Impacto da condição bucal de crianças/adolescentes com paralisia cerebral sobre a a qualidade de vida familiar: resiliência materna e outros fatores associados

Abstract

The aim of this study was to identify the impact of the oral condition of children/adolescents with cerebral palsy (PC) on family quality of life considering maternal resilience and other associated factors. The observational cross-sectional study with a comparison group was developed with a sample of 204 children/adolescents (102 with CP and 102 without CP), between the ages of 3 and 18 years and their respective mothers. The participants were selected in a private dentistry school in São Paulo, Southeast region of Brazil. The mothers responded to a questionnaire structured with items regarding individual, sociodemographic and behavioral aspects about them and the children. They also responded to the Resilience Scale and an instrument about the impact of the oral condition of children on family quality of life (Family impact scale-FIS). An oral examination was carried out on the children/adolescents, investigating the the prevalence of caries (component D/d of the DMFT/dmft index) and the quality of oral hygiene (Simplified Oral Hygiene Index). The theoretical model Directed Acyclic Graph (DAG) was utilized to identify possible confounding variables. The univariable, bivariable (X2 test) and multivariable (logistic regression) were carried out considering a confidence interval of 95%. The study was approved by the Research Ethics Committee of the Universidade Cruzeiro do Sul. The average age of the children/adolescents was 9,5 years (±4.6) and the median was 9 years old. The chance of mothers of children/adolescents diagnosed with CP belonging to the group classified with high impact of the child's oral health on the family quality of life was almost 40 times higher (OR=38.93; CI 95%: 10.22-148.19). Children and adolescents diagnosed with at least one cavity (OR=4.41; CI 95%: 1.01-19.55) and low family income (OR=4.45; CI 95%: 1.07-18.51) had their mothers with a chance approximately 4 times higher of belonging the the group with high impact of the child's oral health on the family quality of life. Mothers classified with low resilience have a 3.83 times higher chance of being in the group of mothers with high impact of the child's oral health on the family quality of life (OR=3.82; CI 95%: 1.10-13.32). It was possible to conclude from this study that a higher impact of the children's oral health on the family quality of life was identified among mothers classified with low resilience and children diagnosed with CP, dental caries and low family income. Thus, thinking of strategies to take care of patients with CP, it is important for the professional to consider psychosocial factors, including the family nucleus in which these patients live.