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罕见病患者牙科保健利用的决定因素:定性探讨。

Determinants of dental care use in patients with rare diseases: a qualitative exploration.

机构信息

Université Paris Cité, Laboratoire ECEVE INSERM, UMR1123, Hôpital Robert Debré, Paris, France.

Centre de Reference, Maladies Orales et Dentaires Rares, Hôpital Rothschild, APHP, Paris, France.

出版信息

BMC Oral Health. 2023 Jun 22;23(1):413. doi: 10.1186/s12903-023-03048-1.

Abstract

BACKGROUND

Oral health is an inherent part of overall health as an important physiological crossroad of functions such as mastication, swallowing or phonation; and plays a central role in the life of relationships facilitating social and emotional expression.Our hypothesis was that in patients with rare diseases, access to dental care could be difficult because of the lack of professionals who know the diseases and accept to treat the patients, but also because some patients with cognitive and intellectual disabilities could not find adequate infrastructure to assist in managing their oral health.

METHODS

This study employed a qualitative descriptive design including semi-structured interviews using guiding themes. The transcripts were reviewed to identify key themes and interviews were performed until the data were saturated and no further themes emerged.

RESULTS

Twenty-nine patients from 7 to 24 years old were included in the study of which 15 patients had an intellectual delay. The results show that access to care is complicated more by aspects concerning intellectual disability than by the fact that the disease is rare. Oral disorders are also an obstacle to the maintenance of their oral health.

CONCLUSION

The oral health of patients with rare diseases, can be greatly enhanced by a pooling of knowledge between health professionals in the various sectors around the patient's care. It is essential that this becomes a focus of national public health action that promotes transdisciplinary care for the benefit of these patients.

摘要

背景

口腔健康是整体健康的固有组成部分,是咀嚼、吞咽或发音等功能的重要生理交叉点;在促进社交和情感表达的人际关系生活中起着核心作用。我们的假设是,在患有罕见病的患者中,由于缺乏了解疾病并愿意治疗患者的专业人员,以及一些认知和智力残疾的患者无法找到足够的基础设施来帮助管理他们的口腔健康,因此获得口腔保健可能会很困难。

方法

本研究采用定性描述设计,包括使用指导主题的半结构式访谈。对转录本进行了审查,以确定关键主题,并进行了访谈,直到数据饱和且不再出现新主题。

结果

研究共纳入了 29 名 7 至 24 岁的患者,其中 15 名患者存在智力发育迟缓。结果表明,获得治疗的困难更多是由于智力障碍方面的问题,而不是疾病的罕见性。口腔疾病也是维持口腔健康的障碍。

结论

通过汇集围绕患者护理的各个领域的卫生专业人员的知识,可以大大改善罕见病患者的口腔健康。这必须成为国家公共卫生行动的重点,以促进跨学科护理,使这些患者受益。

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