Guedes Renata Saraiva, Piovesan Chaiana, Antunes José Leopoldo Ferreira, Mendes Fausto Medeiros, Ardenghi Thiago Machado
Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
Qual Life Res. 2014 Nov;23(9):2521-30. doi: 10.1007/s11136-014-0690-z. Epub 2014 Apr 17.
It has been suggested that subjective measures of oral health are influenced by both individual and contextual characteristics. This study assessed the relationship between neighborhood and individual social networks and child oral health-related quality of life (COHRQoL).
This study followed a cross-sectional design using a multistage sample of 478 children aged 1-5 years old. Caregivers completed the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS) and answered questions related to socioeconomic status and social network. The dental examination provided information on the prevalence of dental caries, dental trauma, and occlusion. Contextual social determinants included the presence of cultural community centers and of workers' association in the neighborhood. Data analysis considered the total ECOHIS scores as the outcome and neighborhood/individual social networks as the independent variables. A multilevel Poisson regression model was used to investigate the association among individual and contextual characteristics and COHRQoL.
Total ECOHIS scores ranged from 0 to 41 (possible range 0-52). The mean ECOHIS score was low (mean = 1.8, SD = 3.9), and the functional domain presented the highest mean impact on COHRQoL (mean = 0.5, SD = 1.4). Following adjusted analysis, low household income, visiting a neighbor less than once a month, the presence of anterior open bite, dental trauma, and dental caries were identified as individual determinants of negative impact on a child's quality of life. These variables remained associated with the outcome even after adding the contextual-level variables in the model. At the contextual level, the presence of community cultural centers was associated with overall mean ECOHIS score; higher impacts on COHRQoL were observed in those living in neighborhoods without cultural community centers.
There is a significant association between individual and contextual social determinants and COHRQoL; unfavorable social conditions and poor socioeconomic status have a negative impact on caregiver reports of children's oral health-related quality of life.
有人提出，口腔健康的主观衡量指标会受到个体特征和环境特征的影响。本研究评估了邻里和个体社交网络与儿童口腔健康相关生活质量（COHRQoL）之间的关系。
本研究采用横断面设计，对478名1至5岁儿童进行多阶段抽样。照顾者完成了巴西版的幼儿口腔健康影响量表（ECOHIS），并回答了与社会经济地位和社交网络相关的问题。牙科检查提供了龋齿、牙外伤和咬合情况的患病率信息。环境社会决定因素包括邻里中文化社区中心和工人协会的存在情况。数据分析将ECOHIS总分作为结果，将邻里/个体社交网络作为自变量。使用多级泊松回归模型来研究个体和环境特征与COHRQoL之间的关联。
ECOHIS总分范围为0至41分（可能范围为0至52分）。ECOHIS平均得分较低（均值 = 1.8，标准差 = 3.9），功能领域对COHRQoL的平均影响最高（均值 = 0.5，标准差 = 1.4）。经过调整分析后，家庭收入低、每月拜访邻居少于一次、存在前牙开合、牙外伤和龋齿被确定为对儿童生活质量产生负面影响的个体决定因素。即使在模型中加入环境层面的变量后，这些变量仍与结果相关。在环境层面，社区文化中心的存在与ECOHIS总体平均得分相关；在没有文化社区中心的邻里中生活的儿童，其COHRQoL受到的影响更大。
个体和环境社会决定因素与COHRQoL之间存在显著关联；不利的社会条件和较差的社会经济地位对照顾者报告的儿童口腔健康相关生活质量有负面影响。
