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1.
Artigo em Inglês | MEDLINE | ID: mdl-32806769

RESUMO

We aimed to investigate the management of urgent dental care, the perception of risk and workplace preparedness among dental staff in Norway during the COVID-19 pandemic. An electronic questionnaire regarding the strictest confinement period in Norway (13 March-17 April 2020) was distributed to dental staff. Among the 1237 respondents, 727 (59%) treated patients, of whom 170 (14%) worked in clinics designated to treat patients suspected or confirmed to have COVID-19. Out of them 88% (143) received training and 64% (103) simulation in additional infection prevention procedures, while 27 (24%) respondents reported deviation. In total, 1051 (85%) respondents perceived that dental staff had a high risk of being infected, 1039 (84%) that their workplace handled the current situation well, 767 (62%) that their workplace had adequate infection control equipment and 507 (41%) agreed that their workplace is well equipped to handle an escalation. Before an appointment, 1182 (96%) respondents always/often inquired per phone information if a patient experienced symptoms of COVID-19, and 1104 (89%) asked about a history of travel to affected areas. Twice as many patients on average per week were treated by phone than in a clinic. A lower proportion of dental staff in high incidence counties applied additional infection prevention measures compared to low and medium incidence counties. To conclude, urgent dental health care was managed relatively well in Norway. Additional training of the dental staff in adequate infection prevention and step-by-step procedures may be needed. These results may be used to improve the dental health service's response to future outbreaks.


Assuntos
Infecções por Coronavirus/epidemiologia , Serviços de Saúde Bucal/organização & administração , Controle de Infecções/organização & administração , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , Estudos Transversais , Serviços de Saúde Bucal/normas , Feminino , Humanos , Controle de Infecções/normas , Capacitação em Serviço/organização & administração , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Pandemias , Medição de Risco , Inquéritos e Questionários , Telemedicina/organização & administração , Telefone , Local de Trabalho/organização & administração
2.
BMC Oral Health ; 20(1): 192, 2020 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-32641034

RESUMO

BACKGROUND: Over the past several decades, changes in legislation and regulations have been implemented in oral health care in the Netherlands. In 1995, for example, a major transformation in the funding of oral health care was implemented, after which most oral health care for adults was no longer covered by national insurance. In 1997, the Individual Healthcare Professions Act, in which the authorizations of care providers were described, was established. The Healthcare Quality, Complaints and Disputes Act, established in 2016, concerns the accountability of professional behavior. Regulations concerning employment have changed several times since 1995. These changes have affected the work and practice situation of oral health care providers. METHODS: Data from many publicly available sources were gathered and combined with internal reports mainly derived from the Data Stations project of the Royal Dutch Dental Association. This project was established in 1995 and, since its initiation, 6716 dentists have participated an average of 6.7 times. RESULTS: Between 1995 and 2018, nearly all professional groups in oral health care increased, particularly those of dental hygienists and prevention assistants. The number of dental practices decreased, but practices got larger in terms of dental units, number of patients, and personnel. The percentage of inhabitants visiting oral health care professionals remained unchanged, but the type of care provided moved towards more prevention. Oral health care providers exploited new opportunities to enhance and express their professional behavior. CONCLUSIONS: Oral health care in the Netherlands has evolved in recent years toward more collaboration in teams, and professions have established institutions to promote the quality and safety of care. Greater emphasis has been placed on prevention of dental diseases. These processes were influenced by new legislation and regulations, demographic changes within professional groups, and other social developments.


Assuntos
Assistência Odontológica/tendências , Serviços de Saúde Bucal/organização & administração , Saúde Bucal/estatística & dados numéricos , Qualidade da Assistência à Saúde , Adulto , Serviços de Saúde Bucal/tendências , Humanos , Países Baixos
3.
Artigo em Inglês | MEDLINE | ID: mdl-32414126

