Muirhead Vanessa, Levine Alissa, Nicolau Belinda, Landry Anne, Bedos Christophe
Community Dent Oral Epidemiol. 2013 Feb;41(1):13-21. doi: 10.1111/j.1600-0528.2012.00741.x.
This study aimed to better understand low-income parents' child dental care decisions through a life course approach that captured parents' experiences within the social context of poverty.
We conducted 43 qualitative life history interviews with 10 parents, who were long-term social assistance recipients living in Montreal, Canada. Thematic analysis involved interview debriefing, transcript coding, theme identification and data interpretation.
Our interviews identified two emergent themes: lay diagnosis and parental oral health management. Parents described a process of 'lay diagnosis' that consisted of examining their children's teeth and interpreting their children's oral signs and symptoms based on their observations. These lay diagnoses were also shaped by their own dental crises, care experiences and oral health knowledge gained across a life course of poverty and dental disadvantage. Parents' management strategies included monitoring and managing their children's oral health themselves or by seeking professional recourse. Parents' management strategies were influenced both by their lay diagnoses and their perceived ability to manage their children's oral health. Parents felt responsible for their children's dental care, empowered to manage their oral health and sometimes forgo dental visits for their children because of their own self-management life history.
This original approach revealed insights that help to understand why low-income parents may underutilize free dental services. Further research should consider how dental programs can nurture parental empowerment and capitalize on parents' perceived ability to diagnose and manage their children's oral health.
本研究旨在通过一种生命历程方法，更好地理解低收入父母关于儿童牙齿护理的决策，该方法捕捉了父母在贫困社会背景下的经历。
我们对10位居住在加拿大蒙特利尔、长期领取社会救助的父母进行了43次定性生命史访谈。主题分析包括访谈汇报、转录编码、主题识别和数据解读。
我们的访谈确定了两个新出现的主题：外行诊断和父母口腔健康管理。父母们描述了一个“外行诊断”过程，包括检查孩子的牙齿，并根据自己的观察解读孩子的口腔体征和症状。这些外行诊断也受到他们自己的牙齿危机、护理经历以及在贫困和牙齿不利的生命历程中获得的口腔健康知识的影响。父母的管理策略包括自己监测和管理孩子的口腔健康，或寻求专业帮助。父母的管理策略受到他们的外行诊断和他们认为自己管理孩子口腔健康的能力的影响。由于他们自己的自我管理生活经历，父母觉得对孩子的牙齿护理负有责任，有能力管理孩子的口腔健康，有时甚至会放弃带孩子看牙医。
这种原创方法揭示了一些见解，有助于理解为什么低收入父母可能未充分利用免费牙科服务。进一步的研究应考虑牙科项目如何培养父母的能力，并利用父母认为自己能够诊断和管理孩子口腔健康的能力。
