Guideline for oral care of dependent elders: mapping review and cross-cultural adaptation to Portuguese-Brazil

Abstract This study aimed to map evidence-based guidelines for oral care of the dependent elders and perform the cross-cultural adaptation to Brazilian Portuguese. Initially, a systematized review was conducted in Medline, Scielo, Scopus, Web of Science, and Google Scholar databases without restrictions in search period or type of study. Articles in English, Spanish, and Brazilian Portuguese describing evidence-based guidelines for oral care, including oral hygiene recommendations, of institutionalized dependent elders were included as long as they presented an evaluation of evident quality. The guideline that met inclusion criteria was submitted to cross-cultural adaptation after obtaining permission from the original authors. Two hundred and nineteen references were found. Three selected articles described evidence-based guidelines for oral care, but the Oral Health Care Guideline for Older People in Long-term Care Institutions (OGOLI), originally developed and implemented in the Netherlands, was selected. It was based on evidence level A2 and consensus of experts and met the quality requirements of the Appraisal of Guidelines for Research & Evaluation (AGREE). This guideline presents oral care recommendations for elders with different levels of dependence in activities of daily living to be performed by caregivers and nursing staff. The adaptation of the OGOLI was mainly on the attributions of care providers, given the differences in professional regulations between Brazil and the Netherlands. The cross-cultural equivalence between OGOLI and its Brazilian Portuguese version was verified.

Avaliação do preenchimento da Caderneta de Saúde da Criança e qualidade do preenchimento segundo o tipo de serviço de saúde usado pela criança / Assessment of the way in which entries are filled out in Child Health Records and the quality of the entries according to the type of health services received by the child

Resumo Objetivou-se avaliar o preenchimento da Caderneta de Saúde da Criança (CSC) e a associação entre qualidade do preenchimento e o tipo de serviço usado para o acompanhamento da saúde das crianças. Estudo transversal com amostra estratificada e proporcional aos 9 Distritos Sanitários de Belo Horizonte, selecionada entre crianças de 3 a 5 anos, no Dia da Campanha de Vacinação Infantil 2014. Realizou-se entrevista com os pais e observação de 21 itens da CSC. A variável dependente foi definida pela qualidade (satisfatória/insatisfatória) do preenchimento da CSC, sendo considerado satisfatório o preenchimento > 60%. As variáveis independentes foram o tipo de serviço para acompanhamento da saúde da criança, características demográficas e condições de saúde da mãe e da criança, e atenção em saúde recebida pela criança. Participaram 367 pais. A proporção de preenchimento insatisfatório foi 55,5%. Não houve associação significativa entre qualidade de preenchimento e tipo de serviço de saúde. O preenchimento insatisfatório esteve associado à idade gestacional < 37 semanas, falta de acesso a informações sobre a CSC e ausência de anotações dos pais na CSC. A CSC tem sido insatisfatoriamente empregada como um instrumento de vigilância da saúde independentemente do tipo de serviço usado pela criança.

Abstract The scope of this study was to assess the way Child Health Records (CHRs) are filled out and the association between the quality of entries and type of service used to monitor the health of children. It involved a cross-sectional study with a stratified sample - proportional for the nine Health Districts of Belo Horizonte, State of Minas Gerais - of 3- to 5-year-old children selected on Child Vaccination Campaign Day in 2014. Interviews with parents including observation of the 21 CHR items were conducted. The dependent variable was defined by the quality of the CHR entry (satisfactory/unsatisfactory), where satisfactory entries were > 60%. The independent variables were the type of service for monitoring child health, demographic and health conditions of the mother and child and healthcare treatment received by the child, with the participation of 367 (96.10%) parents. The prevalence of unsatisfactory entries was 55.5%. No significant association was found between quality of entry and type of healthcare. Unsatisfactory entries were associated with gestational age < 37 weeks, lack of access to information about the CHR and the absence of parental entries on the CHR. The CHR has been unsatisfactorily employed as a tool for monitoring health, irrespective of the type of service used by the child.

Oferta de próteses dentárias na Atenção Primária à Saúde de 2010 a 2016 em Belo Horizonte, Minas Gerais / Supply of dental prostheses in Primary Health Care from 2010 to 2016 in Belo Horizonte, Minas Gerais

Objetivo: O objetivo do presente estudo foi descrever a implementação e oferta de próteses totais removíveis (PT) na Atenção Primária à Saúde (APS) entre 2010-2016, no município de Belo Horizonte (BH). Métodos: Pesquisa documental na nota técnica sobre oferta de PT no Sistema Único de Saúde; legislações e dados sobre credenciamento de Laboratórios Regionais de Prótese Dentária (LRPD) em BH e protocolo para Atenção em Saúde Bucal do município. Com base no consolidado de produtividade das Unidades Básicas de Saúde (UBS) e na nota técnica "Oferta de Prótese Dentária na Rede SUS-BH", 2012, obteve-se o número de próteses ofertadas de 07/2010 a 07/2016 e as taxas de oferta, considerando-se a população estimada com necessidade de PT. Resultados: Em 2004, a Política Nacional de Saúde Bucal instituiu a oferta de próteses na APS. Em 2006, o Protocolo para Atenção em Saúde Bucal definiu a oferta de próteses parciais e totais removíveis em acrílico na APS. Em 2008, houve edital de credenciamento de LRPD. Em 2010, iniciou-se a oferta de PT e houve credenciamento de um LRPD. Cursos de capacitação e suporte por tutor especialista foram disponibilizados. Em 2016, cento e quarenta e oito UBS estavam capacitadas para produção de PT, que foi de 900 próteses em 2010 e 4.573 em 2016, totalizando 25.784 PT ofertadas à população. O aumento foi de 87,6% de 2011 para 2012 e de 44,7% de 2012 para 2013; de 2013 para 2014 reduziu 1,2% e cresceu 15,2% de 2014 para 2015. Houve um aumento nas taxas de produção anual e mensal de próteses. Conclusão: Houve uma ampliação da oferta de PT pela APS de BH. A tutoria e os cursos de capacitação favoreceram a adesão e aperfeiçoamento dos cirurgiões-dentistas na oferta desse serviço.(AU)

Aim: To describe the implementation and supply of total removable dentures (PT) in Primary Healthcare (PHC) between the years of 2010 and 2016 in the city of Belo Horizonte (BH), Brazil. Methods: Documentary research in technical notes on the supply of dental prostheses in the Brazilian Unified Health System (SUS); legislations and data on the accreditation of Regional Dental Prosthesis Laboratories (LRPD) in BH; and protocol for Oral Healthcare in BH. The number of dentures provided from 07/2010 to 07/2016 was obtained based on the consolidated productivity of Basic Health Units (UBS) and the technical notes of "Supply of Dental Prosthesis in the SUS-BH Network" (2012). Results: In 2004, the National Oral Health Policy instituted the supply of prostheses in PHC. In 2006, the Protocol for Oral Healthcare defined the supply of partial and total removable acrylic dentures in PHC. In 2008, there was a bidding process for LRPD accreditation. In 2010, PT began to be provided, and LRPD was accredited. Training and support courses by specialist tutors were provided. In 2016, one hundred fortyeight UBSs were qualified to produce PT, which reached 900 prostheses in 2010 and 4,573 in 2016, with a total of 25,784 PTs offered to the population. The increase was of 87.6% from 2011 to 2012 and of 44.7% from 2012 to 2013; from 2013 to 2014, this number decreased by 1.2%, while it increased 15.2% from 2014 to 2015. Conclusion: There was an expansion of the PTs provided by APS in BH. Tutoring and training courses favored the adherence and improvement of dentists in providing this service.(AU)