RESUMO

The aim of this pilot study was to describe the advantages of telemedicine (TM) in dental practice during the current national emergency condition due to the Covid-19 dissemination. At Department of Oral Surgery and Pathology-Magna Graecia University of Catanzaro, regional reference center for Covid-19-two groups of patients were determined: patients with urgent conditions (group U) and patients in follow-up (group F). Both groups were instructed to implement remote consultations using a messaging service (WhatsApp Messenger, WhatsApp Inc., Mountain View, California, USA) to send photos. A total of 418 photos were collected by 57 patients. Thirty-four photos were obtained by five patients in the U group after surgical procedures. All patients sent photos on the established evening, except for two patients who sent two photos outside the set days. In the F group, 384 photos were collected by 52 patients. None of them sent more photos than the number that was established by the protocol. Telemedicine allowed a monitoring of all patients, reducing costs and limiting human contact, decreasing the risk of Covid-19 dissemination.


Assuntos
Odontologia Comunitária , Infecções por Coronavirus , Serviços de Saúde Bucal/estatística & dados numéricos , Doenças da Boca/diagnóstico , Pandemias , Pneumonia Viral , Consulta Remota , Telemedicina , Adulto , Betacoronavirus , Coronavirus , Atenção à Saúde , Clínicas Odontológicas , Serviços de Saúde Bucal/organização & administração , Odontologia , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis , Projetos Piloto , Odontologia em Saúde Pública , Encaminhamento e Consulta , Adulto Jovem
4.
BMC Oral Health ; 20(1): 145, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429976

RESUMO

BACKGROUND: Dental caries, despite improvement in oral health across the globe, is still a large contributor to the global burden of oral diseases and a major public health concern. In Enugu state, Nigeria, there is minimal access to adequate and proper oral health care. This study examined the determinants of dental caries treatment provision and the challenges of providing equitable access to oral health care. METHOD: This was a mixed-method cross-sectional descriptive urban-rural study conducted in selected oral health facilities offering primary oral health care in Enugu state. The study was conducted in two phases over a 2 month period. Quantitative data was initially collected from all selected oral health care providers using a survey questionnaire format after which qualitative data were collected through in-depth interviews of heads of the selected oral health facilities. The determinants of dental caries treatment services were explored with a focus on provider behavior, cost of dental services, human resource availability and availability of dental equipment. RESULTS: Quantitative findings show that to a larger extent, the cost of raw materials (100%), human resources (98.1%), infection control resources (98.1%), geographical location (98.1), Government policies (88%) and the price of other goods (80.8%) influence provision of dental caries treatment services. Qualitative results show that location and number of oral health facilities, government funding and policies for oral health, cost of dental equipment and materials, the ability of consumers to pay, human resource availability and consumer awareness of oral health are also factors that influence the provision of dental caries treatment services. CONCLUSION: Adequate access to oral health care services is a major concern that affects all aspects of healthcare and a determining factor in the country's drive to achieve universal health coverage. In order to address this, oral health facilities need to be strategically located and have adequate materials, equipment and skilled staff. There is a need to incorporate oral health into the general health care system and improve government policies and funding for oral health.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Cárie Dentária/terapia , Serviços de Saúde Bucal/organização & administração , Saúde Bucal/estatística & dados numéricos , Estudos Transversais , Cárie Dentária/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Entrevistas como Assunto , Nigéria/epidemiologia , Atenção Primária à Saúde , Pesquisa Qualitativa , População Rural , População Urbana
6.
Pan Afr Med J ; 37: 172, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33447327

RESUMO

The interconnectedness of oral, mental, sexual, and reproductive health (OMSRH) in adolescents prompts exploration of novel approaches to facilitate comprehensive access of this population to the relevant health services. This paper proposes an integrated one-stop-shop approach to increasing adolescents' access to OMSRH care by leveraging on dental clinics as a template for integration, using a non-stigmatized platform to deliver stigmatized healthcare. Novel healthcare delivery models are needed to enhance adolescents' access to the comprehensive prevention and treatment services that they critically need. Effective, integrated health care for this population is lacking, especially across various health areas. This is a proposal for leveraging dental clinics for integrated OMSRH care, using facility-based services, to adolescents. Emphasis will be placed on reducing stigma as a barrier to service accessibility, acceptability, equitability and appropriateness. Empirical studies will be required to test the feasibility, validity and effectiveness of this proposed model.


