Understanding oral health care team performance in primary care: a mixed-method study
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFMG |
Texto Completo: | https://doi.org/10.1371/journal.pone.0217738 http://hdl.handle.net/1843/58116 https://orcid.org/0000-0002-6928-8693 https://orcid.org/0000-0001-6900-7559 https://orcid.org/0000-0002-4160-018X https://orcid.org/0000-0001-8794-5725 |
Resumo: | Objective :This study aims to describe the primary care services carried out by Oral Health Teams (OHTs) in Brazil, and to understand the nuances that lead to different levels of OHT performance. Material & methods: A mixed-methods study with a sequential explanatory design was developed. In the quantitative phase, secondary data from a national survey (PMAQ-AB) was used to describe the work of 12,403 OHTs. Item response theory (IRT) was applied, to evaluate the psychometric qualities of 20 oral health questions from PMAQ-AB and to identify the performance of OHT. The quantitative results guided the selection of the qualitative sample. An extreme case sampling strategy was used (opposite results). OHTs were selected from Belo Horizonte metropolitan region in Brazil using scores measured by IRT. Data were collected through semi-structured interviews. Data analysis was conducted using deductive and inductive thematic analysis. Results: Quantitative results showed that there are OHT with high and low performance in Brazil. The IRT analysis showed that items related to prostheses and oral cancer tend to discriminate high-performance OHTs from other OHTs. Qualitative results deepened the understanding of accessing oral health services and found several access barriers, such as the insufficient number of OHTs for the population, and a very long waiting time for dental consultations other than urgency. The qualitative results confirmed that high-performance OHTs tend to emphasize oral cancer surveillance and deliver prostheses in PHC services. Conclusion: Despite the expansion of oral health in PHC in Brazil in recent years, OHTs still face many challenges such as: access barriers; failures in prevention, early diagnosis and follow-up of oral cancer cases; and insufficient rehabilitation with prostheses. |
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2023-08-22T21:28:50Z2023-08-22T21:28:50Z2019145https://doi.org/10.1371/journal.pone.02177381932-6203http://hdl.handle.net/1843/58116https://orcid.org/0000-0002-6928-8693https://orcid.org/0000-0001-6900-7559https://orcid.org/0000-0002-4160-018Xhttps://orcid.org/0000-0001-8794-5725Objective :This study aims to describe the primary care services carried out by Oral Health Teams (OHTs) in Brazil, and to understand the nuances that lead to different levels of OHT performance. Material & methods: A mixed-methods study with a sequential explanatory design was developed. In the quantitative phase, secondary data from a national survey (PMAQ-AB) was used to describe the work of 12,403 OHTs. Item response theory (IRT) was applied, to evaluate the psychometric qualities of 20 oral health questions from PMAQ-AB and to identify the performance of OHT. The quantitative results guided the selection of the qualitative sample. An extreme case sampling strategy was used (opposite results). OHTs were selected from Belo Horizonte metropolitan region in Brazil using scores measured by IRT. Data were collected through semi-structured interviews. Data analysis was conducted using deductive and inductive thematic analysis. Results: Quantitative results showed that there are OHT with high and low performance in Brazil. The IRT analysis showed that items related to prostheses and oral cancer tend to discriminate high-performance OHTs from other OHTs. Qualitative results deepened the understanding of accessing oral health services and found several access barriers, such as the insufficient number of OHTs for the population, and a very long waiting time for dental consultations other than urgency. The qualitative results confirmed that high-performance OHTs tend to emphasize oral cancer surveillance and deliver prostheses in PHC services. Conclusion: Despite the expansion of oral health in PHC in Brazil in recent years, OHTs still face many challenges such as: access barriers; failures in prevention, early diagnosis and follow-up of oral cancer cases; and insufficient rehabilitation with prostheses.Objetivo: Este estudo tem como objetivo descrever os serviços de atenção primária realizados pelas Equipes de Saúde Bucal (ESB) no Brasil e compreender as nuances que levam a diferentes