male participants and 58.6% of female participants had not taken any self-medication. This suggests that the symptoms may not be so bad to take self-medication. The needle phobia was mostly seen in patients having a phobia related to other medical procedure in male as well as female patients (78.4% and 82.3%, respectively). This suggests that the patients having a phobia of other procedure had more chances of getting needle phobia. This finding of our study was similar to finding of study by Wright et al.,[5] in which the needle phobia was observed more commonly in patients having the previous traumatic experience with needles and Khan et al.,[3] in which the incidence of needle phobia was more in patients having previous experience of painful medical procedure. In addition, the fear of needle was observed more commonly in patients with their parents, relatives, or friends having the experience of needle phobia. Most of the participants were not having any previous bad experience of needle injection either in a dental clinic or in the dental college hospital. This was in accordance with the study by Wani et al.,[6] in which the BII phobia was observed more commonly in patients whose relatives having the same experience. This suggests that the needle phobia in most of the patients may be due that they heard about needle phobia from other persons. It is also proved from our next question of reasons for the needle phobia, which had answered most of them as the experience of needle phobia shared by someone else was the most common reason. The pain of the needle insertion was classified by most of the male participants (34.2%) as moderate pain and mild pain by most of the female participants (42.2%). The severity of needle phobia is scaled as an average scale by both male and female patients. The incidence of feeling of anxious by the male participants was 68.2% and 41.2% of female participants. In our study, it was observed that the dramatization and imagination of the situations of the needle phobia was present with the 78.2% male and 60.3% of the female patients. Finally, male and female participants agreed that the experience of the needle phobia produces little impact in their life. In addition, 13.3% of the male participants and 14.6% of the female participants had avoided dental treatment due to fear of needles in their life. In addition the friends or relatives of the participants avoided further dental treatment due to fear of needles. This was in accordance with the study by Wright et al.[5] and Wani et al.[6] It is of interest that during our survey, the main reason for the needle phobia was that the hearing or imagining the situations of the needle phobia from other persons of the community. In our study, we found that the patients from the urban areas are more likely to show needle phobia than that seen in the patients from the rural area.

Previous epidemiological studies have reported that the onset of the identifiable needle phobia is at 5.5 years and remains quite common in adulthood. It has an estimated prevalence rate of 3–4% in the general population.[4],[6] As compared to other phobic patients, which experience tachycardia following exposure to feared object, needle phobia patients typically experience anticipatory tachycardia and hypertension for a short period of time. This is followed by bradycardia and hypotension on needle insertion and may be accompanied by pallor, tinnitus, diaphoresis, syncope, and some may experience systole or even death.[3] The needle phobic people are likely to faint at the sight of blood, the anticipation of physical injury, or the anticipation of an injection.[6] It is also referred to as a BII phobia because often blood, injury, and injection are the keys that can trigger a faint.[6] The most common cause of this phobia is inherited vasovagal reflex reaction, which is triggered by needle piercing. This inherited reflex usually becomes evident after several exposure of needles. Hence, it is referred as inherited as well as learned behavior.[3] The needle phobic patients generally refuse hospital appointments because these things act as a phobic stimulus to them which increase their anxiety.[6] The associated needle phobia and avoidance may adversely restrict important aspects of sufferers' lives including career choice, willingness to have children, and the ability to receive medically necessary treatments, such as self-injected insulin for individuals with diabetes.[1] In addition, injections play a central role in medical healthcare with an estimated 12 billion injections and 100 million childhood vaccinations given worldwide annually. Thus fear of needles may be a barrier to access good medical care.[5]


  Conclusion Top


In healthcare setting including dental treatments, the needle phobia is a common finding, but still very limited studies were done to survey the prevalence of such needle phobia. According to our study, the experience sharing by another person plays a central role in the development of the needle phobia, which may be from friends, relatives, or parents. In addition, some of the participants had avoided dental treatment due to needle phobia. Therefore, more number of such prevalence studies including more number of patients should be carried out to know the status of needle phobia in the community. Furthermore, the health awareness program should include the topic of needle phobia, so that the patient will not avoid the necessary dental or medical treatment.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



Appendix

  1. Personal data

    Name :
    Age/Sex :
    Rural/Urban :
    Education :


  2. Questionnaires for the study of extent of needle phobia: In Table 1.


 
  References Top

1.
Deacon B, Abramowitz J. Fear of needles and vasovagal reactions among phlebotomy patients. J Anxiety Disord 2006;20:946-60.  Back to cited text no. 1
    
2.
Raghvendra, Tyagi P, Yadav P, Saxena S, Dodia RA, Patel TD. Trypanophobia-an extreme and irrational fear of medical procedures: An overview. Int J Pharm Sci Rev Res 2010;4:18-21.  Back to cited text no. 2
    
3.
Khan F, Memon B, Ur-Rehman H, Muhammad SS, Ali A. Prevalence of needle phobia among young patients presenting to tertiary care government hospitals of Karachi, Pakistan. Int J Res 2015;2:127-35.  Back to cited text no. 3
    
4.
Du S, Jaaniste T, Champion GD, Yap CS. Theories of fear acquisition: The development of needle phobia in children. Pediatr Pain Lett 2008;10:13-7.  Back to cited text no. 4
    
5.
Wright S, Yelland M, Heathcote K, Ng SK, Wright G. Fear of needles – Nature and prevalence in general practice. Aust Fam Physician 2009;38:172-6.  Back to cited text no. 5
    
6.
Wani AL, Ara A, Bhat SA. Blood injury and injection phobia: The neglected one. Behav Neurol 2014;2014:471340.  Back to cited text no. 6
    



 
 
    Tables

  [Table 1]


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