Assuntos
Serviços de Saúde do Adolescente/organização & administração , Prestação Integrada de Cuidados de Saúde/organização & administração , Acesso aos Serviços de Saúde , Adolescente , Serviços de Saúde Bucal/organização & administração , Humanos , Serviços de Saúde Mental/organização & administração , Modelos Organizacionais , Nigéria , Serviços de Saúde Reprodutiva/organização & administração
7.
Prim Dent J ; 8(3): 64-74, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31666174

RESUMO

In 2019, in a world of instant gratification, what are the expectations of patients and dentists? Is training sufficient to meet these expectations? Decision-making in dentistry impacts the treatment choices patients are given, and may influence the outcomes of such treatment. It is therefore important to ensure as much standardisation as possible. In order to achieve this, it is important to know the current standard and the views of dentist as this will influence dental treatment planning. Clinical Relevance: This paper captures the treatment planning dilemmas of dentists, specifically of those in their Foundation training year, in order to aid targeting of training and development. Objective Statement: To understand treatment decisions of general dental practitioners and specialists.


Assuntos
Assistência Odontológica/organização & administração , Serviços de Saúde Bucal/organização & administração , Odontólogos/psicologia , Odontologia Geral , Medicina Geral , Odontologia Geral/organização & administração , Humanos
9.
Worldviews Evid Based Nurs ; 16(5): 408-415, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31544360

RESUMO

PURPOSE: The purpose of this study was to examine the Oral Health-Related Quality of Life (OHRQOL) and Oral Health Impact Profile (OHIP) of oral and dental health patients in terms of gender, educational status, and the reason for coming to the oral health center. Also, we investigated the relationships between OHRQOL and OHIP. METHODS: This cross-sectional study was conducted and planned for dental patients in Turkey. OHRQOL-United Kingdom (OHRQOL-UK) and OHIP-14 were used for data collection. Descriptive statistics, correlation analysis, student t-tests, and ANOVA were used for data analyses. RESULTS: Of 527 respondents, 62.8% were female, and 37.2% were male. One-hundred-forty-one (26.8%) participants were illiterate. Three-hundred-fifty-four (67.20%) dental patients had an elementary school degree. Only 32 (6.10%) participants graduated from college and bachelor programs. For dimensions of the OHIP-14 and OHRQOL-UK, we detected statistically significant differences in personal characteristics. We found that gender, marital status, age, education status, and reasons for coming to the hospital have a significant impact on OHRQOL and OHIP. LINKING EVIDENCE TO ACTION: These results are expected to provide important evidence-based information to health managers and decision-makers in health planning and reimbursement policies. Clinicians and health managers should use OHIP, quality of life (QOL), and evidence-based practice to determine individual treatments and approaches to improve oral health. QOL is an outcome indicator in healthcare services and evidence-based practice. Measurements of evidence-based health outcomes in national health systems can be made, and global comparisons and policies in oral and dental health can be developed.


Assuntos
Prática Clínica Baseada em Evidências/normas , Resultado do Tratamento , Adulto , Estudos Transversais , Serviços de Saúde Bucal/organização & administração , Serviços de Saúde Bucal/normas , Serviços de Saúde Bucal/estatística & dados numéricos , Prática Clínica Baseada em Evidências/métodos , Prática Clínica Baseada em Evidências/estatística & dados numéricos , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Inquéritos e Questionários , Turquia
11.
Epidemiol Serv Saude ; 28(2): e2018060, 2019 07 04.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31291436

RESUMO

OBJECTIVE: to evaluate the quality of oral health care in Primary Health Care services in Pernambuco state, Brazil, 2014. METHODS: this was an ecological health evaluation study based on the Donabedian model, involving secondary data from the 2nd cycle of the National Program for Improving Access and Quality of Primary Health Care (PMAQ-AB); comparison between the structure, process and outcome variables was done using the Kruskal-Wallis test (p<0.050); variables showing statistical significance (p<0.05) were portrayed through thematic and spatial dependence maps. Results: the standard of quality in the municipalities for the 'Structure' dimension gained better scores than the 'Work process' dimension; correlations were identified between the indicators for dental urgency, supervised tooth brushing coverage and treatments completed, in quality strata related to the work process of the Oral Health teams. CONCLUSION: organization of the work process was seen to be a determining factor in the impact on some indicators of service use.


