Dental care utilization: patterns and predictors in persons living with HIV in British Columbia, Canada
Dental care utilization: patterns and predictors in persons living with HIV in British Columbia, Canada
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DOI：
10.1111/jphd.12304
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发表时间：
2019-03-01
影响因子：
2.3
通讯作者：
Brondani, Mario
中科院分区：
文献类型：
--
作者：
Jessani, Abbas;Aleksejuniene, Jolanta;Brondani, Mario
目的在不列颠哥伦比亚省HIV感染者(PLHIV)样本中，确定Andersen and Newman(A&N)模式的诱因、促成因素和需求因素及其与牙科服务利用模式的关系。方法参与者匿名回答一份包含40个项目的在线问卷，以探索口腔服务利用的模式。在描述性统计之后，使用简单和多元Logistic回归分析来评估A&N模型因素与主要结果变量(最近一年看过牙和看过牙的原因)之间的关系。结果在600名潜在的PLHIV参与者中，有210人回答了调查，186人符合纳入标准。被牙科专业人员歧视(P=0.005)、有牙科焦虑症(P<；0.001)、没有牙科保险(P=0.001)、生活条件困难(P=0.004)与非急诊就诊显著相关。在多因素Logistic回归分析中，牙科焦虑症(OR=0.1；95%CI 0.0；0.4)、定期看牙医(OR=3.7；95%CI 1.1；12.6)和最近一年去牙科诊所(OR=21.6；95%CI 6.1；76.5)是本研究中预测牙科服务利用的最强因素。结论A&N模型中的几个易感因素、使能因素和需求因素与PLHIV对牙科服务的利用有关。除了各种心理社会障碍外，相当多的受访者报告说，他们经历了口腔护理提供者的污名和歧视。
Objectives To identify the predisposing, enabling, and need factors of the Andersen and Newman (A&N) model and their associations with the pattern of dental service utilization in a sample of people living with HIV (PLHIV) in British Columbia. Methods Participants responded anonymously to a 40-item online questionnaire to explore the patterns of dental service utilization. Following the descriptive statistics, the associations between A&N model factors and main outcome variables (having a dental visit in the last year and reasons for the dental visit) were evaluated using simple and multiple logistic regression analyses. Results Out of 600 potential PLHIV participants, 210 responded to the survey and 186 met the inclusion criteria. The experience of being discriminated against by dental professionals (P = 0.005), having dental anxiety (P < 0.001), not having dental insurance (P = 0.001), and having living condition difficulties (P = 0.004) were significantly associated with nonemergency dental visits. In multiple logistic regression analysis, dental anxiety (OR = 0.1; 95 percent CI 0.0; 0.4), having a regular dentist (OR = 3.7; 95 percent CI 1.1; 12.6), and visiting a dental office in the last year (OR = 21.6; 95 percent CI 6.1; 76.5) were the strongest predictors of dental service utilization in this study. Conclusions Several predisposing, enabling, and need factors from the A&N model were associated with dental service utilization by PLHIV. In addition to various psychosocial barriers, a significant number of respondents reported experiencing stigma and discrimination from their oral care providers.