Senso de coerência materno: relação com saúde bucal de pré-escolares

Abstract

Salutogenic theory proposes that health is the result of adaptative competence for stress by human being, called Sense of Coherence (SOC). Its measuring can be done through tested and validated questionnaires. One of these questionnaires (SOC-13) was validated to Portuguese language in a previous study, but it required a new adaptation to be applied in the subjects of this research. Because of this, the first objective of the present study was to perform the transcultural adaptation and the psychometric tests necessary to prove the applicability of SOC-13 to mothers of preschool children from different social classes, in Belo Horizonte city. The second objective was to analyze the relationship between mothers SOC and the oral health of five-year-old children in a cross-sectional and representative study. The study wasapproved by the UFMG Ethics Committee (ETIC 109/05) and the participating institutions.Informed consent was obtained from each mother selected. For the first six stages of the SOC- 13 adequacy, samples were selected for convenience. Transcultural adaptation consisted of rewording items, changes in questions order, the usage of five rather than seven alternatives, the insertion of middle anchoring phrases and scores inversion. Test-retest reliability for the modified scale was accessed through the weightened Kappa and presented medium values of49.5%. Internal consistency improves from 0.67 for the original scale to 0.71 for the adapted one. After this, sample size was calculated and the five-year-old-children were selected by simple random drawing by lot from public and private preschools in Belo Horizonte city. A total of 87.2% of the respondents completed the questionnaires. Final sample consisted of 546 mothers and their children. Internal consistency for this last stage ranged 0.80. The Spearman correlation showed that questions all together were correlated with total SOC scores. The Social Vulnerability Index (SVI) was used for the sample social classification. Childrens dmf-t index were accessed by two calibrated examiners (Kappa between 0.81 and 1.0). Besides this index, the presence of dental pulp exposure due to caries, root fragment, visible plaque, gingivitis and calculus were notified. The SPSS program and Excel for Windows XPwere used in data analysis. Simple and multiple logistic regression were carried out and significance level adopted was 0.05. Multiple logistic regression revealed that mothers with a lower SOC had a 1.59 greater chance of their children exhibiting dental caries; a 1.99 times greater chance of their children exhibiting dental pulp exposure due to caries; and a 1.85 times greater likelihood of their children having filled teeth, independently child gender or their social class. This study supports that the SOC scale presents adequate psychometric propertiesand that the oral heath of five-year-old children is associated with their mothers SOC.