Assuntos
Serviços de Saúde Bucal/organização & administração , Atenção Primária à Saúde/organização & administração , Qualidade da Assistência à Saúde , Brasil , Serviços de Saúde Bucal/normas , Acesso aos Serviços de Saúde , Humanos , Programas Nacionais de Saúde/organização & administração , Programas Nacionais de Saúde/normas , Equipe de Assistência ao Paciente/organização & administração , Equipe de Assistência ao Paciente/normas , Atenção Primária à Saúde/normas , Indicadores de Qualidade em Assistência à Saúde
12.
BMC Oral Health ; 19(1): 126, 2019 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-31238976

RESUMO

BACKGROUND: User satisfaction represents a patient-centered measure that should be used to assess the quality of oral health services. This study investigated the differences in user satisfaction with public oral health services according to the sociodemographic user profile and the quality of oral health services in primary health care in Brazil. METHODS: Secondary data from a national program obtained through interviews with users were analyzed. Satisfaction was based on the Swan' model relating to perceptions regarding the service performance, assessment of overall satisfaction and the intention to avoid the service in the future. The exploratory variables were demographic characteristics of the users and the quality of the primary service from the user's viewpoint, considering the dimensions: access; receptivity of spontaneous demand; integral health care; bonding, accountability, and coordination of care. RESULTS: A total of 37,262 users participated, and 65.51% reported satisfaction with the oral health service, that was higher among those > 20 years old and beneficiaries of the Family Grant Program and lower among users with a higher level of schooling and those who reported being employed. Users who rated oral health service positively were more satisfied. CONCLUSIONS: Socioeconomically disadvantaged user was more satisfied with oral health services and the satisfaction increased with age. The improvement in the quality of oral health services in primary care can result in greater satisfaction.


Assuntos
Serviços de Saúde Bucal/organização & administração , Saúde Bucal , Satisfação do Paciente , Satisfação Pessoal , Atenção Primária à Saúde/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Feminino , Acesso aos Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde , Inquéritos e Questionários , Adulto Jovem
13.
Cien Saude Colet ; 24(5): 1809-1820, 2019 May 30.
Artigo em Português | MEDLINE | ID: mdl-31166514

RESUMO

Ensuring access to dental care services requires the development of healthsurveillance practices to ensure comprehensive health care. The objective of this study was toinvestigate the association between social and economic indicators of Brazilian municipalities, work process characteristics, and performance of a list of curative dental procedures by oral health teams. It involved an exploratory, cross-sectional study withmulticenter data collection from 11,374 oral health teams assessed by the National Program for Improvement of Access to and Quality of Primary Healthcare. Multilevel Poisson regression was used to obtain the prevalence of curative dental procedures, which was 69.51%. The social/economic and work variables that remained associated with the outcome included municipalities in which the proportion of primary care-sensitive admissions was below 28% and that of tooth extractions below 8%; and oral health teams classified as type II (including oral health assistant and technician) that had different materials available and better work processes. This multilevel analysis, which took into consideration the performance of curative dental care in Brazil, reveals a worrying oral healthcare scenario.


Assuntos
Assistência Odontológica/organização & administração , Serviços de Saúde Bucal/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Atenção Primária à Saúde/organização & administração , Brasil , Assistência Integral à Saúde/organização & administração , Estudos Transversais , Serviços de Saúde Bucal/normas , Acesso aos Serviços de Saúde , Humanos , Programas Nacionais de Saúde/organização & administração , Saúde Bucal , Atenção Primária à Saúde/normas , Qualidade da Assistência à Saúde
14.
Ciênc. Saúde Colet ; 24(5): 1809-1820, Mai. 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1001784

