Impact of the COVID-19 Pandemic on the Oral Health Workforce: A Multicenter Study from the Southern Region of Brazil
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Eligibility Criteria
2.3. Pilot Study
2.4. Data Collection
2.5. Reproducibility
2.6. Database and Data Analyzes
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | n | % | CI 95% |
---|---|---|---|
Gender (n = 2558) | |||
Female | 2005 | 78.4 | 76.9–79.9 |
Male | 553 | 21.6 | 20.1–23.1 |
Age (years) (n = 2560) | |||
18–24 | 134 | 5.2 | 4.4–6.1 |
25–39 | 1231 | 48.1 | 46.0–50.1 |
40–59 | 1105 | 43.2 | 41.3–45.2 |
≥60 | 90 | 3.5 | 2.8–4.2 |
Residence (n = 2560) | |||
Paraná | 1127 | 44.0 | 42.0–46.0 |
Santa Catarina | 790 | 30.9 | 29.1–32.7 |
Rio Grande do Sul | 643 | 25.1 | 23.4–26.8 |
Occupation (n = 2560) | |||
Dentists | 1941 | 75.8 | 74.2–77.4 |
Dental assistants | 401 | 15.7 | 14.3–17.1 |
Dental technicians | 218 | 8.5 | 7.5–9.6 |
Completion of training (years) (n = 2553) | |||
Up to 10 | 1135 | 44.5 | 42.5–46.4 |
11–20 | 695 | 27.2 | 25.4–29.0 |
≥20 | 723 | 28.3 | 26.6–30.1 |
Higher graduate level * (n = 1941) | |||
Specialization/Residency | 1153 | 59.4 | 57.2–61.6 |
Master | 256 | 13.2 | 11.7–14.7 |
PhD | 172 | 8.9 | 7.6–10.1 |
None | 360 | 18.5 | 17.0–20.2 |
Postgraduate areas# (n = 1941) | |||
Public health | 387 | 19.9 | 18.2–21.7 |
Clinical specialties # | 1188 | 61.2 | 59.0–63.4 |
None | 360 | 18.5 | 16.7–20.4 |
Not informed | 6 | 0.3 | 0.1–0.5 |
Working sector (n = 2560) | |||
Public ¶ | 1350 | 52.7 | 50.8–54.5 |
Private | 966 | 37.7 | 36.0–39.6 |
Other | 244 | 9.5 | 8.4–10.7 |
Risk factors for severe forms of COVID-19 (n = 2558) | |||
Only age over 60 years old | 62 | 2.4 | 1.8–3.0 |
Health condition only | 219 | 8.6 | 7.6–9.6 |
Age over 60 and health condition | 19 | 0.7 | 0.4–1.1 |
None | 2258 | 88.3 | 87.1–89.4 |
Absence from work during the pandemic (n = 2560) | |||
No | 769 | 30.0 | 28.2–32.1 |
Yes, due to suspected or confirmed COVID-19 | 336 | 13.1 | 11.9–14.5 |
Yes, due to other reasons | 1455 | 56.8 | 54.7–58.8 |
Testing for COVID-19 (n = 2560) | |||
No | 1179 | 46.1 | 44.0–48.0 |
Yes | 1381 | 53.9 | 52.0–56.0 |
Organization of Health Services (Surveillance, Planning and Management) | Always (Score 5) n (%) | Very Often (Score 4) n (%) | Sometimes (Score 3) n (%) | Rarely (Score 2) n (%) | Never (Score 1) n (%) | Mean * | (SD) | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Suspended elective procedures and care restricted to urgency/emergency | 961 | (37.5) | 702 | (27.4) | 460 | (18.0) | 242 | (9.5) | 166 | (6.5) | 3.8 | (1.2) |
Participation in decision making about changes in work during the pandemic | 1321 | (51.6) | 557 | (21.8) | 245 | (9.6) | 121 | (4.7) | 173 | (6.8) | 4.1 | (1.2) |
Reduced workload or professional turnover to minimize the risk of contamination | 916 | (35.8) | 259 | (10.1) | 354 | (13.8) | 220 | (8.6) | 784 | (30.7) | 3.1 | (1.7) |
Worked directly in COVID-19 reception/sorting/fast-track procedures | 763 | (29.8) | 276 | (10.8) | 398 | (15.6) | 219 | (8.6) | 863 | (33.7) | 2.9 | (1.7) |
