老人口腔狀況與口腔健康相關生活品質之探討 ~以大台北地區健檢老人與門診老人之比較

The assessment of oral status and oral health related quality of life among the elderly ~ Comparing physical checkup group and clinical dental group in Taipei

李薇芳(Wei-Fang Lee)

指導教授 ： 李勝揚

共同指導教授 ： 蔡?痟f

臺北醫學大學/口腔醫學院/牙醫學系碩博士班/碩士(2009年)

摘要

人口老化已成為全球趨勢，當然台灣也不例外。口腔健康是老人健康和福祉的重要因素，隨著老人年齡的增加，生理機能逐漸退化，造成說話、咀嚼和吞嚥的困難，亦會間接影響全身健康。本研究的目的為調查大台北地區老人口腔狀況並探討影響老人口腔健康生活品質的因素。
本研究以橫斷式研究方法，立意取樣大台北地區醫院健檢及牙科門診之老人，調查對象為65歲（含）以上之老人，行動方便且可溝通者，調查人數共計409位。以結構式問卷訪談及臨床牙醫師的口腔檢查之資料收集。研究工具有：(1)口腔檢查表；(2)老人口腔健康生活評量表（GOHAI）；(3)面孔量表（Face Scale）及(4)基本問卷表等。
研究對象平均年齡為73.77?b7.34歲，年齡以65至74歲人數居多（55.8％）。老人口腔健康生活評量方面，健檢老人的分數為52.35±4.56分、門診老人為46.7±7.71分，顯示健檢老人有較佳的口腔健康生活品質；面孔量表方面，擁有好的生活品質者（健檢老人佔82.7%、門診老人佔74.2%），顯示健檢老人有較佳的生活品質。齒列狀況方面，健檢老人平均剩餘牙齒數目為21.36±8.17顆、門診老人則為19.37±9.53顆；咬合分類（A類）方面，健檢老人佔60.6%、門診老人佔53.5%；全口無牙方面，健檢老人佔4.3%、門診老人佔6.5%。結果顯示，健檢老人有較佳的口腔健康狀況。
影響因素而言，不論以主觀或客觀方式測得之咀嚼能力，是影響老人的口腔健康相關生活品質最主要因素，其他因素還包括年齡、婚姻狀況、罹患慢性病數及慢性用藥種類、每日潔牙習慣及裝戴假牙情形。本研究對象以大台北地區老人為主，期盼未來能擴及全國，調查瞭解老人之口腔健康問題，做為老人口腔健康促進之參考指標。

關鍵字

老人 ； 口腔狀況 ； 口腔健康相關生活品質

並列摘要

The aging of the population has been a global trend, with no exception of Taiwan. Oral health status is an important factor affecting health and well-being of the elderly. With the increasing of the age of the elderly, their physical function is gradually declining, causing difficulty in speaking, chewing and swallowing and also indirectly affecting the general health. The purpose of the present study was to investigate the oral health status of the elderly in Taipei region and to confer the factor affecting oral health-related quality of life (OHRQOL) of the elderly.
A cross-sectional study technique and a convenient sampling method was used in the present study. A total of 409 elderly, individuals who were over 65 years old and were easy to communicate with, were include in this study. The data regarding the questionnaire, which was collected by face-to-face interview, and the clinical oral examination gathered by the dentists. The assessment tools were (1)Dental clinic charts, (2)Geriatric Oral Health Assessment Index (GOHAI), (3)Face scale, and (4)Basic questionnaire.
The average age was 73.77?b7.34 years old and the major of the survey subjects were between 65 to 74 years old (55.8％). With the respect of GOHAI, the average score in the elderly from physical checkup group was 52.35±4.56 while the elderly from clinical dental group was 46.7±7.71, which showed better OHRQOL in the elderly from physical checkup group. With the respect of Face Scale, subjects with high quality of life (82.7% were from physical checkup group and 74.2% were from clinical dental group), which showed better QOL in the elderly from physical checkup group. With respect to dentition status, the average residual teeth were 21.36±8.17 in the elderly from physical checkup group while the other was 19.37±9.53. The A type in the Eichner Index classification was 60.6% of the elderly from physical checkup group and in 53.5% the other. The 4.3% of the elderly from physical checkup group was edentulism while the 6.5% of the elderly from clinical dental group was edentulism. The result showed that the elderly from physical checkup group had better oral health status.
The major factor affecting OHRQOL in the elderly was chewing ability, no matter measured in subjective or objective way, while other minor factors included the age, marital status, chronic systemic disease, medication, daily oral hygiene activity and whether the subject wore denture or not. This survey subjects lived almost in Taipei region. We hope, however, we can expand the sampling data to the whole country, and investigate the oral health problems in the elderly in the future, as the reference to promote the elderly oral health.

並列關鍵字

elderly ； oral status ； oral health-related quality of life

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