- 學位論文
國小一年級學童口腔保健及甜食使用教育介入研究
Intervention Study of Oral Health Care and Sweet Intake Behavior of First Grade Elementary Schoolchildren
摘要
背景： 氟化物的使用、牙菌斑控制與限制吃糖是預防齲齒的三個重點工作。目前國小學童己全面使用含氟漱口水，但牙菌斑控制在一年級學童而言是有困難的，他們無法做好精細的刷牙動作，而且多數孩子從小被教育知道吃糖會導致齲齒，但是卻無法抗拒糖的誘惑。所以，如何使孩童在既能滿足吃糖的慾望，又能達到預防齲齒的目的，是我們努力的目標。 研究目的： 因此，本研究主要是為設計一套適合低年級學童以改變吃甜食習慣為目的的口腔衛生教材，並探討此教材之成效，同時亦探討影響成效之因素，及影響學童口腔衛生行為之相關因素。 材料與方法： 研究對象為台北縣某國小一年級學生，隨機指派實驗組與對照組各二班，全程參與者兩組各有66人，合計132人。 本研究工具主要有1.口腔健康問卷：分為前測、後測、後後測等三次收集資料。2.口腔健康檢查。3.潔牙與甜食記錄單共三部份。 而最主要的教育介入則分三階段進行：第一階段為一般口腔健康教育課程：共計六週。知識性的教材設計包括使用繪本故事、圖卡、遊戲；而潔牙等技術性教材則考量能增加學童的興趣，而以自製刷牙動畫為主。第三週後加入增強潔牙行為動機之增強物。第四週再針對甜食行為控制增加成果的分享與討論。整個介入過程設計以活潑、快樂、有趣以及正向鼓勵為主。 結果： 研究結果顯示，在教育介入方面，實驗組的口腔健康知識及行為分數在前測、後測、後後測都顯著高於對照組。在潔牙次數方面，在第三週起由於增強物的介入使與前測潔牙次數之變化量加大，由2.87次增加為3.21次，且達顯著差異。在甜食次數方面，第四週由於成果分享與討論課程的加入，而與前一週甜食次數變化量由減少1.21次增加為減少1.56次，且到後測時達到減少2.05(±1.19)次，學童在後測時平均每天吃甜食次數為0.29(±0.59)次。 結論： 由研究顯示，學童的健康知識不隨時間距離而減少，但習慣會因為沒有被督促而鬆懈，因此，建議在知識方面，應由專業人員作階段性介入；在行為改變方面，應由學校行政人員及導師作連續性的介入；本研究以增強物及討論、分享的方法成功的增加學童刷牙的次數以及降低了學童兩餐間甜食次數。因此，而對一年級潔牙行為而言，適當增強物介入是必要的；在甜食控制上，使用成果分享與討論的方式有助於學童在不增加額外刷牙次數下，使享受甜食與預防齲齒間達到雙贏的目的。
並列摘要
Background: The three key points in the prevention of dental caries are the use of fluoride, the control of dental plaque, and the restraint of sugar consumption. Currently, there is a comprehensive use of fluoride-containing mouth-rinse among elementary schoolchildren. However, it is generally difficult for first-grade elementary schoolchildren to control the development of dental plaque because they are incapable of performing delicate tooth-brushing skills. Most children cannot resist the temptation of sugar, although they are fully aware of the correlation between sugar consumption and development of dental caries. Therefore, be the ultimate goal that we are aiming for is both satisfying children’s desire for sweets and helping them prevent dental caries from occurring. Research purpose: The purpose of this study was to design a set of teaching materials, suitable for junior-grade schoolchildren, on oral health with the aim of changing these children’s sweet consumption habit. The usefulness and success of this teaching material set, along with all relevant influencing factors on children’s oral hygiene behavior, were explored and discussed. Materials and methods: Subjects were first-grade schoolchildren from one elementary school in Taipei County. For classes of students were randomly selected, two classes were assigned to the experimental group and two to the control groups. Combining both groups, there were a total of 132 children (66 in each group) participating throughout the entire study. Research instruments used in this study included: 1) oral health questionnaires (data collection was divided into pre-test, post-test, and post-post-test parts), 2) oral health examinations, and 3) record-taking on both teeth-cleaning and sweets consumption. The major educational intervention proceeded in three stages. The first stage was the regular courses on oral health in a six-week period, with the inclusion of educational design such as the use of story-drawing booklets, picture cards, and games. Teaching materials focused on technical skills, such as tooth brushing, were included. In order to promote learning interests of children, a self-design tooth-brushing computer animation was used. The supplemental materials aimed at enhancing motive for teeth cleaning were added in the third week. In the fourth week, there were experience-sharing and discussions focused on the results of behavioral control on sweets. The entire interventional process was designed on the basis of vividness, happiness, fun, and positive encouragement. Research results: The results demonstrated that children from the experimental group exhibited higher scores of oral hygiene knowledge and behavior on all questionnaires (pre-test, post-test, and post-post-test) than children from the control group. As far as the number of tooth brushings was concerned, they increased from 2.87 to 3.21 times and showed a significant difference (p<0.0001). This was mainly due to the intervention of enhancing supplements to increase the changed scale of tooth-cleaning frequencies in pre-test starting from the third week. On sweets consumption frequency, due to the addition of experience sharing and discussion sections in the fourth week, the number changed from 1.21 to 1.56 times less frequent compared to the previous week’s sweets consumption; furthermore, this frequency number was even at 2.05(±1.19) times less frequent during the post-test. On average, children consumed sweets 0.29(±0.59) times less frequent during the post-test period. Conclusion The study showed that schoolchildren’s oral health knowledge will not be eliminated with the lapse of time, but their sweets consumption habits will decrease due to less urge. Therefore, from the knowledge aspect, it is suggested that the intervention need to be performed by professionals in a stage-wise manner. On the other hand, from the aspect of behavioral changes, the intervention need to be performed by school administrative personnel and class mentors in a persistent manner. This study successfully increased schoolchildren’s tooth-brushing frequency and reduced their sweets consumption frequency during meals by the way of enhancing supplements and experience sharing and discussion. Hence, it is essential to implement enhancing supplements for the intervention on the tooth-brushing behavior of first-grade elementary schoolchildren. From the aspect on the control of sweets consumption, the use of experience sharing and discussion can help schoolchildren to not only increase their tooth brushing frequency while reaching the double goal of win-win situation both enjoying sweets and preventing the occurrence of dental caries.