RESUMO
AIM: To evaluate the association between outpatient's perceived psychosocial impact of dental aesthetics and experiencing discrimination at a Peruvian public hospital. MATERIAL AND METHODS: Cross-sectional study in a Peruvian public hospital, where 207 outpatients (18-30 years old) were surveyed. We asked participants about self-reported experiences of discrimination in the last six months at a Peruvian public hospital using a question from the Peruvian National Household Survey on Living Conditions and Poverty (ENAHO) 2017. We also measured the perceived psychosocial impact of dental aesthetics with the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Additionally, we evaluated age, sex, ethnicity, education, income, and reason for being discriminated against. Association was assessed with Poisson regression using a robust estimator of variance and reporting prevalence ratios with 95% confidence intervals in crude and adjusted models. RESULTS: About two out of every five participants having experienced discrimination at a Peruvian public hospital in the last six months. On our adjusted estimates, we found discrimination to be positively associated with two components of the psychosocial impact of dental aesthetics, which were social impact (PR 1.02, 95% CI 1.00-1.04) and the psychological impact (PR 1.07, 95% CI 1.04-1.10). Conversely, dental self-confidence (PR 0.96, 95% CI 0.93-0.98) was negatively associated with discrimination. CONCLUSIONS: The perceived psychosocial impact of dental aesthetics is associated with experiencing discrimination among outpatients from a Peruvian public hospital. We advocate for structural changes to address discrimination in healthcare spaces by corresponding governmental authorities.
Assuntos
Estética Dentária , Pacientes Ambulatoriais , Adolescente , Adulto , Estudos Transversais , Hospitais Públicos , Humanos , Peru , Qualidade de Vida , Inquéritos e Questionários , Adulto JovemRESUMO
The aims of this study were to assess factors associated with catastrophic healthcare expenditure (CHE) and the burden of out-of-pocket (OOP) payments for specific healthcare services in Peru. We used data from 30,966 households that participated in the 2016 National Household Survey (Encuesta Nacional de Hogares, ENAHO). Participants reported household characteristics and expenditure on ten healthcare services. CHE was defined as healthcare spending equal to or higher than 40% of the household's capacity to pay. The associations of various household characteristics and OOP payments for specific healthcare services with CHE were assessed in logistic regression models. Poorer, rural and smaller households as well as those with older adults and individuals with chronic conditions had greater odds of facing CHE. According to the estimates from the adjusted regression model, healthcare services could be grouped into three groups. Medical tests, surgery and medication were in the first group with odds ratios (ORs) between 6.43 and 4.72. Hospitalisation, outpatient, dental and eye care were in the second group with ORs between 2.61 and 1.46. Child care, maternity care and other healthcare services (such as contraceptives, rehabilitation, etc.) were in the third group with non-significant ORs. Many Peruvian households are forced to finance their healthcare through OOP payments, burdening their finances to the extent of affecting their living standards.
RESUMO
Resumen Objetivo: Determinar si existen diferencias entre conocimientos, percepción y actitudes de las medidas de prevención relacionadas al COVID-19 entre los odontólogos de los distintos distritos de Lima, Perú de mayor y menor número de contagiados. Métodos: El tamaño de muestra fue un total de 117 odontólogos pertenecientes a los distritos de mayor número de contagiados y 125 de los distritos de menor número de contagiados. Estos distritos de ambos extremos se basaron en las tasas de contagio que presentaron en agosto del 2020 según el Ministerio de Salud. Se utilizó un cuestionario como instrumento que constó de 33 preguntas cerradas de opción múltiple y se distribuyó vía redes sociales. Para el análisis univariado, se obtuvo la estadística descriptiva donde se calcularon las medidas de frecuencia absoluta y relativa para las variables dependientes, independientes y covariables. Para el análisis bivariado, se realizó la comparación entre las variables conocimiento, percepción y actitudes con los odontólogos de los distritos con mayor y menor número de contagiados mediante la prueba Chicuadrado. Resultados: Los odontólogos de los distritos de mayor número de contagiados presentan mayores conocimientos sobre los principales síntomas, vías de transmisión y medidas de prevención frente a la COVID-19 a comparación de los odontólogos de los distritos de menor número de contagiados. Además, los de mayor número de contagiados perciben a la COVID-19 como muy peligroso, mientras que los de menor número de contagiados lo perciben moderadamente peligroso y muy peligroso en proporciones iguales. Por último, con respecto a la actitud, los de mayor número de contagiados no atienden a un paciente sospechoso y lo derivan a un centro de salud, mientras que los de menor número de contagiados sí los atienden y los derivan a un centro de salud. Conclusión: Se encontraron diferencias entre conocimientos, percepción y actitudes de las medidas de prevención relacionadas al COVID-19 entre los odontólogos de los distintos distritos de Lima, Perú de mayor y menor número de contagiados.
Knowledge, perception and attitudes of prevention measures related to COVID-19 among dentists from different districts of Lima, Peru with the highest and lowest number of infected Abstract Objective: To determine if there are differences between knowledge, perception and attitudes of the prevention measures related to COVID-19 among the dentists of the different districts of Lima, Peru with the highest and lowest number of infection cases. Methods: The sample size was 265 dentists, of which 117 were from the districts with the greatest impact and 148 from the districts with the least impact. These districts of both extremes were based on the contagion rates that they presented in August 2020 according to the Ministry of Health. A questionnaire was used as an instrument and it was distributed via social networks. For the univariate analysis, the descriptive statistics were obtained where the absolute and relative frequency measures were calculated for the dependent, independent and covariate variables. For the bivariate analysis, a comparison was made between the variable's knowledge, perception and attitudes with the dentists of the districts with the highest and lowest number of infected using the Chi-square test. Results: The dentists of the districts with the highest impact have greater knowledge about the main symptoms, transmission routes and prevention measures against COVID-19 compared to the dentists of the districts with the least impact. In addition, those with the greatest impact perceive COVID-19 as very dangerous, while those with the least impact perceive it as moderately dangerous and very dangerous in equal proportions. Finally, with regard to attitude, those with the greatest impact do not care for a suspicious patient and refer him to a health center, while those with the least impact do care for them and refer them to a health center. Conclusión: Finally, differences were found between knowledge, perception and attitudes of the prevention measures related to COVID-19 among the dentists of the different districts of Lima, Peru with the highest and lowest number of infected people.