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口腔衛生教育介入對南部地區發展遲緩兒童口腔衛生狀況之成效評估

The Effect of Oral Hygiene Intervention on Developmentally Delayed Children in Southern Taiwan

摘要


背景:根據國內、外研究指出,齲齒為威脅發展遲緩兒童口腔健康最嚴重的問題,因此口腔衛生之照護,對發展遲緩者而言,比一般人還要來得重要。然而,口腔衛生教育介入對提升口腔健康狀況是最直接有效的方法。方法:本研究對象以立意取樣方式。以南部地區早療機構的學齡前兒童為對象,共計301人。針對受試兒童、父母或主要照顧者提供口腔衛生教育課程等潔牙技巧教導及口腔保健宣導,採一對一個別潔牙技巧指導,並執行前測牙菌斑檢測,間隔2週後執行二次團體衛教介入及後測牙菌斑檢測,分析比較兩階段間的差異。以描述性統計進行各變項初步分析,再使用Mc Nemar's test及paired t-test進行推論性統計。結果:研究發現兒童在口腔衛生教育介入後,不論是全口或是不同側面的牙菌斑殘留率皆低於介入前,其中頰側面牙菌斑殘留率改善最多,而改善效果最小為遠心舌側;口腔衛生教育介入後,照顧者平均知識得分高於介入前;而在照顧者態度部份,在介入後平均態度分數較介入前高,表示在口腔衛生教育介入後,照顧者知識有顯著提升,且態度較正向。結論:本研究發現口腔衛生教育課程介入後,兒童不管在口腔衛生行為或是潔牙後牙菌斑殘留率都有改善,可推論發展遲緩見童經由口腔潔牙技巧教導後,可讓兒童在口腔清潔上具有改善效果。而主要照顧者在照護知識有顯著提升,而且態度較正向。整體而言,口腔衛生教育課程的介入對發展遲緩兒童的口腔衛生真有改善的效果。

並列摘要


Dental caries is a serious problem that threatens not only the oral health but also general health of children with developmentally delayed. So oral health care is more important in children with developmentally delayed than in normal people. N the other way, more than 40% of parents and caregivers of children with developmentally delayed have not received any oral health instruction or education, which reflects that the parents and caregivers need oral health education and practice training courses. Actually, oral health education intervention is the most direct and effective way to enhance the oral health status of children with developmentally delayed. Methods: The research subjects were obtained with purposive sampling and a total of 301 pre-school children from early intervention institutions in the southern region of Taiwan were recruited. Oral health education courses, such as teeth cleaning skills and oral health advocacy were provided one-to-one individually to the parents and caregivers of children with developmentally delayed. Two times of primary and advanced oral health education intervention was conducted, compare the difference of knowledge, attitude of parents and caregivers, the residual plaque index of dental plaque of children with developmentally delayed between before and after the oral health intervention program by an interval of two weeks. Descriptive statistics were used for preliminary analysis of each variable and McNemar's test, paired t-test for inferential statistics. Results: The study found that children's plaque residual rate was lower after the intervention of oral health education, either whole mouth or different areas of the mouth. Plaque residual rate on the buccal side improved most, followed by the mesial buccal side, distal buccal side, lingual side and mesial side of the teeth. There was less improvement in the distal lingual side. After oral health education intervention, the caregiver's average knowledge scores were higher than before intervention. As to the attitude of caregivers, the average scores were also higher after intervention. Oral health education intervention significantly enhanced the caregiver's knowledge and a more positive attitude. Conclusion: This study proposes that after the intervention of the oral health education programs, regardless of whether the acts of oral hygiene or plaque residual rate after cleaning teeth, all improve in children. It can be inferred that via oral teeth cleaning techniques teaching, children with developmental delays show improvement in oral hygiene. There is no significant difference before and after the behavior intervention by the primary caregivers, whereas their knowledge significantly improves and attitude is positive. Overall, oral health education intervention for children with developmental delays presents with improved effect.

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