Barriers and Facilitators to Dental Care Services Utilization Among Children With Disabilities: A Systematic Review and Thematic Synthesis

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES Health Expectations Pub Date : 2024-09-30 DOI:10.1111/hex.70049

Shiamaa Al-Mashhadani, Mona Nasser, Anas Alsalami, Lorna Burns, Martha Paisi

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Abstract

Background

This systematic review investigates barriers and enablers to dental care utilization by disabled children. Given the high global prevalence of disabilities in children, coupled with poor oral hygiene and a 45% rate of dental caries in this group, developing inclusive oral health strategies is critical. The review aims to synthesize literature on factors affecting oral healthcare improvement for disabled children, identifying barriers, facilitators and knowledge gaps.

Methods

The review was conducted following the Joanna Briggs Institute's methods and reported according to PRISMA guidelines. A comprehensive search spanned multiple databases, considering perspectives from carers, parents, dentists and health professionals. The focus was on studies involving children up to age 17 with disabilities, as defined by WHO, using dental care services. Exclusions included non-qualitative studies, populations over 18 and nondisabled children. There were no restrictions on publication date or language. Thematic synthesis of the studies extracted themes related to barriers and enablers in oral healthcare for disabled children.

Results

Thematic synthesis identified five overarching themes: stigma, communication issues, professional development, oral health education and medical-dental collaboration. Facilitators included enhancing accessibility and availability of dental care through a holistic approach, improving dental care facility environments and ensuring skilled dental care providers.

Discussion

The review underscores the importance of interprofessional collaboration, improved parent/caregiver education and specialized dental facilities to support children with disabilities. It identifies key barriers and facilitators in dental care, including challenging stereotypes, improving communication between providers and parents, enhancing holistic training and addressing gaps in oral health education and integrated healthcare systems.

Conclusion

Addressing the complex dynamics of dental care for disabled children is essential for developing inclusive and effective preventive and therapeutic strategies. This review highlights the need for tailored approaches and enhanced support systems to improve oral health outcomes in this vulnerable population.

Patient and Public Contribution

The members of the family support department, Middle East and North Africa (MENA) Organization for Rare Disease and Disability who provided the disability voice and contributed to providing input to the review protocol.

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残疾儿童利用牙科保健服务的障碍和促进因素：系统回顾与主题综合。

背景：本系统综述调查了残疾儿童利用牙科保健的障碍和促进因素。鉴于残疾儿童在全球的高发病率，加上该群体口腔卫生状况不佳，龋齿率高达 45%，因此制定包容性口腔健康战略至关重要。本综述旨在对影响残疾儿童口腔保健改善的因素进行文献综述，找出障碍、促进因素和知识差距：综述按照乔安娜-布里格斯研究所的方法进行，并根据 PRISMA 指南进行报告。在多个数据库中进行了全面搜索，并考虑了照顾者、家长、牙医和医疗专业人员的观点。重点是涉及世界卫生组织定义的 17 岁以下使用牙科保健服务的残疾儿童的研究。不包括非定性研究、18 岁以上人群和非残疾儿童。对出版日期或语言没有限制。对研究进行主题综合，提取出与残疾儿童口腔保健的障碍和促进因素相关的主题：专题综述确定了五大主题：耻辱感、沟通问题、专业发展、口腔健康教育和医疗牙科合作。促进因素包括通过整体方法提高牙科保健的可及性和可用性、改善牙科保健设施环境以及确保熟练的牙科保健提供者：讨论：本综述强调了跨专业合作、改善家长/护理人员教育和专业牙科设施对支持残疾儿童的重要性。讨论：综述强调了跨专业合作、改善家长/护理人员教育和专业牙科设施对支持残疾儿童的重要性，并指出了牙科护理中的主要障碍和促进因素，包括挑战陈规定型观念、改善提供者和家长之间的沟通、加强整体培训以及解决口腔健康教育和综合医疗保健系统中的差距：解决残疾儿童牙科保健的复杂动态对于制定包容性的有效预防和治疗策略至关重要。本综述强调，有必要采取有针对性的方法并加强支持系统，以改善这一弱势群体的口腔健康状况：中东和北非（MENA）罕见疾病和残疾组织家庭支持部的成员，他们提供了残疾人的声音，并为审查协议提供了意见。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.