ABSTRACT
OBJECTIVE: To investigate the effectiveness of botulinum toxin in the salivary glands of patients with neurological impairment and drooling and its impact on the quality of life. MATERIALS AND METHODS: This systematic review was registered with the International Prospective Register of Systematic Reviews (CRD 42,023,435,242) and conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. An electronic search was performed in the PubMed/MEDLINE, Embase, Scopus, Cochrane Library, and clinical trial databases until August 2023, no language restriction. Cohort studies and randomized clinical trials of patients diagnosed with drooling and neurological impairment who used botulinum toxin on the salivary gland were included, which evaluated subjective quality of life parameters. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist and Risk of Bias 2 tools. The certainty of the evidence was analyzed using the Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS: Eight studies involving 317 patients were included. All studies, through subjective parameters, suggested the effectiveness of botulinum toxin in reducing drooling, resulting in an improvement in the quality of life. Three studies demonstrated improvements in swallowing and four in cases of respiratory diseases. Two clinical trials had a high risk of bias, whereas one had low risk. The five cohort studies that were evaluated had a high risk of bias. The certainty of the evidence was considered low. CONCLUSIONS: Based on the patient/caregivers' perception of improvement in drooling, dysphagia, and respiratory symptoms, it can be inferred that botulinum toxin application reduces subjective drooling in neurologically compromised patients. Its impact contributes to the general well-being and quality of life. CLINICAL RELEVANCE: Injection of botulinum toxin into the salivary glands can be considered an alternative technique to surgical or medicinal approaches in reducing drooling. It is effective, less invasive and without significant side effects. It promotes a positive impact on the well-being and quality of life of neurological patients.
Subject(s)
Quality of Life , Sialorrhea , Humans , Botulinum Toxins/therapeutic use , Botulinum Toxins, Type A/therapeutic use , Nervous System Diseases/complications , Neuromuscular Agents/therapeutic use , Sialorrhea/drug therapyABSTRACT
O estudo objetivou conhecer a percepção de residentes multiprofissionais de um hospital público sobre a importância dos cuidados odontológicos no cenário hospitalar. Foi realizado um estudo do tipo transversal, observacional, descritivo com amostra por conveniência, composta por 63 residentes do Programa de Residência Multiprofissional Integral de Saúde Hospitalar (RIMUSH) do Hospital Universitário Lauro Wanderley. O instrumento de coleta de dados foi um questionário adaptado contendo sete perguntas. Para análise, os residentes foram divididos em dois grupos, o grupo 1 (G1) possui cirurgião-dentista (CD) na equipe multiprofissional e o grupo 2 (G2) não possui CD na equipe. A maioria dos residentes respondeu que avaliação odontológica nos pacientes hospitalizados é muito importante, que condições sistêmicas, medicações e condição de saúde bucal impactam na recuperação. Porém, os residentes do G1 compreenderam melhor as atribuições do CD na equipe, assim como quando indicar um pedido de consulta odontológica comparados aos do G2. Conclui-se que os residentes das demais áreas da saúde percebem a importância da Odontologia Hospitalar e que a presença do CD nas equipes de residência contribui para a capacitação desses profissionais, para a troca de saberes interprofissionais e para a promoção de assistência integral (AU).
El estudio tuvo como objetivo conocer la percepción de los residentes multidisciplinarios de un hospital público sobre la importancia de la atención odontológica en el ámbito hospitalario. Se realizó un estudio transversal, observacional, descriptivo, con una muestra de conveniencia, conformada por 63 residentes del Programa de Residencia Multiprofesional Integral en Salud Hospitalaria (RIMUSH) del Hospital Universitario Lauro Wanderley. El instrumento de recolección de datos fue un cuestionario adaptado que contenía siete preguntas. Para el análisis, los residentes fueron divididos en dos grupos, el grupo 1 (G1) tiene un cirujano dentista (CD) en el equipo multidisciplinario y el grupo 2 (G2) no tiene un dentista en el equipo. La mayoría de los residentes respondieron que la evaluación dental en pacientes hospitalizados es muy importante, que las condiciones sistémicas, los medicamentos y la condición de salud oral impactan en la recuperación. Sin embargo, los residentes de G1 entendieron mejor las funciones del CD en el equipo, así como cuándo indicar una solicitud de cita dental en comparación con G2. Los residentes de otras áreas de salud se dan cuenta de la importancia de la Odontología Hospitalaria y la presencia de CD en los equipos de residencia contribuye a la formación de estos profesionales, al intercambio de conocimientos interprofesionales y a la promoción de la atención integral (AU).
