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Item Fatores psicossociais maternos e a saúde bucal de pré-escolares(Universidade Federal de Goiás, 2019-02-26) Ferreira, Juliana Borges da Silva; Costa, Luciane Ribeiro de Rezende Sucasas da; http://lattes.cnpq.br/9906371509661305; Freire, Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078; Freire, Maria do Carmo Matias; Jordão, Lídia Ribeiro; Oliveira, Ana Cristina Borges deIntroduction: The psychosocial determinants of oral health are more frequently investigated in adults and there are still gaps in knowledge with regard to preschool children. Objective: To investigate whether maternal psychosocial factors (Religiosity and Sense of Coherence) are associated with the oral health of children aged 4 to 6 years. Methodology: Cross-sectional study of 85 children attended in dental clinics of two schools of specialization in Paediatric Dentistry of Goiás, the Central-West region of Brazil, and their mothers. The dependent variables were related to the children’s oral health: behaviour in the dental clinic, dental health condition (caries experience) and oral health behaviours (oral hygiene and consumption of foods containing sugar). The explanatory variables were the maternal Religiosity and Sense of Coherence (SOC). Other independent variables were related to the children (sociodemographic and oral health characteristics), the families (socioeconomic condition, parents living together and care of the child) and the mothers (age, schooling, number of children, perception of the children's teeth and oral health variables). The data were collected through interview and questionnaire with the mothers and the children's clinical records. For the data analysis bivariate tests and Poisson regression were performed. This study protocol was approved by the Research Ethics Committee (CAAE: 81203317.5.0000.5083). Results: Children’s caries prevalence was 83.5%, most of them brushed their teeth from one to two times a day (91.4%) and made daily use of dental floss (63.8%). Regarding the children’s diet, 68.2% of them had low frequency of sweets consumption, 87.1% of soft drinks and 67.1% of artificial juice. Nearly 21% of the children showed negative behaviour during the dental care. Most of the mothers had high levels of SOC (51.8%) and of Religiosity (65.5%). There was association between maternal SOC and the children's behaviour in dental clinic (p= 0.004; PR= 0,26; 95%CI= 0.09-0.64). The prevalence of negative behaviour was nearly 4 times lower in the group of children whose mothers had higher SOC, and nearly 3 times lower among children whose mothers perceived their children’s teeth as good or very good. The other outcome variables were not associated with maternal psychosocial factors. Conclusion: The SOC was independently associated with the children's behaviour in the dental clinic, showing to be a protection factor to this behaviour. The perception of mothers about their children's teeth also showed to be a protective factor for their behaviour. Maternal religiosity was not associated with the outcome variables.Item Determinantes individuais e contextuais das alterações periodontais, má-oclusão e fluorose em escolares de 12 anos do município de Goiânia-GO(Universidade Federal de Goiás, 2013-12-20) Jordão, Lidia Moraes Ribeiro; Freire, Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078; Freire, Maria do Carmo Matias; Costa, Luciane Ribeiro de Rezende Sucasas da; Lemos, Cristiane Lopes SimãoInformation on social inequities in health is valuable when allocating resources for public services and formulating health strategies. Research is needed to deepen the understanding of the determinants that lead to inequities in oral health. This cross-sectional study aimed to analyze the association between individual and contextual factors and the prevalence of adverse periodontal condition, malocclusion and dental fluorosis among Brazilian 12- year-old schoolchildren. This study included data from an oral health survey carried out in 2010 in the city of Goiania, Brazil (n = 2,075) and secondary data obtained from the files of the local health authority. Data were collected through oral clinical examinations. For assessment of periodontal status two components of the Community Periodontal Index (CPI) were used: calculus and bleeding after probing. The Dental Aesthetic Index (DAI) was used to assess occlusion and the Dean Index to assess fluorosis. Dependent variables were presence of any periodontal condition, presence of malocclusion (DAI>25) and presence of fluorosis, analyzed separately. Independent individual variables were the children’s sex and color/race, and their mother’s level of schooling. Contextual variables were related to the schools (type and existence of toothbrushing program) and its geographic location in the