- 學位論文
南臺灣學齡前兒童的牙科拜訪經驗之相關因素探討：應用安德森醫療服務利用行為模式
The factors of regular utilization of dental services among preschool children in southern Taiwan: applying Andersen’s behavioral model
摘要
研究背景： 齲齒在學齡前兒童中是普遍常見的口腔疾病，通常會造成兒童的生長發育、飲食、外觀甚至社交方面影響，牙科服務利用已被認為是一項重要預防齲齒的影響因素，而過去台灣研究以探討兒童齲齒影響因素為主，影響兒童的牙科服務利用因素討論較少，因此在這方面還有許多需要探討。 研究目的： 利用安德森醫療服務利用行為模型來探討學齡前兒童與照護者的個人因素與兒童的口腔健康行為、定期牙科拜訪習慣之間的相關性。 材料與方法： 本研究為橫斷性研究，研究樣本為2017年至2018年居住於台南市、高雄市、屏東縣的滿6個月至未滿6歲的學齡前兒童，總計2142人，本研究資料以卡方分析、獨立雙樣本T檢定、單因子ANOVA檢定及階層邏輯斯迴歸分析，探討兒童及照護者的個人因素與兒童口腔健康行為、定期牙科拜訪習慣的相關因素。 結果： 本研究的兒童男女生比例各為51.12%與48.88%，有定期牙科拜訪習慣的兒童有46.36%。影響兒童每日潔牙2次以上的因素為高年齡的學前兒童(OR=16.51, 95%CI 8.05~33.86)、照護者「非常贊成」自己能夠幫孩子完成睡前潔牙(OR=2.60, 95%CI 1.66~4.08)有較明顯的顯著相關；影響照護者每天都會幫兒童完成睡前潔牙因素為「非常贊成」自己能夠幫孩子完成睡前潔牙(OR=7.94, 95%CI 4.98~12.65)、夫妻學歷均為大專以上(OR=2.80, 95%CI 1.66~4.73)有較明顯的顯著相關；兒童有定期牙科拜訪習慣的影響因素為知道塗氟政策的照護者 (OR=1.79, 95%CI 1.22~2.63)、「非常贊成」自己能夠幫孩子完成睡前潔牙(OR=2.10, 95%CI 1.32~3.35)、夫妻學歷均為大專以上(OR=2.49, 95%CI 1.50~4.14)、診所密度(OR=1.18, 95%CI 1.12~1.23)。 結論： 可以發現照護者的個人因素與兒童的定期牙科拜訪習慣和口腔健康相關行為有關，若要促進兒童的口腔健康，未來應從照護者的自我效能來介入改善，促使提升兒童口腔狀況。
並列摘要
Background: Dental caries is a common oral disease in preschool children, it can affect children's growth, diet, appearance and even sociality. Utilization of dental services has recognized as an important factor in preventing dental caries. But, studies in Taiwan mainly focused on the influencing factors of dental caries among children, but less on the utilization of dental services. Objectives: We aimed to use Andersen’s behavioral model to determine the factors of personal characteristics of preschool children and caregiver related to oral health care behavior and utilization of dental services among preschool children. Methods: A cross-sectional study of 2142 preschool children aged 6 months to 5 years was carried out in southern Taiwan from 2017 to 2018. Chi-square, two sample t-test, one-way ANOVA and hierarchical multiple regression were used in this study to identify the variables associated with preschool children’s oral health behavior and regular dental visit half a year. Results: In total, 993(46.36%) had regular dental visit half a year. The factors associated with preschool children’s toothbrush twice or more per day were older children (OR=16.51, 95%CI 8.05~33.86), caregiver “strongly agree” can help child’s toothbrush before go to bed (OR=2.60, 95%CI 1.66~4.08). In addition, “strongly agree” can help child’s toothbrush before go to bed (OR=7.94, 95%CI 4.98~12.65), earners' education both greater than high school (OR=2.80, 95%CI 1.66~4.73) were significantly associated with caregiver helps child’s toothbrush before who go to bed per day. Preschool children who have regular dental visit half a year was significant associated with caregiver knows policy of varnish fluoride (OR=1.79, 95%CI 1.22~2.63), “strongly agree” can help child’s toothbrush before go to bed (OR=2.10, 95%CI 1.32~3.35), earners' education both greater than high school (OR=2.49, 95%CI 1.50~4.14), higher density of clinic (OR=1.18, 95%CI 1.12~1.23). Conclusion: Findings from the theory-based population-based study informs caregiver of factors to consider when promoting dental care among early childhood. The caregiver’s determinants seem to be important predictors of regular dental visit.