Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Ghasrdasht street, Shiraz, Iran.
Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.
BMC Health Serv Res. 2021 Dec 4;21(1):1302. doi: 10.1186/s12913-021-07293-4.
The provision of dental services for children with special health care needs (CSHCN) needs to be considered by policymakers. This study is aimed to explore the determinant factors affecting dental and oral services provision for this vulnerable group.
A review was conducted applying the 9-steps approach. Five scientific databases of PUBMED, SCOPUS, Web of Science and PROQUEST and EMBASE were searched up to 10.07.2021, applying appropriate keywords. Thematic analysis was used to analyse the extracted data, and a conceptual map was developed according to JBI manual for evidence synthesis.
From the abstracts of the 136 articles that fulfilled the inclusion criteria, 56 articles were included. Five main themes were identified as determinants affecting the provision of dentistry services for CSHCN, including needs assessment, policy advice, oral health interventions, providers' perception and access barriers. According to the developed conceptual map, assessing the needs of CSHCN can lead to particular policy advice. Regarding the policies, appropriate oral health interventions can be presented. These interventions, along with providers' perception about service delivery to CSHCN and the barriers to access them, determine the provision of dentistry services for CSHCN.
An effective needs assessment of CSHCN and their parents/carers can lead to evidence-informed policymaking and applicable policy advice according to the needs. Then policymakers should develop interventions to improve the community's health literacy, as well as support the seeking behaviours for appropriate services. Policymakers should also consider how to limit the barriers to accessing oral and dental health by CSHCN to decrease disparities.
决策者需要考虑为有特殊医疗需求的儿童（CSHCN）提供牙科服务。本研究旨在探讨影响这一弱势群体提供牙科和口腔服务的决定因素。
采用 9 步方法进行综述。截至 2021 年 7 月 10 日，在 PUBMED、SCOPUS、Web of Science 和 PROQUEST 以及 EMBASE 这五个科学数据库中应用适当的关键词进行了检索。采用主题分析对提取的数据进行分析，并根据 JBI 证据综合手册制作概念图。
从符合纳入标准的 136 篇摘要中，有 56 篇被纳入。确定了五个影响为 CSHCN 提供牙科服务的决定因素，包括需求评估、政策建议、口腔健康干预、提供者认知和获取障碍。根据制定的概念图，评估 CSHCN 的需求可以为特定的政策建议提供依据。关于政策，可以提出适当的口腔健康干预措施。这些干预措施，加上提供者对为 CSHCN 提供服务的认知以及他们获取服务的障碍，决定了为 CSHCN 提供牙科服务的情况。
对 CSHCN 及其父母/照顾者进行有效的需求评估，可以为循证决策和根据需求提供适用的政策建议提供依据。然后，决策者应制定干预措施，提高社区的健康素养，并支持寻求适当服务的行为。决策者还应考虑如何限制 CSHCN 获取口腔和牙齿健康的障碍，以减少差异。
