長期照護機構住民口腔健康狀況之研究

Research of the Oral Health for the Residents in the Long-term Care Institutions

蔡秀霞(Shiou-Shya Tsai)

指導教授 ： 黃純德

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(2004年)

摘要

高雄醫學大學口腔醫學院口腔衛生科學研究所
論文名稱：長期照護機構住民口腔健康狀況之研究
指導教授：黃純德
研究生：蔡秀霞
摘要
本研究目的為瞭解長期照護機構住民口腔健康狀況，並探討與教育程度、入住年數、意識狀態、日常生活活動能力、飲食習慣、甜食態度、口腔衛生習慣等之相關性。
採立意取樣針對高雄縣市四家長期照護機構各年齡層之住民，利用系統式問卷訪談及牙醫師口腔檢查收集資料。研究工具包括：口腔檢查表、巴氏量表及問卷表。全部樣本共920人，完成口腔檢查者共601人，完成問卷訪查者共797人，其中完成口腔檢查及問卷訪查者共485人。
結果顯示：樣本中平均年齡為72.81±12.99歲，平均齲齒經驗指數(DMFT)為21.29±8.27，平均齲齒數(D)為3.45±4.67顆，平均缺牙數(M)為14.81±10.19顆，平均填補數(F)為3.04±5.12顆，平均填補率為16.47±25.86%，平均全口無牙率為20.13%，平均牙周疾病率為93.3%，平均齲齒率為92.2%，有20顆牙以上者為36.8%。
就口腔健康狀況與問卷的各項影響因素做相關性的探討後發現：(1)教育程度愈低且年齡層愈高者，其口腔健康狀況顯著愈不佳，顯示口腔照護知識不足及高齡者因身體功能變差，自理能力下降而會影響口腔品質。(2)在入住機構年數小於一年即有顯著性差異，顯示在長期照護機構之住民在進住機構前口腔健康狀況即已不佳。(3)意識狀態愈差或無法表達之住民，其有牙周疾病率顯著亦較高。(4)日常生活活動能力完全依賴無法自理者其有牙周疾病率顯著較高，卽日常生活活動能力可自理者，因可自行清潔口腔其口腔健康狀況亦顯著較佳。(5)食物種類為甜食者，及很喜歡吃甜食者且吃甜食的次數高者其缺牙、齲齒經驗指數皆顯著較高。(6)執行口腔清潔為自理者比由機構中工作人員清潔口腔者，其有牙周疾病的比率顯著較低，顯示機構中的工作人員對住民的口腔健康有顯著影響，所以機構中的工作人員需要定期接受口腔保健知識、態度及技術的教育。
結論：本研究結果顯示由於台灣老年人口日益增多且因受限於身體功能障礙依賴性高，而口腔健康狀況亦不佳。其相關影響因素為：教育程度、意識狀態、日常生活活動能力、飲食習慣、甜食態度、口腔衛生習慣等。因此為提升長期照護機構住民之口腔健康，建議應在機構設置專業專職口衛人員，且機構之工作人員需接受口腔保健之在職教育，並請牙醫師每半年至機構做例行性口腔檢查，及推廣老人的口腔保健知識、態度行為與身體健康的相關性及重要性。
關鍵字：長期照護機構、長期照護、機構住民、口腔健康、口腔照護

關鍵字

長期照護機構 ； 長期照護 ； 機構住民 ； 口腔健康 ； 口腔照護

並列摘要

Research of the Oral Health for the Residents in the Long-term Care Institutions
Abstract
The purpose of this study was to investigate the oral hygiene and health of nursing home residents and to examine related factors such as education level, years of residence, degree of consciousness, activities of daily life and kind of diet that influence their oral hygiene and health.
In Kaohsiung area, we randomly selected four nursing homes. The information was collected by systematic questionnaire and oral health examination. There were a total of 920 subjects examined. Out of these subjects 601 had oral screening. It showed that 797 residents had answered the questionnaire and 485 had both. The average age of sample was 72.81 ± 12.99. From those subjects screened for oral health (601), the DMFT index was 21.29 ± 8.27. The decayed index (D index) was 3.45 ± 4.67. The missing index (M index) was 14.81 ± 10.19. The filling index (F index) was 3.04 ± 5.12. The filling rate was 16.47± 25.86 %.The edentulous rate was 20.13%, the prevalence rate of periodontal disease was 93.3% 、caries rate was 92.2%.The subjects with more than 20 teeth was 36.8%.
From the discussion among the oral health and related factors ,the following were concluded:(1) The oral health was significantly worse in the less educated and the elder subjects. This showed that the lost of physical activity due to aging and the lack of knowledge in oral hygiene compounded the effect on oral health. (2) Those residing in the nursing home for less then one year also had bad oral health suggesting that their dental hygiene was poor prior to entering. (3) The percentage of periodontal disease was significantly higher in residents with less mental awareness. (4) Residents losing the activities of daily life had higher percentage of periodontal disease and vice versa. (5) Numbers of missing teeth and DMFT were significantly higher in groups who prefer frequent intake of sweet diets. (6) Those residents who could take care their oral hygiene independcntly had significantly better oral health than those residents who took care their oral hygiene dependently. These implicated that it is inportant to educate the nursing personnel in these various institutions in terms of knowledge, attitude and skills in oral hygiene and oral health.
The conclusions are following: with increasing number of elder population in Taiwan, the worse oral health condition are resulted from physical disabled and loss of self-care. The related factors shown from our studies suggest that the level of education, years of residence, consciousness, activites of daily life and kind of diet that influence their oral hygiene and health. In order to improve the oral health of nursing home residents, we propose that the professional oral hygiene specialist should be established in the institution and the biannual oral examination for nursing home residents is highly recommended. However, it is important to develop a adquate knowledge and practice of oral hygiene and close relationship with general health since young age.
Keywords: Nursing Home, Long Term Nursing, Residents,
Oral Hygiene, Oral Health

並列關鍵字

Nursing Home ； Long Term Nursing ； Residents ； Oral Hygiene ； Oral Health

參考文獻

參考文獻

一、英文部份

1. Ajwani S, Tervonen, T, Narhi TO, Ainamo A. Periodontal

health status and treatment needs among the elderly.Spec

Care Dentist 2001；21:98-103.