níveis de desempenho da ESB. Material e métodos: Foi desenvolvido um estudo de métodos mistos com um desenho explicativo sequencial. Na fase quantitativa, foram utilizados dados secundários de uma pesquisa nacional (PMAQ-AB) para descrever o trabalho de 12.403 ESB. A teoria de resposta ao item (TRI) foi aplicada para avaliar as qualidades psicométricas de 20 questões de saúde bucal do PMAQ-AB e para identificar o desempenho da ESB. Os resultados quantitativos orientaram a seleção da amostra qualitativa. Foi utilizada uma estratégia de amostragem de casos extremos (resultados opostos). ESBs foram selecionados da região metropolitana de Belo Horizonte no Brasil usando escores medidos pelo IRT. Os dados foram coletados por meio de entrevistas semiestruturadas. A análise dos dados foi realizada por meio da análise temática dedutiva e indutiva. Resultados: Os resultados quantitativos mostraram que existem ESB com alto e baixo desempenho no Brasil. A análise da TRI mostrou que itens relacionados a próteses e câncer bucal tendem a discriminar ESBs de alto desempenho de outros ESBs. Os resultados qualitativos aprofundaram o entendimento sobre o acesso aos serviços de saúde bucal e constataram diversas barreiras de acesso, como número insuficiente de ESB para a população e tempo de espera muito longo para consultas odontológicas que não sejam de urgência. Os resultados qualitativos confirmaram que os ESB de alto desempenho tendem a enfatizar a vigilância do câncer bucal e a entrega de próteses nos serviços de APS. Conclusão: Apesar da expansão da saúde bucal na APS no Brasil nos últimos anos, as ESB ainda enfrentam muitos desafios como: barreiras de acesso; falhas na prevenção, diagnóstico precoce e acompanhamento dos casos de câncer bucal; e reabilitação insuficiente com próteses.CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoFAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas GeraisCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorengUniversidade Federal de Minas GeraisUFMGBrasilFAO - DEPARTAMENTO DE ODONTOLOGIA SOCIAL E PREVENTIVAMED - DEPARTAMENTO DE MEDICINA PREVENTIVA SOCIALPLoS ONESaúde BucalEquipe de assistência ao pacienteAtenção primária à saúdeOral health careTeam performancePrimary careUnderstanding oral health care team performance in primary care: a mixed-method studyCompreendendo a atuação da equipe de saúde bucal na atenção básica: um estudo de método mistoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0217738Clarice Magalhães Rodrigues ReisAntônio Thomaz Gonzaga Matta-machadoJoão Henrique Lara AmaralJuliana Vaz de Melo MambriniMarcos Azeredo Furquim WerneckMauro Henrique Nogueira Guimarães de Abreuapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGLICENSELicense.txtLicense.txttext/plain; charset=utf-82042https://repositorio.ufmg.br/bitstream/1843/58116/1/License.txtfa505098d172de0bc8864fc1287ffe22MD51ORIGINALUnderstanding oral health care team performance in primary care_ A mixed-method study.pdfUnderstanding oral health care team performance in primary care_ A mixed-method study.pdfapplication/pdf273192https://repositorio.ufmg.br/bitstream/1843/58116/2/Understanding%20oral%20health%20care%20team%20performance%20in%20primary%20care_%20A%20mixed-method%20study.pdfa8da3ca2e94f900967a11a85370121aeMD521843/581162023-08-22 18:28:50.951oai:repositorio.ufmg.br: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Repositório de PublicaçõesPUBhttps://repositorio.ufmg.br/oaiopendoar:2023-08-22T21:28:50Repositório Institucional da UFMG - Universidade Federal de Minas Gerais (UFMG)false |
dc.title.pt_BR.fl_str_mv |
Understanding oral health care team performance in primary care: a mixed-method study |
dc.title.alternative.pt_BR.fl_str_mv |
Compreendendo a atuação da equipe de saúde bucal na atenção básica: um estudo de método misto |
title |
Understanding oral health care team performance in primary care: a mixed-method study |
spellingShingle |
Understanding oral health care team performance in primary care: a mixed-method study Clarice Magalhães Rodrigues Reis Oral health care Team performance Primary care Saúde Bucal Equipe de assistência ao paciente Atenção primária à saúde |
title_short |
Understanding oral health care team performance in primary care: a mixed-method study |
title_full |
Understanding oral health care team performance in primary care: a mixed-method study |
title_fullStr |
Understanding oral health care team performance in primary care: a mixed-method study |
title_full_unstemmed |
Understanding oral health care team performance in primary care: a mixed-method study |
