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      The impact of socioenvironmental characteristics on domains of oral health-related quality of life in Brazilian schoolchildren

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          Abstract

          Background

          Recent researches have pointed out the need to consider the functional and psychosocial dimensions of oral health, such as Oral Health-related Quality of Life (OHRQoL). The aim of this study was to investigate the influence of oral health status, socioeconomic factors and home environment of children on the four health domains of Child Perceptions Questionnaire (CPQ 11-14).

          Methods

          A cross-sectional study was conducted in Brazil with a sample of 286 schoolchildren aged 12 years and their parents. The schoolchildren were clinically examined, and participants were asked to complete the CPQ 11-14, as well as a questionnaire about home environment. In addition, a questionnaire was sent to each child’s parents asking them about family socioeconomic status. The chi-square test and Poisson’s regression analysis were performed.

          Results

          After adjusting for potential confounders, variables sex, monthly family income, mothers’ education showed a statistically significant association with all health domains of the CPQ 11-14. The family structure and presence of bleeding impacted on emotional (p = 0.0135), and social (p = 0.0010) well-being health domain scores. Orthodontic treatment need showed a strong negative effect on functional limitations domain score (p = 0.0021).

          Conclusions

          Clinical and socio-environmental factors had different impacts on domains of oral health-related quality of life, demonstrating the need to consider these conditions in planning strategies for the oral health of schoolchildren.

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          Most cited references31

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          Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes.

          Our model proposes a taxonomy or classification scheme for different measures of health outcome. We divide these outcomes into five levels: biological and physiological factors, symptoms, functioning, general health perceptions, and overall quality of life. In addition to classifying these outcome measures, we propose specific causal relationships between them that link traditional clinical variables to measures of HRQL. As one moves from left to right in the model, one moves outward from the cell to the individual to the interaction of the individual as a member of society. The concepts at each level are increasingly integrated and increasingly difficult to define and measure. AT each level, there are an increasing number of inputs that cannot be controlled by clinicians or the health care system as it is traditionally defined.
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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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              Validity and reliability of a questionnaire for measuring child oral-health-related quality of life.

              Oral-health-related quality of life measures that exist are designed for adults. This study aimed to develop and evaluate the CPQ(11-14), a self-report measure of the impact of oral and oro-facial conditions on 11- to 14-year-old children. An item pool was generated with the use of a literature review and interviews with health professionals, parents, and child patients. The 36 items rated the most frequent and bothersome by 83 children were selected for the CPQ(11-14). Validity testing involved a new sample of 123 children. Test-retest reliability was assessed in a subgroup of these children (n = 65). Mean CPQ(11-14) scores were highest for oro-facial (31.4), lower for orthodontic (24.3), and lowest for pedodontic (23.3) patients. There were significant associations between the CPQ(11-14) score and global ratings of oral health (p < 0.05) and overall well-being (p < 0.01). The Cronbach's alpha and intraclass correlation coefficient for the CPQ(11-14) were 0.91 and 0.90, respectively. These results suggest that the CPQ(11-14) is valid and reliable.
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                Author and article information

                Contributors
                Journal
                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central
                1472-6831
                2013
                28 January 2013
                : 13
                : 10
                Affiliations
                [1 ]Department of Community Dentistry, Division of Health Education and Health Promotion, Piracicaba Dental School, University of Campinas –UNICAMP, P.O. BOX 52, Piracicaba, SP, 13414-903, Brazil
                [2 ]Department of Community Dentistry, Division of Statistic, Piracicaba Dental School, University of Campinas –UNICAMP, P.O. BOX 52, Piracicaba, SP, 13414-903, Brazil
                [3 ]Department of Public Health, Medicine School, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
                Article
                1472-6831-13-10
                10.1186/1472-6831-13-10
                3573924
                23356655
                4b3b7990-5327-4f83-846a-718de767d1b0
                Copyright ©2013 de Paula et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 October 2012
                : 22 January 2013
                Categories
                Research Article

                Dentistry
                Dentistry

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