Structural validity of the Brazilian version of the Sense of Coherence scale (SOC-13) in oral health research: exploratory and confirmatory factor analysis.

BACKGROUND: The Sense of Coherence (SOC) construct has been used worldwide in oral health research, but rigorous factor analyses of the scale are scarce. We aim to test the dimensional structure of the Brazilian short version of the SOC scale with 13 items. METHODS: This study is a secondary analysis of four independent cross-sectional Brazilian studies on oral health, using the 13-items SOC scale. Sample 1 was conducted on 1760 mothers and 1771 adolescents. Sample 2 comprised 1100 adults. Sample 3 had 720 adults and older individuals. Sample 4 comprised 664 adolescent students. Confirmatory Factor Analysis (CFA) was conducted on sample 1 to compare two models: 3-factor versus 1-factor. Because they were refuted, Exploratory Factor Analysis was implemented in samples 2 and 3. Modified models were tested in sample 4 using CFA. All analyses were conducted with MPlus version 7.11. RESULTS: CFA of sample 1 resulted in an unacceptable fit (RMSEA = 0.12;CFI = 0.78; TLI = 0.73; and WRMR = 3.28) for 1-factor model and 3-factor (RMSEA = 0.10; CFI = 0.87; TLI = 0.84; and WRMR = 2.50). The EFA on samples 2 and 3 showed, respectively, two eigenvalues greater than 1 (4.11 and 1.56) and (4.32 and 1.42), but the scale items soc1, soc2 and soc3 formed an uninterpretable second factor. Another CFA, using sample 4, showed acceptable model fit after removing those three items and also soc11 (RMSEA = 0.05; CFI = 0.98; TLI = 0.99; and WRMR = 0.71). CONCLUSION: The results indicate that the SOC-13 scale needs further adjustments. The one-factor model with nine items showed a good statistical fit, but the implications of excluding items should be further investigated, considering the scale's content validity, cross-cultural adaptation and theoretical background.

Occupational stress and self-perceived oral health in Brazilian adults: a Pro-Saude study.

The scope of this study is to investigate the association between occupational stress and self-perception of oral health. Data were obtained through a self-administered questionnaire filled out in a Pró-Saúde Study by 3253 administrative technical staff from Rio de Janeiro's State University. Occupational stress was measured by means of a questionnaire elaborated in 1970 by Karasek, duly shortened by Thorell in 1988. Ordinal logistic regression was used for data analysis, subsequently adjusted for three blocks of variables. Workers exposed to high occupational demands and little occupational control and to passive work had higher chances of self-perception of worse oral health, when compared with those exposed to low occupational demands, there being no association observed in those exposed to active work. However, in the multiple regression model the following estimates were reduced in magnitude and lost statistical significance, namely high occupational demands and passive work. Workers exposed to high occupational demands revealed worse self-reported oral health, which seems to be partly explained by health behavior patterns, the presence of oral health problems and seeking dental services at longer intervals than once per year.

Advising mothers about breastfeeding and weaning reduced pacifier use in the first year of life: a randomized trial.

OBJECTIVE: To assess the effectiveness of home visits for advising mothers about breastfeeding and weaning on pacifier use in the first year of life. METHOD: A randomized field trial was conducted on mothers who gave birth within the public health system in the Brazilian city of Sao Leopoldo (intervention group = 200; controls = 300). The intervention group received the advice 10 days after the child's birth, monthly up to 6 months, at 8, 10, and 12 months, based on the 'Ten Steps for Healthy Feeding', a Brazilian national health policy for primary care, which follows WHO guidelines. Relative risk (RR) was used to estimate the effects of the intervention on the risk of using a pacifier. RESULTS: 55.4% of the children in the intervention group and 66.1% of the controls used a pacifier in the first year of life. The risk of using a pacifier was 16% lower for the intervention group (RR = 0.84; 95% CI, 0.71-0.99). A multivariable Poisson regression model showed higher adjusted risk of using a pacifier for children who had breastfeeding interrupted in the first month of life (RR = 1.43; 95% CI, 1.21-1.69) and whose mothers presented higher level of depression (RR = 1.40; 95% CI, 1.17-1.66). CONCLUSIONS: Pacifier use is highly prevalent in the population studied. The home visits for dietary advice appear to help in reducing pacifier use in infants. These findings suggest the need for public health strategies that address early advice on pacifier use to promote child oral and general health.

Occupational stress and self-perceived oral health in Brazilian adults: a Pro-Saude study / Estresse no trabalho e autopercepção de saúde oral entre adultos brasileiros: Estudo Pró-Saúde

The scope of this study is to investigate the association between occupational stress and self-perception of oral health. Data were obtained through a self-administered questionnaire filled out in a Pró-Saúde Study by 3253 administrative technical staff from Rio de Janeiro's State University. Occupational stress was measured by means of a questionnaire elaborated in 1970 by Karasek, duly shortened by Thorell in 1988. Ordinal logistic regression was used for data analysis, subsequently adjusted for three blocks of variables. Workers exposed to high occupational demands and little occupational control and to passive work had higher chances of self-perception of worse oral health, when compared with those exposed to low occupational demands, there being no association observed in those exposed to active work. However, in the multiple regression model the following estimates were reduced in magnitude and lost statistical significance, namely high occupational demands and passive work. Workers exposed to high occupational demands revealed worse self-reported oral health, which seems to be partly explained by health behavior patterns, the presence of oral health problems and seeking dental services at longer intervals than once per year.

O objetivo deste estudo é investigar a associação entre estresse no trabalho e a autopercepção de saúde bucal. Os dados foram obtidos por meio de questionário de autopreenchimento de 3.253 funcionários técnicos administrativos da Universidade Estadual do Rio de Janeiro em um Estudo do Pró-Saúde. O estresse no trabalho foi medido por meio de um questionário elaborado por Karasek em 1970 e reduzido por Theorell em 1988. Para a análise dos dados, utilizou-se regressão logística ordinal, posteriormente ajustada para três blocos de variáveis. Trabalhadores expostos a alta exigência e pouco controle no trabalho e ao trabalho passivo, tiveram maiores chances de perceber pior saúde bucal, quando comparados àqueles expostos a baixa exigência no trabalho, não se observando associação com aqueles expostos ao trabalho ativo. Entretanto, no modelo de regressão múltipla, estas estimativas reduziram em magnitude e perderam significância estatística, a saber: alta exigência e trabalho passivo. Funcionários expostos à alta exigência no trabalho apresentaram pior saúde bucal autorreferida que parece ser em parte explicada pelas comportamentais em saúde, presença de problemas de saúde bucal e uso de serviços odontológicos com uma frequência maior do que uma vez ao ano.