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评估影响血友病患者获得初级牙科护理服务的因素。

Assessing the factors affecting the accessibility of primary dental care for people with haemophilia.

作者信息

Sipos Kitti, Márton Ildikó, Móré Marianna, Nagy Attila Csaba, Kiss Csongor

机构信息

Department of Operative Dentistry and Endodontics, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary.

Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.

出版信息

Haemophilia. 2025 Jan;31(1):69-77. doi: 10.1111/hae.15124. Epub 2024 Nov 27.

Abstract

INTRODUCTION

Patients with haemophilia (PWH) often have difficulty accessing dental services.

AIM

To determine the accessibility of dental care for PWH and to examine their perceptions of how coronavirus type-2 (CoV-2) disease (COVID-19) has affected their ability to access dental treatments following the pandemic.

METHODS

The questionnaire survey was conducted between July 2022 and December 2022 at haemophilia treatment centres in Hungary. Variables with statistical significance (Pearson's Chi-squared test; p < .05) were included in logistic regression analyses. Least absolute shrinkage and selection operator (LASSO) regression was used as a machine learning technique to identify the most predictive variables.

RESULTS

Twenty-one percent of the sixty-eight participants reported that they had been refused dental treatment, mainly in primary care (86%). Dental refusal was influenced by infectious disease (OR: 4.48, CI: 1.14-17.69) and previous dental bleeding complications (OR: 4.23, CI: 1.10-16.27). There was correlation between dental visits and having a permanent dentist or receiving oral hygiene advice (OR: 9.95, CI: 2.86-34.62 and OR: 3.84, CI: 1.09-13.58). Participation in an oral hygiene consultation increased patients' satisfaction with their dental care (OR: 6.28, 95% CI: .71-55.88). Twenty-eight percent of patients had experienced difficulties since the start of the COVID-19, but 84% had visited their dentist at least once between 2021 and 2022 (p = .002). Nevertheless, 16% of respondents went for only the most necessary treatments due to pandemic.

CONCLUSION

Refusal of dental care was high among participants, especially in primary care. The COVID-19 pandemic has exaggerated the difficulties of PWH in accessing dental treatment.

HIGHLIGHTS

Patients with haemophilia (PWH) have difficulty accessing dental care, and the coronavirus type 2 (CoV-2) disease pandemic (COVID-19) has created a new barrier. The study revealed a high prevalence of dental care refusal (21%), particularly in primary care (86%). This 2022 survey found that 28% of patients experienced difficulties since the pandemic started and 16% only sought necessary treatments.

摘要

引言

血友病患者(PWH)在获得牙科服务方面常常存在困难。

目的

确定PWH获得牙科护理的可及性,并调查他们对于2型冠状病毒(CoV-2)疾病(COVID-19)如何影响大流行后其接受牙科治疗能力的看法。

方法

于2022年7月至2022年12月在匈牙利的血友病治疗中心进行问卷调查。具有统计学意义的变量(Pearson卡方检验;p < 0.05)纳入逻辑回归分析。使用最小绝对收缩和选择算子(LASSO)回归作为机器学习技术来识别最具预测性的变量。

结果

68名参与者中有21%报告称他们被拒绝接受牙科治疗,主要是在初级保健机构(86%)。牙科治疗被拒受传染病(比值比:4.48,置信区间:1.14 - 17.69)和既往牙科出血并发症(比值比:4.23,置信区间:1.10 - 16.27)影响。看牙次数与有固定牙医或接受口腔卫生建议之间存在相关性(比值比:9.95,置信区间:2.86 - 34.62和比值比:3.84,置信区间:1.09 - 13.58)。参与口腔卫生咨询提高了患者对牙科护理的满意度(比值比:6.28,95%置信区间:0.71 - 55.88)。自COVID-19开始以来,28%的患者遇到了困难,但84%的患者在2021年至2022年期间至少看过一次牙医(p = 0.002)。然而,16%的受访者因疫情仅接受最必要的治疗。

结论

参与者中牙科护理被拒率很高,尤其是在初级保健机构。COVID-19大流行加剧了PWH获得牙科治疗的困难。

要点

血友病患者(PWH)在获得牙科护理方面存在困难,2型冠状病毒(CoV-2)疾病大流行(COVID-19)造成了新的障碍。该研究显示牙科护理被拒率很高(21%),尤其是在初级保健机构(86%)。这项2022年的调查发现,自疫情开始以来,28%的患者遇到了困难,16%的患者仅寻求必要的治疗。

相似文献

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[Dental management of patients with haemophilia].[血友病患者的牙科治疗]
Orv Hetil. 2022 Jun 12;163(24):943-951. doi: 10.1556/650.2022.32491.
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WFH Guidelines for the Management of Hemophilia, 3rd edition.《血友病管理的居家指南》第三版
Haemophilia. 2020 Aug;26 Suppl 6:1-158. doi: 10.1111/hae.14046. Epub 2020 Aug 3.

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