Estudos sobre acesso aos serviços de saúde bucal no Brasi.
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFMA |
Texto Completo: | https://tedebc.ufma.br/jspui/handle/tede/tede/3408 |
Resumo: | Access to oral health services in Brazil is exclusive, being determined by numerous factors that guide the lives of individuals. Measuring what these factors are and evaluating how access to oral health services in Brazil takes place, from the perspective of vulnerable populations, is still a gap in the literature. This thesis aimed to evaluate the variables associated with the frequency of use of oral health services in Brazil (Chapter I) and access to primary health care (PHC) oral health services and associated variables, by quilombolas in Maranhão, Brazil (Chapter II). Chapter I was a systematic review study with meta-analysis, including the PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS and Google Scholar databases, as well as reference lists and sites for dissertations and theses. Observational studies were selected using the PEO (Population/Exposure/Outcome) strategy in May 2020. The outcome of this study was the frequency of use of oral health services in the last year. A Mantel-Haenszel random effect meta-analysis was performed, using the Prevalence Ratio (PR) and 95% confidence interval as measures of association. In Chapter II, a cross-sectional population-based study was carried out in the Santa Rosa dos Pretos quilombo, in Itapecuru Mirim, in the state of Maranhão. Adult users who had lived in the household for at least 12 months were included, and individuals who had been absent from the household for 6 or more months were excluded, as well as those who did not have health conditions to answer the questionnaires. Data were collected by previously trained researchers through structured questionnaires. Questionnaires captured sociodemographic information; socioeconomic; from self-perception to oral health; discrimination; in addition to the oral health assessment in PHC, through the Primary Care Assessment Tool – Oral Health of Adults (PCATool-OH). Three attributes of PCATool-OH were used: affiliation; first-contact access-use; first-contact access-accessibility; in addition to the access score. A cutoff point >5.5 was used for high scores on access to oral health services in the PHC. The association between the mean scores in relation to the independent variables was assessed using the Mann-Whitney or Kruskal-Wallis tests. In the multivariate analysis, Poisson Regression was used. Analyzes were performed adopting a 95% confidence level and a 5% significance level. In chapter I, 94 studies were selected, 25 of which were aggregated in the meta-analysis. The use of oral health services in the last year was associated with higher education (PR=0.49, (95%CI:0.39-0.60)); higher family income (PR=0.79, (95%CI:0.74-0.84)); and urbanity (RP=0.79, (95%CI:0.64-0.97)). In chapter II, 293 individuals participated in the study, with mean and standard deviation of the access score of 3.93 (SD ± 1.37), where 91.4% classified the access score as poor. There was an association between self-perception of oral health with the attributes affiliation (p=0.049), first contact access (use) (p=0.014), and with the access score (p=0.002). An association was also observed between monthly family income and the attribute of first contact access (accessibility) (p=0.012). In chapter I, it was possible to conclude that the frequency of use of oral health services in Brazil is uneven, reinforcing the need for public policies and programs that promote access and use by more vulnerable groups. In chapter II, it was possible to conclude that the assessment of access to PHC oral health services by the quilombolas of Santa Rosa dos Pretos was poor, requiring the strengthening of this service, focusing on vulnerable populations. |