RESUMO

Resumo A garantia de atenção odontológica passa pelo desenvolvimento de práticas pautadas na vigilância em saúde, a fim de concretizar a integralidade. Objetivou-se avaliar a associação entre aspectos contextuais dos municípios brasileiros, características do processo de trabalho e a realização de um rol de procedimentos odontológicos curativos pelas equipes de saúde bucal (ESB). Trata-se de estudo exploratório transversal cuja coleta multicêntrica de dados se deu em 11.374 ESB avaliadas pelo Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica. Foi empregada regressão de Poisson multinível para obtenção da prevalência de realização de procedimentos odontológicos curativos, que foi de 69,51%. As variáveis contextuais e da equipe de saúde que se mantiveram associadas ao desfecho incluíram municípios cuja proporção de internações sensíveis à atenção básica foi menor que 28% e cuja proporção de exodontias foi menor que 8%; bem como ESB de modalidade II que tinham à disposição materiais, insumos e melhores processos de trabalho. Esta análise multinível, que considera o desempenho da atenção odontológica curativa no Brasil, aponta para um cenário de atenção odontológica preocupante.


Abstract Ensuring access to dental care services requires the development of healthsurveillance practices to ensure comprehensive health care. The objective of this study was toinvestigate the association between social and economic indicators of Brazilian municipalities, work process characteristics, and performance of a list of curative dental procedures by oral health teams. It involved an exploratory, cross-sectional study withmulticenter data collection from 11,374 oral health teams assessed by the National Program for Improvement of Access to and Quality of Primary Healthcare. Multilevel Poisson regression was used to obtain the prevalence of curative dental procedures, which was 69.51%. The social/economic and work variables that remained associated with the outcome included municipalities in which the proportion of primary care-sensitive admissions was below 28% and that of tooth extractions below 8%; and oral health teams classified as type II (including oral health assistant and technician) that had different materials available and better work processes. This multilevel analysis, which took into consideration the performance of curative dental care in Brazil, reveals a worrying oral healthcare scenario.


Assuntos
Humanos , Equipe de Assistência ao Paciente/organização & administração , Atenção Primária à Saúde/organização & administração , Assistência Odontológica/organização & administração , Serviços de Saúde Bucal/organização & administração , Atenção Primária à Saúde/normas , Qualidade da Assistência à Saúde , Brasil , Saúde Bucal , Estudos Transversais , Assistência Integral à Saúde/organização & administração , Serviços de Saúde Bucal/normas , Acesso aos Serviços de Saúde , Programas Nacionais de Saúde/organização & administração
15.
Cien Saude Colet ; 24(3): 953-961, 2019 Mar.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30892516

RESUMO

The goal was to assess the access and factors connected to dental visits in children up to age five in the city of Porto Alegre, Brazil. The cross-sectional study was conducted in 10 Basic Health Units through a questionnaire and clinical examination on 560 children. Clinical (visible plaque, gingival bleeding and defs), socio-demographic, and visit access variables were assessed. Poisson Regression was used to calculate the Prevalence Ratios (PR), with a 95% confidence interval. Results showed that 68.2% of children had never gone to a dentist. The main reason reported for not visiting a dentist was not feeling the need (48.7%) and difficult access to a health clinic (15.8%). The purpose of going to the dentist was for prevention/revision (55.8%), and the most sought-after places for visits were the private office (43.9%) and health clinic (39.5%). The final multivariate model showed that age of the child (95%CI, PR = 1.03 (1.02-1.05)), household income (PR = 1.05; (1.01-1.08)), and the mother having completed high school (PR = 1.69 (1.15-2.56)) were associated with seeking dental consultation. Thus, it is crucial to recognize the importance of the family setting during the first years of life.


Assuntos
Assistência Odontológica para Crianças/estatística & dados numéricos , Serviços de Saúde Bucal/estatística & dados numéricos , Acesso aos Serviços de Saúde , Saúde Bucal/estatística & dados numéricos , Adulto , Fatores Etários , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Serviços de Saúde Bucal/organização & administração , Placa Dentária/epidemiologia , Escolaridade , Feminino , Hemorragia Gengival/epidemiologia , Humanos , Renda , Lactente , Masculino , Análise Multivariada , Distribuição de Poisson , Inquéritos e Questionários , Adulto Jovem
16.
BMJ Open ; 9(3): e024995, 2019 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-30904857

