O papel dos fatores psicossociais e o impacto da cárie dentária na qualidade de vida relacionada a saúde de crianças de doze anos de idade

Abstract

The objective of this study was to evaluate the role of psychosocial and socioeconomic factors in the impact of dental caries on symptoms and functions related to oral health and health-related quality of life in 12-year-old children, based on the theoretical model of Wilson and Cleary. A longitudinal study involving 376 children, randomly selected, was carried out in public schools in the eastern zone of the city of Manaus, AM, Brazil. Parents / guardians answered a questionnaire about socioeconomic status (SES) and Sense of Coherence (SOC). The children were interviewed for HRQoL (Kiddo-KINDL), OHRQoL (CPQ 11-14), self-esteem and social support, in two times (baseline and after 6 months). Calibrated dentists performed clinical examinations to record the number of decayed and missing teeth. The study was approved by the Research Ethics Committee of the Federal University of Amazonas (CAAE 57273316.1.0000.5020). The Wilson & Cleary model, adapted, was used to estimate direct and indirect effects among variables through structural equation modeling. "Social support" (β = -0,227) and SOC (β = -0.104) were direct predictors for the dimension "Symptoms - CPQ11-14" (p <0.05). "Social support" (β = 0.498), SOC (β = 0.100) and the "Symptom 6 months" (β = - 0,146) and "6 month function" (β = -0.209) dimensions of CPQ11-14 were directly associated with HRQoL. SES was indirectly related to the dimensions "Symptom" (β = -0,053) and "Symptom 6 months" (β = -0,029) of the OHRQoL questionnaire via SOC (β = -0,053) as well as the dimension "Function 6 months" = -0.024) via social support. Clinical measures (number of decayed teeth, number of missing teeth) as well as self-esteem showed no significant effect on the Symptom and Function domains of OHRQoL and HRQoL. However, social support and a sense of coherence were important predictors of HRQoL over the 6-month period through direct and indirect mechanisms, suggesting different areas of intervention for public policies directed at the oral health of children.