老人口腔健康狀態與生活品質之關係暨其影響因素之探討

The relationship of the oral health status and the quality of life in elderly and the exploration of the related determinants

李易蓁(I-Chen Lee)

指導教授 ： 蔡吉政

高雄醫學大學/口腔醫學院/牙醫學研究所/博士(2007年)

https://doi.org/10.6832/KMU.2007.00005

摘要

研究目的：探究台灣地區65歲以上老人口腔健康狀態與健康相關生活品質的關係暨其影響因素為何。研究方法：研究樣本為高雄市1,600名老人，問卷回收率71.62%。研究工具為研究人員自行設計的結構式問卷，經由受過訓練的訪員到受訪者家中進行面對面訪視並收集資料。本研究將口腔健康狀態分為臨床口腔疾病與受訪者自覺口腔健康狀況兩種。臨床口腔疾病主要是以口內有無自然牙齒為代表，而OHIP的總分則代表受訪者自覺口腔健康狀況。再以SF-36工具測量健康相關生活品質。研究結果：老人的口腔健康狀態與健康相關生活品質有明顯的關聯性。至於與老人全口無牙有關的因素為年齡愈大、女性、教育程度愈低、一星期內社交活動頻率較低、牙疼時無固定就醫場所、刷牙頻率較低、零食食用頻率較高以及有嚼食檳榔習慣、罹患高血壓、糖尿病等慢性病。與OHIP總分較高，即自覺口腔健康狀況較差相關的因素為教育程度較低、一星期內社交活動頻率較低、牙疼時無固定就醫場所、零食食用頻率較高、罹患糖尿病、視力狀況較差、IADL失能、對目前生活不滿意程度較高以及生理功能狀況較差。影響健康相關生活品質的因素分成兩部分：與生理健康層面生活品質較差有關的因素為自覺口腔健康狀況較差(OHIP總分較高)、年齡較大、女性、一星期內社交活動頻率較低、經濟狀況較差、每個月需要固定看醫師或拿藥、過去六個月內曾經住院、IADL失能、罹患關節炎或風濕、心臟病、糖尿病等慢性病以及對目前生活不滿意程度較高。與心理健康層面生活品質較差有關的因素為自覺口腔健康狀況較差(OHIP總分較高)、女性、教育程度較低、一星期內社交活動頻率較低、以及對目前生活不滿意程度較高。結論：本研究結果除了將提供相關單位制訂口腔健康保健政策時之參考，建議未來研究必須進一步探究臨床因素(即口腔方面疾病)與全口無牙之關係。此外，在探究口腔健康狀態對健康相關生活品質的影響時，發現受訪者的自覺口腔健康狀況對生活品質的影響較臨床口腔疾病明顯，建議未來生活品質相關研究更要謹慎地將受訪者的主觀感受納入考量。

關鍵字

老人 ； SF-36 ； OHIP ； 全口無牙 ； 生活品質

並列摘要

Objective: The purpose of this study is to explore the relationship between oral health and health-related quality of life and the possible causes of them on Taiwanese elders, aged over 65 years. Material and methods: 1,600 elderly persons, over 65 years old, were sampled as the research target. The overall response rate was 71.62%. Measurement parameters used in this research were structured questionnaires composed by the researchers. Information gathering was done by trained individuals who visited the subjects at their homes. This research divides oral health status into two parts: clinical disease and patients’ subjective perceptions. SF-36 was used to measure the health-related quality of life, OHIP was used to measure individuals’ subjective perception of their oral health status, and the number of natural teeth was considered as the clinical issue. Results: Oral health has the significant association with health-related quality of life . The associated factors of edentulism include age, gender, education level, number of weekly social activities, consistent dentist and location of dental clinics for dental pain, frequency of tooth brushing, frequency of snacking, current or previous habit of consuming betel nuts, as well as currently suffering with hypertension and diabetes. The associated factors of OHIP score include education level, number of weekly social activities, consistent dentist and location of dental clinics for dental pain, frequency of snacking, visual station, abnormal IADL patients, diabetes, the satisfaction level of current lifestyle as well as physical functioning (PF). There are 12 items which affect quality of life in the physical aspect, namely: OHIP score; age; gender; weekly frequency of social activities and interactions; financial status; physician visits per month on a regular basis; hospitalization during the last six months; arthritis, rheumatism, cardiovascular disease or diabetes; abnormal IADL patients; and the satisfaction level of current lifestyle. Factors affecting quality of life (i.e. mental aspects), are few, including: OHIP score, gender, education level, weekly frequency of social activities and interactions, and satisfaction level of current lifestyle. Conclusions: In order to provide a holistic perspective of oral health maintenance policy, considering the clinical factors (e.g., oral diseases) as one of the associated factors of edentulism in the future study is strongly suggested. Additionally, the results indicate that individuals’ subjective perceptions of their oral health status had a greater impact, than did the clinical issue, on their health-related quality of life. The outcomes and findings derived from this research may provide alternative perspectives for professionals, so that they may be more careful concerning individuals’ subjective perceptions.

並列關鍵字

elderly ； SF-36 ； OHIP ； edentulism ； quality of life

參考文獻

參考文獻

英文文獻

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