h1

% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@PHDTHESIS{Ponomarenko:1011698,
      author       = {Ponomarenko, Maksym},
      othercontributors = {Kaifie-Pechmann, Andrea and Kraus, Thomas},
      title        = {{O}ral health, stress and barriers accessing dental health
                      care among war-affected {U}krainian refugees in {G}ermany},
      school       = {Rheinisch-Westfälische Technische Hochschule Aachen},
      type         = {Dissertation},
      address      = {Aachen},
      publisher    = {RWTH Aachen University},
      reportid     = {RWTH-2025-04660},
      pages        = {1 Online-Ressource : Illustrationen},
      year         = {2025},
      note         = {Veröffentlicht auf dem Publikationsserver der RWTH Aachen
                      University; Dissertation, Rheinisch-Westfälische Technische
                      Hochschule Aachen, 2025},
      abstract     = {Background: After Russian invasion many Ukrainians fled to
                      European countries including Germany. In this context, the
                      German health care system faced challenges delivering dental
                      care to a displaced population. Recently surfaced obstacles
                      as well as different cultural and medical traits need to be
                      considered in order to deliver appropriate medical care. The
                      aim of this study was to evaluate oral health and hygiene of
                      Ukrainian refugees, identify barriers accessing dental
                      health care and explore the relation to their mental health
                      state. MethodsThis cross-sectional study was conducted using
                      a self-assessment questionnaire, distributed via
                      non-probability snowball sampling method among war-affected
                      Ukrainians, who fled to Germany. The online form was
                      distributed via web-based platforms, the printed version was
                      hand-delivered across diverse local venues. Chi-Square
                      Tests, T-Tests and Mann-Whitney-U Tests were performed.
                      Analysis of variance and Spearman correlation coefficient
                      analysis were also conducted. Results: From 819 completed
                      questionnaires, 724 questionnaires were included in the
                      analysis with 78 males $(10.8\%)$ and 640 females $(88.6\%)$
                      and a mean age of 37.5 years (SD = 10.5). The majority
                      of participants rated their state of teeth $(77\%)$ and gums
                      $(81\%)$ as average or better. The main problems, caused by
                      state of their teeth, were: “Have avoided smiling because
                      of teeth” $(23.6\%)$ or “Felt embarrassed due to
                      appearance of teeth” $(22.2\%).$ The most frequent
                      limiting factors to access dental care were finances
                      $(82.6\%),$ language $(82.2\%)$ and complicated health care
                      system $(74.1\%).$ $45.8\%$ of the participants scored 10 or
                      more in the Patient Health Questionnaire and $37.4\%$ in the
                      Generalized Anxiety Disorder 7-item scale, respectively.
                      These participants were more likely to report pain, poor
                      state of teeth and gums and to fail a dental consultation.
                      Overall, $59.6\%$ participants reported not consulting a
                      dentist, when needed. Failed consultations were associated
                      with a poorer reported state of teeth and gums.Conclusions:
                      Ukrainian refugees reported barriers accessing dental health
                      care in Germany. It is important to improve oral health
                      literacy and dental services for displaced people and
                      provide help and guidance in seeking dental care.},
      cin          = {922110 ; 922120},
      ddc          = {610},
      cid          = {$I:(DE-82)521001-2_20140620$},
      typ          = {PUB:(DE-HGF)11},
      doi          = {10.18154/RWTH-2025-04660},
      url          = {https://publications.rwth-aachen.de/record/1011698},
}