This study aimed to investigate the perception of multiprofessional residents of a public hospital about the importance of oral care in the hospital setting. A cross-sectional, observational study of descriptive design was conducted with a convenience sample, including 63 residents of the Multiprofessional Integrated Residency Program in Hospital Care (RIMUSH) at the University Hospital Lauro Wanderley. The instrument used for data collection was an adapted questionnaire containing seven questions. For the analysis, residents were divided into two groups: group 1 (G1) included a dental surgeon (DS) in the multiprofessional team, and group 2 (G2) did not include a DS in the team. Most residents answered that dental evaluation of hospitalized patients was very important, and that systemic conditions, medications and oral health had a significant impact on recovery. However, G1 residents had better understanding of the duties of the DS in the team and of timely referral of hospitalized patients for a dental consultation, compared to G2. Residents of other Health Care courses realize the importance of Hospital Dentistry and understand that the presence of DSs in residency teams is acontributing factor to the qualification of these professionals, exchange of interprofessional knowledge and promotion of comprehensive care (AU).
Subject(s)
Humans , Male , Female , Adult , Patient Care Team , Social Perception , Dental Care , Hospitals , Internship and Residency , Oral Health , Cross-Sectional Studies/methods , Surveys and Questionnaires , Data Interpretation, Statistical , Observational StudyABSTRACT
O objetivo do presente estudo foi avaliar a presença do cirurgião-dentista (CD) em Programas de Residência Multiprofissionalhospitalares(PRMH)do Brasil.Trata-se de um estudo de caráter exploratório, descritivo,com abordagem quantitativa. Foi realizada análise documental de editais de PRMHem saúde,vigentes no ano de 2019,vinculados ahospitais de universidade federais do Brasil, coletando as variáveismacrorregião, áreas de concentraçãoepresença do núcleo profissional Odontologia.A análise constou de correlação de Spearman para associação do índice de desenvolvimento humano, índice de Gini, equipes de saúde bucal, cobertura populacional e cursos de Odontologia e a presença de CDs nos PRMH. Dos 41 PRMH, 5(12%)encontram-se no Centro-Oeste;6(15%)no Norte;12(29%)no Sudeste;14 (34%) no Nordeste,e 4(10%)no Sul. Das 93 áreas de concentração, 27(29%)possuem o CD na equipe multiprofissional. AsregiõesNordeste(n=26, 27,9%)e Sudeste(n=32,34,4%)apresentam a maior diversidade de áreas de concentração, sendoa presença do CD de10(38,4%)e 9(28,1%), respectivamente,em cada região. A área de concentração mais predominante noseditais é saúde da criança e materno-infantil(n=26,27,9%), estandoo CD presente em 7(26,9%) delas. O CD encontra-seem muitos programas de residência, embora se perceba a necessidade de ampliação do número de vagas ofertadas (AU).
The aim of the study was to evaluate the presence of dental surgeons (DS) in Hospital Multiprofessional Residency Programs (HMRPs) in Brazil. This is an exploratory, descriptive study, with a quantitative approach.Documentary analysis was performed of health HMRPs edicts, in effect during the year of 2019, linked to federal university hospitals in Brazil, collecting the macroregion variables, areas of concentration, and presence of a dentistry professional core. The analysis consisted of Spearman's correlation for the association of the Human Development Index, Gini index, oral health teams, population coverage, and dental courses with the presence of DSs in HMRPs. Of the 41 HMRPs, 5 (12%) are in the Midwest; 6 (15%) in the North; 12 (29%) in the Southeast; 14 (34%) in the Northeast, and 4 (10%) in the South. Of the 93 areas of concentration, 27 (29%) have a DS on the multiprofessional team. The Northeast (n=26, 27.9%) and Southeast (n=32, 34.4%) have the greatest diversity of areas of concentration, with the presence of a DS in 10 (38.4%) and 9 (28.1%), respectively, in each region. The most predominant area of concentration in the public notices is child and maternal-infant health (n=26, a 27.9%), and the DS is present in 7 (26.9%) of them. The DS is in many residency programs, although it is noticed the need to expand the number of vacancies offered (AU).