Investigation of respiratory infection symptoms in appointment scheduling | 474 | (18.5) | 222 | (8.7) | 393 | (15.4) | 289 | (11.3) | 1144 | (44.7) | 2.4 | (1.6) |
Patients with symptoms of respiratory tract infection immediately isolated | 1726 | (67.4) | 319 | (12.5) | 215 | (8.4) | 111 | (4.3) | 117 | (4.6) | 4.4 | (1.1) |
Waiting room respecting the minimum distance of 1 m between people | 1533 | (59.9) | 319 | (12.5) | 120 | (4.7) | 100 | (3.9) | 280 | (10.9) | 4.2 | (1.4) |
Availability of visual alerts in the health service | 1709 | (66.8) | 446 | (17.4) | 195 | (7.6) | 100 | (3.9) | 58 | (2.3) | 4.4 | (1.0) |
Urgency based on pre-established clinical protocols | 1451 | (56.8) | 345 | (13.5) | 250 | (9.8) | 157 | (6.1) | 287 | (11.2) | 4.0 | (1.4) |
Orientation of patients about COVID-19 | 1296 | (50.6) | 463 | (18.1) | 415 | (16.2) | 185 | (7.2) | 156 | (6.1) | 4.0 | (1.2) |
Use of digital tools for teleorientation or telemonitoring | 641 | (25.0) | 257 | (10.0) | 353 | (13.8) | 268 | (10.5) | 912 | (35.6) | 2.8 | (1.6) |
Interaction with other health professionals | 849 | (33.2) | 550 | (21.5) | 683 | (26.7) | 248 | (9.7) | 214 | (8.4) | 3.6 | (1.3) |
Work Biosafety | Always (Score 5) | Very Often (Score 4) | Sometimes (Score 3) | Rarely (Score 2) | Never (Score 1) | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
n | (%) | n | (%) | n | (%) | n | (%) | n | (%) | Mean * | (SD) | |
Disinfection of the environment by a trained professional with appropriate PPE | 1386 | (54.2) | 403 | (15.7) | 226 | (8.8) | 185 | (7.2) | 307 | (12.0) | 4.0 | (1.4) |
Disinfection of suction hoses | 1143 | (44.7) | 348 | (13.6) | 302 | (11.8) | 245 | (9.6) | 367 | (14.3) | 3.7 | (1.5) |
Use of sterile micromotors at every dental appointment | 983 | (38.4) | 273 | (10.7) | 270 | (10.6) | 313 | (12.2) | 653 | (25.5) | 3.2 | (1.7) |
Intraoral radiographic examinations were avoided | 372 | (14.5) | 604 | (23.6) | 589 | (23.0) | 332 | (13.0) | 573 | (22.4) | 2.9 | (1.4) |
Performing four-handed dental procedures | 1077 | (42.1) | 387 | (15.1) | 307 | (12.0) | 328 | (12.8) | 400 | (15.6) | 3.6 | (1.5) |
Use of the dental dam in high-rotation procedures | 315 | (12.3) | 297 | (11.6) | 406 | (15.9) | 316 | (12.3) | 1072 | (41.9) | 2.4 | (1.5) |
Procedures that generate aerosols were avoided | 508 | (19.9) | 663 | (25.9) | 546 | (21.3) | 359 | (14.0) | 422 | (16.5) | 3.2 | (1.4) |
Use of suction system (vacuum pump) | 1132 | (44.2) | 165 | (6.4) | 136 | (5.3) | 76 | (3.0) | 954 | (37.3) | 3.2 | (1.9) |
Proper removal of personal protective equipment | 1362 | (53.2) | 546 | (21.3) | 241 | (9.4) | 141 | (5.5) | 216 | (8.4) | 4.1 | (1.3) |
N95/PFF2 mask reuse with proper criteria | 1437 | (56.2) | 362 | (14.1) | 251 | (9.8) | 95 | (3.7) | 285 | (11.1) | 4.1 | (1.4) |
Disinfection of face shield | 2220 | (86.8) | 150 | (5.9) | 55 | (2.1) | 26 | (1.0) | 54 | (2.1) | 4.8 | (0.7) |
Variables | Dentists | Dental Assistants | Dental Hygienists | Total | ||||
---|---|---|---|---|---|---|---|---|
n | (%) | n | (%) | n | (%) | n | (%) | |
