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      Oral health-related quality of life in the elderly population receiving health care at the public hospital network in Medellín, Colombia, and its related factors

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          Abstract

          Metrosalud is the largest public hospital network in the city of Medellin and one of the most important in Colombia providing health care to the most vulnerable population. The objective of the study was to determine the Oral HealthRelated Quality of Life (OHRQoL) and its related factors in the elderly population receiving health care at the public hospital network in Medellin (Colombia). A crosssectional design was used. Men and women ≥ 65 years old were considered for this research, selected from first consultation records by the institution’s statistical unit for 2011, who accepted to participate after being contacted by telephone. Sampling was performed in two stages: simple random sampling for selecting Hospital Units HUand Health Centers HCthroughout the hospital network in the city, followed by random quota sampling in proportion to the number of elderly population assigned to each HU and HC. A total 342 patients (58.2% women) participated in the study. The project involved the use of a structured questionnaire and complete dental examination with information on sociodemographic data, selfperceived health variables (mental, general and oral), use of oral health services, Oral HealthRelated Quality of Life (OHRQoL as measured with GOHAI index), temporomandibular joint test, oral mucosa, soft tissue evaluation, periodontal, dental and prosthetic examination. Descriptive and bivariate analyses were conducted to determine statistically significant differences. Multivariate analysis was performed, using logistic regression, calculating crude and adjusted odds ratios (OR) with their 95% confidence intervals (95% CI). Impacts were found to be generated by education levels, differences in socioeconomic status and urban or rural housing conditions. The results of this research show low OHRQoL levels in the elderly population receiving health care services at the public hospital network in Medellin.

          Translated abstract

          Metrosalud es la Empresa Social del Estado (E.S.E.) y red hospitalaria pública más grande de la ciudad de Medellín y una de las más importantes del país en materia de atención en salud a la población más vulnerable. El objetivo de este estudio fue determinar la calidad de vida relacionada con salud bucal (CVRSB) en la población adulta mayor atendida en la red hospitalaria pública de Medellín (Colombia) y sus factores relacionados. Se realizó un estudio descriptivo trasversal. La muestra fue constituida por población adulta mayor de la ESE Metrosalud. Hombres y mujeres mayores de 65 años fueron considerados para esta investigación y fueron seleccionados de los registros de consulta de la unidad de estadística de la institución (año 2011) e invitados a participar a través de contacto telefónico. Se realizó un muestreo en dos etapas, en primer lugar se seleccionaron aleatoriamente los centros y unidades hospitalarias y en segundo lugar se realizó un muestreo por cuotas teniendo en cuenta la distribución de adultos mayores, uso del Índice GOHAI, examen de articulación temporomandibular, mucosa bucal, evaluación de tejidos blandos, examen periodontal, dental y protésico. Se realizaron análisis de 342 adultos mayores (58,2% mujeres) participaron en el estudio. El proyecto contempló la utilización de encuesta estructurada y examen odontológico completo, con información sobre datos sociodemográficos, variables de salud autopercibida (mental, general y bucal), utilización de servicios de salud bucal, calidad de vida relacionada con la salud bucal (CVRSB). Análisis descriptivos y bivariados fueron realizados para observar diferencias estadísticamente significativas. Se realizó análisis multivariado por regresión logística, calculando odds ratios (OR) crudas y ajustadas con sus intervalos de confianza al 95% (IC 95%). Los hallazgos indican impactos en la Calidad de Vida Relacionada con la Salud Bucal CVRSB generados por variables como los niveles de educación, las diferencias en niveles socioeconómicos y las condiciones de la vivienda urbana o rural. Los resultados de esta investigación muestran bajos niveles de CVRSB en la población adulta mayor vinculados a los servicios de la red de publica hospitalaria en la ciudad de Medellín.

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          The Duke-UNC Functional Social Support Questionnaire. Measurement of social support in family medicine patients.

          A 14-item, self-administered, multidimensional, functional social support questionnaire was designed and evaluated on 401 patients attending a family medicine clinic. Patients were selected from randomized time-frame sampling blocks during regular office hours. The population was predominantly white, female, married, and under age 45. Eleven items remained after test-retest reliability was assessed over a 1- to 4-week follow-up period. Factor analysis and item remainder analysis reduced the remaining 11 items to a brief and easy-to-complete two-scale, eight-item functional social support instrument. Construct validity, concurrent validity, and discriminant validity are demonstrated for the two scales (confidant support--five items and affective support--three items). Factor analysis and correlations with other measures of social support suggest that the three remaining items (visits, instrumental support, and praise) are distinct entities that may need further study.
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            Development of the Geriatric Oral Health Assessment Index.

            The development of measures for assessing oral health status is essential to the evolution and maturation of a scientific knowledge base in geriatric dentistry. The literature suggests a high prevalence of dental diseases in older adults, yet valid and reliable instruments to assess the impact of oral diseases on older individuals or populations are lacking. This paper describes the rationale for and the development of the Geriatric Oral Health Assessment Index (GOHAI), a self-reported measure designed to assess the oral health problems of older adults. Following a review of the literature and consultation with health care providers and patients, a pilot instrument was developed. The GOHAI was initially tested on a convenience sample of 87 older adults. A revised instrument was then administered to a sample of 1755 Medicare recipients in Los Angeles County. The GOHAI demonstrated a high level of internal consistency and reliability as measured by a Cronbach's alpha of 0.79. Associations of the GOHAI with a single-item rating of dental health and with clinical and sociodemographic supported the construct validity of the index. Having fewer teeth, wearing a removable denture and perceiving the need for dental treatment were significantly related to a worse (lower) GOHAI score. Respondents who were white, well educated, and with a higher annual household income were more likely to have a high GOHAI score, indicating fewer dental problems. Additional applications of the GOHAI are necessary to further evaluate the instrument's validity and reliability, and to establish population norms of oral health in older adult populations as measured by the GOHAI.
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              Assessment of oral health related quality of life

              In Dentistry, as in other branches of Medicine, it has been recognised that objective measures of disease provide little insight into the impact of oral disorders on daily living and quality of life. A significant body of development work has been undertaken to provide health status measures for use as outcome measures in dentistry. In descriptive population studies, poor oral health related quality of life is associated with tooth loss. There is a less extensive literature of longitudinal clinical trials, and measurement of change and interpretation of change scores continues to pose a challenge. This paper reviews the literature regarding the development and use of these oral health related QoL measures and includes an appraisal of future research needs in this area.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                aol
                Acta Odontológica Latinoamericana
                Acta odontol. latinoam.
                Sociedad Argentina de Investigación Odontológica (Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina )
                1852-4834
                September 2016
                : 29
                : 2
                : 151-161
                Affiliations
                [01] Medellín orgnameUniversity Foundation Autónoma de las Américas orgdiv1School of Dentistry orgdiv2Research Group in Health and Community GISCO Colombia
                [02] Medellín orgnameUniversity of Antioquia orgdiv1School of Dentistry Colombia
                Article
                S1852-48342016000200008
                e8b72e6c-0699-486e-8cf2-bf879c44adf4

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 36, Pages: 11
                Product

                SciELO Argentina


                Calidad de vida,Salud bucal,Percepción,Evaluación geriátrica,Quality of life,Oral health,Perception,Geriatric assessment

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