Coesão familiar associada à saúde bucal, fatores socioeconômicos e comportamentos em saúde

Individual and contextual determinants associated with traumatic dental injuries in children eight to ten years of age: a multilevel analysis

OBJECTIVE

Investigate individual and contextual determinants associated with traumatic dental injuries in schoolchildren.

METHODS

A cross-sectional study with 739 pairs of parents and children. Parents answered a sociodemographic questionnaire, the Family Adaptability and Cohesion Evaluation Scale and a questionnaire on the child's use of electronic devices. Examinations of the children were conducted at the school by calibrated examiners using the diagnostic criteria proposed by Andreasen. Contextual variables of the school were also collected. Multilevel Poisson regression for complex samples was performed (p < 0.05).

RESULTS

The individual factors associated with the outcome were children of single parents (PR = 2.33; 95% CI: 1.79-2.66), practice of sports (PR = 2.46; 95% CI: 1.70-3.22), the daily use of electronic devices (PR = 1.78; 95% CI: 1.31-1.81), more than 2 h per day of screen time (PR = 3.84; 95% CI: 1.94-4.28) and chaotic family adaptability (PR = 4.22; 95% CI: 3.44-4.99). The contextual variables were studying at a public school (PR = 1.77; 95% CI: 1.02-3.05) and the presence of rigid floor in the school courtyard (PR = 1.99; 95% CI: 1.15-3.15).

CONCLUSION

Individual determinants, studying at a public school and the presence of rigid floor in the school courtyard were associated with traumatic dental.

Individual and Contextual Factors Associated with Adolescents' Self-Perceived Need for Treatment

The present study aimed to investigate associations between the self-perceived dental treatment need and clinical factors, familial characteristics, and school context in adolescents. A cross-sectional study was conducted with a representative sample of 746 students aged 15 to 19 years in a medium-sized city in Brazil. Data collection involved the use of a sociodemographic questionnaire, an oral health questionnaire, and the Family Adaptability and Cohesion Scales (FACES III) instrument. Clinical examinations were performed by two trained and calibrated examiners (Kappa > 0.80) using the Nyvad criteria. A robust logistic regression analysis for complex samples was performed using a multilevel approach (α = 5%). The individual factors associated with the self-perceived treatment need were dental pain (OR = 1.08; 95% CI: 1.01-1.16), the loss of the first molars (OR = 1.09; 95% CI: 1.03-1.15), and disengaged family cohesion (OR = 1.15; 95% CI: 1.01-1.31). In terms of context, attending a public school was associated with the self-perceived treatment need (OR = 1.17; 95% CI: 1.02-1.33). Thus, the individual factors of toothache, tooth loss, and a disengaged family, as well as the school context, exerted an influence on the self-perceived treatment need.

Structuring of the effects of oral health literacy on dental caries in 12-year-old adolescents

OBJECTIVES

To explore the pathways by which oral health literacy is associated with dental caries in adolescents, assessing direct and indirect effects of family cohesion and socioeconomic status.

METHODS

A population-based, representative cross-sectional study was conducted with 740 12-year-old adolescents in Campina Grande, Brazil. Parents/guardians answered a sociodemographic questionnaire. Adolescents answered validated questionnaires addressing family cohesion and oral health literacy. Dental caries was diagnosed using Nyvad criteria. Two dentists underwent training exercises for the diagnosis and administration of the questionnaires (k > 0.80). Descriptive analysis was followed by the use of structural equation modelling to determine direct and indirect associations between the variables incorporated into the theoretical model of the study (95% CI).

RESULTS

Oral health literacy (standardized coefficient: -3.472, p < .01) and mother's schooling (standardized coefficient: -0.405, p < .01) were directly associated with dental caries, whereas family cohesion and socioeconomic status exerted an indirect effect on the occurrence of dental caries in the adolescents.

CONCLUSIONS

Sociodemographic factors, family characteristics and oral health literary are associated with dental caries in 12-year-old adolescents.

Socio-demographic factors, dental status, oral health knowledge and attitude, and health-related behaviors in dental visits among 12-year-old Shenzhen adolescents: a multilevel analysis

BACKGROUND

Dental visits can provide education, prevention and treatment measures for teenagers, and help to form correct oral health knowledge and attitude. The purpose of this study was to evaluate the effects of socio-demographic factors, dental status, oral health literacy, and health-related behaviors on dental visits in early 12-year-old adolescents.