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ALVES, Cláudia Maria CoelhoHUGO, Fernando NevesALVES, Cláudia Maria CoelhoHUGO, Fernando NevesNEVES, MatheusPINHO, Judith Rafaelle OliveiraPEREIRA, Adriana de Fátima VasconcelosTEIXEIRA, Cinthia Nara Gadelha2021-11-27T14:40:39Z2020-12-11TEIXEIRA, Cinthia Nara Gadelha. Estudos sobre acesso aos serviços de saúde bucal no Brasi.. 2020. 157 f. Tese( Programa de Pós-Graduação em Odontologia/CCBS) - Universidade Federal do Maranhão, São Luis,2020.https://tedebc.ufma.br/jspui/handle/tede/tede/3408Access to oral health services in Brazil is exclusive, being determined by numerous factors that guide the lives of individuals. Measuring what these factors are and evaluating how access to oral health services in Brazil takes place, from the perspective of vulnerable populations, is still a gap in the literature. This thesis aimed to evaluate the variables associated with the frequency of use of oral health services in Brazil (Chapter I) and access to primary health care (PHC) oral health services and associated variables, by quilombolas in Maranhão, Brazil (Chapter II). Chapter I was a systematic review study with meta-analysis, including the PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS and Google Scholar databases, as well as reference lists and sites for dissertations and theses. Observational studies were selected using the PEO (Population/Exposure/Outcome) strategy in May 2020. The outcome of this study was the frequency of use of oral health services in the last year. A Mantel-Haenszel random effect meta-analysis was performed, using the Prevalence Ratio (PR) and 95% confidence interval as measures of association. In Chapter II, a cross-sectional population-based study was carried out in the Santa Rosa dos Pretos quilombo, in Itapecuru Mirim, in the state of Maranhão. Adult users who had lived in the household for at least 12 months were included, and individuals who had been absent from the household for 6 or more months were excluded, as well as those who did not have health conditions to answer the questionnaires. Data were collected by previously trained researchers through structured questionnaires. Questionnaires captured sociodemographic information; socioeconomic; from self-perception to oral health; discrimination; in addition to the oral health assessment in PHC, through the Primary Care Assessment Tool – Oral Health of Adults (PCATool-OH). Three attributes of PCATool-OH were used: affiliation; first-contact access-use; first-contact access-accessibility; in addition to the access score. A cutoff point >5.5 was used for high scores on access to oral health services in the PHC. The association between the mean scores in relation to the independent variables was assessed using the Mann-Whitney or Kruskal-Wallis tests. In the multivariate analysis, Poisson Regression was used. Analyzes were performed adopting a 95% confidence level and a 5% significance level. In chapter I, 94 studies were selected, 25 of which were aggregated in the meta-analysis. The use of oral health services in the last year was associated with higher education (PR=0.49, (95%CI:0.39-0.60)); higher family income (PR=0.79, (95%CI:0.74-0.84)); and urbanity (RP=0.79, (95%CI:0.64-0.97)). In chapter II, 293 individuals participated in the study, with mean and standard deviation of the access score of 3.93 (SD ± 1.37), where 91.4% classified the access score as poor. There was an association between self-perception of oral health with the attributes affiliation (p=0.049), first contact access (use) (p=0.014), and with the access score (p=0.002). An association was also observed between monthly family income and the attribute of first contact access (accessibility) (p=0.012). In chapter I, it was possible to conclude that the frequency of use of oral health services in Brazil is uneven, reinforcing the need for public policies and programs that promote access and use by more vulnerable groups. In chapter II, it was possible to conclude that the assessment of access to PHC oral health services by the quilombolas of Santa Rosa dos Pretos was poor, requiring the strengthening of this service, focusing on vulnerable populations.O acesso aos serviços de saúde bucal no Brasil é excludente, sendo determinado por inúmeros fatores que norteiam a vida dos indivíduos. Mensurar quais são estes fatores e avaliar como se dá o acesso aos serviços de saúde bucal no Brasil, sob a ótica de populações vulneráveis, ainda é uma lacuna na literatura. Esta tese objetivou avaliar as variáveis associadas com a frequência de utilização dos serviços de saúde bucal no Brasil (Capítulo I) e o acesso aos serviços de saúde bucal da Atenção Primária à Saúde (APS) e variáveis associadas, por quilombolas do Maranhão, Brasil (Capítulo II). O Capítulo I foi um estudo de revisão sistemática, com metanálise, sendo