Factores determinantes para la atención clínica odontológica de pacientes con discapacidad / Determining factors for the clinical dental care of patients with disabilities

Objetivo: identificar los factores, inherentes a la práctica clínica, que determinan la atención odontológica de pacientes con discapacidad. Métodos: realización de estudio descriptivo, de alcance explicativo, cuantitativo y corte transversal; aplicación de en-cuesta dirigida a odontólogos que ejercen como profesionales independientes, con la cual se midieron variables de caracterización, conocimientos, habilidades, percepción, infraestructura y atención del paciente con discapacidad. También, se desarrolló un análisis descriptivo, correlacional y multivariado. Resultados: no todos los odontólo-gos recibieron formación para la atención clínica de personas con discapacidad; algu-nos conocen los métodos de comunicación alternativa y aumentativa y, de estos, una mayoría representativa no los sabe manejar. Sobre la infraestructura, se identificó que esta cumple parcialmente con la normatividad y que la mayoría de los profesionales se sienten medianamente preparados para llevar a cabo esta atención, por lo que el 67,3% (99) afirmó atender esta población con sus protocolos clínicos habituales, pero, el 83,7% (123) manifestó brindar la atención solo en casos de urgencia odontológica. Los factores que determinan la atención del paciente con discapacidad están relacio-nados con la cantidad de pacientes asistentes, las experiencias negativas previas, las habilidades en el manejo de la consulta, la sensación de preparación y los años de ex-periencia clínica. Conclusiones: las experiencias negativas previas en la práctica clínica con pacientes con discapacidad son determinantes; para su disminución se sugiere la urgente implementación de técnicas comunicativas, la adecuación de infraestructura y el desarrollo de habilidades para la atención integral e inclusiva.

Objective: Identify the factors that establish dental clinic care for patients with disabilities, that are inherent to the professional and to the clinical practice. Methods:A descriptive study of explanatory quantitative cross-cutting score was done. It was applied to dentists that worked independently where characterization variables, abilities, perception, infrastructure were measured, and attention to the patient in a situation of disability. A descriptive, correlational, multivariate analysis. Results: Only some dentists received the I information for the clinic care of patients in a situation of disability. Only some of them know the methods of alternative and augmentative communication and most of them don't know how to work with them. The infrastructure partially complies with the regulations and most of the professionals feel moderately prepared, so 67,3%(99) attend those patients in their usual clinical practice, but 83,7%(123) would attend them only in an emergency case. The factors that establish dental clinic care for patients with disabilities are related with the quantity of patients in a situation of disability, the previous, negative experiences, management skills in the consult, preparation sensation and the years of clinical experience. Conclusions: The previous negative experiences in the clinical practice with patients in a situation of disability are the most important factor for the dental clinic care for patients with disabilities, these experiences should decrease a from implementation of communication techniques, infrastructure adjustments and the development of abilities for the comprehensive and inclusive attention.

Epidemiologia do tracoma em povoado da chapada do Araripe - CE / Epidemiology of trachoma in the village of Araripe plateau - Ceará State

Objetivo: Avaliar os fatores epidemiológicos do tracoma no povoado de Simão. Métodos: Através de um trabalho de campo, examinou-se 412 indivíduos (178 homens e 234 mulheres) em um povoado da chapada do Araripe, vertente cearense. A mediana das idades foi de 34 anos para ambos os sexos. Coletaram-se dados relativos à epidemiologia do tracoma, realizando o diagnóstico de tracoma com lupa de 2,5x. Resultados: 304 (73,8 por cento) indivíduos eram normais e 108 (26,2 por cento) tracomatosos (5 TF, 98 TS, 3 TT e 2 CO). Quanto aos fatores socioeconômicos referentes aos indivíduos, os analfabetos apresentaram 1,9 vezes mais chances de terem tracoma (p<0,0001), mas os de maior poder aquisitivo foram mais acometidos (p<0,0001). Quanto ao aspecto da face, houve maior prevalência da doença nos que a apresentaram suja (p=0,432). Nos fatores socioeconômicos referentes à moradia, foi percebida diferença na análise multivariada apenas na variável número de pessoas por cômodo, que foi maior no grupo dos normais (p=0,010). Conclusões: A boa infraestrutura encontrada no povoado de Simão, principalmente a quantidade de casas com água encanada, associada ao bom hábito de higiene pessoal, favoreceram o encontro de baixa quantidade de formas infecciosas.

Purpose: To evaluate the epidemiological factors of trachoma in the Simão village. Methods: Through a field research, 412 individuals (178 men and 234 women) were examined in a village of the Araripe plateau in Ceará State. The median age was 34 years for both genders. Traditional data from trachoma epidemiology were collected and diagnosis of trachoma was performed using binocular loupes of x 2.5. Results: 304 (73.8 percent) individuals were normal and 108 (26.2 percent) were trachomatous (5 TF, 98 TS, 3 TT and 2 CO). Regarding socio-economic factors relating to individuals, the illiterate were 1.9 times more likely to have trachoma (p<0.0001), but the more affluent were more affected (p<0.0001). As for the face appearance, the disease was more prevalent in patients with dirty faces (p=0.432). A difference was noted in multivariate analysis of socio-economic factors relating to housing; only the variable number of people per room, which was higher in the normal group (p=0.010). Conclusions: The good infrastructure found in the Simão village, especially the amount of houses with piped water and the good personal hygiene habits, favored the low findings of infectious forms.