بررسی مؤلفه های تعیین کننده بر دسترسی به خدمات دندانپزشکی پیشگیرانه

نوع مقاله : پژوهشی اصیل

نویسندگان

1 گروه مدیریت خدمات بهداشتی و درمانی، دانشکده مدیریت و علوم اجتماعی، دانشگاه آزاد اسلامی واحد تهران شمال، تهران، ایران

2 گروه سیاستگذاری سلامت دانشکده مدیریت و آموزش پزشکی، دانشگاه علوم پزشکی شهیدبهشتی، تهران، ایران

3 مرکز تحقیقات مدیریت سلامت، دانشگاه علوم پزشکی بقیه الله (عج)، تهران، ایران

چکیده

زمینه و هدف: دندانپزشکی نظامی، مراقبت بیمار محور را با دیدگاه سلامت عمومی ترکیب می­‌کند تا خدماتی قابل استقرار، چابک و جامع فراهم کند. بیماری دهان در پرسنل نظامی می­‌تواند به‌­طور قابل ملاحظه‌­ای توانایی عملیاتی فرد را مختل کند. دسترسی به خدمات دندانپزشکی نیازمند درک موانع و تسهیلات است. این مطالعه با هدف تعیین روابط سیستماتیک بین مؤلفه‌­های تاثیرگذار بر دسترسی به خدمات دندانپرشکی پیشگیری انجام شد.
روش‌ها: این مطالعه توصیفی و تحلیلی در دو مرحله کیفی و کمی در سال 1400 انجام گرفته است. در مرحله کیفی از طریق مرور ادبیات و با استفاده از روش گلوله برفی، مصاحبه با 10 نفر از صاحب­‌نظران حوزه دندانپرشکی پیشگیری و سلامت دهان و دندان انجام شد. جهت شناسایی و اخذ کدها از نرم افزار MAXQDA و بررسی متن مقالات و مصاحبه‌ها استفاده گردید. سپس الگوی مفهومی پژوهش در قالب 30 مؤلفه فرعی و شش گروه اصلی براساس مدل دسترسی سورمان به عنوان مدل پایه و چارچوب تحلیلی مولفه­‌های دسترسی به خدمات سلامت دهان و دندان طراحی گردید. پرسشنامه فاز کمی پژوهش به روش دیمتل با 30 سؤال طراحی و به شیوه هدفمند 30 نفر از خبرگان دانشگاه­‌های علوم پزشکی کشور تکمیل و جمع‌آوری گردید. داده‌های جمع‌آوری شده با استفاده از تحلیل ساختاری روابط علی و از طریق نرم‌افزارهای SPSS و DEMATEL تجزیه و تحلیل شدند.
یافته‌ها: بر اساس یافته­‌های مرحله کیفی، 51 مؤلفه فرعی شناسایی و بر اساس چارچوب تحلیلی مطالعه در قالب 6 مؤلفه اصلی بر اساس مدل سوربان، توان مالی؛ مقبولیت؛ دستیابی، آگاهی و توانمندسازی؛ کفایت و فراهمی دسته­‌بندی شدند. کلیه خبرگان با مؤلفه­‌های پیشنهادی تاثیرگذار بر دسترسی به خدمات دندانپزشکی موافق بودند و مؤلفه جدیدی را پیشنهاد نکردند (0/0001=P < /span>). نتایج تحلیلی روابط عوامل تاثیرگذار بر دسترسی به خدمات دندانپزشکی پیشگیری بیانگر تاثیرگذاری مؤلفه­‌های توان مالی (ضریب 1/05) و مقبولیت (ضریب 0/37) بر دسترسی بوده و در گروه علت­‌ها قرار گرفتند. مؤلفه­‌های توانمندسازی؛ دستیابی؛ کفایت و فراهمی نیز در گروه معلول­‌ها و تاثیرپذیر بودند. مؤلفه‌­های توان مالی و فراهمی به ترتیب با مختصات­‌های (1/05 و 11/88) و (0/57- و 11/35)، اولویت­‌های اول و آخر شناخته شدند.
نتیجه‌گیری: یک جزء اساسی در پرسنل نظامی، عوارض دندانی "پنهان" است. این جزء با ارزیابی عوارض دندانی تقریباً به یک سوم کاهش می­‌یابد. شناسایی عوامل کلیدی مؤثر بر دسترسی در این پژوهش می‌تواند به طراحی مداخلات پیشگیری کمک کند. همچنین بستری برای تدوین سیاست­‌های پیشگیری و ارتقای سلامت باشد.

کلیدواژه‌ها


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