Nível de conhecimento quanto à doença periodontal entre pessoas com diabetes e um instrumento para sua avaliação: um enfoque no letramento em saúde bucal

Abstract

Chronic diseases are causes of morbidity and mortality that justify policies on the social determinants of health. Among them, diabetes, considered a public health problem worldwide, due to its high rates of mortality, morbidity and compromised quality of life, has an association of feedback with Periodontal Diseases (PDs). To reduce complications and aggravation of these diseases, patients need to participate in decisions, and a partnership between patients and health professionals with collaborative treatment proposals is imperative. Therefore, diabetes and PDs, a prevalent Oral Health (SB) problem, are eligible diseases for the Health Literacy (HL) study, which encompasses knowledge, motivation and competence to access, understand, evaluate and apply related information the health. It is suggested that scientific evidence on such literacy is scarce and deficient in relation to BS, especially regarding PDs in people with diabetes. Thus, valid, reliable, easy to apply and interpret instruments can contribute to the identification of LS levels regarding PDs among people with diabetes. In this context, a systematic literature review on the association between knowledge arising from SL and the feedback relationship between PDs and diabetes was conducted. It was found that access and knowledge are not directly related to an adequate understanding and application of information in people's daily lives. In this sense, health professionals should consider the concept of health literacy, which has been described as individual skills to access health-related information and understand / critically evaluate and apply them to their own situation, making health decisions appropriate, thus stimulating the promotion of educational actions. There was a need for assessment instruments that address the LS domains with regard to PDs among people with diabetes. Thus, 129 people with diabetes assisted in the FHS were considered in the evaluation of the instrument entitled “Literacy regarding Periodontal Condition among people with Diabetes” (LPCD). The structural validity of the instrument was estimated through Confirmatory Factor Analysis (CFA) with quality of fit of the models estimated via: Chi-square per degrees of freedom ratio (X2/g.l); Comparative Fit Index (CFI); Tucker-Lewis Index (TLI); Goodness-of-Fit Index (GFI), and Root-Mean-Square Error of Approximation (RMSEA). Internal consistency was estimated via Cronbach's Alpha (AC) and Composite Reliability (CR). Convergent validity was evaluated using Average Variance Extracted (AVE). The interpretability of the binary versions of the instrument considered the upper limit of the 95% confidence interval as a cutoff. The models presented X2/g.l ≤ 5; CFI, TLI, GFI ≥ 0.90; RMSEA > 0.05; AC, CR and AVE satisfactory. In the binary assessment of the instrument's dimensions, inadequacy and interpretability, with adjustment indices considered adequate. The construct can be considered in the elaboration of strategies for health promotion, disease prevention and mitigation of complications from periodontal diseases and diabetes.