Qualidade de vida relacionada à saúde bucal em crianças com anemia falciforme e suas famílias: há uma correlação entre o relato de pais e filhos?

Abstract

The aim of this study was to determine the child-parent-family correlation in assessment of oral-health-related quality of life (OHRQoL) in a pediatric population with sickle cell disease (SCD) and to determine the background characteristics that influence the degree of agreement between parent and child assessments. A cross sectional study was conducted with 106 children aged 8 to 14 years diagnosed with SCD in Minas Gerais, Brazil, and their parents/caregivers. Patients with SCD were recruited from the outpatient Sickle Cell Anemia Clinic at a Hematology Center of Minas Gerais (Hemominas). OHRQoL was measured using the Brazilian version of Child perception Questionnaires for children aged 8-10 (CPQ8-10) and 11-14 years (Brazilian short version of CPQ11-14), the Parental-Caregiver Perceptions Questionnaire (P-CPQ), and the Family Impact Scale (FIS). Calibrated dental examiner performed the oral examinations for dental caries, malocclusion and gingival bleeding according to the criteria of the World Health Organization (WHO). Demographic and medical information were obtained on all children through parental report. Statistical analysis was performed using the Spearman correlation and linear regression. There was a strong correlation between parent-proxy and family assessments of OHRQoL (rs=0.732). There was a moderate correlation between child and parent-proxy assessments (rs=0.433), and a low correlation between childrens reports of OHRQoL and family impacts (rs=0.331). Higher z-score differences between P-CPQ and FIS were associated with younger child age (p<0.01), lower religiosity/ spirituality (p<0.05), more severe malocclusion (p<0.05), and lower family income (p<0.01). Higher z-score differences between parent proxy report and children self report in OHRQoL were associated with malocclusion (p<0.05). The weakest correlation was found between child OHRQoL and family impact scores. In conclusion, this study demonstrated that there was a moderate correlation between the evaluation of children and parents about OHRQoL. In contrast, the correlation between the childs perception about their OHRQoL and the impact on their family reported by parents was poor in family conflicts, and financial burden subscales. Our findings provide further support for the need to assess OHRQoL in children with SCD from multiple sources, and using multiple indicators.