Oral health-related quality of life (OHRQOL) refers to the impact of oral disorders on aspects of everyday life that are important to patients and persons, with those impacts being of sufficient magnitude, whether in terms of severity, frequency or duration, to affect an individual's perception of their life overall. OHRQOL has become an important focus for assessing the impact of oral conditions on every day life, sometimes as an outcome of clinical care (e.g. Allen et al 2001; Locker 2004; Marshman and Robinson 2007). To date, several studies have explored children's OHRQOL using such child-centred measures. These studies show that oral health can impact on children's functioning and well-being. However, none of these studies have incorporated a broad range of clinical and other non-clinical variables factors that may influence children's OHRQOL or attempted to explicitly test the relationships between them within a theoretical model. Such research hopefully would highlight important issues to further our understanding of the antecedents and consequents of children OHRQOL in order to facilitate effective intervention strategies. Thus, this research alms to assess relationships between clinical and non-clinical variables in relation to children's OHRQOL. The theoretical model chosen to guide the research is that by Wilson and Cleary (1995), which classifies the variables at five main levels; clinical status, symptom status, functioning, general health perceptions and overall quality of life. The model has been used in adults in relation to several health chronic conditions, including oral health (Baker et al 2007; Baker et al 2008) but is relatively untested in children's oral health and oral health related quality of life. 12 This thesis is structured as follows: Chapter One captures the overview of the research. Chapter Two is a narrative reVIew of the literature. It considers health as conceptualized within different approaches; the biomedical, psychosocial model and bio-psychosocial models, to develop an understanding on OHRQOL. The review also introduces two models feasible for use in the study; Locker (1988) and Wilson and Cleary (1995). The Wilson and Cleary model is then used to structure a brief discussion on individual factors, sense of coherence, self esteem, oral health beliefs and health locus of control that may play a role in OHRQOL. Included also are environmental factors such as parental income, education level and work status. Chapter Three summarises the rationale, aim and objectives of the study. It argues that clinical and non clinical variables impact on children's QOL. Individual factors and environment issues may be important factors that need to be considered in understanding children's oral health. Furthermore, no study so far has systematically considered these factors guided by a theoretical framework. The study therefore aimed to identify the determinants and consequences of oral health related quality of life in children. The objectives are as follows; • To test the relationships between clinical variables, symptom status, functioning, general health perceptions and overall well-being as hypothesised within Wilson and Cleary's model of patient outcomes. • To examine whether socio-demographic and individual difference factors influence children's OHRQOL and the key relationships identified within the Wilson and Cleary model. • To explore different configurations of SOC, COHRQOL and the model Chapter Four describes the translation procedures conducted to achieve high quality translated measures that are suitable for children. Chapter Five details the material and methods including a brief description on the data analysis strategy, missing data management and data analysis management. 13 Chapter Six presents the research findings. The sample had good clinical status. Broadly speaking in lagged analyses the linear relationships of the model were not strongly supported, whereas individual factors, notably sense of coherence, were consistently linked to symptoms, functional limitation and overall quality of life. Chapter Seven brings together the discussion highlighted from the findings. Chapter Eight highlights the major conclusions and summarises the recommendations arising from the research. Chapter Nine lists the references. Appendices section contains copies of key research documents.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:522344 |
| Date | January 2010 |
| Creators | Mat, Amdah |
| Publisher | University of Sheffield |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://etheses.whiterose.ac.uk/14535/ |
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