RESUMO

OBJECTIVES: To understand approaches to priority setting for healthcare service resource allocation at an operational level in a nationally commissioned but regionally delivered service. DESIGN: Qualitative study using semistructured interviews and a Framework analysis. SETTING: National Health Service dentistry commissioning teams within subregional offices in England. PARTICIPANTS: All 31 individuals holding the relevant role (dental lead commissioner in subregional offices) were approached directly and from this 14 participants were recruited, with 12 interviews completed. Both male and female genders and all regions were represented in the final sample. RESULTS: Three major themes arose. First, 'Methods of priority setting and barriers to explicit approaches' was a common theme, specifically identifying the main methods as: perpetuating historical allocations, pressure from politicians and clinicians and use of needs assessments while barriers were time and skill deficits, a lack of national guidance and an inflexible contracting arrangements stopping resource allocation. Second, 'Relationships with key stakeholders and advisors' were discussed, showing the important nature of relationships with clinical advisors but variation in the quality of these relationships was noted. Finally, 'Tensions between national and local responsibilities' were illustrated, where there was confusion about where power and autonomy lay. CONCLUSIONS: Commissioners recognised a need for resource allocation but relied on clinical advice and needs assessment in order to set priorities. More explicit priority setting was prevented by structure of the commissioning system and standard national contracts with providers. Further research is required to embed and simplify adoption of tools to aid priority setting.


Assuntos
Serviços de Saúde Bucal , Alocação de Recursos para a Atenção à Saúde , Pessoal Administrativo , Serviços de Saúde Bucal/economia , Serviços de Saúde Bucal/organização & administração , Inglaterra , Alocação de Recursos para a Atenção à Saúde/métodos , Alocação de Recursos para a Atenção à Saúde/organização & administração , Prioridades em Saúde/organização & administração , Humanos , Determinação de Necessidades de Cuidados de Saúde , Pesquisa Qualitativa , Regionalização da Saúde/métodos , Medicina Estatal
17.
Ciênc. Saúde Colet ; 24(3): 953-961, mar. 2019. tab
Artigo em Português | LILACS | ID: biblio-989581

RESUMO

Resumo O objetivo foi avaliar o acesso e fatores associados à consulta odontológica em crianças de até 5 anos no município de Porto Alegre, Brasil. Estudo transversal realizado em 10 Unidades Básicas de Saúde, através de questionário e exame clínico em 560 crianças. Foram avaliadas variáveis clínicas (placa visível, sangramento gengival e ceo-s), sociodemográficas, e de acesso à consulta. Regressão de Poisson foi utilizada para cálculo de Razões de Prevalência (RP), com intervalo de confiança de 95%. Os resultados mostraram que 68,2% das crianças nunca haviam ido ao dentista. O principal motivo relatado para a não realização de consulta odontológica foi não ter sentido necessidade (48,7%) e dificuldade de acesso ao posto de saúde (15,8%). A procura pelo dentista teve como propósito a prevenção/revisão (55,8%) e os locais mais procurados para consultas foi o consultório particular (43,9%) e o posto de saúde (39,5%). O modelo multivariado final mostrou que a idade da criança (IC95%, RP = 1,03 (1,02-1,05)), a renda familiar (RP = 1,05; (1,01-1,08)) e a mãe ter concluído o ensino médio (RP = 1,69 (1,15-2,56)) estiveram associados com a procura por consulta odontológica. Assim, torna-se fundamental reconhecer a importância do contexto familiar durante os primeiros anos de vida.


Abstract The goal was to assess the access and factors connected to dental visits in children up to age five in the city of Porto Alegre, Brazil. The cross-sectional study was conducted in 10 Basic Health Units through a questionnaire and clinical examination on 560 children. Clinical (visible plaque, gingival bleeding and defs), socio-demographic, and visit access variables were assessed. Poisson Regression was used to calculate the Prevalence Ratios (PR), with a 95% confidence interval. Results showed that 68.2% of children had never gone to a dentist. The main reason reported for not visiting a dentist was not feeling the need (48.7%) and difficult access to a health clinic (15.8%). The purpose of going to the dentist was for prevention/revision (55.8%), and the most sought-after places for visits were the private office (43.9%) and health clinic (39.5%). The final multivariate model showed that age of the child (95%CI, PR = 1.03 (1.02-1.05)), household income (PR = 1.05; (1.01-1.08)), and the mother having completed high school (PR = 1.69 (1.15-2.56)) were associated with seeking dental consultation. Thus, it is crucial to recognize the importance of the family setting during the first years of life.


