动机性访谈在基层医疗预防幼儿龋病中的应用:一项基于社区的随机对照群研究。

Motivational Interviewing in Preventing Early Childhood Caries in Primary Healthcare: A Community-based Randomized Cluster Trial.

机构信息

Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.

Graduate Program in Assessment Technology for the National Health System (SUS), Grupo Hospitalar Conceição (GHC), Porto Alegre, Brazil.

出版信息

J Pediatr. 2018 Oct;201:190-195. doi: 10.1016/j.jpeds.2018.05.016. Epub 2018 Jun 6.

Abstract

OBJECTIVE

To assess the effectiveness of motivational interviewing in preventing early childhood caries compared with conventional oral health education.

STUDY DESIGN

Twelve health care units in southern Brazil were randomly allocated in 2 groups of 6 and professionals in 1 group were trained in motivational interviewing. The mothers/children and external examiners were blinded to the intervention. The data were collected by calibrated examiners using questionnaires and a clinical examination based on modified International Caries Detection and Assessment System criteria. Of the 674 children born in the catchment area in the year 2013, 469 received the intervention (224 in the conventional oral health education group, 245 in the motivational interviewing group), and 320 were examined by the end of the study (145 in the conventional oral health education group, 175 in the motivational interviewing group), with mean age of 30 months. The final follow-up was 68%, after 3 years.

RESULTS

Mean of decayed, missing, and filled surfaces at the end of the study period for the whole sample was 1.34 (95% CI 0.97-1.71). The caries rate per 100 surface-year in the conventional oral health education group was 1.74 (95% CI 1.14-2.34) and in the motivational interviewing group, it was 0.92 (95% CI 0.63-1.20). To correct for clustering effect and unbalanced factors, multilevel Poisson regression was fitted and the effect of motivational interviewing on the incidence rate ratio was 0.40 (95% CI 0.21-0.79).

CONCLUSIONS

An intervention based on the principles of motivational interviewing style was more effective in reducing the number of surfaces affected by early childhood caries compared with conventional oral health education intervention.

TRIAL REGISTRATION

ClinicalTrials.govNCT02578966, Brazilian Registry of Clinical Trials RBR-8fvwxq.

摘要

目的

评估与传统口腔健康教育相比,动机访谈在预防幼儿龋齿方面的效果。

研究设计

巴西南部的 12 个医疗保健单位被随机分为 2 组,每组 6 个,其中一组的专业人员接受动机访谈培训。母亲/儿童和外部检查者对干预措施不知情。数据由经过校准的检查者使用问卷和基于改良国际龋齿检测和评估系统标准的临床检查收集。在 2013 年该地区出生的 674 名儿童中,有 469 名接受了干预(传统口腔健康教育组 224 名,动机访谈组 245 名),研究结束时有 320 名接受了检查(传统口腔健康教育组 145 名,动机访谈组 175 名),平均年龄为 30 个月。3 年后,最终随访率为 68%。

结果

整个样本在研究期末的平均患龋失补牙面数为 1.34(95%CI 0.97-1.71)。传统口腔健康教育组的龋病发生率为每 100 个表面年 1.74(95%CI 1.14-2.34),动机访谈组为 0.92(95%CI 0.63-1.20)。为了校正聚类效应和不平衡因素,拟合了多层次泊松回归,动机访谈对发病率比的影响为 0.40(95%CI 0.21-0.79)。

结论

基于动机访谈模式原则的干预措施在减少幼儿龋齿受影响表面数量方面比传统口腔健康教育干预更有效。

试验注册

ClinicalTrials.govNCT02578966,巴西临床试验注册 RBR-8fvwxq。

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