health districts. Rao-Scott tests were performed for each of the three outcomes and multilevel analysis was performed for periodontal condition (Poisson regression) and malocclusion (Logistic regression). The results are presented in three original articles. The prevalence of calculus and/or bleeding was 7% and higher (P<0.05) in brown pupils, from public schools, and those located in health districts with intermediate socioeconomic indicators. The prevalence of malocclusion was 40.1%. Significantly higher rates of malocclusion were found among children from public schools, those located in less affluent health districts, and whose mothers had less years of education. The prevalence of fluorosis was 18.7%, predominantly of the very mild degree (11.2%). No significant association was found between fluorosis and the investigated variables. It was concluded that the inequalities in the distribution of adverse periodontal condition and malocclusion were determined by individual as well as contextual factors. Appropriate strategies addressed to the areas of socioeconomic deprivation are needed to reduce the disparities.Item Comportamentos de risco à saúde geral e bucal em adolescentes no Brasil: distribuição temporal, desigualdades socioeconômicas, padrões de agrupamentos e fatores associados(Universidade Federal de Goiás, 2017-01-23) Jordão, Lídia Moraes Ribeiro; Freire, Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078 Nomes dos; Freire, Maria do Carmo Matias; Morais Neto, Otaliba Libânio de; Queiroz, Edna Mendonça Oliveira de; Costa, Nádia do Lago; Barata, Terezinha de Jesus EstevesThis thesis focuses on oral and general health-compromising behaviours among Brazilian adolescents. Such behaviours constitute major causes of morbimortality in the worldwide population, are often initiated during adolescence, and tend to track into adulthood. Oral diseases, like dental caries, periodontal disorders and cancer, share a number of behavioural risk factors that are common to other preventable chronic noncommunicable diseases. Nevertheless, there is no evidence about the overtime distribution, and socioeconomic inequalities, neither about clustering patterns with other health behaviours and associated factors of oral health- compromising behaviours among Brazilian adolescents. The present studied aimed to analyze oral health-compromising behaviours based on the Brazilian National School-based Student Health Surveys (PeNSE) as regards to: a) overtime distribution and social inequalities, and b) clustering patterns with other health behaviours and associated factors. The first approach is presented in one original paper regarding oral health behaviours changes over time in Brazilian adolescents, in relation to maternal educational inequalities. For this, we used data from PeNSE for the years 2009 and 2012, a survey that investigates health risk and protective factors among Brazilian adolescents attending schools. The results showed that: the proportion of adolescents with low toothbrushing frequency increased, and the consumption of sweets and soft drinks, and cigarette experimentation decreased. In private schools, we found higher soft drink consumption and higher cigarette experimentation among students who reported greater maternal education, while in public schools we found higher soft drink consumption among students who reported lower maternal education, and higher cigarette experimentation among students who reported greater maternal education. There were no inequalities for toothbrushing frequency or sweets consumption in both types of school. The second approach is presented in two original papers that described the clustering patterns of oral and general health-compromising behaviours among Brazilian adolescents and identified associated factors. For these analyses, we used data from the Brazilian National School-based Student Health Survey (PeNSE) for the year 2012. The main findings are: a) oral and general health-compromising behaviours were inter-related and clustered into two specific patterns; one cluster gathered a combination of lack of adherence to preventive behaviours and the undertaking of risky conduct, while the second reflected an unhealthy lifestyle; and b) the odds for presenting two or more oral health-compromising behaviours were greater for adolescents without parental involvement in homework, from public schools, males, whose mothers had fewer years of education, and of lower family affluence. It was concluded that the oral health-compromising behaviours underwent changes in their distribution over time; however they were not related to maternal education inequalities, have clustered with other health behaviours and were associated with sociodemographic and family factors among Brazilian adolescents. Interventions aiming at reducing health-compromising