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Condi??es de sa?de bucal de idosos institucionalizados: um estudo de coorte prospectiva

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Previous issue date: 2017-10-30 / O objetivo desta pesquisa foi avaliar a sa?de bucal de idosos institucionalizados ao longo do tempo e os fatores associados. Para tanto, foi realizado um estudo de coorte prospectiva em 11 Institui??es de Longa Perman?ncia para Idosos (ILPIs) do munic?pio de Natal/RN, nos anos de 2013 e 2017, resultando numa amostra final de 124 idosos. A coleta de dados incluiu exame epidemiol?gico bucal dos idosos, aplica??o de um question?rio aos mesmos, al?m de consulta aos prontu?rios e entrevista aos dirigentes institucionais. Foi realizada an?lise descritiva para caracteriza??o da amostra segundo as dimens?es investigadas, usando o teste do qui-quadrado de McNemar ou o teste t emparelhado, seguida de an?lise da trajet?ria da situa??o de sa?de bucal. Ap?s isso, foi verificada a influ?ncia das vari?veis sociodemogr?ficas, institucionais, de condi??es de sa?de geral e de uso dos servi?os odontol?gicos sobre a diferen?a de situa??o das condi??es bucais ao longo do tempo, agrupadas em dimens?es e rotuladas como situa??o inadequada (piora e estabilidade desfavor?vel) e adequada (estabilidade favor?vel e melhora). A an?lise bivariada teve n?vel de signific?ncia de 5%, usou os testes do qui-quadrado ou exato de Fisher, aferindo a magnitude do efeito atrav?s das medidas de risco relativo (RR) com intervalo de confian?a 95%. Como resultados, em 2013, a m?dia de idade dos idosos foi de 79,1 anos (? 8,44), com tempo m?dio de institucionaliza??o de 4,9 anos (? 5,37), sendo a maioria do sexo feminino, ra?a/cor branca, residentes em ILPI sem fins lucrativos. Entre as duas ondas de observa??o, aumentou significativamente a ocorr?ncia de idosos com c?rie radicular (13,56% para 35,59%, p<0,001) e diminu?ram a ocorr?ncia de DTM (de 32,1% para 15,1%, p<0,05) e o n?mero de sextantes v?lidos para avalia??o periodontal (de 0,99 para 0,86, p<0,05) e de sextantes centrais superior e inferior presentes (44,63% para 37,60%, p<0,001). As trajet?rias de hipossaliva??o/xerostomia e das dimens?es periodontal e de reabilita??o revelaram predom?nio da situa??o de sa?de bucal inadequada, com exce??o da DTM, em que predominou a situa??o adequada. A an?lise bivariada demonstrou que, ao longo da coorte, as vari?veis de sa?de bucal n?o sofreram influ?ncias estat?sticas significativas das condi??es sociodemogr?ficas, institucionais, de sa?de geral e de uso dos servi?os odontol?gicos. Pode-se concluir que, apesar de haver diferen?as consider?veis nas condi??es de vida dos idosos institucionalizados, as condi??es de sa?de bucal foram inadequadas, est?veis ao longo do tempo e n?o sofreram influ?ncia significativa das vari?veis avaliadas. / The purpose of this study was to evaluate the oral health status of institutionalized elderly over time and the associated factors. A prospective cohort study was carried out in 11 long-term institutions for the aged (LTIA) in the city of Natal (Brazilian Northeast), in the years of 2013 and 2017, resulting in a final sample of 124 elderly people. The data collection included elderly?s oral epidemiological examination, application of a questionnaire to them, medical records assessment and institutional directors interviews. Descriptive analysis was performed to characterize the sample according to the dimensions investigated, using the McNemar chi-square test or the paired t-test, followed by analysis of the oral health status trajectory over time. After this, it was evaluated the influence over time of sociodemographic, institutional, general health and dental services use on the difference in oral conditions - grouped in dimensions and labeled as inadequate situation (worsening and unfavorable stability) and adequate (favorable stability and improvement). The bivariate analysis had significance level of 5%, using chi-square or Fisher's exact tests to assess the magnitude of the effect through measures of relative risk (RR) with 95% confidence interval. As results, in 2013, the mean age of the elderly was 79.1 years (? 8.44), with an average institutionalization time of 4.9 years (? 5.37), the majority being female, race/color white, residents of non-profit institutions. Between the two observation waves, there was stability in most of the parameters evaluated, but root caries of elders was increased (from 13.56% to 35.59%, p <0.001) and decreased the occurrence of temporomandibular dysfunction - TMD (from 32.1% to 15.1%, p <0.05), number of valid sextants for periodontal evaluation (from 0,99 to 0,86, p <0.05) and present central sextants (from 44,63% to 37,60%, p <0.001). The hyposalivation / xerostomia and periodontal and rehabilitation dimensions trajectories revealed inadequate oral health situation predominance, with the exception of TMD, for wich prevailed adequate situation. The bivariate analysis showed that, throughout the cohort, the oral health variables did not suffer significant statistical influences of the sociodemographic, institutional, general health and use of dental services. It can be concluded that, although there were considerable differences in the institutionalized elderlys living conditions, oral health conditions were inadequate, stable over time and not significantly influenced by the evaluated variables.

Identiferoai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/24956
Date30 October 2017
CreatorsAguiar, Maria Cec?lia Azevedo de
Contributors50337157472, Teixeira, Ana Karine Macedo, 65419456320, Oliveira, ?ngelo Giuseppe Roncalli da Costa, 42313384420, Lucena, Eudes Euler de Souza, 01360681469, Noro, Luiz Roberto Augusto, 02255508818, Lima, Kenio Costa de
PublisherPROGRAMA DE P?S-GRADUA??O EM SA?DE COLETIVA, UFRN, Brasil
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis
Sourcereponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN
Rightsinfo:eu-repo/semantics/openAccess

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