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      Multilevel analysis of self-perception in oral health and associated factors in Southern Brazilian adults: a cross-sectional study Translated title: Análisis multinivel de la autopercepción de la salud oral y factores asociados en adultos del sur de Brasil: un estudio transversal Translated title: Análise em multinível da autopercepção em saúde bucal e fatores associados em adultos do Sul do Brasil: um estudo transversal

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          Abstract

          The aim of this study was to evaluate the association between individual and contextual variables related to self-perception in oral health among residents in the municipality of São Leopoldo, Rio Grande do Sul State, Brazil. The cross-sectional design involved 1,100 adults in 38 census tracts. The self-perception was evaluated using the Oral Health Impact Profile (OHIP-14) tool. A logistic multilevel analysis was performed. The multivariate analysis revealed that those who are of the female gender, older, with lower scores of quality of life and less social support, with poor healthy eating habits, smokers and those living in low-income census tracts presented higher odds of reporting worse oral health self-perception (OHIP-1). We concluded that individual and contextual variables are associated with oral health self-perception. This is essential information for planning health services wishing to meet the health needs of the population.

          Translated abstract

          El objetivo de este estudio fue evaluar la asociación entre los factores individuales y contextuales de la salud oral en la percepción subjetiva de los habitantes de Sao Leopoldo, Río Grande do Sul, Brasil. Este fue un estudio transversal con una muestra aleatoria de 1.100 adultos en 38 secciones censales. La autopercepción se evaluó utilizando el Oral Health Impact Profile (OHIP-14). El análisis de datos utilizó la regresión logística multinivel. En el análisis multivariado, los sujetos femeninos con edad avanzada, con peores calificaciones de calidad de vida y el apoyo social, malos hábitos alimenticios, tabaquismo y pertenecientes a las secciones censales de bajos ingresos eran más propensos a informar un peor estado de salud bucal autopercibida (OHIP-1). El estudio identifica los factores asociados con la salud auto-evaluada a nivel individual y sus factores contextuales. Esto es esencial para la planificación de los servicios de salud que desean satisfacer las necesidades de información sobre salud de la población.

          Translated abstract

          O objetivo deste trabalho foi avaliar a associação entre aspectos individuais e contextuais com a autopercepção em saúde bucal em moradores do município de São Leopoldo, Rio Grande do Sul, Brasil. É um estudo com delineamento transversal, numa amostra probabilística de 1.100 adultos em 38 setores censitários. A autopercepção foi avaliada por meio do Oral Health Impact Profile (OHIP-14). A análise dos dados utilizou regressão logística multinível. Na análise multivariável, indivíduos do gênero feminino, com idade avançada, piores escores de qualidade de vida e de apoio social, com hábitos alimentares ruins, fumantes e residentes em setores censitários com baixa renda apresentaram maiores chances de relatar pior autopercepção em saúde bucal (OHIP-1). O estudo identificou os fatores associados à autopercepção de saúde nos níveis individual e contextual. Essa é informação imprescindível para o planejamento de serviços de saúde que pretendam atender às necessidades de saúde da população.

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          Derivation and validation of a short-form oral health impact profile.

          Growing recognition that quality of life is an important outcome of dental care has created a need for a range of instruments to measure oral health-related quality of life. This study aimed to derive a subset of items from the Oral Health Impact Profile (OHIP-49)-a 49-item questionnaire that measures people's perceptions of the impact of oral conditions on their well-being. Secondary analysis was conducted using data from an epidemiologic study of 1217 people aged 60+ years in South Australia. Internal reliability analysis, factor analysis and regression analysis were undertaken to derive a subset (OHIP-14) questionnaire and its validity was evaluated by assessing associations with sociodemographic and clinical oral status variables. Internal reliability of the OHIP-14 was evaluated using Cronbach's coefficient alpha. Regression analysis yielded an optimal set of 14 questions. The OHIP-14 accounted for 94% of variance in the OHIP-49; had high reliability (alpha = 0.88); contained questions from each of the seven conceptual dimensions of the OHIP-49; and had a good distribution of prevalence for individual questions. OHIP-14 scores and OHIP-49 scores displayed the same pattern of variation among sociodemographic groups of older adults. In a multivariate analysis of dentate people, eight oral status and sociodemographic variables were associated (P < 0.05) with both the OHIP-49 and the OHIP-14. While it will be important to replicate these findings in other populations, the findings suggest that the OHIP-14 has good reliability, validity and precision.
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            Development and evaluation of the Oral Health Impact Profile.