Assuntos
Humanos , Masculino , Feminino , Lactente , Adulto , Adulto Jovem , Saúde Bucal/estatística & dados numéricos , Assistência Odontológica para Crianças/estatística & dados numéricos , Serviços de Saúde Bucal/estatística & dados numéricos , Acesso aos Serviços de Saúde , Brasil/epidemiologia , Distribuição de Poisson , Hemorragia Gengival/epidemiologia , Estudos Transversais , Análise Multivariada , Inquéritos e Questionários , Fatores Etários , Serviços de Saúde Bucal/organização & administração , Placa Dentária/epidemiologia , Escolaridade , Renda
19.
Aust Dent J ; 64(1): 55-65, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30375645

RESUMO

BACKGROUND: Pregnant women in Australia seldom seek dental care and are unaware of its importance. To address these gaps the midwifery-initiated oral health dental service (MIOH-DS) program was comprehensive trialled and found effective. The aim of this study was to undertake a process evaluation of the MIOH-DS using the perspectives of pregnant women who participated in the trial. METHODS: A qualitative research design was utilized, whereby content analysis was undertaken on data from 11 semi-structured interviews with women who participated in the program. RESULTS: All participants were receptive of the MIOH-DS intervention, and found it to be an acceptable intervention that met their needs, and encouraged future positive oral health practices and health-seeking behaviours. They expressed that midwives were an appropriate professional to conduct oral health assessments, education and referrals to affordable dental services. Although some participants were initially apprehensive towards receiving treatment during pregnancy, dental staff members were able to appropriately educate and reassure them during treatment. CONCLUSIONS: The MIOH-DS represents a promising and acceptable intervention strategy for pregnant women to promote their oral health. Findings merit further investigation on whether positive outcomes achieved can be sustained when implemented in other national or international settings similar to the study setting.


Assuntos
Serviços de Saúde Bucal/organização & administração , Tocologia , Saúde Bucal , Aceitação pelo Paciente de Cuidados de Saúde , Austrália , Feminino , Humanos , Tocologia/organização & administração , Gravidez , Avaliação de Programas e Projetos de Saúde , Encaminhamento e Consulta
20.
Rio de Janeiro; s.n; 2019. 232 f p. fig, tab, graf.
Tese em Português | LILACS | ID: biblio-998336

