牙醫師人口比與民眾牙科就醫行為比較之探討－以台中縣為例

Investigation of the Relationship between the Dentist/resident Ratio and their Dental Visit Behaviors--- A Case Study in Taichung Count

鄭麗美(Li-Mei Zheng)

指導教授 ： 楊奕馨

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

中文摘要
本研究為瞭解台中縣牙醫師人口比與18歲以上居民牙科就醫行為及口腔衛教需求之差異，本研究於民國90年針對台中縣進行抽樣調查，研究設計採分層多階段集束抽樣調查法(stratified multi-stage cluster sampling)，以結構式問卷對台中縣四個鄉鎮400案樣本進行抽樣調查，其項目包括：是否覺得需加強口腔衛生知識、最希望從何管道得知、最期望獲得何種口腔衛生知識、定期看牙醫的態度，行為現況。共回收377份，資料以JMP4.2版(SAS)統計軟體進行資料整理及分析。結果；台中縣每萬人口牙醫師人口比平均為3.99人(豐原4.97人、烏日3.28人、大雅3.16人、大安0.47人)，台中縣居民牙科定期就醫比率平均為24.95﹪(男性22.83﹪ 女性27.07﹪)其中大雅佔39.11%比率最高，豐原15.14%最低，顯示有75%的民眾並沒有定期看牙醫的習慣，而定期看牙醫頻率：半年一次佔52.13﹪、一年一次佔47.87﹪，而過去一年看牙醫的次數統計結果為46.54﹪沒有看過牙醫，只有一次(20.75﹪)、二次(15.43﹪)、三次以上(17.29﹪)；而大安在看牙醫三次以上僅佔12.95%為低，顯示民眾一年中看牙的次數不高。推測可能民眾皆到牙齒痛才看病有關，當問看牙醫的時機統計結果，也以牙齒不舒服才去(男性佔72.65﹪、女性佔66.74﹪)為最多，而民眾不看牙原因中「牙齒很好，從沒有牙痛」平均佔68.09﹪(大安佔88.79%最高)，推測民眾看牙較不高及無定期看牙醫習慣，可能是民眾等到牙齒痛才看病並自認牙齒很好，缺少保建關念有關而，而有定期檢查習慣以專科以上48.87﹪、高於小學以下3.11﹪；年齡以18∼34歲35.59﹪高於65歲以上7.80﹪顯示年齡越輕、學歷越高者，較注重定期檢查牙齒。有關口腔衛生知識需求中48.25﹪希望由傳播媒體，54.47﹪希望寄資料到府，而有73.15﹪的民眾希望得到牙齒保健、68.48﹪希望得到牙周病的預防、64.20%的民眾希望得到口腔癌自我檢查之口腔衛生知識，由研究資料顯示民眾牙科定期就醫及口腔保健教育需要提升，而每萬人口牙醫師比密度最高之豐原(4.97人)、其民眾定期就醫比率(15.14%)，遠低於密度最低(0.47人)之大安定期就醫比率(19.93%)；而看牙醫時機中，定期檢查習慣者及經常去治療兩項比率，大安遠高於牙醫師人口比較密集之豐原，由此顯示；地域的不同、牙醫師人口比的不同似乎不至於會影響民眾牙醫就醫行為，而且並非牙醫師人口比密度高的地區，民眾定期就醫比率、口腔保健行為就高，顯然牙醫師人口比低的地方，民眾仍有良好的就醫行為，且不影響其就醫之習慣，反倒是民眾口腔保健、心理建設教育需求之必要性勝過於牙齒就醫需求。

關鍵字

牙醫師 ； 人口比 ； 就醫行為 ； 口腔保健 ； 牙科

並列摘要

Abstract
The purposes of the study were to explore dentist/resident ratio as well as to understand the differences of dental visiting behaviors and the needs of oral health education among adults over 18 years old in Taichung County. The investigation was carried out in Taichung in 2001, when a stratified multi-stage cluster sampling was employed along with a structured questionnaire completed by 400 subjects. The questionnaire contained personal viewpoint toward the need of strengthening oral health knowledge, the best way to obtain the necessary information, the attitude toward regular dental visits and subjects’ current dental visit behavior. In total, 377 questionnaires were collected. Data analyses were performed on Statistical Analysis System (SAS, JMP V4.2) package.
The results of the study were described as follows: the average resident/dentist ratio in Taichung County was 10,000 to 3.99, with 10,000 to 4.97 in Fengyuan, 10,000 to 3.28 in Wur, 10,000 to 3.16 in Daya and 10,000 to 0.47 in Da-An. The average percentage of regular dental visit was 24.95% among the 377 Taichung County residents (approximately 22.83% of men and 27.07% of women). The highest rate of regular dental visit (39.11%) appeared in Daya and the lowest (15.14%) in Fengyuan, both of which indicated that 75% of the Taichung County residents did not have the habit to visit dentists regularly. Among the people who paid regular dental visits, about 52.13% went once every six months, and nearly 47.87% went once a year. The frequencies of participants’ dental visiting during the past year were as follows: 46.54% for none, 20.75% for once, 15.43% for twice, and 17.29% for three times or more. A small percentage (12.95%) of the subjects from Da-An visited the dentists three times or more. The statistics aforementioned revealed that the residents’ frequency of annual dental visit was not high; we suggested that this was probably because the residents paid dental visits only when their tooth ached. The statistics of dental visit timing indicated that those who paid dental visits when they had toothache were the majority (72.65% of the male and 66.74% of the female). On average, 68.09% of the subjects reported that they did not visit dentists because “the teeth were fine and never ached”--- the highest percentage (88.79%) appeared in Da-An. The following reasons, we inferred, probably could explain the residents’ low dental visiting frequency and their lack of the habit of visiting dentists regularly: going to the dentists only when their tooth ached, deeming their teeth to be good, and lacking the concept of oral health care. In terms of the percentage of having the habit of paying dental visit regularly, the group with junior college education background or above (48.87%) was higher than the group with elementary school education background (3.11%) and the group aged 18-34 was higher than the group aged 65 or over (7.80%)--- which showed that the younger and the higher educated the subjects were, the greater the emphasis they laid on regular dental examination.
With regard to oral health knowledge, about 48.25% of the 377 subjects hoped to get the related knowledge from the mass media, 54.47% hoped to have the information mailed to their house, 73.15% hoped to obtain information on dental health care, 68.48% hoped to have information on prevention of periodontal disease, and 64.20% hoped to obtain the oral health knowledge concerning oral cancer self-examination; this finding suggested that the habit of regular dental visit and oral health education should be promoted among the residents.
The percentage of regular dental visits in Fenyuan (15.14%), where the resident/ dentist ratio was the highest (10,000 to 4.97), was far lower than that in Da-An, where the resident/dentist ratio was the lowest (10,000 to 0.47). As for the timing of dental visit, the percentage of paying regular dental visits and of having frequent dental treatment in Da-An were much higher than those in Fengyuan, though the resident/ dentist ratio in Fengyuan was relatively higher; the result revealed that the differences of area and resident/dentist ratio did not seem to influence the residents’ dental visit behavior. Moreover, high resident/dentist ratio did not necessarily mean high percentage of regular dental visit or good oral health behaviors. Obviously, the subjects from areas with low resident/dentist ratio could still leave their habit of dental visit unaffected and had good dental visiting behaviors. Rather, the residents’ need of education of oral health care and psychological fortification is stronger than the need of dental treatment.

並列關鍵字

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參考文獻

參考文獻

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