Socio-medical approach to the design of the model for monitoring the patients with dentures

Abstract

extensive, monitoring of the patients with dentures in our country has not been established yet, and the data on these patients are insufficient. There are no reliable data on the number of patients who used the services of dental prosthetics in the period of one year, i.e. number of those who had dental prosthetic interventions, information on the number and the type of interventions, as well as on the oral health-related quality of life of these patients. Therefore, it is impossible to consider this problem in social and medical aspects. Bearing this in mind, it became necessary to define the model for monitoring the patients with dentures, which would enable the provision of relevant indicators for consideration of these important oral health-related problems, such as planning and programming the measures in this area in terms of public health. Objective: The main objective of this study was to define the model for monitoring the patients with dentures, with special emphasis on oral health-related quality of life. Specific objectives were: 1. To use a pilot study in order to determine the consistency, reliability and stability of GOHAI questionnaire as an instrument for measuring oral healthrelated quality of life in the patients with dentures; 2. To determine the condition of oral health and oral hygiene of respondents, as well as the state of existing dentures and the need for treatment; 3. To determine an index value of their knowledge of oral health; 4. To determine the index value of their oral health-related quality of life (GOHAI and SOHAI) before the intervention and three months after the dental prosthetic intervention; 5. To determine the most appropriate instrument (GOHAI or SOHAI) for assessing the oral health-related quality of life of patients in our environment, from the aspect of patients and dental prosthetics specialists. Methods and instruments: The study was designed as an evaluation, sociomedical, prospective epidemiological study, which was conducted on a group of 179 respondents of both sexes, aged over 40, a variety of occupations before and three months after the dental prosthetic intervention. The study was conducted at the Military Medical Center "Novi Beograd" and Medical Center "Dr Simo Milosevic" in Belgrade, 2008-2009: -During the research a complete dental examination of the patients and the assessment of dental-prosthetic treatment were conducted. -Dental prosthetic interventions were conducted on all the patients i.e. all the patients had new dentures in accordance with the assessed needs...

Uvod: Iako je obim rada u oblasti stomatološke protetike veliki, monitoring pacijenata sa zubnim nadoknadama na nivou naše zemlje nije uspostavljen, a podaci o ovim pacijentima su insuficijentni. Ne postoje validni podaci o broju lica kojima su tokom godine pružene usluge iz oblasti stomatološke protetike, odnosno na kojima su izvršene stomato-protetske intervencije, informacije o broju i vrsti intervencija, kao i o oralno-zdravstvenom kvalitetu života ovih pacijenata. Zato je nemoguće sagledati ovaj problem sa socijalno-medicinskog aspekta. Imajući ovo u vidu, nametnula se potreba definisanja modela monitoringa pacijenata sa zubnim nadoknadama, koji bi omogućio obezbeđivanje relevantnih indikatora za sagledavanje ovog značajnog oralnozdravstvenog problema, kao i planiranje i programiranje mera u ovoj oblasti sa aspekta javnog zdravlja. Cilj: Osnovni cilj ovog istraživanja bio je definisanje modela monitoringa pacijenata sa zubnim nadoknadama, sa posebnim osvrtom na oralno-zdravstvene aspekte kvaliteta života. Posebni ciljevi bili su: 1. Pilot studijom utvrditi konzistentnost, pouzdanost i stabilnost GOHAI upitnika, kao instrumenta za merenje oralno-zdravstvenog kvaliteta života pacijenata sa zubnim nadoknadama; 2. Ustanoviti stanje oralnog zdravlja i oralne higijene ispitanika, kao i stanje postojećih zubnih nadoknada i potrebe za tretmanom; 3. Ustanoviti vrednosti indeksa njihovog znanja o oralnom zdravlju; 4. Ustanoviti vrednosti indeksa njihovog oralno-zdravstvenog kvaliteta života (GOHAI i SOHAI) pre i tri meseca posle stomato-protetske intervencije; 5. Ustanoviti najadekvatniji instrument (GOHAI ili SOHAI) za procenu oralnozdravstvenog kvaliteta života ispitanika u našim uslovima, sa aspekta pacijenata i specijalista stomatološke protetike. Metode i instrumenti: Istraživanje je dizajnirano kao evaluaciona, socijalnomedicinska, prospektivna epidemiološka studija, koja je sprovedena na grupi od 179 ispitanika, oba pola, starosti preko 40 godina, raznih zanimanja, pre i tri meseca posle stomato-protetske intervencije. Istraživanje je sprovedeno u Vojnomedicinskom centru „Novi Beograd“ i u Domu zdravlja „Dr Simo Milošević“ u Beogradu, tokom 2008- 2009. godine: -U toku istraživanja obavljeni su kompletni stomatološki pregledi pacijenata, kao i procena potreba za stomato-protetskim tretmanom. -Izvršene su stomato-protetske intervencije, odnosno svim pacijentima su urađene nove zubne nadoknade u skladu sa procenjenim potrebama. -Svi pacijenti intervjuisani su pre i tri meseca posle stomato-protetskih intervencija...