RESUMO

Esta tese tem como objeto analisar a Política Nacional de Saúde Bucal (PNSB) e a sua conexão com a Rede de Cuidados à Pessoa com Deficiência (RCPD) no estado do Amazonas. Para compreender a configuração da Política e a transversalidade com a Rede nessa localidade, os processos de pesquisa foram delineados para o cerne dessa questão e o enfoque dos referenciais teóricos e levantamento de dados obtidos a partir desse direcionamento. Os encaminhamentos metodológicos partiram de duas frentes de busca - configuração da Política e atenção à saúde bucal às pessoas com deficiência (PcD) no Amazonas, nos três níveis de atenção. Desta forma os dados foram coletados através dos bancos de dados oficias do governo federal - Sistemas de Informações Ambulatoriais (SIA/SUS), Sistema de Informações Hospitalares (SIH/SUS) e Cadastro Nacional de Estabelecimentos de Saúde (CNES), todos do Departamento de Informática do Sistema Único de Saúde (DATASUS), através das ferramentas TABNET e TABWIN. Os resultados das pesquisas verificaram que este estado possui os mesmos problemas de ordem nacional que os demais estados brasileiros, somados ao desfavorecimento regional e aos problemas locais, a falta de infraestrutura associada ao isolamento geográfico e político, a grande dispersão populacional e a dificuldade de locomoção são características peculiares desse estado. Além de existirem grandes desigualdades socioeconômicas entre os municípios amazonenses, expressas pela desigualdade de renda no Amazonas (maior que no Brasil) e pelos indicadores sociais insatisfatórios (40,3% dos municípios têm Índice de Desenvolvimento Humano (IDH) baixo e o estado possui o progresso social baixo ­ Índice de Progresso Social IPS/54,92). Essas adversidades não podem ser tratadas de maneira singular e, por consequência, esse estado demanda atenção diferenciada com necessidade de investimentos em diversos setores, incluindo a saúde. A configuração da PNSB está fortemente concentrada na cidade de Manaus, principalmente no que diz respeito a atenção terciária, pois os dois hospitais aderidos à RCPD estão localizados nessa cidade. A atenção à saúde bucal, na atenção básica (AB), no Amazonas, apresenta baixa cobertura populacional tanto no estado (36,1%) quanto na capital (14,0%), refletindo em baixo acesso à saúde bucal individualizada. E a lógica do SIA/SUS não permite separar a população individualmente, o que prejudica o planejamento, programação, regulação, avaliação, controle e auditoria dos serviços ambulatoriais de saúde bucal para as PcD na AB. Na média complexidade, constatamos que dos 62 municípios amazonenses apenas nove (14,5%) possuem oferta da atenção à saúde bucal especializada, sendo 13 Centros de Especialidades Odontológicas (CEO) no estado, o que significa que 35% da população do Amazonas (1.427.527 habitantes), encontra-se desassistida da atenção à saúde bucal nesse nível de atenção. Sendo assim apresentamos algumas sugestões com o intuito de aprimorar a PNSB e a atenção à saúde bucal das PcD


This thesis aims to analyze the National Oral Health Policy (PNSB) and its connection to the Care Network for the Disabled Person (RCPD) in the state of Amazonas. In order to understand the configuration of the Policy and the transversality with the Network in that locality, the research processes were delineated to the core of this issue and the focus of the theoretical references and data collection obtained from this targeting. The methodological guidelines started from two fronts of search - configuration of the Policy and Oral Health Care for People with Disabilities (PwD) in Amazonas, in the three levels of attention. In this way the data were collected through the official databases of the federal government - Outpatient Information Systems (SIA/SUS), Hospital Information System (SIH/SUS) and National Registry of Health Establishments (CNES), all from the Department of Informatics of the Unified Health System (DATASUS), through the tools TABNET and TABWIN. The results of the surveys verified that this state has the same problems of national order as other Brazilian states, together with regional disadvantage and local problems: the lack of infrastructure associated with the geographical and political isolation, a large population dispersion and the difficulty of locomotion are peculiar characteristics of this state. In addition to the large socioeconomic inequalities between Amazonas municipalities, expressed by income inequality in Amazonas (higher than in Brazil) and by unsatisfactory social indicators (40.3% of municipalities have a low Human Development Index (HDI), and the state has low social progress - Social Progress Index IPS/54,92). These adversities cannot be treated in a singular way and, as consequence, this state demands differentiated attention with the need of investments in several sectors, including health. The configuration of the PNSB is strongly concentrated in the city of Manaus, especially regarding tertiary care, as the two hospitals adhered to RCPD are located in that city. The oral health care in primary care (AB) in Amazonas has low population coverage in both the state (36.1%) and the capital (14.0%), reflecting low access to individualized oral health. And the SIA/SUS logic doesn't allow the separation of the individual population, which impairs the planning, programming, regulation, evaluation, control and audit of outpatient oral health services for the PwD in AB. In terms of complexity, we found that only nine (14.5%) of the 62 municipalities of Amazonas have specialized oral health care, 13 of which are Dental Specialty Centers (CEO) in the state, which means that 35% of the Amazonas population (1.427.527) is disassociated from oral health care at this level of care. Thus, we present some suggestions with the aim of improving the PNSB and the oral health care of PcD


Assuntos
Humanos , Atenção Primária à Saúde , Sistema Único de Saúde , Brasil , Saúde Bucal , Pessoas com Deficiência , Assistência Odontológica para Pessoas com Deficiências/organização & administração , Serviços de Saúde Bucal/organização & administração , Política de Saúde
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