特殊教育學校學童家長口腔健康相關KAP與身心障礙學童口腔健康狀況之相關性探討

背景：國內身心障礙者的口腔健康一直有齲齒及牙周病的嚴重問題，影響身心障礙者的飲食及生活品質，而身心障礙者在接受口腔照護及治療上一直沒有很好的效果。「預防勝於治療」相信是最好的照顧方式，提前做好預防保健以避免疾病的產生，更能提升身心障礙者的口腔健康，以及降低醫療費用。口腔疾病的預防以及口腔健康的維持，必須從學童做起，建立良好的習慣，使身心障礙者及照護者有正確的知識及態度。研究目的：本研究目的是瞭解身心障礙者學童口腔健康需求，並探討其口腔健康現況以及其家長口腔健康知識態度行為之相關性。研究方法：共調查697名3~22歲身心障礙學童的口腔狀況，並由其父母填寫關於口腔健康知識、態度及行為問卷。討論身心障礙學童的口腔狀況與其父母口腔健康知識、態度及行為的相關性結果學童的口腔健康狀況隨著年齡的增加，齲齒情形越嚴重，學童的齲齒指數：乳齒deft為3.07±4.09、齲齒盛行率為45.39%、填補率為30.55%，混合齒列deft +DMFT為3.74±3.94、齲齒盛行率56.68%、填補率33.59%，恆齒DMFT為4.04±4.27、齲齒盛行率60.35%、填補率42.64%。家長口腔健康相關知識分數分為0~60、61~70和71~100分，而家長口腔健康相關態度分數則分為15~45、46~52、53~75，以知識層面來看，家長分數為60~70分的學童恆齒填補數2.30±3.27顆(p=0.0349)及恆齒填補率53.50%(p=0.0125)顯著高於家長分數為0~60分的學童恆齒填補數1.35±2.37顆(p=0.0349)及恆齒填補率35.59%；以態度層面來看，家長分數為53~75分的學童口腔狀況：乳齒填補率為35.80%(p=0.0300)、混合齒列填補率為39.62%(p=0.00068)、恆齒填補數為1.96顆(p=0.0214)及恆齒填補率為47.43%(p=0.0301)皆顯著高於家長態度分數為15~45分的學童，其乳齒填補率為19.97%、混合齒列填補率為20.39%、恆齒填補數為0.83顆及恆齒填補率為27.95%。結論學童的齲齒經驗指數及齲齒率隨著年齡增加而增加，而影響學童口腔健康狀況的生活習慣為攝取甜食的頻率，，隨著頻率越高，齲齒經驗指數越高，其中攝取方式以學童主動要求及家長以甜食做為鼓勵或安慰品為主要。並且在家長的口腔相關知識及態度上，以家長的態度分數為高的學童填補率顯著為高。

關鍵字

口腔健康；身心障礙學童；父母KAP

並列摘要

Background: The condition of dental caries and periodontal disease is a serious problem of the disabled in Taiwan. They affect mastication, swallowing and even the quality of life. Prevention is better and more important than cure, to care and prevent the initiation of dental disease is the best way to improve their dental health, improve mastication, swallowing effect, quality of life and even reduce medical expenditure. The dental health related KAP of the parents and caregivers of people with disabilities usually impacts the implementation and the effect of prevention and dental care strategy for people with disabilities and influences their dental health status. Study objectives: The purpose of this research was to evaluate the relationship between the dental health of students with disabilities and the oral health related KAP of their parents in Taiwan. Study methods: A total number of 697 students with disabilities aged 3~22 years-old was surveyed for their dental health, and their parents were asked to complete a questionnaire related to the oral health KAP. The relationship between the dental health of students and KAP of their parents was discussed. The examination of student’ dental health and answers to the questionnaires of their parents were coded and entered in a data bank in Microsoft Office Access program, using ANOVE statistical analysis with a significance level of 0.05. Results: 1) Dental health status of students with disabilities The dental health status of students is affected by age. The oral health status of this study showed a deft index: 3.07±4.09, caries prevalence: 45.39% and filling rate: 30.55%; in the mixed dentition, the deft+DMFT index, caries prevalence and filling rate were 3.74±3.94, 56.68% and 33.59% respectively. In the permanent dentition, the DMFT index, caries prevalence and filling rate were 4.04±4.27, 60.35%, 42.64% respectively. 2) Relationship among dental health status of students with disabilities and dental health related KAP of their parents The score of dental related knowledge of parents was divided into three groups: score 0~60, 61~70 and 71~100. And the score of dental related attitude of parents was divided into three groups: score 15~45, 46~52 and 53~75. In knowledge aspect, ft index: 2.30±3.27 (p=0.0349) and permanent filling rate: 53.50 %( p=0.0125) of students of parents with a knowledge score of 61~70 was significantly higher than the ft index: 1.35±2.37 and premanent filling rate: 35.59% of students of parents with knowledge score of 0~60. In attitude aspect, primary filling rate: 35.80%(p=0.0300), mixed dentition filling rate: 39.62%(p=0.00068), FT: 1.96 (p=0.0214) and permanent filling rate: 47.43%(p=0.0301) of students of parents with a knowledge score of 53~75 was significantly higher than the primary filling rate: 19.97%, mixed dentition filling rate: 20.39%, FT: 0.83 and permanent filling rate: 27.95% of students of parents with a knowledge score of 15~45. Conclusion: The dental health related KAP of the parents of students with disabilities is related to the dental health of students with disabilities, especially in filled teeth number and filling rate. The better the dental health related knowledge and attitude of the parents, the better the dental health of their children.