behaviours among adolescents should prioritize groups that have been identified as being at most risk and preferably employ a common risk factor approach.Item Ambiente escolar promotor de saúde, qualidade educacional e saúde bucal de adolescentes das capitais brasileiras: estudo com base na Pesquisa Nacional de Saúde do Escolar (PeNSE 2015)(Universidade Federal de Goiás, 2020-02-20) Nery, Newillames Gonçalves; Jordão, Lidia Moraes Ribeiro; http://lattes.cnpq.br/8872679253627903; Freire, Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078; Freire, Maria do Carmo Matias; Costa, Luciane Ribeiro de Rezende Sucasas da; Novais, Tatiana Oliveira; Weiss, Veruska Prado Alexandre; Faria, Patrícia Corrêa deEvidence about the influence of contextual factors of schools and municipalities on the oral health of adolescents is scarce, with important gaps in relation to the school environment. The aim of this study was to investigate associations between the potential support of schools for oral health promotion, the educational quality of the school and oral health outcomes among adolescents in the Brazilian State Capitals. The study was cross-sectional, with individual and aggregated approaches. Data were obtained from the Brazilian National Adolescent School-Based Health Survey (PeNSE) and the Basic Education Development Index (IDEB), conducted in 2015, in addition to other secondary sources. The individual variables referred to students in the 9th grade of elementary schools: sociodemographic, prevalence of dental pain and oral health-related behaviours (frequencies of dental visits, toothbrushing, and soft drinks and sweets consumption, cigarette and alcoholic beverages experimentation). The contextual variables were related to schools, Brazilian capitals and regions (educational quality of the school – measured by IDEB, Human Development Index - HDI and Gini Index). The analyses were carried out in three steps. In step 1, the Oral Health Promoting School Environment (OHPSE) indicator was obtained using the Categorical Principal Components Analysis (CATPCA), to measure the potential support of school environment for oral health promotion in public and private schools of the capitals. Bivariate associations (Chi-square test) between OHPSE and contextual variables were verified. In step 2, associations between OHPSE (explanatory variable) and dental pain and oral health-related behaviours (outcome variables) were tested in two-level multi-level mixed-effects Poisson regression. And in step 3, with data aggregated by capitals, associations were verified between IDEB and the outcomes: the OHPSE indicator and its dimensions (in public schools), dental pain and oral health-related risk behaviours. In all steps, the level of significance was 5%. The results were: Step 1 - There was a higher frequency of schools with higher OHPSE in the public schools (58.1%), and in regions and capitals with a lower Gini Index (52.8% / 55.7%) and higher HDI (57.4% / 61.0%), respectively. Step 2 - In the adjusted model, private and public schools with higher OHPSE had 6%, 6% and 4% lower prevalence rates of a “low frequency of annual dental visits” [PR = 0.94 (95%CI 0.90; 0.99)], “high weekly soft drinks consumption” [PR = 0.94 (95%CI 0.89; 0.99)] and “high weekly sweets consumption” [PR = 0.96 (95%CI 0.93; 1.00)], respectively. Schools with intermediate OHPSE had 12% and 8% higher prevalence ratios of a “low daily toothbrushing frequency” [PR = 1.12 (95%CI 1.03; 1.23)] and “cigarette experimentation” [PR = 1.08 (95%CI 1.01; 1.16)]. OHPSE was not associated with dental pain and "alcoholic beverages experimentation". Step 3: IDEB correlated with the OHPSE dimension referred to within-school aspects, with “low daily toothbrushing frequency” and with “low frequency of annual dental visits”. In the adjusted regression model, capitals with the higher IDEB were associated with “low daily toothbrushing frequency” [B = 1.560 (95% CI 0.360; 2.760), p = 0.013; β = 0.519]. It was concluded that were associations between the potential support of school environment for oral health promotion and some oral health outcomes of adolescents in the Brazilian capitals. Higher potentials for oral health promotion (in private and public schools) were related to more favorable behaviours regarding dental visits and consumption of food with added sugars, and less favorable for toothbrushing frequency and cigarette experimentation, while better educational quality (in public schools) was related to low toothbrushing frequency among adolescents. Inequalities among schools regarding oral health promotion were also found, indicating the need to reorient public policies for the oral health of schoolchildren.Item Associação entre bem-estar psicossocial, religiosidade e espiritualidade em pacientes com sequelas aparentes de cirurgia