incluídas na busca as bases de dados PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS e Google Scholar, além de listas de referências e sites de dissertações e teses. Os estudos observacionais foram selecionados usando a estratégia PEO (População/Exposição/Desfechos), em maio de 2020. O desfecho deste estudo foi a frequência de utilização dos serviços de saúde bucal no último ano. Foi realizada uma metanálise de efeito randômico de Mantel-Haenszel, tendo a Razão de Prevalência (RP) e o intervalo de confiança de 95% como medidas de associação. No Capítulo II foi realizado um estudo transversal, de base populacional, no quilombo Santa Rosa dos Pretos, em Itapecuru Mirim, no estado do Maranhão. Foram incluídos os usuários adultos, que residiam há pelo menos 12 meses no domicílio, sendo excluídos os indivíduos ausentes do domicílio por 6 ou mais meses, além daqueles que não tiveram condições de saúde para responder os questionários. Os dados foram coletados por pesquisadoras previamente treinados, por meio de questionários estruturados. Os questionários captaram informações sociodemográficas; socioeconômicas; de autopercepção à saúde bucal; discriminação; além da avaliação da saúde bucal na APS, através do Primary Care Assessment Tool – Oral Health of Adults (PCATool OH). Foram utilizados três atributos do PCATool-OH: afiliação; acesso de primeiro contato utilização; acesso de primeiro contato-acessibilidade; além do escore acesso. Utilizou-se o ponto de corte >5,5 para escores altos do acesso aos serviços de saúde bucal da APS. A associação entre as médias dos escores em relação às variáveis independentes foi avaliada por meio dos testes Mann-Whitney ou Kruskal-Wallis. Na análise multivariada foi utilizada a Regressão de Poisson. As análises foram realizadas adotando 95% de nível de confiança e significância de 5%. No capítulo I foram selecionados 94 estudos, sendo 25 agregados na metanálise. A utilização dos serviços de saúde bucal no último ano esteve associada com a maior escolaridade (RP=0,49, (IC95%:0,39-0,60)); maior renda familiar (RP=0,79, (IC95%:0,74-0,84)); e a urbanidade (RP=0,79, (IC95%:0,64-0,97)). No capítulo I participaram do estudo 293 indivíduos, com média e desvio padrão do escore acesso de 3,93 (DP ± 1,37), onde 91,4% classificaram o escore acesso como ruim. Houve associação entre a autopercepção de saúde bucal com os atributos afiliação (p=0,049), acesso de primeiro contato (utilização) (p=0,014), e com o escore acesso (p=0,002). Também foi observada associação entre a renda mensal familiar e o atributo acesso de primeiro contato (acessibilidade) (p=0,012). No capítulo I foi possível concluir que a frequência de utilização aos serviços de saúde bucal no Brasil é desigual, reforçando a necessidade de políticas públicas e programas que promovam acesso e utilização por grupos de maior vulnerabilidade. No capítulo II foi possível concluir que a avaliação do acesso dos serviços de saúde bucal da APS pelos quilombolas de Santa Rosa dos Pretos foi ruim, sendo necessário o fortalecimento deste serviço, com foco nas populações vulneráveis.Submitted by Maria Aparecida (cidazen@gmail.com) on 2021-11-27T14:40:39Z No. of bitstreams: 1 A Imprimir ...C-Users-User-Documents-Cinthia Nara.pdf: 45490611 bytes, checksum: 86805e00402d432440385c391ef2017b (MD5)Made available in DSpace on 2021-11-27T14:40:39Z (GMT). No. of bitstreams: 1 A Imprimir ...C-Users-User-Documents-Cinthia Nara.pdf: 45490611 bytes, checksum: 86805e00402d432440385c391ef2017b (MD5) Previous issue date: 2020-12-11FAPEMAapplication/pdfporUniversidade Federal do MaranhãoPROGRAMA DE PÓS-GRADUAÇÃO EM ODONTOLOGIA/CCBSUFMABrasilDEPARTAMENTO DE ODONTOLOGIA I/CCBSAcesso aos Serviços de Saúde;Serviços de Saúde Bucal;Avaliação em Saúde;Saúde BucalHealth Services Accessibility;Dental Health Services;Health Evaluation;Oral HealthSaúde PublicaEstudos sobre acesso aos serviços de saúde bucal no Brasi.Studies on access to oral health services in Brazil.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFMAinstname:Universidade Federal do Maranhão (UFMA)instacron:UFMAORIGINALA Imprimir ...C-Users-User-Documents-Cinthia Nara.pdfA Imprimir ...C-Users-User-Documents-Cinthia Nara.pdfapplication/pdf45490611http://tedebc.ufma.br:8080/bitstream/tede/3408/2/A+Imprimir+...C-Users-User-Documents-Cinthia+Nara.pdf86805e00402d432440385c391ef2017bMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82255http://tedebc.ufma.br:8080/bitstream/tede/3408/1/license.txt97eeade1fce43278e63fe063657f8083MD51tede/34082021-11-27 11:40:39.508oai:tede2: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Biblioteca Digital de Teses e Dissertaçõeshttps://tedebc.ufma.br/jspui/PUBhttp://tedebc.ufma.br:8080/oai/requestrepositorio@ufma.br||repositorio@ufma.bropendoar:21312021-11-27T14:40:39Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA)false |
