第二型糖尿病患牙周相關認知、態度、行為及生活品質探討

Periodontal Knowledge,Attitude,Behavior and Quality of Life in Type II Diabetic Patients

蔡欣恬(Hsin-Tie Tsai)

指導教授 ： 黃曉靈

高雄醫學大學/口腔醫學院/口腔衛生學系碩士在職專班/碩士(2014年)

https://doi.org/10.6832/KMU.2014.00135

摘要

背景：牙周病是糖尿病常見合併症之一，糖尿病患有牙周病風險達非糖尿病患的2.1~3.0倍，糖尿病患常忽略口腔問題，過去研究針對糖尿病患牙周知識、態度、行為與生活品質探討較少。
目的：探討第二型糖尿病患牙周相關口腔知識、態度、行為與生活品質之相關性。
研究方法：本研究為橫斷性研究，採立意取樣方式，以南部某醫學中心及某市立醫院新陳代謝科門診第二型糖尿病病患97位受試者，使用結構式問卷訪視來收集資料。統計分析以皮爾森相關係數檢定變項間相關性，最後以線性迴歸、邏輯斯迴歸檢定各變項間相關強度。
結果：研究結果顯示口腔健康知識與態度有顯著相關性(r=0.45，p<0.05)、口腔健康態度與口腔健康生活品質有顯著相關性(r=0.34，p<0.05)。在多變項邏輯斯迴歸分析中，牙線使用習慣(有使用vs.無使用)與口腔健康態度 (OR=1.41,95%CI=1.03,1.93)、在牙線使用習慣(有使用vs.無使用)與性別(女、男)(OR=21.06,95%CI=2.04,216.69)以及與工作(有、無)(OR=26.69,95%CI=1.34,531.39)、在最近一次看診(六個月以內vs.超過六個月)與工作(有、無) (OR=8.07,95%CI=1.40,46.41)、在牙刷多久換一次(3個月以內vs.超過3個月)與牙醫師診斷有無口腔問題(無、有) (OR=0.30,95%CI=0.10,0.90)，在統計上達顯著相關，p值<0.05。在多變項線性迴歸分析中，口腔健康生活品質與工作(有、無)(B=-2.46; 95%CI=-4.69,-0.22)、自覺口腔狀況(好、不好) (B=-6.00;
95%CI=-8.25,-3.76)、口腔健康態度 (B=0.55; 95%CI=0.25,0.85)，在統計上達顯著相關，p值<0.05。
結論：在口腔健康態度和牙線使用行為有相關，因此未來在設計發展適切糖尿病病患牙周衛教介入時，強化糖尿病病患在牙周相關健康態度，藉由改善口腔保健行為，尤其是牙線使用行為，使其維護口腔健康，以提升口腔照護品質進而提升生活品質。

關鍵字

第二型糖尿病 ； 牙周病 ； 口腔健康知識 ； 口腔健康態度 ； 口腔保健行為 ； 口腔健康生活品質

並列摘要

Background:
Diabetic patients are at 2.1~3.0 times risk to have periodontal disease than individuals without diabetes. Diabetic patients often ignore oral problems. Previous researches seldom assessed periodontal related knowledge, attitude, behavior and quality of life in diabetes patients.
Objective:
To assess the relationship among periodontal related knowledge, attitude, behavior and quality of life in type 2 diabetic patients.
Method:
It’s a cross-sectional study and purposive sampling method were used for data collection. Ninety-seven type 2 diabetic patients in the division of Endocrinology & Metabolism at a medical center and a municipal hospital in southern Taiwan were recruited in our study. We used a face-to-face interview with structured questionnaire to collect the information. Pearson correlation coefficient, linear regression and logistic regression analyzed relationship and strength among variables.
Result:
It showed that oral health knowledge is significantly associated with attitude(r=0.45) and oral health attitude is significantly associated with oral health quality of life (r=0.34). In linear regression analysis, oral health knowledge and education level (B=1.82; 95%CI=0.96,2.69), oral health attitude and education level (B=1.91; 95%CI= 0.75,3.07) , attitude and higher household income(B=0.71; 95%CI=0.21,1.21) and oral health quality of life and bass method use (B=-0.70; 95%CI=-1.40,-0.01) showed significant result. In logistic regression analysis, oral health knowledge and sensitive toothpaste use (OR=1.22; 95% CI=1.01,1.49), knowledge and dental-flossing habit (OR=1.54; 95%CI=1.18,2.00) and oral health attitude and dental-flossing habit (OR=1.58; 95% CI=1.22,2.05) showed significant result.
Conclusion:
There is a relationship among oral health knowledge, attitude and dental-flossing behavior. Therefore, future design and development of appropriate periodontal health education intervention for diabetic patients should increase their periodontal related knowledge, strengthen attitude and improve their oral health behavior, especially dental-flossing behavior.

並列關鍵字

Type 2 diabetes ； Periodontal disease ； Oral health knowledge ； Oral health attitude ； Oral health behavior, ； oral health quality of life

參考文獻

Aggarwal, A., & Panat, S. R. (2012). Oral health behavior and HbA1c in Indian adults with type 2 diabetes. J Oral Sci, 54(4), 293-301.

Allen, E., Irwin, C., Ziada, H., Mullally, B., & Byrne, P. J. (2007). Periodontics: 6. The management of gingival recession. Dent Update, 34(9), 534-536, 538-540, 542.

Allen, E. M., Ziada, H. M., O'Halloran, D., Clerehugh, V., & Allen, P. F. (2008). Attitudes, awareness and oral health-related quality of life in patients with diabetes. J Oral Rehabil, 35(3), 218-223. doi: 10.1111/j.1365-2842.2007.01760.x

Apoorva, S. M., Sridhar, N., & Suchetha, A. (2013). Prevalence and severity of periodontal disease in type 2 diabetes mellitus (non-insulin-dependent diabetes mellitus) patients in Bangalore city: An epidemiological study. J Indian Soc Periodontol, 17(1), 25-29. doi: 10.4103/0972-124X.107470

Bernabe, E., & Marcenes, W. (2010). Periodontal disease and quality of life in British adults. J Clin Periodontol, 37(11), 968-972. doi: 10.1111/j.1600-051X.2010.01627.x