METHODS

953 subjects aged 12 in Longhua district of Shenzhen were investigated. The questionnaire and clinical examination were applied in schools, and two-level logistic regression models were constructed to interpret the effect of individual and contextual factors on Shenzhen adolescents' dental visits.

RESULTS

A total of 27.6% of the participants had not been to a dentist. After the multiple factors binary logistic regression analysis, it confirmed that the following variables: Shenzhen Hukou (OR 2.133, 95% CI 1.429-3.185), moderate caries (OR 1.404, 95% CI 1.022-1.928) and severe caries (OR 2.546, 95% CI 1.461-4.437), Angle Class II malocclusion (OR 1.703, 95% CI 1.134-2.556), sometimes or never toothbrushing (OR 2.985, 95% CI 1.491-5.975), dental floss usage (OR 1.829, 95% CI 1.250-2.677), having had a toothache within the last 12 months (OR 1.469, 95% CI 1.086-1.986), high knowledge attitude level (OR 1.570, 95% CI 1.106-2.229), moderate knowledge attitude level (OR 1.534, 95% CI 1.073-2.193), were associated factors for dental visit experience.

CONCLUSIONS

The dental visits of 12-year-old children in Longhua district of Shenzhen is affected by multi-dimensional factors. It is suggested that oral health education should be strengthened, good oral hygiene habits should be cultivated, and the needs and utilization of oral health services for non-Shenzhen Hukou adolescents should be paid attention to, so as to effectively improve the overall oral health level of adolescents.

Family and contextual factors associated with licit drug use in adolescence

OBJECTIVE:

TO evaluate the family and contextual factors associated with licit drug use among 15 to 19-year-old adolescents in the school context.

METHODS:

This is a representative, school-based, cross-sectional study conducted with 746 adolescents from 15 to 19 years old enrolled in public and private schools. Parents/guardians reported on the sociodemographic variables, while adolescents answered questionnaires on drug use, family cohesion and adaptability, oral health literacy and visits to the dentist. Information on school context was obtained at the institution and via municipal publications. Associations between variables were analyzed using unadjusted and adjusted multilevel Poisson regression models.

RESULTS:

Prevalence of licit drug use at least once and a pattern indicative of harmful drug use were 39.8% and 15.1%, respectively. After the adjusted analysis of licit drug use at least once, the variables gender (PR = 1.26; 95%CI: 1.01–1.59), family cohesion (PR = 9.81; 95%CI: 1.23–72.54), and average income of the school district (PR = 0.72; 95%CI: 0.57–0.91) remained in the final model. As for drug abuse, only the detached type (PR = 23.01; 95%CI: 2.46–214.87) and separated type (PR = 13.54; 95%CI: 1.40–130.97) of family cohesion remained in the final model.

CONCLUSION:

Experience with licit drug use was associated with family and contextual factors among the adolescents, while family cohesion was the main factor related to harmful drug use.

Attention-deficit Disorder, Family Factors, and Oral Health Literacy

Introduction

Relationships amongst attention-deficit/hyperactivity disorder (ADHD), family factors, and oral health literacy (OHL) in adolescents are unclear. The objective of this research was to investigate whether family environment and signs of ADHD are associated with OHL at the onset of adolescence.

Methods

A cross-sectional study was performed with 448 twelve-year-old adolescents enrolled in schools in Cajazeiras, Brazil. Adolescents responded to an instrument measuring OHL (Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry [BREALD-30]) and a validated questionnaire addressing family cohesion and adaptability (Family Adaptability and Cohesion Scales [FACES III]). Parents and teachers answered subscales of the Swanson, Nolan, and Pelham Questionnaire (SNAP-IV) and a socioeconomic questionnaire. Adjusted Poisson regression analysis was employed for the data analysis (P < .05).

Results

Greater OHL was found in adolescents with higher family cohesion scores (rate ratio [RR], 1.02; 95% confidence interval [CI], 1.01–1.03), those whose mothers had more than 8 years of schooling (RR, 1.07; 95% CI, 1.03–1.12), and those whose families earned more than the Brazilian minimum salary (RR, 1.08; 95% CI, 1.03–1.12). Higher family adaptability scores (RR, 0.99; 95% CI, 0.98–0.99) and more signs of ADHD (teachers’ reports) (RR, 0.95; 95% CI, 0.91–0.99) were associated with lower OHL.

