桌上遊戲介入對智能障礙者之口腔衛生認知與牙菌斑指數成效:先驅性研究

研究背景：相關研究指出，智能障礙者較同年齡的非身心障礙者有較差的口腔健康狀況。智能障礙者由於自身障礙的關係，認知與行為能力較一般人不好，且由於缺乏正確口腔衛生認知及正確口腔清潔技巧，使得智能障礙者較同年齡同儕的口腔健康狀況不好。研究顯示，口腔衛生介入對於智能障礙者的口腔衛生認知提升及牙菌斑指數降低是有成效的，目前尚未有桌上遊戲介入在智能障礙者的口腔衛生認知與牙菌斑指數成效的研究。研究目的：本研究的目的是桌上遊戲介入的先驅性研究來探討桌上遊戲對智能障礙者的口腔衛生認知影響成效與牙菌斑指數影響成效，進而改善智能障礙者的口腔健康狀況。研究方法：本研究採單組前後測準實驗設計。研究對象為高雄市某間全日型身心障礙福利機構20~65歲的智能障礙者，共有42人。介入組為有桌上遊戲介入，對照組為沒有桌上遊戲介入。在前測及後測，每位研究對象均需接受口腔衛生知識評量及牙菌斑指數檢測，研究對象的主要照顧者須填寫身心障礙者口腔健康狀況及相關影響因子之問卷調查，以記錄其基本資料、飲食習慣、口腔衛生習慣及看牙經驗。以Microsoft Excel進行資料建檔，以SPSS20.0來做統計分析。結果：有桌上遊戲介入的介入組，在口腔衛生認知及牙菌斑指數上都有顯著的改善。介入組的口腔衛生認知第一次後測比前測提升了1.68(p<0.001)；介入組的口腔衛生認知第二次後測比前測提升了3.18(p<0.001)；介入組的口腔衛生認知第三次後測比前測提升了4.32 (p<0.001)。介入組牙菌斑指數第一次後測比前測降低了12.65％(p=0.026)；介入組牙菌斑指數第二次後測比前測降低了44.38％ (p<0.001)；介入組牙菌斑指數第三次後測比前測降低了31.68％ (p<0.001)。結論：本研究應用桌上遊戲介入的先驅性研究顯示桌上遊戲介入除了對智能障礙者的口腔衛生認知有提升成效，對牙菌斑指數也有降低成效。

關鍵字

桌上遊戲；智能障礙者；口腔衛生認知；牙菌斑指數；先驅性研究

並列摘要

Background: Due to lack of oral hygiene knowledge and lack of accurate oral cleaning skill, oral health of people with intellectual disability is not well. Oral hygiene intervention is useful to improve oral hygiene knowledge and oral hygiene of people with intellectual disability. Table game have been gradually used as a tool for intervention in recent years. But, there was lack of research which applying a table game in an oral hygiene intervention program. Objective: The purpose of this pilot study was using a table game to improve the oral hygiene knowledge and oral hygiene of people with intellectual disability. Material and methods: This pilot study was a single group with two-stage intervention design and which were divided into two stages: the control stage without board game intervention and intervention stage with board game intervention. Both stages performed oral hygiene knowledge score and plaque index (O'Malley et al.) before and after the intervention. The total of 42 subjects, aged 20 to 65 years, lived in institutions were included. The main caregivers of the study subjects were required to fill in a questionnaire about the oral health status and related impact factors (such as basic information, eating habits, oral hygiene habits and dental experiences). Data was builded by Microsoft Excel and data were analyzed by SPSS20.0. Results: Oral hygiene knowledge and plaque index of intervention stage were both improved. Compared to pre-test of oral hygiene knowledge score of intervention stage, 1st post-test of oral hygiene knowledge score of intervention stage increased 1.68 (p<0.001); 2nd post-test of oral hygiene knowledge score of intervention stage increased 3.18 (p<0.001); 3rd post-test of oral hygiene knowledge score of intervention stage increased 4.32 (p<0.001). Compared to pre-test of plaque index of intervention stage, 1st post-test of plaque index of intervention stage decreased 12.65％(p=0.026); 2nd post-test of plaque index of intervention stage decreased 44.38％(p<0.001); 3rd post-test of plaque index of intervention stage decreased 31.68％ (p<0.001). Conclusion: From this pilot study which applying a table game as a tool of an oral hygiene intervention program, applying a table game in an oral hygiene intervention program can improve both oral hygiene knowledge score and plaque index of people with intellectual disability.