Subject(s)
Humans , Patient Care Team/ethics , Dentists/ethics , Hospitals, University , Internship and Residency/methods , Brazil , Oral Health , Cross-Sectional Studies/methods , Data Interpretation, Statistical , Statistics, Nonparametric , Gini CoefficientABSTRACT
Abstract Objective: To investigate the impact of inadequate prostheses on older adult's quality of life at the Integrated Health Center for Older Adults in the northeastern city of Brazil. Material and Methods: A cross-sectional study involving 147 older adults aged 60-90 years old in João Pessoa, Brazil. Interviews and oral examinations were carried out to collect demographic characteristics (age and gender) and clinical dental measures (use of inadequate upper and/or lower dental prosthesis) and Oral Health Impact Profile (OHIP-14 Questionnaire). The Pearson Chi-square and Fisher's exact tests were used to evaluate the association between the OHIP-14 dimensions and the use of unsatisfactory prostheses (p<0.05). Results: The sample consisted of 90.5% of women being a mean age of 69.86 (± 6.60) years. Individuals with inadequate prostheses had a higher impact on quality of life, with a predominant prevalence ratio for developing physical pain (PRR = 3.52; CI = 4.69-2.65), psychological discomfort (PRR = 5.0; CI = 5.85-4.26) and psychological inability (PRR = 1.71; CI = 2.56-1.14). Conclusion: The use of inadequate prostheses had a negative impact on the quality of life of the older adult population. Therefore, services, which provide health care for older adults, should overcome this reality by providing broad access to oral rehabilitation that is appropriate to the needs of each individual.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Quality of Life/psychology , Aged/psychology , Cross-Sectional Studies , Dental Care for Aged/psychology , Dental Prosthesis/psychology , Brazil/epidemiology , Chi-Square Distribution , Surveys and Questionnaires , Statistics, Nonparametric , Prevalence Ratio , Mouth Rehabilitation/psychologyABSTRACT
Abstract This study aimed to explore the association between use and need of dental prostheses to the quality of life in elderly individuals in a Referral Center for Elderly Care in the northeastern of Brazil. A cross-sectional study was developed with 199 elderlies of both sexes. Data were collected from clinical examinations (WHO criteria) and a questionnaire regarding socioeconomic status, Oral Health Impact Profile index (OHIP-14) by a single calibrated examiner with Kappa = 0.91. Data were analyzed using Mann-Whitney test, Poisson regression (p<0,05). The sample consisted of 84.9% women, mean age of 70.02 (sd±6.50) years. There was an independent association between quality of life and the covariates sex and need of dental prostheses. Men showed lower values of the score (PR = 0.734, p = 0.011) than women. Individuals without normative need for dental prostheses showed lower values of OHIP-14 (PR = 0.767; p = 0.003) than those in need.
Resumo O objetivo desse estudo foi verificar a associação entre o uso e a necessidade de prótese dentária e qualidade de vida em idosos de um Centro de Referência de Atenção ao Idoso no Nordeste do Brasil. Um estudo transversal foi desenvolvido com a participação de 199 idosos de ambos os sexos. Os dados clínicos foram coletados conforme a Organização Mundial de Saúde, através de exames clínicos e questionário sobre dados socioeconômicos, índice Oral Health Impact Profile (OHIP-14), por um examinador previamente treinado (kappa=0,91). Os dados foram analisados pelo Mann-Whitney, regressão de Poisson (p>0,05). A amostra consistiu de 84,9% de mulheres, com idade média de 70,02 (dp±6,50) anos. Houve associação independente entre a qualidade de vida e as covariáveis sexo e necessidade de prótese. Idosos do sexo masculino apresentaram menores valores do escore (RP=0,734; p=0,011) do que as mulheres. Indivíduos sem necessidade normativa de prótese dentária apresentaram menores valores do OHIP-14 (RP=0,767; p=0,003) do que aqueles com necessidade.
