新移民與本土籍學齡前兒童口腔健康不均等與母親特質對口腔健康之影響-以高雄市為例

Oral Health Disparity between Immigrant and Native Pre-school Children and Mothers’ Characteristics Influencing Oral Health in Kaohsiung City

陳志章(Chih-Chang Chen)

指導教授 ： 黃曉靈

高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士班/碩士(2012年)

https://doi.org/10.6832/KMU.2012.00052

摘要

背景：
台灣近年來女性新移民配偶人數急遽上升，新移民配偶本身與家中成員的口腔疾病與健康不均等問題，伴隨著一些障礙之下，已成為一個重要的口腔公共衛生課題。另外，目前台灣學齡前兒童的齲齒經驗指數(deft/dmft)與齲齒率相較於歐美國家仍高居不下，並且仍無法達到世界衛生組織(World Health Organization, WHO)訂立之目標。
目的：
比較新移民(Immigrant, IM)與對照組本土籍(Native, NA)學齡前兒童之間口腔健康狀況差異；並探討新移民母親的特質對其學齡前兒童口腔健康狀況的影響因素。
方法：
本研究採用橫斷性研究設計針對高雄市內新移民(越南與印尼)配偶及其學齡前期兒童(4~6歲)進行母親結構性問卷與孩童口腔狀況檢查，並分別於高雄市三民區87里中選取約20里以立意取樣(Purposive Sampling)取得新移民母親150位、孩童191位為主要對象，並於三民區內32間公、私立托兒所(或幼稚園)中以系統隨機抽樣(Systematic Random Sampling)選取15間取得本土籍母親440位、孩童458位作為對照組。最後採用迴歸分析學齡前兒童的口腔狀況[齲齒顆數(decayed teeth, dt)、缺牙顆數(missing teeth, mt)、填補顆數(filled teeth, ft)、齲齒經驗指數(dmft)、齲齒面數(decayed surface, ds)、缺牙面數(missing surface, ms)、填補面數(filled surface, fs)、齲齒經驗面數(dmfs)]與母親口腔保健知識、自我效能、口腔保健態度、飲食習慣態度、口腔保健管教態度、母親自身口腔保健行為、母親對孩童之口腔保健行為之間的相關性。
結果：
新移民學齡前兒童的dt、mt、dmft、dmfs、ms及dmfs皆顯著高於對照組(P<0.05)，而ft和fs則是對照組顯著高於新移民兒童(P<0.001)；在影響因素方面，主要為母親潔牙次數(aOR=3.02 in dt, aOR=5.61 in dmft, aOR=3.46 in dmfs)、母親牙科就診(aOR=3.60 in ds, aOR=3.92 with dmfs)、孩子甜食習慣(aOR=0.38 with ft)、孩子牙科就診(aOR=0.33 with ft)。。
結論：
口腔健康狀況差異與母親特質對口腔的影響確實被發現存在新移民族群中，因此在未來擬定與提供跨文化適切的口腔健康介入計畫，促進新移民母親與其學齡前兒童的口腔健康，是十分重要的課題。

關鍵字

新移民母親 ； 學齡前兒童 ； 口腔健康

並列摘要

Background: Since year 2000, a large number of transnational marriage spouses are growing in Taiwan. Oral disease and health inequality of the spouses themselves and their family members have become an important problem of oral public health. Furthermore, the dental caries index (deft/dmft) and decayed rate of pre-school children in Taiwan are both higher than Europe and the United States. Also the decayed rate is still unable to reach the oral health objectives in 2010 set up by the World Health Organization (W.H.O.).
Objectives: To compare the difference of oral health status between immigrant (IM) and native (NA) children as well as to investigate the influence of immigrant mothers’ characteristics on oral health disparity among IM preschool children.
Methods: A cross-sectional study was designed to collect the oral health status and associated factors among IM and NA children in San-min district of Kaohsiung City from 2010 to 2011. The standardized self-administered questionnaire was filled out by mothers. The IM group was selected 150 mothers and 191 children among 20 of 87 villages by the purposive sampling, and the NA group was selected 440 mothers and 458 children among 15 of 32 public or private kindergartens in San-min District by systematic random sampling. Finally, we used regression models to analysis the correlation between child’s oral health [decayed teeth(dt), missing teeth (mt), filled teeth(ft), caries index (dmft), decayed surface(ds), missing surface(ms), filled surface (fs), dental caries surface index (dmfs)] and mothers’ oral health knowledge, self-effiicacy, attitude toward oral hygiene ,attitude toward diet, parental indulgence attitude, the mother's own oral health behavior and oral health care behavior for children.
Results: We found that dt, mt, ft, dmft, ds, ms, fs and dmfs were significant differences between the IM group and the NA group. The IM group’s dt, mt, ds, ms, dmft and dmfs index were much higher than the NA group (p<0.05); whereas the IM group’s ft was less than NA group (p<0.001). The effect factors include mother's tooth-brushing frequency (aOR=3.02 in dt, aOR=5.61 in dmft, aOR=3.46 in dmfs), mothers’ dental visits (aOR= 3.60 in ds; aOR=3.92 with dmfs), sweet habits of children (aOR=0.38 in ft), children dental visits (aOR=0.33 in ft).
Conclusion: Oral health disparities and the effect of mothers’ characteristics in oral health were found indeed among IM preschool children. Suggest that cross-cultural appropriate oral health promotion intervention programs should be developed and provided in such children and their mothers. It is a very important thing in the future

並列關鍵字

Immigrant mother ； Pre-school Children ； Oral health

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