Rural Mexican immigrant parents' interpretation of children's dental symptoms and decisions to seek treatment
Rural Mexican immigrant parents' interpretation of children's dental symptoms and decisions to seek treatment
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DOI：
10.1922/cdh_2320horton06
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发表时间：
2009-12-01
影响因子：
1.7
通讯作者：
Barker, J. C.
中科院分区：
文献类型：
--
作者：
Horton, S.;Barker, J. C.
目的：与所有其他种族/民族的儿童相比，墨西哥裔儿童的龋齿患病率更高，牙齿利用率更低。不同的文化群体对牙科症状的解释说明了他们关于寻求治疗的不同决策过程。通过美国一个小城市的民族志研究，我们调查了低收入的墨西哥移民照顾者对他们孩子牙齿症状的解释和对治疗需求的评估。基础研究设计：我们对26名墨西哥移民照顾者进行了49次深入访谈，了解他们对孩子牙齿症状的看法，并观察此类照顾者寻求帮助的过程以及其他30名照顾者在牙科诊所呈现孩子症状的情况。所有访谈和实地笔记都通过一系列阅读和编码进行了定性分析。结果：建立了照顾者决策过程的概念模型。大多数照顾者从看得见的外表推断牙齿的健康状况，因此，仅靠儿童对疼痛的抱怨往往不能有效地引发牙科就诊。照顾者经常推迟治疗，因为他们认为孩子的口腔疾病只是需要清洁的“污渍”，而不是需要恢复性治疗的细菌感染。父母似乎混淆了龋齿“污渍”和墨西哥农村常见的氟中毒污渍。结论：即使当墨西哥移民照顾者认识到牙齿问题时，他们也经常将其误解为“污渍”。照顾者对腐烂的解释是由于他们缺乏对墨西哥农村儿童腐烂的经验。口腔健康教育计划应该帮助农村移民照顾者区分“污渍”和“龋齿”，并了解工业化国家对致龋性饮食的更高口腔卫生要求。
Objective: Mexican-origin children have higher rates of decay and lower dental utilization rates than children from all other racial/ethnic groups. Different cultural groups interpretations of dental symptoms illuminate their different decision-making process about seeking care. Through ethnography in a small rural U.S. city, we examined low-income Mexican immigrant caregivers' interpretations of their children's dental symptoms and evaluations of the need for treatment. Basic Research Design: We conducted 49 in-depth interviews with 26 Mexican immigrant caregivers about their perceptions of their children's dental symptoms, and observations of live such caregivers' help-seeking episodes and 30 other caregivers' presentation of their children's symptoms at dental clinics. All interviews and fieldnotes were analyzed qualitatively through a series of readings and codings. Results: A conceptual model of caregivers' decision-making processes was developed. Most caregivers deduced the health of teeth from visible appearance, and thus children's complaints of pain alone were often ineffective in triggering a dental visit. Caregivers often delayed treatment because they viewed their children's oral disease as mere "stains" requiring cleaning rather than as bacterial infections requiring restorative treatment. Parents appeared to confuse carious "stains" with fluorosis stains common in rural Mexico. Conclusions: Even when Mexican immigrant caregivers recognize a dental problem, they often misinterpret it as a "stain." Caregivers' interpretations of decay were shaped by their lack of experience with children's decay in rural Mexico. Oral health education programs should help rural immigrant caregivers distinguish between "stains" and "cavities," and understand the heightened oral hygiene requirements of the cariogenic diet in industrialized countries.