Conclusions

OHL in adolescents was influenced by family adaptability and cohesion, signs of ADHD, maternal schooling, and family income.

Attention-deficit/hyperactivity disorder and oral health literacy exert an influence on the occurrence of dental caries in early adolescence

Little is known regarding the influence of psychosocial factors on dental caries at early adolescence. The study aimed to investigate associations between family environment, attention-deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) with dental caries experience in early adolescence. A cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents at public and private schools in North-eastern Brazil. Parents/guardians and teachers answered the Brazilian version of the inattention and hyperactivity/impulsivity subscales (SNAP- IV) for the evaluation of ADHD and a sociodemographic questionnaire. An OHL instrument (BREALD-30) and the Family Adaptability and Cohesion Scales (FACES III) were administered to the adolescents. Caries experience (DMFT) was the dependent variable. Data analysis involved Poisson regression with robust variance (α = 5%). Adolescents with more symptoms of ADHD (teachers' reports) (RR: 1.73; 95% CI: 1.31-2.28), those with lower OHL (RR: 1.59; 95% CI: 1.01-2.51), those with a lower family income (RR: 1.38; 95% CI: 1.03-1.83), and those from families with a greater number of residents in the home (RR: 1.18; 95% CI: 1.06-1.31) had greater caries experience. Family adaptability and cohesion were not associated with caries experience. Dental caries experience in early adolescence was influenced by symptoms of ADHD, OHL, and sociodemographic factors.

Family Cohesion Is Associated with the Self-Perceived Need for Dental Treatment among Adolescents

This study explored the association between family cohesion and self-perceived need for dental treatment among adolescents. A school-based representative cross-sectional study was conducted with 746 students aged 15 to 19 randomly selected from schools in Campina Grande, Brazil. Parents/guardians provided information on sociodemographic data, and students completed questionnaires about the self-perceived need for dental treatment, dental pain, and family cohesion and adaptability (FACES III). Two dentists were trained (kappa >0.80) to diagnosis dental caries using the Nyvad criteria and assess adolescents' level of functional oral health literacy (BREALD-30). Descriptive analysis was performed, followed by nonadjusted and adjusted robust binary logistic regression for complex samples (α = 5%). The prevalence of self-perceived need for dental treatment was 88.6%. The presence of dental caries (OR = 2.10; IC 95%: 1.22-3.61), tooth loss (OR = 15.81; IC 95%: 2.14-116.56), dental pain in the last six months (OR = 1.87; IC 95%: 1.06-3.31), and enmeshed family cohesion type (OR = 10.23; IC 95%: 3.96-26.4) remained associated with the self-perceived need for dental treatment in the final model. In conclusion, dental caries, dental pain, tooth loss, and family cohesion influenced the self-perceived need for dental treatment in adolescents.

Family Resilience and Its Association with Psychosocial Adjustment of Children with Chronic Illness: A Latent Profile Analysis

PURPOSE

The purpose of this study was to investigate the characteristics of family resilience in a sample of Chinese families with children diagnosed with chronic illness using Latent Profile Analysis (LPA). In particular, we examined the association of family resilience profiles with the psychosocial adjustment of children, and identified the socio-demographic correlates of these latent profiles.

DESIGN AND METHODS

A cross-sectional study was conducted at comprehensive hospitals and children hospitals in three cities (Hangzhou, Ningbo and Wenzhou) of Zhejiang province, China. Parents (n = 277) of children diagnosed with a chronic illness completed a socio-demographic questionnaire, the Chinese version of the family resilience assessment scale, and the Strengths and Difficulties Questionnaire.

RESULTS

A three-class solution was found to demonstrate the best fit [low family resilience (74.7%), moderate family resilience (14.1%), and high family resilience (11.2%)]. One-way ANOVA revealed significant differences between the three groups with respect to peer relationship problems and pro-social behaviors of children. On multinomial logistic regression analysis, the type of childhood chronic disease, time since diagnosis, family monthly income, medical insurance, and parents employment status significantly predicted the profile membership.

CONCLUSION

Inadequate family resilience was found to be a common phenomenon in families with children affected by chronic illness. Family resilience profiles were associated with psychological adjustment of children.

PRACTICE IMPLICATION

Our findings may help inform tailored family-strength based interventions to promote better psychosocial adjustment of children with chronic illness.

