Lee Helen H, Lehew Charles W, Avenetti David, Buscemi Joanna, Koerber Anne
Dr. Lee is an assistant professor, Department of Anesthesiology, College of Medicine, Department of Pediatric Dentistry, Chicago, Ill., USA;, Email:
Dr. Lehew is a research assistant professor, Department of Pediatric Dentistry, Chicago, Ill., USA.
J Dent Child (Chic). 2019 May 15;86(2):101-108.
To identify factors that influence oral health behaviors in the pediatric population treated for caries under general anesthesia (GA).
Nineteen semi-structured key informant interviews were conducted with caregivers while their children received comprehensive dental care under GA. Interviews were recorded on audio and professionally transcribed. Transcripts were coded using an inductive approach, with codes categorized and themes identified in an iterative process among four investigators.
Data from 14 English and five Spanish interviews were reported. Factors that impacted accessing dental services, toothbrushing, and sugar intake were related to experiences living with severe caries and family dynamics. Many caregivers found the process of accessing care challenging, with barriers ranging from a caregiver's denial of disease severity to insurance status and provider availability. Discordant dynamics between parents and their children hindered efforts to change oral health behaviors. Stress of daily life impacted the ability for some caregivers to prioritize oral health.
Our findings provide a better understanding of how a family's experiences and dynamics prior to dental care under GA can serve as barriers to changing oral health behaviors within an urban, Medicaid-enrolled population. Future work should address the complexity and context of familial interactions in efforts to improve surgical outcomes.
确定在全身麻醉（GA）下接受龋齿治疗的儿童人群中影响口腔健康行为的因素。
在儿童接受GA下的全面牙科护理时，对19名照顾者进行了19次半结构化关键信息访谈。访谈进行了录音并由专业人员转录。转录本采用归纳法编码，四名研究人员在一个迭代过程中对代码进行分类并确定主题。
报告了来自14次英文访谈和5次西班牙文访谈的数据。影响获得牙科服务、刷牙和糖摄入的因素与患有严重龋齿的经历和家庭动态有关。许多照顾者发现获得护理的过程具有挑战性，障碍包括照顾者对疾病严重程度的否认、保险状况和提供者的可及性。父母与子女之间不一致的动态关系阻碍了改变口腔健康行为的努力。日常生活的压力影响了一些照顾者将口腔健康列为优先事项的能力。
我们的研究结果有助于更好地理解在GA下进行牙科护理之前家庭的经历和动态如何成为城市中参加医疗补助计划人群改变口腔健康行为的障碍。未来的工作应在努力改善手术结果时解决家庭互动的复杂性和背景问题。