dc.title.por.fl_str_mv |
Estudos sobre acesso aos serviços de saúde bucal no Brasi. |
dc.title.alternative.eng.fl_str_mv |
Studies on access to oral health services in Brazil. |
title |
Estudos sobre acesso aos serviços de saúde bucal no Brasi. |
spellingShingle |
Estudos sobre acesso aos serviços de saúde bucal no Brasi. TEIXEIRA, Cinthia Nara Gadelha Acesso aos Serviços de Saúde; Serviços de Saúde Bucal; Avaliação em Saúde; Saúde Bucal Health Services Accessibility; Dental Health Services; Health Evaluation; Oral Health Saúde Publica |
title_short |
Estudos sobre acesso aos serviços de saúde bucal no Brasi. |
title_full |
Estudos sobre acesso aos serviços de saúde bucal no Brasi. |
title_fullStr |
Estudos sobre acesso aos serviços de saúde bucal no Brasi. |
title_full_unstemmed |
Estudos sobre acesso aos serviços de saúde bucal no Brasi. |
title_sort |
Estudos sobre acesso aos serviços de saúde bucal no Brasi. |
author |
TEIXEIRA, Cinthia Nara Gadelha |
author_facet |
TEIXEIRA, Cinthia Nara Gadelha |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
ALVES, Cláudia Maria Coelho |
dc.contributor.advisor-co1.fl_str_mv |
HUGO, Fernando Neves |
dc.contributor.referee1.fl_str_mv |
ALVES, Cláudia Maria Coelho |
dc.contributor.referee2.fl_str_mv |
HUGO, Fernando Neves |
dc.contributor.referee3.fl_str_mv |
NEVES, Matheus |
dc.contributor.referee4.fl_str_mv |
PINHO, Judith Rafaelle Oliveira |
dc.contributor.referee5.fl_str_mv |
PEREIRA, Adriana de Fátima Vasconcelos |
dc.contributor.author.fl_str_mv |
TEIXEIRA, Cinthia Nara Gadelha |
contributor_str_mv |
ALVES, Cláudia Maria Coelho HUGO, Fernando Neves ALVES, Cláudia Maria Coelho HUGO, Fernando Neves NEVES, Matheus PINHO, Judith Rafaelle Oliveira PEREIRA, Adriana de Fátima Vasconcelos |
dc.subject.por.fl_str_mv |
Acesso aos Serviços de Saúde; Serviços de Saúde Bucal; Avaliação em Saúde; Saúde Bucal |
topic |
Acesso aos Serviços de Saúde; Serviços de Saúde Bucal; Avaliação em Saúde; Saúde Bucal Health Services Accessibility; Dental Health Services; Health Evaluation; Oral Health Saúde Publica |
dc.subject.eng.fl_str_mv |
Health Services Accessibility; Dental Health Services; Health Evaluation; Oral Health |
dc.subject.cnpq.fl_str_mv |
Saúde Publica |
description |
Access to oral health services in Brazil is exclusive, being determined by numerous factors that guide the lives of individuals. Measuring what these factors are and evaluating how access to oral health services in Brazil takes place, from the perspective of vulnerable populations, is still a gap in the literature. This thesis aimed to evaluate the variables associated with the frequency of use of oral health services in Brazil (Chapter I) and access to primary health care (PHC) oral health services and associated variables, by quilombolas in Maranhão, Brazil (Chapter II). Chapter I was a systematic review study with meta-analysis, including the PubMed, SciELO, LILACS, BBO, EMBASE, Scopus, WOS and Google Scholar databases, as well as reference lists and sites for dissertations and theses. Observational studies were selected using the PEO (Population/Exposure/Outcome) strategy in May 2020. The outcome of this study was the frequency of use of oral health services in the last year. A Mantel-Haenszel random effect meta-analysis was performed, using the Prevalence Ratio (PR) and 95% confidence interval as measures of association. In Chapter II, a cross-sectional population-based study was carried out in the Santa Rosa dos Pretos quilombo, in Itapecuru Mirim, in the state of Maranhão. Adult users who had lived in the household for at least 12 months were included, and individuals who had been absent from the household for 6 or more months were excluded, as well as those who did not have health conditions to answer the questionnaires. Data were collected by previously trained researchers through structured questionnaires. Questionnaires