Vamos Cheryl A, Walsh Margaret L, Thompson Erika, Daley Ellen M, Detman Linda, DeBate Rita
Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL, 33612, USA,
Matern Child Health J. 2015 Jun;19(6):1263-75. doi: 10.1007/s10995-014-1632-7.
Pregnancy is identified as a sensitive period of increased risk for poor oral health among mothers and offspring. Subsequently, both medical and dental associations have re-endorsed consolidated, inter-professional guidelines promoting oral health during pregnancy. The objective was to explore prenatal and oral health providers' information, motivation and practice behaviors related to oral health during pregnancy. Twenty-two in-depth interviews were conducted with prenatal and oral health providers based on the Information-Motivation-Behavioral Skills Model. Data were analyzed using the constant comparative method in NVivo 10. Providers held variable knowledge with regards to identified oral-systemic connections and implications. Most providers were unaware of the guidelines; however, some oral health providers reported avoiding specific treatment behaviors during this period. Motivation to address oral-systemic health during pregnancy included: prevention; healthy pregnancy/birth outcomes; patient's complaint/question as cue to action; comprehensive, patient-centered, and family-centered care; ethical duty; and professional governing body. Oral health providers reported assessing, educating, and communicating with patients about oral health issues; whereas prenatal providers rarely addressed oral health but reported signing approval forms to receive such care. A few oral health providers highlighted lifecourse implications and the need for family-centered care when addressing poor oral health among pregnant patients. Findings suggest gaps in oral health prevention information and behaviors among prenatal and oral health providers. Future efforts should examine effective dissemination and implementation strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improve oral-systemic health among women and their offspring across the lifecourse.
怀孕被视为母亲和后代口腔健康风险增加的敏感时期。随后，医学和牙科协会都再次认可了促进孕期口腔健康的综合跨专业指南。目的是探讨产前和口腔健康提供者与孕期口腔健康相关的信息、动机和实践行为。基于信息-动机-行为技能模型，对产前和口腔健康提供者进行了22次深入访谈。使用NVivo 10中的持续比较法对数据进行了分析。提供者对已确定的口腔-全身联系及影响的了解程度各不相同。大多数提供者不知道这些指南；然而，一些口腔健康提供者报告在此期间避免特定的治疗行为。孕期关注口腔-全身健康的动机包括：预防；健康的妊娠/分娩结局；患者的投诉/问题作为行动提示；全面、以患者为中心和以家庭为中心的护理；道德责任；以及专业管理机构。口腔健康提供者报告对患者的口腔健康问题进行评估、教育和沟通；而产前提供者很少提及口腔健康，但报告签署批准表格以接受此类护理。一些口腔健康提供者强调了生命历程的影响以及在解决孕妇口腔健康不佳问题时以家庭为中心护理的必要性。研究结果表明产前和口腔健康提供者在口腔健康预防信息和行为方面存在差距。未来的努力应研究有效的传播和实施策略，将基于证据的指南转化为临床实践，最终目标是在生命历程中改善妇女及其后代的口腔-全身健康。
