牙科治療前後對口腔健康相關生活品質之相關性

The Relationship of Dental Treatment Intervention on Patients’ Oral Health-Related Quality of Life

駱蔓萱(Man-Hsuan Lo)

指導教授 ： 楊奕馨

高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/碩士(2011年)

https://doi.org/10.6832/KMU.2011.00129

摘要

研究背景︰
因口腔問題影響健康相關生活品質為目前國人所重視，研究報告指出牙醫師臨床處置治療與心理、生理及社會等層面之健康相關生活品質有關。對於病患接受適當的治療之前，牙醫師瞭解病患之就診原因，以利恢復其口腔健康並改善口腔健康相關生活品質。
研究目的︰
本研究針對高雄市某牙科診所15歲至50歲之病患，瞭解就診原因及牙醫師臨床處置與治療前後口腔健康相關生活品質之改變的相關性。
研究方法︰
對象為99年2月至6月之高雄市某牙科診所患者，共145位完成前測問卷，臨床處置6個月後回診患者為76位完成後測問卷。其中除了牙醫師口腔臨床診斷外，問卷調查內容包含：社會人口學基本資料、口腔健康相關生活品質量表（OHIP-49、OIDP）及整體性健康相關生活品質量表（WHOQoL-BREF）。OHIP-49及OIDP量表總分分數越高表示生活品質越差，WHOQoL-BREF量表總分分數越高表示生活品質越好。統計分析以單因子變異數分析（One-way ANOVA）方法分析社會人口學基本資料與各量表之相關性， 並以一般線性模式（General Linear Model，GLM）統計方法，調整性別、年齡層及經濟狀況後，探討病患就診原因及臨床處置項目與各量表的相關性，同時以配對t檢定(Paired- t test)探討臨床處置後病患就診原因及處置項目與各量表之改變量。
研究結果︰
治療後顯示，OHIP-49在各項臨床處置後皆有顯著改善（除了植牙外），男性及女性的改變量在OHIP-49、OIDP皆有顯著差異（p＝0.0193, 0.0010），在經濟來源方面，以非自己工作所得之口腔健康相關生活品質改變較多（OHIP-49＝25.47分）。調整性別、年齡層及經濟狀況後，臨床處置6個月後，就診原因以拔牙改善最多（OHIP-49＝56.78分），而以植牙改善最少（OHIP-49＝0.71分），反之，根管治療後對OIDP影響最大（-0.38分）；臨床處置以牙齦炎或牙周炎緊急處理治療後之OHIP-49改善最好（39.31分），而以植牙對OIDP影響最大（1.12分）。
結論︰
經過臨床處置6個月後，牙齦炎或牙周炎緊急處理、洗牙、齲齒填補等治療可減少社交限制（social disability），拔牙治療相對地能降低殘障（handicap）在口腔健康相關生活品質之影響，植牙治療有改善口腔健康相關生活品質(OHIP-49)及口腔日常生活影響指標(OIDP)。

關鍵字

Self-report ； Clinical treatments ； OHIP-49 ； OIDP

並列摘要

Background:
The oral health-related quality of life has been emphasized .Many studies reported that dental treatments are related to health-related quality of life which includes psychological, physical and social aspects. Before patients received their dental treatments, dentists should understand the reasons why they visit dentists and help patients to recover their oral health; hence, the oral health-related quality of life can be improved.
Study objective:
The purpose of this study was to assess the changes in oral health-related quality of life between patients’ after dental treatments in relation to self-reported symptoms and clinical examination.
Study methods:
This prospective study collected the data of 15-50 year-old patients at a dental clinic in Kaohsiung city during February to June, 2010. Participants were asked to complete questionnaire before their dental treatments. There were 145 patients initially enter the study and filled the questionnaire. After receiving dental treatments for 6 months, there were only 76 subjects who completed both questionnaire and clinical diagnosis examinations. The differences in the demographic characteristics of the three measurements were analyzed by using the One-way ANOVA. The changes in the OHIP-49, OIDP, WHOQoL-BREF scores between baseline and after 6 months were analyzed by using General Linear Models (GLM) and Paired t-test .
Study results:
The changes between the pre- and post-dental treatment scores were statistically significantly different in both gender on OHIP-49 and OIDP (p=0.0193, 0.0010). In terms of economic resource status, self-support patients have better oral health-related quality of life (OHIP-49=25.47). After 6 months, extraction improved most of the oral health-related quality of life after adjusting gender, age, economic of models (OHIP-49=56.78) and implant treatments are less improved (OHIP-49=0.71). Conversely, endodontic treatment improved in OIDP (OIDP=-0.38); treatment of gingivitis or periodontitis emergency improved better (OHIP-49=39.31)and implant have great impacts on OIDP (OIDP=1.12).
Conclusion:
After 6 months, gingivitis, emergency periodontitis treatment, scaling, and operative dentistry therapy help to decrease the social disability dimension. Relatively, extraction decreases the influence of handicap and implant treatment improved oral health-related quality of life (OHIP-49 and OIDP).

並列關鍵字

Self-report ； Clinical treatments ； OHIP-49 ； OIDP

參考文獻

參考文獻

中文文獻

溫永頌.(2003). 口腔癌健康相關生活品質量表之建立•中國醫藥學院醫務管理研究所碩士論文.

黃素微. (2005). 台灣簡明版世界衛生組織生活品質問卷之效度再探. 國立台北師範學院教育心理與諮商學系碩士論文.

陳佩靖.(2003).口腔癌病患治療後生活品質及其相關因素探討-橫斷式研究. 高雄醫學大學牙醫學系碩士論文.