captured sociodemographic information; socioeconomic; from self-perception to oral health; discrimination; in addition to the oral health assessment in PHC, through the Primary Care Assessment Tool – Oral Health of Adults (PCATool-OH). Three attributes of PCATool-OH were used: affiliation; first-contact access-use; first-contact access-accessibility; in addition to the access score. A cutoff point >5.5 was used for high scores on access to oral health services in the PHC. The association between the mean scores in relation to the independent variables was assessed using the Mann-Whitney or Kruskal-Wallis tests. In the multivariate analysis, Poisson Regression was used. Analyzes were performed adopting a 95% confidence level and a 5% significance level. In chapter I, 94 studies were selected, 25 of which were aggregated in the meta-analysis. The use of oral health services in the last year was associated with higher education (PR=0.49, (95%CI:0.39-0.60)); higher family income (PR=0.79, (95%CI:0.74-0.84)); and urbanity (RP=0.79, (95%CI:0.64-0.97)). In chapter II, 293 individuals participated in the study, with mean and standard deviation of the access score of 3.93 (SD ± 1.37), where 91.4% classified the access score as poor. There was an association between self-perception of oral health with the attributes affiliation (p=0.049), first contact access (use) (p=0.014), and with the access score (p=0.002). An association was also observed between monthly family income and the attribute of first contact access (accessibility) (p=0.012). In chapter I, it was possible to conclude that the frequency of use of oral health services in Brazil is uneven, reinforcing the need for public policies and programs that promote access and use by more vulnerable groups. In chapter II, it was possible to conclude that the assessment of access to PHC oral health services by the quilombolas of Santa Rosa dos Pretos was poor, requiring the strengthening of this service, focusing on vulnerable populations. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020-12-11 |
dc.date.accessioned.fl_str_mv |
2021-11-27T14:40:39Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
TEIXEIRA, Cinthia Nara Gadelha. Estudos sobre acesso aos serviços de saúde bucal no Brasi.. 2020. 157 f. Tese( Programa de Pós-Graduação em Odontologia/CCBS) - Universidade Federal do Maranhão, São Luis,2020. |
dc.identifier.uri.fl_str_mv |
https://tedebc.ufma.br/jspui/handle/tede/tede/3408 |
identifier_str_mv |
TEIXEIRA, Cinthia Nara Gadelha. Estudos sobre acesso aos serviços de saúde bucal no Brasi.. 2020. 157 f. Tese( Programa de Pós-Graduação em Odontologia/CCBS) - Universidade Federal do Maranhão, São Luis,2020. |
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https://tedebc.ufma.br/jspui/handle/tede/tede/3408 |
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por |
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por |
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info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal do Maranhão |
dc.publisher.program.fl_str_mv |
PROGRAMA DE PÓS-GRADUAÇÃO EM ODONTOLOGIA/CCBS |
dc.publisher.initials.fl_str_mv |
UFMA |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
DEPARTAMENTO DE ODONTOLOGIA I/CCBS |
publisher.none.fl_str_mv |
Universidade Federal do Maranhão |
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reponame:Biblioteca Digital de Teses e Dissertações da UFMA instname:Universidade Federal do Maranhão (UFMA) instacron:UFMA |
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Universidade Federal do Maranhão (UFMA) |
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UFMA |
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Biblioteca Digital de Teses e Dissertações da UFMA |
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Biblioteca Digital de Teses e Dissertações da UFMA |
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http://tedebc.ufma.br:8080/bitstream/tede/3408/2/A+Imprimir+...C-Users-User-Documents-Cinthia+Nara.pdf http://tedebc.ufma.br:8080/bitstream/tede/3408/1/license.txt |
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Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA) |
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repositorio@ufma.br||repositorio@ufma.br |
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1809926198639198208 |