Access to technical standards and recommendations | 1132 | (58.3) | 170 | (42.4) | 104 | (47.7) | 1406 | (54.9) |
Technical note GVIMS/GGTES/ANVISA N° 04/2020 | 1189 | (61.3) | 122 | (30.4) | 80 | (36.7) | 1391 | (54.3) |
Recommendation booklet of the Federal Council of Dentistry (CFO) | 1195 | (61.6) | 183 | (45.6) | 101 | (46.3) | 1479 | (57.8) |
Recommendation booklet of the Regional Council of Dentistry (CRO) from own state | 310 | (16.0) | 22 | (5.5) | 12 | (5.5) | 344 | (13.4) |
Recommendation booklet of the Regional Council of Dentistry (CRO) from other state | 1011 | (52.1) | 212 | (52.9) | 120 | (55.0) | 1343 | (52.5) |
Recommendations from the Municipal/State Secretariat | 81 | (4.2) | 31 | (7.7) | 15 | (6.9) | 127 | (5.0) |
None | 1455 | (75.0) | 357 | (89.0) | 184 | (84.4) | 1996 | (78.0) |
Other documents * | 1132 | (58.3) | 170 | (42.4) | 104 | (47.7) | 1406 | (54.9) |
Training on COVID-19 | Strongly Agree (Score 5) | Agree (Score 4) | Undecided (Score 3) | Disagree (Score 2) | Strongly Disagree (Score 1) | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | n | % | Mean * | (SD) | |
I consider that I received guidance at my workplace regarding measures to be taken during the COVID-19 pandemic | 1392 | (54.4) | 683 | (26.7) | 164 | (6.4) | 145 | (5.7) | 148 | (5.8) | 4.1 | (1.3) |
I was able to apply the knowledge acquired in training/education about COVID-19 to modify my practice | 1051 | (53.4) | 656 | (33.3) | 132 | (6.7) | 58 | (2.9) | 29 | (1.4) | 4.6 | (1.1) |
I feel sufficiently enlightened and secure to work properly in dental practice during the COVID-19 pandemic | 978 | (38.2) | 1017 | (39.7) | 179 | (7.0) | 206 | (8.0) | 141 | (5.5) | 3.9 | (1.2) |
I feel anxious and concerned to work properly in dental practice during the COVID-19 pandemic | 894 | (34.9) | 841 | (32.9) | 227 | (8.9) | 257 | (10.0) | 306 | (12) | 2.2 | (1.3) |
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Warmling, C.M.; Spin-Neto, R.; Palma, L.Z.; Silva-Junior, M.F.; Castro, R.G.; Finkler, M.; Baldani, M.H.; Bitencourt, F.V. Impact of the COVID-19 Pandemic on the Oral Health Workforce: A Multicenter Study from the Southern Region of Brazil. Int. J. Environ. Res. Public Health 2023, 20, 1301. https://doi.org/10.3390/ijerph20021301
Warmling CM, Spin-Neto R, Palma LZ, Silva-Junior MF, Castro RG, Finkler M, Baldani MH, Bitencourt FV. Impact of the COVID-19 Pandemic on the Oral Health Workforce: A Multicenter Study from the Southern Region of Brazil. International Journal of Environmental Research and Public Health. 2023; 20(2):1301. https://doi.org/10.3390/ijerph20021301
Chicago/Turabian StyleWarmling, Cristine Maria, Rubens Spin-Neto, Luciana Zambillo Palma, Manoelito Ferreira Silva-Junior, Renata Goulart Castro, Mirelle Finkler, Márcia Helena Baldani, and Fernando Valentim Bitencourt. 2023. "Impact of the COVID-19 Pandemic on the Oral Health Workforce: A Multicenter Study from the Southern Region of Brazil" International Journal of Environmental Research and Public Health 20, no. 2: 1301. https://doi.org/10.3390/ijerph20021301