oncológica na região de cabeça e pescoço(Universidade Federal de Goiás, 2016-12-20) Reis, Liliane Braga Monteiro dos; Leles, Cláudio Rodrigues; http://lattes.cnpq.br/6740286066154410; Freire, Maria do Carmo Matias; http://lattes.cnpq.br/6740286066154410; Freire, Maria do Carmo Matias; Rotta, Rejane Faria Ribeiro; Costa, Nádia do Lago; Silveira, Nusa de Almeida; Nunes, Maria de FátimaTreatment of cancer located in the head and neck region includes different therapeutic interventions according to the staging of the tumor, and the surgical approach may culminate in considerable sequelae and biopsychosocial changes in individuals. The objective of this study was to investigate the association between psychosocial well-being and religiosity / spirituality in patients with apparent sequelae of oncologic surgery in the head and neck region. A crosssectional study was conducted in 202 adults at a referral center for cancer treatment in the Midwest Brazil. Sociodemographic, health and health related behavious and psychosocial data were collected through interviews, clinical exams and search of medical records. The variables related to psychosocial well-being were: quality of life (QOL), using the Functional Assessment of Cancer Therapy Head and Neck (FACT-HN) and the University of Washington Quality of Life Questionnaire for patients with head and neck cancer (UW-QOL); and self-perception of appearance, assessed by the Derriford Appearance Scale 24 (DAS24). The explanatory independent variables were: religiosity, evaluated through the Duke University's Index of Religiosity (DUREL) and spirituality, with the Functional Assessment of Chronic Illness TherapySpiritual Well-Being Scale (FACIT-Sp12). Data were analyzed using the Chi-square test and Poisson regression with robust variance. The mean QOL score (FACT-HN) was 97.9 (SD=20.1) and the QOL (UW-QOL) was 744.6 (SD=228.0). The mean total self-perception score was 36.0 (SD=11.7). Religiousness had a mean score of 21.6 (SD=5.0) and spirituality 35.5 (SD=7.5). In the bivariate analyzes, the variables religiousness and spirituality were individually associated with the QOL evaluated by the FACT-HN instrument, while only religiosity was associated with the QV evaluated by the UW-QOL and only spirituality was associated with self-perception of appearance. In the final model of Poisson regression, after adjusting for clinical, sociodemographic characteristics and health behaviors, the variables associated with high QOL (FACT-HN) were: high religiosity and spirituality, male sex and surgery time equal to or greater than two years. Those associated with high QV (UW-QOL) were: high religiosity, cancer sites except oral cavity and oropharynx, types of cancer except squamous cell and basal cell, site of sequelae except the lower / cervical thirds and only surgery as treatment. The variables associated with the best self-perception of appearance were high spirituality, stage T of the lesion (T1+T2), cancer site except oropharynx and only surgery as treatment. It was concluded that there is an association between QOL, religiosity and spirituality and between self-perception of appearance and spirituality, regardless of sociodemographic variables, clinical conditions and health behaviors.Item Fatores psicossociais e a percepção familiar sobre a saúde dental de crianças pré-escolares(Universidade Federal de Goiás, 2020-02-13) Rigo, Danielle Cristina Alves; Freire, Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078; Freire, Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078; Abreu, Mauro Henrique Nogueira Guimarães de; Sacono, Nancy TomokoIntroduction: Maternal perception of children's dental health has been investigated, however, knowledge about children in pre-school age is still scarce and the influence of maternal psychosocial factors is not known. Objective: To analyze the maternal perception about the dental health of his/her child at preschool age and associated factors. Methodology: Cross- sectional study. The sample consisted of 146 mother-child dyads from 4 to 6 years old, attending dental clinics of two specialization courses in Pediatric Dentistry in Goiânia, Goiás, in 2018 and 2019. Data collection instruments were an structured interview form and a questionnaire with dental and psychosocial scales for mothers, as well as a form to register data from the children's clinical records. Maternal perception about the child's dental health was the outcome variable, categorized as positive (very good and good) and negative (neither good nor bad, bad and very bad). The independent variables were related to mothers (sociodemographic, oral health-related and psychosocial) and children (sociodemographic and oral health-related). Data analysis consisted of descriptive statistics, bivariate tests and Poisson Regression. Results: Most mothers