- 學位論文
高雄縣市長期照護機構45歲以上中老年人口腔健康狀況調查
Oral Health Survey of Institutionalized Residents More than 45 Years Old in Kaohsiung
摘要
背景：近年來國人的平均年齡逐漸增加，漸漸邁入「高齡社會」。老年人口的大量增加勢必會突顯出許多長期照護的問題，不僅有老年人常伴隨的身心障礙問題，許多潛在的慢性疾病也會慢慢顯露症狀。這些慢性疾病大多都是因為生活習慣與生活方式不良所造成的，因此也會影響口腔健康，使生活品質受到影響。而口腔為整個身體的重要部份，會影響到咀嚼、吞嚥、說話、臉部表情及自尊等等。除了口腔疼痛令人疼痛難耐外，口腔疾病也會阻礙吞嚥或說話，影響到享受美食的樂趣及營養的均衡。 目的：針對高雄地區長期照護機構45歲以上住民進行口腔健康調查，以了解住民之口腔健康狀況，並且探討與社會人口學和身體活動狀況之間的關係，進而了解身體活動狀況與口腔健康狀況之關係。 方法：本研究之研究對象為45歲以上之長照機構住民，使用分層隨機抽樣方法，分別從高雄市抽出8間長照機構，高雄縣抽出8間，共16間長照機構。長照機構之照護員或護理人員對住民做事前說明，並就其願意簽署受試者同意書之住民進行口腔健康調查，共747人。研究工具包括結構式問卷、口腔健康狀況檢查表。統計方法有描述性統計、t檢定、卡方檢定、變異數分析及線性/邏輯迴歸分析。 結果：高雄地區調查長期照顧機構住民，男性333人(44.58％)，女性414人(55.42％)。住民平均年齡為77.68±11.09歲。住民每人平均缺牙數為20.58±10.43顆，平均齲齒數為1.17±3.12顆，平均填補數為0.16±0.89顆，平均牙根齲齒數為0.39±1.62顆，平均殘根數為2.21±3.81顆，平均之固定贋復體為3.06±5.25顆，全口無牙之比率為28.25％。缺牙數和全口無牙的影響因素為性別、年齡層、教育程度。住民達成8020 (80歲以上擁有20顆以上有功能牙齒)之比率為3.08％。住民之牙菌斑指數平均為1.86±0.88，牙齦狀況平均為2.13±0.92，牙結石指數平均為1.14±1.01，牙齒磨耗指數平均為1.16±1.15，牙齒動搖度平均為0.23±0.51，舌苔指數平均為0.66±0.89。 結論：高雄地區長期照護機構中，45歲以上住民的口腔健康狀況都不理想，牙齦炎和牙結石的狀況都很普遍，而且缺牙和全口無牙的情況更是嚴重。未來，長期照護針對口腔健康問題與口腔預防保健需求相當重要，有效及正確的口腔照護將可降低口腔疾病，預防口腔感染，增進口腔健康及整體健康，提升口腔生活品質及整體生活品質。
並列摘要
Background: Throughout the world, the proportion of older people in the general population has increased in recent years. In addition to other general health issues there are tremendous implications for oral health. Previous studies have shown widespread oral health problems among nursing home residents, including poor oral hygiene, high levels of dental needs and low rates of dental care utilization. Purpose: The purpose was to report the oral health among residents in Kaohsiung City and County, and to evaluate the correlation between oral conditions and socio-demographic variables, as well as between oral conditions and daily activities variables. This research was to improve the oral health status, general health, enhance the daily oral function activity quality and general daily activities through this project including oral health survey for long-term care institutionalized residents. Methods: The 16 registered long-term care institutions of Kaohsiung City and County were selected at stratified random sampling, and 747 persons of their residents registered as people with disabilities and over 45 years old, showed willingness to cooperate to this program were used in this research. This program was conducted under complete explanation to the institutes, and the residents only conducted to those people who have signed the agreement and consent to this program. The materials used in this research included structural sampling questionnaires, oral health status examinations. Statistical methodology included descriptive statistics, t-Test, Chi-square test, ANOVA and linear/logistic regression analyze. Results: There were 747 institutionalized residents who more than 45 years old enrolled in this study. The number of males was 333 and the number of females was 414, and the average of age was 77.68±11.09 years old. For the dentition status, the average number of missing teeth was 20.58±10.43 teeth per person, decay teeth was 1.17±3.12 teeth, filled teeth was 0.16±0.89 teeth, root caries was 0.39±1.62 teeth, residual root was 2.21±3.81 teeth, and the average number of fixed prosthesis was 3.06±5.25 teeth. For the edentulous status, the rate of edentulous was 28.25%. For the missing teeth and edentulism, gender, age groups and education level showed statistically significant differences. The rate of residents who achieve 8020 was 3.08%. Plaque index was 1.86±0.88, gingival status was 2.13±0.92, calculus index was 1.14±1.01, attrition was 1.16±1.15, mobility was 0.23±0.51, and tongue coating score was 0.66±0.89. Conclusion: This study has shown a lot of oral health problems among institutionalized residents, including poor oral hygiene, plaque, calculus, missing teeth and edentulism. Therefore, the results suggest the necessity of improving and implementing the dental health services programs. In order to promote oral health for the institutionalized residents, the care givers and dental professionals’ cooperation are necessary to help the residents to maintain good oral hygiene and raise the quality of life of the residents.