Validity and reproducibility of the revised oral assessment guide applied by community health workers
Validity and reproducibility of the revised oral assessment guide applied by community health workers
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DOI：
10.1111/ger.12014
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发表时间：
2014-06-01
期刊：
影响因子：
2
通讯作者：
Ferreira e Ferreira, Efigenia
中科院分区：
文献类型：
--
作者：
Ribeiro, Marco Tulio F.;Ferreira, Raquel C.;Ferreira e Ferreira, Efigenia
目的确定修订后的口腔评估指南（ROAG）作为家庭健康战略（FHS）社区卫生工作者（CHW）对老年人使用的预诊断工具的有效性和可重复性。材料和方法首先，我们将英文版本调整为葡萄牙语，然后在社区卫生工作者的参与下，在该市老年人登记人数最多的选定地区制定了使用 ROAG 的培训计划。这些老年人被分配到 10 名接受过培训的社区卫生工作者中。为了评估 ROAG 的有效性，社区卫生工作者和牙医（被视为黄金标准）对同一个人进行了独立评估。 ROAG 的可重复性由每个社区卫生工作者对 5-6 名老年人检查两次（间隔 7 天）进行评估。结果灵敏度范围为唾液评估的 0.17 到声音评估的 0.80。具体范围从牙齿/假牙的 0.69 到使用镜子唾液的 0.98，准确度范围从吞咽的 0.92 到粘膜的 0.64。 ROAG 的评估者内部重现性非常适合评估声音、嘴唇和吞咽 (=1.000)。 结论 当受过训练的 CHW 使用时，ROAG 是一种具有高灵敏度和特异性的工具，用于评估声音、吞咽、舌头和牙齿/假牙。此外，它可以有效地检测出嘴唇、唾液、粘膜和牙龈没有变化的患者。几乎所有类别都观察到高再现性。经过培训的社区卫生工作者可以使用此工具来改善老年患者获得牙科服务的机会。
ObjectiveTo determine the validity and reproducibility of the Revised Oral Assessment Guide (ROAG) as pre-diagnostic tool used in elderly citizens by community health workers (CHWs) of the Family Health Strategy (FHS).Material and methodsInitially, we adjusted the English version to Portuguese and then developed a training program for use of ROAG, with the participation of CHWs, in selected districts that had the highest enrolled number of elderly people in the city. The elderly persons were distributed among 10 previously trained CHWs. To assess the validity of the ROAG, a CHW and a dentist (considered as the gold standard) independently evaluated the same individual. The reproducibility of the ROAG was evaluated by each of the CHWs examining 5-6 elderly individuals twice with a 7-day interval.ResultsThe sensitivity ranged from 0.17 for evaluation of saliva to 0.80 for voice. The specific ranged from 0.69 for teeth/dentures to 0.98 for saliva using mirror and the accuracy ranged from 0.92 for swallow to 0.64 for mucosa. The intra-rater reproducibility of the ROAG was perfect for evaluation of voice, lips and swallow (=1.000).ConclusionWhen used by trained CHWs, the ROAG is a tool with high sensitivity and specificity to assess voice, swallowing, tongue and teeth/dentures. Moreover, it can efficiently detect patients showing no alteration in lips, saliva, mucosa and gums. High reproducibility was observed in almost all the categories. Trained CHWs can use this tool to improve the access of elderly patients to dental services.