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Quality of Life , Oral Health , Dental Prosthesis/statistics & numerical data , Socioeconomic Factors , Brazil , Pilot Projects , Sex Factors , Cross-Sectional Studies , Surveys and Questionnaires , Independent Living , Middle AgedABSTRACT
This study aimed to explore the association between use and need of dental prostheses to the quality of life in elderly individuals in a Referral Center for Elderly Care in the northeastern of Brazil. A cross-sectional study was developed with 199 elderlies of both sexes. Data were collected from clinical examinations (WHO criteria) and a questionnaire regarding socioeconomic status, Oral Health Impact Profile index (OHIP-14) by a single calibrated examiner with Kappa = 0.91. Data were analyzed using Mann-Whitney test, Poisson regression (p<0,05). The sample consisted of 84.9% women, mean age of 70.02 (sd±6.50) years. There was an independent association between quality of life and the covariates sex and need of dental prostheses. Men showed lower values of the score (PR = 0.734, p = 0.011) than women. Individuals without normative need for dental prostheses showed lower values of OHIP-14 (PR = 0.767; p = 0.003) than those in need.
Subject(s)
Dental Prosthesis/statistics & numerical data , Oral Health , Quality of Life , Aged , Aged, 80 and over , Brazil , Cross-Sectional Studies , Female , Humans , Independent Living , Male , Middle Aged , Pilot Projects , Sex Factors , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
A interprofissionalidade promove o aperfeiçoamento da assistência integral à saúde. Porém, o trabalho em equipe, por vezes, é permeado por conflitos, os quais podem ser gerenciados através das competências emocionais. Esse estudo objetiva relatar uma experiência de desenvolvimento de competências emocionais para fortalecimento do processo de trabalho interprofissional, com vistas à integralidade do cuidado. O Programa de Educação pelo Trabalho em Saúde desenvolveu essa experiência em 2015, num serviço de média complexidade. Inicialmente, foi utilizado um jogo, visando explorar fragilidades do serviço, o qual possibilitou identificar o sentimento de inibição de muitos profissionais diante de situações do cotidiano laboral. Posteriormente, objetivando contornar tais inibições, atividades lúdicas foram realizadas por meio de vídeos, jogos e rodas de conversas, que promoveram diálogos interprofissionais, com foco nas competências empatia e assertividade, que resultaram em uma postura mais ativa e questionadora dos profissionais frente às necessidades do processo de trabalho da equipe (AU).
The interprofessionality promotes the improvement of the full assistance of the health care. However, sometimes teamwork is surrounded by conflicts that can be managed through emotional competencies. This study aims to report an experience of promoting emotional competencies for the strengthen of the interprofessional work's process, aiming to achieve the integrality of care. The Programa de Educação pelo Trabalho em Saúde developed this experience in 2015, in a medium complexity service. Initially, a game was used to explore the weaknesses of the service, which allowed to identify the feeling of inhibition of many professionals in a daily work situation. Subsequently, to overcome these inhibitions, playful activities were done through videos, games, and conversations, that promoted interprofessional dialogues, focused on the empathy and assertiveness competences, that resulted in a more active and questioning posture of the professionals face to the team work's process needs (AU).
La interprofesionalidad promueve la mejora de la asistencia integral de la salud. Sin embargo, el trabajo en equipo, a veces, está rodeado por conflictos, que pueden ser administrados a través de las competencias emocionales. Este estudio tiene como objetivo informar una experiencia de desarrollo de las competencias emocionales para la consolidación del proceso de trabajo interprofesional, con el fin de alcanzar la integralidad del cuidado. El Programa de Educación por el Trabajo en Salud desarrolló esa experiencia en 2015, en un servicio de mediana complejidad. En el principio, se utilizó un juego para explorar las debilidades en el servicio, el cual posibilitó identificar el sentimiento de inhibición de muchos profesionales frente a situaciones del cotidiano laboral. En seguida, para superar estas inhibiciones, se realizaron actividades lúdicas a través de videos, juegos y ruedas de conversación, que promovieron diálogos interprofesionales, cetrados en las competencias empatía y asertividad, que resultaron en una postura más activa y cuestionadora de los profesionales frente a las necesidades del proceso de trabajo del equipo (AU).