title_sort |
Understanding oral health care team performance in primary care: a mixed-method study |
author |
Clarice Magalhães Rodrigues Reis |
author_facet |
Clarice Magalhães Rodrigues Reis Antônio Thomaz Gonzaga Matta-machado João Henrique Lara Amaral Juliana Vaz de Melo Mambrini Marcos Azeredo Furquim Werneck Mauro Henrique Nogueira Guimarães de Abreu |
author_role |
author |
author2 |
Antônio Thomaz Gonzaga Matta-machado João Henrique Lara Amaral Juliana Vaz de Melo Mambrini Marcos Azeredo Furquim Werneck Mauro Henrique Nogueira Guimarães de Abreu |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Clarice Magalhães Rodrigues Reis Antônio Thomaz Gonzaga Matta-machado João Henrique Lara Amaral Juliana Vaz de Melo Mambrini Marcos Azeredo Furquim Werneck Mauro Henrique Nogueira Guimarães de Abreu |
dc.subject.por.fl_str_mv |
Oral health care Team performance Primary care |
topic |
Oral health care Team performance Primary care Saúde Bucal Equipe de assistência ao paciente Atenção primária à saúde |
dc.subject.other.pt_BR.fl_str_mv |
Saúde Bucal Equipe de assistência ao paciente Atenção primária à saúde |
description |
Objective :This study aims to describe the primary care services carried out by Oral Health Teams (OHTs) in Brazil, and to understand the nuances that lead to different levels of OHT performance. Material & methods: A mixed-methods study with a sequential explanatory design was developed. In the quantitative phase, secondary data from a national survey (PMAQ-AB) was used to describe the work of 12,403 OHTs. Item response theory (IRT) was applied, to evaluate the psychometric qualities of 20 oral health questions from PMAQ-AB and to identify the performance of OHT. The quantitative results guided the selection of the qualitative sample. An extreme case sampling strategy was used (opposite results). OHTs were selected from Belo Horizonte metropolitan region in Brazil using scores measured by IRT. Data were collected through semi-structured interviews. Data analysis was conducted using deductive and inductive thematic analysis. Results: Quantitative results showed that there are OHT with high and low performance in Brazil. The IRT analysis showed that items related to prostheses and oral cancer tend to discriminate high-performance OHTs from other OHTs. Qualitative results deepened the understanding of accessing oral health services and found several access barriers, such as the insufficient number of OHTs for the population, and a very long waiting time for dental consultations other than urgency. The qualitative results confirmed that high-performance OHTs tend to emphasize oral cancer surveillance and deliver prostheses in PHC services. Conclusion: Despite the expansion of oral health in PHC in Brazil in recent years, OHTs still face many challenges such as: access barriers; failures in prevention, early diagnosis and follow-up of oral cancer cases; and insufficient rehabilitation with prostheses. |
publishDate |
2019 |
dc.date.issued.fl_str_mv |
2019 |
dc.date.accessioned.fl_str_mv |
2023-08-22T21:28:50Z |
dc.date.available.fl_str_mv |
2023-08-22T21:28:50Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/1843/58116 |
dc.identifier.doi.pt_BR.fl_str_mv |
https://doi.org/10.1371/journal.pone.0217738 |
dc.identifier.issn.pt_BR.fl_str_mv |
1932-6203 |
dc.identifier.orcid.pt_BR.fl_str_mv |
https://orcid.org/0000-0002-6928-8693 https://orcid.org/0000-0001-6900-7559 https://orcid.org/0000-0002-4160-018X https://orcid.org/0000-0001-8794-5725 |
url |
https://doi.org/10.1371/journal.pone.0217738 http://hdl.handle.net/1843/58116 https://orcid.org/0000-0002-6928-8693 https://orcid.org/0000-0001-6900-7559 https://orcid.org/0000-0002-4160-018X https://orcid.org/0000-0001-8794-5725 |
identifier_str_mv |
1932-6203 |
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eng |
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eng |
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PLoS ONE |
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openAccess |
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Universidade Federal de Minas Gerais |
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UFMG |
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Brasil |
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FAO - DEPARTAMENTO DE ODONTOLOGIA SOCIAL E PREVENTIVA MED - DEPARTAMENTO DE MEDICINA PREVENTIVA SOCIAL |
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Universidade Federal de Minas Gerais |
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