had a negative perception of their child's dental health (54.8%). In the bivariate analysis, the perception was associated with the child's caries experience (ceo-d index) and the report of dental pain at some time in life (p <0.05). In the non-adjusted regression these variables were included as well as the other independent variables associated to the outcome with p values <0,25. In the adjusted regression model, Organizational Religiosity (RO) and the child's caries experience were associated with the outcome, regardless of the other variables (p <0.05). The proportion of mothers with negative perception of their children's dental health was 1.45 higher in the group with low OR (PR = 1.45; 95% CI 1.10-1.91) and 2.31 higher in the group of children with high caries experience (PR = 2.31; 95% CI 1.50-3.54). The other variables were not associated with the outcome. Conclusions: The maternal perception about the dental health of the preschool child was predominantly negative and associated with the mother's religiosity and the child's caries experience.Item Motivação de adolescentes para começar e parar de fumar e fatores associados: estudos embasados em teorias de mudança de comportamento(Universidade Federal de Goiás, 2020-12-22) Rios, Leonardo Essado; Freire, Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078; Freire, Maria do Carmo Matias; Faria, Patrícia Corrêa de; Oliveira, Ana Cristina Borges de; Oliveira, Ana Maria de; Pinheiro, Helder Henrique CostaIntroduction: Smoking is a chronic disease caused by nicotine dependence, and a risk factor for several general and oral health problems. Multiple factors have been linked to smoking during adolescence, including psychosocial indicators. At the same time, the Behaviour Change Science has advanced in identifying the three essential elements of the mental motivational system that prompts smoking initiation and cessation: beliefs, desires, and intentions. However, the relationships between these factors need to be better understood in the adolescent population. Objective: To investigate the motivation of adolescent students to start and stop smoking based on Behaviour Change Theories and associated factors. Methods: A systematic review of the literature with meta-analysis, and three cross-sectional analytical studies were carried out. Adolescents aged 12 to 19 years were the target population. In the review, a systematic search for eligible studies was conducted on scientific bases by previously calibrated reviewers, who selected and evaluated studies about the intention of adolescents to quit smoking based on the Transtheoretical Model of Stages of Change. In the cross-sectional studies, the data were collected in federal schools of a Brazilian Midwest state. A self-administered questionnaire was used, containing: a) questions based on the Prime Theory of Motivation that measured desires, beliefs and intentions related to smoking initiation and cessation, b) psychosocial variables through validated scales of Sense of Coherence (SOC) and Duke University Religion Index (DUREL), and c) questions about adolescents' belief regarding the benefit of smoking cessation interventions in medical and dental services. Poisson or Logistics regressions were used in the statistical analysis. Results: Among the participants in the systematic review (n=6469), 41% of smokers had no intention of quitting smoking, which was associated with more unfavourable characteristics in relation to smoking, such as lower decisional balance and self-efficacy (p<0.05). In the cross-sectional analyses (n=3034), most smokers (57%) did not want to, nor intended to quit smoking, and approximately 6% of the non-smokers had the highest level of motivation to start (simultaneous presence of desire, belief, and intention). Among the non-smokers, an inverse association was observed between the motivation to start smoking and the SOC, so that for each increase of one unit in the SOC score, the probabilities of desire to smoke, belief in the benefit of the habit, and intention to smoke in the future decreased by three, three and five times, respectively. Similarly, for each unit increased in scores for Organizational, Non-Organizational, and Intrinsic Religiosity, the likelihood of motivation to start smoking decreased by 23, 23 and 15 times, respectively. Among the smokers, an increase in the Intrinsic Religiosity score increased the motivation to quit by 1.13 times. Compared to those unmotivated to quit smoking, the motivated ones had a greater belief in the benefit of interventions for smoking cessation in health services (p <0.05). Conclusion: The proportion of adolescents motivated to start or stop smoking was low and associated with psychosocial factors, which could be considered as potential influences of anti-smoking interventions for this population.