Family cohesion and attention deficit exert an influence on visits to the dentist in early adolescence

OBJECTIVES

To determine whether family environment, signs of attention deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) are associated with visits to the dentist in adolescents.

METHODS

A school-based cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents enrolled at schools in the city of Cajazeiras, Brazil. The adolescents answered a validated questionnaire addressing family cohesion and adaptability (FACES III), an OHL measure (Brazilian Rapid Estimate of Adult Literacy in Dentistry [BREALD-30]) and a questionnaire addressing the history of visits to the dentist and previous toothache experience. The parents answered a questionnaire addressing sociodemographic characteristics. Parents and teachers answered the inattention and hyperactivity/impulsivity subscales of the Swanson, Nolan & Pelham (SNAP-IV) questionnaire for the detection of signs of ADHD. Multiple Poisson regression with robust variance was used for data analysis (α = 5%).

RESULTS

The prevalence of having visited a dentist some time in life was higher among adolescents with enmeshed (PR = 1.08; 95% CI: 1.01-1.15) and connected (PR = 1.06; 95% CI: 1.01-1.13) families and those with attention deficit according to parents' reports (PR = 1.09; 95% CI: 1.04-1.14). A family income higher than the Brazilian minimum wage (PR = 1.06; 95% CI: 1.01-1.12) and toothache in the previous six months (PR = 1.05; 95% CI: 1.01-1.11) were also associated with the outcome.

CONCLUSION

Family cohesion and attention deficit according to parental reports influenced visits to the dentist among adolescents. In contrast, OHL was not associated with the outcome.

Oral health literacy, sociodemographic, family, and clinical predictors of dental visits among Brazilian early adolescents

BACKGROUND

The prevalence of dental caries is high in adolescents worldwide, and a large percentage have never been to a dentist or have not had regular dental appointments.

AIM

To evaluate the influence of oral health literacy and sociodemographic, clinical, and family factors on dental visits among early adolescents.

DESIGN

A cross-sectional study was conducted with 740 12-year-old students in Campina Grande, Brazil. Students answered about their level of oral health literacy (BREALD-30), levels of family adaptability and cohesion (FACES III), and visits to the dentist sometime in life. Dental caries experience was evaluated using Nyvad criteria. Robust Poisson regression for complex samples was performed.

RESULTS

A higher level of oral health literacy (PR = 1.01; 95% CI: 1.01-1.03), high social class (PR = 1.28; 95% CI: 1.09-1.50), higher mother's schooling (PR = 1.58; 95% CI: 1.37-1.83), family cohesion classified as enmeshed (PR = 1.55; 95% CI: 1.19-2.02) and connected (PR = 1.22; 95% CI: 1.02-1.44), and the absence of toothache (PR = 1.18; 95% CI: 1.01-1.38) remained associated with having visited a dentist.

CONCLUSIONS

Oral health literacy and sociodemographic, family, and clinical factors were predictors of having visited a dentist among early adolescents.

Qualidade de vida, coesão e adaptabilidade em famílias beneficiárias do Programa Bolsa Família

Resumo Avaliou-se a associação entre qualidade de vida, coesão familiar e fatores sociodemográficos de famílias beneficiárias do Programa Bolsa Família (PBF). Estudo transversal, analítico e de caráter exploratório com amostra representativa de 385 entrevistados. A variável dependente foi a qualidade de vida (WHOQOL-BREF), e as variáveis independentes quantificadas em características sociodemográficas, autopercepção sobre saúde, coesão e adaptabilidade familiar (FACES III). A melhor qualidade de vida associou-se com idade menor ou igual a 36 anos (OR = 2,15), maior nível educacional (OR = 1,54), boa/muito boa saúde (OR = 6,39), não ter problema de saúde atual (OR = 5,68), sem tratamento (OR = 1,76), moderada (OR = 3,39) e alta (OR = 3,66) coesão familiar e moderada adaptabilidade (OR = 2,23). Indivíduos provenientes de famílias com moderada e alta coesão familiar tiveram mais chance de ter uma melhor qualidade de vida do que aqueles vindos de famílias com baixa coesão. Os voluntários do sexo masculino tiveram 3,54 vezes mais chance de apresentar uma melhor qualidade de vida. Concluiu-se que níveis moderados e altos de coesão podem impactar positivamente uma melhor qualidade de vida das pessoas beneficiárias do PBF, indicando que as ações sociais devem buscar o fortalecimento dessa dinâmica.