高雄市長期照護機構50歲以上住民牙科就醫行為之調查

Dental Visit behavior for Elderly Residents in Long-term Care Institutions in Kaohsiung Area

王文岑(Wen-Chen Wang) ； 林靜芬(Ching-Fen Lin) ； 黃純德(Shun-Te Huang)

《Taiwan Journal of Oral Medicine Sciences》 28卷2期 (2013/08) Pp. 103-115

摘要

2010年台灣65歲以上老年人口占總人口比率為10.74%，且老化指數不斷持續地上升。老年人常會合併多種慢性病且也有活動障礙情形出現，因而限制他們牙科就醫行為。本研究主要目的是了解近年來長照機構住民牙科就醫行為和住民本身的肢體活動障礙、慢性病、存留牙顆數、日常生活能力（ADL）等身體問題，並進一步探討這些問題與長照住民的牙科就醫行為之關係。材料與方法：本研究採方便抽樣調查法（convenience sampling survey）。針對高雄地區共205家機構，取得18家中型以上長期照顧機構同意，由訓練過之研究調查員以一對一方式，對50歲以上長照機構住民進行問卷調查。樣本數總共512人，有468人完成完整的牙科就醫行為或經驗調查。結果：468位住民中，其中男性233位，女性235位，平均年齡78.85歲，以75歲至84歲之年齡層住民最多。平均每人罹患慢性病2.4種，疾病診斷以高血壓居多（53.21%）、其次為糖尿病（29.49%）、第三則是中風（23.29%）。在口腔方面，存留牙顆數未滿20顆的住民佔80.98%。3年內有牙科就醫行為的比率為34.40%，1年內有定期回診率6.41%。不規律牙科就醫的大部份原因是老人自覺不需要（58.12%），其次有活動障礙者佔41.03%。結論：長照機構中老年人牙科就醫行為之相關影響因素為：上下肢活動功能、存留牙顆數，和口腔清潔方式，並顯示住民因受限於身體功能障礙、慢性疾病較多和牙科醫療利用率低，使口腔健康狀況亦不佳。因此，介入計畫應包括有口腔衛教、機構照護者的口腔清潔訓練，以及克服交通障礙來增加定期回診，這工作是刻不容緩的。

關鍵字

長期照護機構 ； 牙科就醫行為 ； 活動障礙

並列摘要

Background:The elderly person more than 65 years old shares 10.74% of total population in Taiwan by 2010, and the elderly index is increasing rapidly. As the elderly persons always combined with several kinds of chrome diseases, and with difficulty in moving, it will restrict their dental visit behavior prominently. The further research to explore their physical, physiological limitation is planned.The purpose of this study was to understand the current status of the dental visit behavior and the physical problems of old residents in the long-term care institutions, including the physical disability, the chronic disease, the tooth number, ADL(Activity of daily living) and so on. And further it explored the relationship between the physical problems and the dental visits of residents.Method:This study used ”convenience sampling survey”. The study focused on residents who were over fifty years old and resides in long-term care institutions of Kaohsiung area. The data was collected from March to December 2010. There were 18 institutions) 512 questionnaires in total, and 468 completions.Results:There were a total of 468 residents interviewed in long-term care institutions, 233 male residents and 235 female residents. The average age of the residents was 78.85 years old. Concerning diagnosed chronic diseases, hypertension, DM and stroke were 53.21 %, 29.49% and 23.29% respectively. There were 80.98% of residents had existed teeth number less than 20 teeth. The utilization of dental visits in the past three years was 34.40% and the follow-up rate every year in the past three years was 6.41%.The majority of reasons for irregular dental visits was ”no need” (58.12%), and the activity barrier was 41.03%.Conclusions:The study shows that primary factors of effecting dental visit are as follows: the limb activity function, the existed tooth number and the oral cleaning method. Due to activity barrier and chronic diseases in the old residents of which the population is gradually increasing, the oral health condition of the old residents also is becoming worse. The intervention program includes training course of oral health education, oral care practice to the caregivers in the institutions and overcome the barrier of transportation to increase the periodically follow-up are urgent task for us to do.

並列關鍵字

long-term care institutions ； dental visits behavior ； activity barrier