USO DOS SERVIÇOS ODONTOLÓGICOS POR GESTANTES: CAPACITAÇÃO DE PROFISSIONAIS DA EQUIPE DE SAÚDE SOBRE SUA IMPORTÂNCIA

• Autor(a) principal: Silva , Cáren Coronel da
• Data de Publicação: 2020
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional Universidade Franciscana
• Texto Completo: http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/868
• topic: Tecnologia em saúde; Saúde bucal; Educação em saúde; Gestantes; Estudos Transversais; Pesquisa Qualitativa.; Saúde Materno Infantil

Introduction: Pregnancy is a special moment in a woman’s life, marked by several transformations physical, hormonal and psychological; those demand attention during the pre-natal care. In this phase, an approach towards the development of health care becomes more favorable due to the fact that the pregnant is willing to acquire some knowledge, change habits and improve her health practices to her own benefit along with her baby’s. For this reason, women must be informed about the importance of keeping a good dental health during pregnancy, as well as being instructed on how to properly take care of her kids' dental health in the future. Some pieces of evidence suggest that the lack of attention to dental health during pregnancy may cause negative repercussions such as pre-eclampsia, premature birth and low birth weight. Taking this into consideration, it becomes essential that professionals from the health area work together, with the purpose of clarifying doubts and refer women to carry out the dental pre-natal care. General objective: Build a Distance Learning training program effective to help professionals of the health area to understand the importance of pre-natal dental care. Specifics : (1) Identify the factors involved in the usage of dental services in the gestational and pre-gestational moments; (2) Understand the perception of professionals of the health area in health centers (UBS - from the Brazilian abbreviation) and in the Brazilian project Family Health Strategy (ESF - from the Brazilian abbreviation) about the pre-natal dental care, before and after the training program. Methodology: In order to achieve the first specific objective, a cross-sectional study was developed in a random group of 256 expecting women who were receiving pre-natal care in the public system in the city of Santa Maria, south of Brazil. Through a questionnaire the usage of dental service by pregnant women in the last 12 months was collected, altogether with socioeconomical, psychosocial, behavioral and mouth health. The dental anxiety was evaluated through the Brazilian version of the Dental Anxiety Scale (DAS). To the study, the dental services used in the last year, as well as their source (public or private) were evaluated. Models of Poisson regression with robust variance were applied to evaluate the connections between the predictor variables and the outcome through a hierarchical approach. The results were presented in the Prevalence Ratio (PR) and 95% Confidence Interval (95% CI). To carry out the second specific objective, aligned with the general objective proposed, a training program was created to instruct the professionals involved with pre-natal care in UBSs and ESFs in the city of Santa Maria/RS about the importance of dental pre-natal care for both mother and baby. To elaborate the training program, technology focused on distance learning was applied through a Moodle platform, using several resources, such as video classes, availability of additional material and evaluations of the discussed topics. The subjects of the training program also answered a survey before and after the course in order to evaluate how the program influenced their knowledge about the topic and to better comprehend the dynamics of referring pregnant patients to the dental surgeon services. Results: Regarding the cross-sectional study, 256 pregnant patients were evaluated; 255 of those answered the question related to the use of services in the last 12 months. The average 13 age of those patients was 25,42 (SD 6,57) years old. Pregnant women who presented high dental anxiety had 47% less prevalence in the use of dental services in the last 12 months (PR 1,47; 95% IC 1,04 – 2,07). The ones with low schooling, less frequent teeth brushing and who evaluated their own dental health as bad or appalling have also made less frequent use of dental services. In regarding to the type of this dental care, women with less than 8 years of schooling, in a lower socioeconomical group and who did not attend to the pregnancy group were more susceptible to use the public health system. In what comes to the results of the study used to answer the second specific objective of this thesis, the group of subjects was composed by 38 professionals - two physicians, three nurses, nine community health agents (ACS – from the Brazilian abbreviation), eight nursing technicians, three receptionists, one dental health care assistant - from the UBSs and ESFs in the region of Santa Maria – RS. The average age was 45 years old (minimal age being 24 and maximum 60), thirty-two participants were female and six were male. Through the initial survey it was observed that the majority of the participants reported having little or no knowledge in regarding to the approached topic, what seems to be reflected in the deficiency related to the process of referring pregnant patients to the dental pre-natal care. After the training program, the subjects demonstrated to be more secure and well biased to discuss the topic and account for the importance of pregnant patients having regular follow ups with a dental surgeon, as motivation during this period as well as to prevent diseases and complications for the woman’s and baby’s health. Thus, the training program managed to clarify, instruct and motivate those professionals to encourage pregnant patients to carry out with the dental pre-natal care, demystifying possible misbelieves and myths regarding this service. Final considerations: The first study of this thesis has shown a reduced use of dental services during the pre-gestational and gestational periods, being propellant to the construction of professional training in regarding to the importance of dental services during the pre-natal care to the professionals of health centers (UBSs) and the Family Health Strategy project (ESFs). To estimate the values of the training program to the service, a second study was conducted, in which it was possible to verify the perception of the health team before and after it was carried out. It is believed that an interdisciplinary approach is one of the most meaningful ways to improve the use of dental services by pregnant women, reverberating positively in their own health and also their babies’. Technical product: The product of this research was a training program, through distance learning, considered a meaningful educational material to clarify, instruct and demystifying issues related to pre-natal dental care. By the same token, reinforce its importance to professionals of UBSs and ESFs, stimulating them to refer pregnant patients to dental surgeons. It’s crucial to stress how effortless it can be applied in different cities, considering it can be accessed anywhere in conjunction with its meaningfulness in the health of the mother-baby binomial.