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孕妇牙科服务利用障碍与促进因素的定性探索:一种三角验证法。

Qualitative exploration of barriers and facilitators of dental service utilization of pregnant women: A triangulation approach.

作者信息

Bahramian Hoda, Mohebbi Simin Z, Khami Mohammad Reza, Quinonez Rocio Beatriz

机构信息

Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

BMC Pregnancy Childbirth. 2018 May 10;18(1):153. doi: 10.1186/s12884-018-1773-6.

Abstract

BACKGROUND

Pregnant women are vulnerable to a wide range of oral health conditions that could be harmful to their own health and future child. Despite the usefulness of regular dental service utilization in prevention and early detection of oral diseases, it is notably low among pregnant women. In this qualitative study, we aimed to explore barriers and facilitators influencing pregnant women's dental service utilization.

METHODS

Using a triangulation approach, we included pregnant women (n = 22) from two public health centers, midwives (n = 8) and dentists (n = 12) from 12 other public centers in Tehran (Iran). Data was gathered through face-to-face semi-structured interviewing and focus group discussion methods. The analysis of qualitative data was performed using conventional content analysis with MAXQDA10 software.

RESULTS

Reported barriers of dental service utilization among pregnant women were categorized under emerging themes: Lack of knowledge and misbelief, cost of dental care, physiological changes, fear and other psychological conditions, time constraint, dentists' unwillingness to accept pregnant women treatment, cultural taboos and lack of interprofessional collaboration. Solutions proposed by dentists, midwives and pregnant women to improve dental care utilization during pregnancy were categorized under three themes: Provision of knowledge, financial support and establishing supportive policies.

CONCLUSIONS

Understanding perceived barriers of dental service utilization during pregnancy can serve as baseline information for planning and formulating appropriate oral health education, financial support, and legislations tailored for lower income pregnant women, midwives and dentists in countries with developing oral health care system.

摘要

背景

孕妇易患多种口腔健康问题,这些问题可能对她们自身的健康以及未来的孩子有害。尽管定期使用牙科服务对预防和早期发现口腔疾病很有用,但孕妇的使用率却明显较低。在这项定性研究中,我们旨在探讨影响孕妇牙科服务利用的障碍和促进因素。

方法

我们采用三角测量法,纳入了来自两个公共卫生中心的孕妇(n = 22)、来自德黑兰(伊朗)其他12个公共中心的助产士(n = 8)和牙医(n = 12)。通过面对面半结构化访谈和焦点小组讨论方法收集数据。使用MAXQDA10软件通过常规内容分析法对定性数据进行分析。

结果

孕妇牙科服务利用的报告障碍分为以下几个新出现的主题:知识缺乏和错误观念、牙科护理费用、生理变化、恐惧和其他心理状况、时间限制、牙医不愿接受孕妇治疗、文化禁忌以及缺乏跨专业协作。牙医、助产士和孕妇提出的改善孕期牙科护理利用的解决方案分为三个主题:提供知识、财政支持和制定支持性政策。

结论

了解孕期牙科服务利用的感知障碍可为规划和制定适合口腔卫生保健系统发展中国家低收入孕妇、助产士和牙医的适当口腔健康教育、财政支持和立法提供基线信息。

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本文引用的文献

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Periodontal Disease and Pregnancy Outcomes: Overview of Systematic Reviews.牙周疾病与妊娠结局:系统评价综述
JDR Clin Trans Res. 2018 Jan;3(1):10-27. doi: 10.1177/2380084417731097. Epub 2017 Sep 25.
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Oral health promotion interventions during pregnancy: a systematic review.孕期口腔健康促进干预措施:一项系统评价
Community Dent Oral Epidemiol. 2015 Oct;43(5):385-96. doi: 10.1111/cdoe.12167. Epub 2015 May 8.
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Management of pregnant patient in dentistry.牙科中妊娠患者的管理。
J Int Oral Health. 2013 Feb;5(1):88-97. Epub 2013 Feb 26.

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