Desenvolvimento e implementação de uma escala de autoeficácia em saúde oral para usuários de overdenture mandibular

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Universidade Federal de Goiás


Introduction: Self-efficacy, a concept coined by Albert Bandura, refers to an individual's belief in their ability to perform behaviors necessary to achieve specific performance goals. In the context of oral health, self-efficacy plays a pivotal role in influencing behaviors related to oral hygiene practices. Objective: This study aimed to develop an oral health self-efficacy scale and evaluate the relationship between oral health self-efficacy and the peri-implant health status of individuals using implant-retained overdentures. Materials and Methods: This was a cross-sectional observational study nested within a clinical trial at the Prosthesis and Implant Research Center (NPPI) at the Federal University of Goiás (UFG), Goiânia, Brazil. The project received approval from the Ethics Committee for Research at the Federal University of Goiás. A 25-item questionnaire was developed based on the Dental Self-Efficacy Scale (DSE), revised by a panel of experts, translated into Brazilian Portuguese, and piloted for clarity. The 25-item OHSE-OVER questionnaire collected data across four dimensions: (1) routine challenges – 4 items; (2) self-rated performance – 5 items; (3) attitudes towards oral health – 6 items; (4) challenges in special occasions – 10 items. The questionnaire score was calculated by first reversing the scale of dimensions 1 and 4 and then summing the scores of all dimensions. The final score repre-sented oral health self-efficacy (higher scores indicating greater oral health self-efficacy). The study included patients with mandibular overdentures retained by implants as part of a larger study involving mini-implants. Randomization was based on a surgical approach and loading protocol. All clinical procedures took place at NPPI/UFG, with no cost to the participants. Twelve-month follow-up assessments included pillar plaque evaluations, peri-implant bleeding, and denture surface plaque. A single clinician conducted clinical assessments for all patients and administered the Oral Health Self-Efficacy Evaluation for Overdenture Users (OHSE-OVER) questionnaire in an interview format during evaluation. Clinical data were compared with OHSE-OVER questionnaire responses. Statistical analyses, including Confirmatory Factor Analysis and regression, were conducted using IBM-SPSS 22.0 and Mplus 8.8 software, with a significance level of p < 0.05. Results: Out of the initially invited 74 patients, 69 participated in the study. Among them, the majority were female (63.8%), aged between 36 and 81 years (mean = 65.0; SD = 8.1), with nearly half being current or ex-smokers (47.8%), and most were taking regular medication (82.6%). Self-efficacy scores varied across different dimensions, with an overall mean score of 2.35. The scale demonstrated good reliability (Cronbach's alpha = 0.799). Con-firmatory factor analysis supported the four-factor model, with the removal of two items due to their low factor loadings. Regression analysis revealed that higher self-efficacy was linked to better denture hygiene outcomes in the overall scale, a positive association between oral health self-efficacy and sex(male), as well as an inverse relationship between oral health self-efficacy and plaque index in dimensions 1 and 2, respectively. No significant associations were observed in dimensions 3 and 4. Conclusion: The research underscores the fundamental role of self-efficacy in determining oral health outcomes in individuals using implant-retained overdentures. It establishes a significant association between oral health self-efficacy and key oral hygiene indicators, such as plaque index and denture hygiene, in patients relying on implant-retained overdentures. Additionally, the validation of the OHSE-OVER's psychometric robustness and internal structure reinforces its efficacy as a valuable instrument specifically developed to assess and address oral health self-efficacy in patients with mandibular overdentures, both in clinical and research contexts.



MOORE, S. Desenvolvimento e implementação de uma escala de autoeficácia em saúde oral para usuários de overdenture mandibular. 2023. 66 f. Dissertação (Mestrado em Odontologia) - Faculdade de Odontologia, Universidade Federal de Goiás, Goiânia, 2023.