探討桃園縣國中生口腔健康相關生活品質的影響因素

A Study of the Related Factors for the Oral Health-Related Quality of Life in the Students of Junior High Schools in Taoyuan County

李火傳(Huo-Chwan Lee)

指導教授 ： 謝天渝

高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/碩士(2003年)

摘要

研究目的：調查桃園縣國中生口腔健康狀態與口腔健康相關生活品質，並進一步探討影響口腔健康相關生活品質的因素。
材料與方法：本研究隨機抽取桃園縣2所國中，行文經校方同意後從抽出的班級再隨機抽出男女生各30人，每個年級60人，總樣本為360名國中生。以受過訓練的牙醫師利用WHO發展之口腔檢查量表調查個案的口腔健康情形，並以標準化結構式問卷請學生自填，進行所需資料的收集，並使用口腔健康相關生活品質問卷(OHIP)作為測量工具。總共得到有效樣本數356名。
研究結果：桃園縣國中生齲齒率高達95.2﹪，其中男生為93.3﹪，女生為96.6﹪，沒有性別上的顯著差異(p=0.223)。而平均DMFT為4.9；男性是4.6，女性是5.3(p=0.026)；有42.7﹪學生具有牙周疾病，女性的40.5﹪和男性的40.2﹪相近。若以分組的DMFT來看，「4-7顆」的比例最多，為56.5%。OHIP量表平均得分頗低，為0.83，其中以「心理上的不安/不適」對國生影響最大，得分為1.15，其次為「生理上之疼痛」為0.98分。而父母親教育程度愈低、有齲齒、DMFT愈高者，其口腔健康相關生活品質會愈差。此外，三餐外吃零食頻率高者其口腔健康相關生活品質也會愈差。而女性在「心理上的不安/不適」範疇所受的衝擊比男性大。
結論：由本研究結果可知桃園縣國中生的口腔健康狀況不佳，其齲齒率高達95.2%，此現象急待改善。在影響國中生OHIP量表得分上以雙親教育程度、有無齲齒和DMFT與得分有顯著相關。一般而言，雙親教育程度(尤其是父親)高、無齲齒、DMFT少，則OHIP得分低，即口腔健康相關生活品質愈佳。此外，OHIP應用在青少年族群上可能需要再修改。雖然如此，但分析結果仍發現口腔問題對青少年而言，在心理不安與生理疼痛等生活層面造成一定程度的衝擊。所以，口腔健康狀況也是會對青少年的口腔健康相關生活品質造成影響。
因此，在中學生齲齒情形居高不下的現在，可嘗試藉由影響層面較嚴重的方向切入國中生的口腔衛生教育，以收成效。並將口腔衛生習慣落實於日常生活中，使中學生在注意課業之時，不會疏於對自己口腔健康的照護，而能改善口腔健康情形，進一步提高其生活品質。

關鍵字

國中生 ； 口腔健康相關生活品質

並列摘要

There is no enough data about oral health-related quality of life in adolescents. The aim of the present study used OHIP as a measuring method of oral health-related quality of life in junior high school students in Taoyuan County.
Two junior high schools, Na Kan and Guanng Ming were selected via random sampling. The subjects in this study were 356 junior high school students by stratified grade-sex random sampling. The examination was carried out in two parts. In the first part, a questionnaire was composed of items including demographical variables, OHIP and oral hygiene behaviors. In the second part, the students were clinically examined in their schools using procedures and diagnostic criteria recommended by the World Health Organization (1997).
The prevalence of caries was 95.2%. Boys and girls respectively take 93.3% and 96.6%. DMFT in girls was 5.3 that higher than 4.6 in boys. About 43% students suffered from periodontal disease, 40.2% for boys and 40.5% for girls, respectively. The mean score of OHIP was 0.83, and the most important effect among junior high students was “Psychological Discomfort”. The domain’s score was 1.15, and girl>boy. The second important was “Physical Pain” that score was 0.98. If parents’ education level were low, especially father’s, the OHIP score would high. It represented the lower oral health-related quality of life. In addition, the mean OHIP score had significant difference between with caries (0.84) and without caries (0.54) (p=0.021); and DMFT had positive correlation with OHIP score, markedly. It showed that the poor oral health status had low oral health-related quality of life.
We could think that older people oral health as being important to life quality in a variety of different ways, and younger people too. So, oral health status is closely associated with oral quality of life for both adults and children.

並列關鍵字

junior high school ； oral health-related quality of life

參考文獻

1. Hornick B. Diet and nutrition implications for oral health. J Dent Hyg 2002; 76:67-78.

2. Walls AW, Steele JG, Sheiham A, Marcenes W, Moynihan PJ. Oral health and nutrition in older people. J Public Health Dent 2000; 60:304-7.

3. Pla GW. Oral health and nutrition. Prim Care 1994; 21:121-33.

4. Oral Health in America: A Report of the Surgeon General p1-p28, 1998.

5. WHO: Oral Health Surveys - Basic Methods 4th Edition, 1997.