The feminization of dentistry and the perceptions of public service users about gender issues in oral health

Kfouri, Maria da Graça; Moysés, Simone Tetu; Gabardo, Marilisa Carneiro Leão; Nascimento, Antonio Carlos; Rosa, Saulo Vinicius da; Moysés, Samuel Jorge

doi:10.1590/1413-812320182411.00832018

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FREE THEMES • Ciênc. saúde coletiva 24 (11) • Nov 2019 • https://doi.org/10.1590/1413-812320182411.00832018 copy

The feminization of dentistry and the perceptions of public service users about gender issues in oral health

A feminização da odontologia e as percepções dos usuários do serviço público sobre as questões de gênero em saúde bucal

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

It was investigated the perception of service users in relation to the professional practice of dentists, based on gender differences. The Primary Care Assessment Tool (PCATool) was applied to 900 users of the Public Service in Curitiba, PR, Brazil. Sixty clinics were selected using random sampling, divided between conventional Primary Health Care (PHC) Units and PHC with Family Health System Units. The attributes of PHC that compound the PCATool were analyzed. A question was added about user preference regarding the gender of the dental professional, thus generating four dyads derived from user gender/dentist gender (FF, FM, MM, MF). The attributes were linked to the dyads by applying the independent sample t test. Using logistic regression, the dyads were linked to 23 factors relating to scaled-up care in PHC. Many users showed a clear preference for being attended by female dentists. Users who prefer to be cared for by women tend to better evaluate PHC on issues related to “active listening”, while those who prefer to be cared for by male dentists highlight the attributes of “care integration” and “community guidance”. In other factors and attributes studied, there is no difference between the care given by men or women, regardless the unit.

Key words
Dentist; Gender; Primary health care

Professional's gender according to user preference X PHC Attributes and Scores	n		Mean±SD		t^* * t value - statistic resulting from the independent sample t test	GL^ Degree of freedom - statistic resulting from the independent sample t test.	P
	Man	Woman	Man	Woman
First contact	190	557	6.89±1.50	6.94±1.66	-0.32	745	0.75
Accessibility	190	557	5.85±0.84	5.84±0.75	0.14	745	0.89
Continuity of care	190	557	7.29±0.70	7.30±0.70	-0.02	745	0.98
Care integration	40	113	8.13±0.80	7.85±0.57	2.35	151	0.02
Information System	190	557	8.24±1.41	8.14±1.40	0.81	745	0.42
Clinical comprehensiveness	190	557	7.50±0.51	7.47±0.50	0.90	745	0.37
Extended comprehensiveness	190	557	7.08±1.23	6.95±1.31	1.19	745	0.23
Family orientation	190	557	7.36±1.17	7.23±1.20	1.31	745	0.19
Cultural competence	190	557	7.76±0.92	7.70±0.95	0.80	745	0.43
Community orientation	190	557	7.59±1.42	7.30±1.61	2.21	745	0.03
Primary score	190	557	7.17±0.55	7.12±0.56	0.95	745	0.34
Overall score	190	557	7.57±0.86	7.41±0.93	2.11	745	0.04

Variables	Unit	MM	MF	FF	FM
I think the dentist has a good understanding of what I say or ask during the appointments. (D2)	PHC PHC/FHS	No NS	Yes NS	No NS	Yes NS
The dentist allows enough time for me to talk about my concerns or problems. (D5)	PHC PHC/FHS	NS NS	NS NS	NS Yes	NS No
The dentist knows me more as a person than just as a patient. (D7)	PHC PHC/FHS	NS NS	NS NS	Yes No	No Yes
The dentist has detailed knowledge of all my health problems, not just my oral health problems. (D11)	PHC PHC/FHS	Yes No	No Yes	NS NS	NS NS

Health Unit	User gender/ dentist gender dyads	Source	Value	Wald X2	p	OR	OR (CI:-95%+95%)
PHC/FHS Unit	MM/MF	Intercept	0.57	0.00	0.99
		D11-No	0.80	1.88	0.17	2.24	0.70-7.11
	FF/FM	Intercept	1.26	1509.80	0.00	0.99
	FM/FF	D5-No D7-No D5-No	0.70 -1.08 0.70	1.45 4.58 1.45	0.22 0.03 0.22	0.49 2.95 2.01	0.15-1.54 1.09-7.93 0.64-6.30
PHC Unit	MM/MF	Intercept	0.73	0.00	0.99
		D2-No	1.87	2.81	0.09	6.50	0.72-58.00
		D11-No	-1.19	5.28	0.02	0.30	0.11-0.83
	FF/FM	Intercept	1.67	0.00	0.98
		D2-No	-1.02	4.04	0.04	2.79	1.02-7.57
		D7-Yes	-0.03	0.00	0.92	1.03	0.50-2.13

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[1] Collaborators

MG Kfouri contributed to the study conception and design, and acquisition of data. ST Moysés contributed to the acquisition of data, analysis and interpretation of them. MCL Gabardo contributed to the analysis and interpretation of data and in drafting the manuscript. AC Nascimento contributed revising the text critically for important intellectual content and edited the manuscript. SV Rosa revised the entire manuscript. SJ Moysés participated in the study design, supervised the data analysis, the writing of the manuscript and contributed to the final approval of the version to be published.