            The capacity of dental clinicians and researchers to assess oral health and to advocate for dental care has been hampered by limitations in measurements of the levels of dysfunction, discomfort and disability associated with oral disorders. The purpose of this research was to develop and test the Oral Health Impact Profile (OHIP), a scaled index of the social impact of oral disorders which draws on a theoretical hierarchy of oral health outcomes. Forty nine unique statements describing the consequences of oral disorders were initially derived from 535 statements obtained in interviews with 64 dental patients. The relative importance of statements within each of seven conceptual subscales was assessed by 328 persons using Thurstone's method of paired comparisons. The consistency of their judgements was confirmed (Kendall's mu, P < 0.05). The reliability of the instrument was evaluated in a cohort of 122 persons aged 60 years and over. Internal reliability of six subscales was high (Cronbach's alpha, 0.70-0.83) and test-retest reliability (intraclass correlation coefficient, 0.42-0.77) demonstrated stability. Validity was examined using longitudinal data from the 60 years and over cohort where the OHIP's capacity to detect previously observed associations with perceived need for a dental visit (ANOVA, p < 0.05 in five subscales) provided evidence of its construct validity. The Oral Health Impact Profile offers a reliable and valid instrument for detailed measurement of the social impact of oral disorders and has potential benefits for clinical decision-making and research.
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              From social integration to health: Durkheim in the new millennium.

              It is widely recognized that social relationships and affiliation have powerful effects on physical and mental health. When investigators write about the impact of social relationships on health, many terms are used loosely and interchangeably including social networks, social ties and social integration. The aim of this paper is to clarify these terms using a single framework. We discuss: (1) theoretical orientations from diverse disciplines which we believe are fundamental to advancing research in this area; (2) a set of definitions accompanied by major assessment tools; and (3) an overarching model which integrates multilevel phenomena. Theoretical orientations that we draw upon were developed by Durkheim whose work on social integration and suicide are seminal and John Bowlby, a psychiatrist who developed attachment theory in relation to child development and contemporary social network theorists. We present a conceptual model of how social networks impact health. We envision a cascading causal process beginning with the macro-social to psychobiological processes that are dynamically linked together to form the processes by which social integration effects health. We start by embedding social networks in a larger social and cultural context in which upstream forces are seen to condition network structure. Serious consideration of the larger macro-social context in which networks form and are sustained has been lacking in all but a small number of studies and is almost completely absent in studies of social network influences on health. We then move downstream to understand the influences network structure and function have on social and interpersonal behavior. We argue that networks operate at the behavioral level through four primary pathways: (1) provision of social support; (2) social influence; (3) on social engagement and attachment; and (4) access to resources and material goods.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                csp
                Cadernos de Saúde Pública
                Cad. Saúde Pública
                Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (Rio de Janeiro )
                1678-4464
                January 2015
                : 31
                : 1
                : 49-59
                Affiliations
                [1 ] Pontifícia Universidade Católica do Paraná Brazil
                [2 ] Universidade do Vale do Rio dos Sinos Brazil
                Article
                S0102-311X2015000100049
                10.1590/0102-311X00037814
                25715291
                1089f913-2210-4a3a-bcb3-482e98823a06

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielosp.org/scielo.php?script=sci_serial&pid=0102-311X&lng=en
                Categories
                Health Policy & Services

                Public health
                Multilevel Analysis,Oral Health,Quality of Life,Análisis Multinivel,Salud Bucal,Calidad de Vida,Análise Multinínel,Saúde Bucal,Qualidade de Vida

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