Influência do capital social no acesso aos serviços de saúde por adultos

• Ano de defesa: 2019
• Autor(a) principal: Koch, Luiza Foltran de Azevedo
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Positivo; Brasil; Pós-Graduação; Programa de Pós-Graduação em Odontologia Clínica; UP
• Palavras-chave em Português: Odontologia; Acesso aos serviços de saúde; Maturidade; Capital social; CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA
• Link de acesso: https://repositorio.cruzeirodosul.edu.br/handle/123456789/2164

Social capital, whose theoretical concept is quite broad, can be understood as a network of relationships established between people that generates trust and a bearing environment, which favors the improvement of their living conditions. Thus, this thesis had as a general proposition to verify whether social capital exerts any influence on adult access to health services. For this, two articles were proposed. The first was a systematic review of the literature, with a view to answering the question: "Does social capital influence access to health services by adults?". The bases were consulted: PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane, and gray literature. A total of 3733 studies were selected, after the selection of studies that met the inclusion criteria, permeceream seven in the systematic review. To evaluate the risk of bias of the studies, the Downs and Black tool was used. It was verified that four studies presented low risk of bias, two moderate risks and one study with high risk of bias. A thematic synthesis was performed in order to interpret and summarize the results, which indicated a great diversity of methods. In this article it was not possible to verify the association between social capital and access to health services, showing the relevance of developing more research better designed to verify the existence of this association. The second article, with a population-based approach, aimed to investigate the association between social capital and access to medical and dental health services, with a sample of 373 adults living in the Ferraria District, located in the municipality of Campo Largo, Paraná, Brazil. A validated and pre-tested questionnaire was applied contained information about socioeconomic, sociodemographic variables, habits, selfperception of general and oral health, social capital, and these outcomes of access to health services. Social capital was defined from the dimensions: social trust, social support, informal social control, political effectiveness and social action. Associations were explored between explanatory variables and outcomes using the Chi-square Test, followed by multinominal logistic regression. As results, individuals older, non-smoking and with better self-perception of general health sought more medical services. The visit to the dentist showed no statistically significant difference in relation to any independent variable. Regarding the dimensions of social capital, only political efficacy, in the moderate category, increased the chance of the respondent accessing the medical service. In this article it was concluded that access to medical services was influenced by social capital through political effectiveness. As a general conclusion of this thesis, it was found that social capital, despite the lack of consistent evidence revealed by the present systematic review of the literature, may be associated with adult access to the health services studied, as results of the observational study.