家長對兒童牙科行為誘導之態度

Parents's attitudes toward various techniques of behavior management used in pediatric dentistry

張家馨(Chia-Hsing Chang)

指導教授 ： 陳弘森

高雄醫學大學/口腔醫學院/牙醫學研究所/碩士(2005年)

摘要

兒童牙科醫師進行治療時，經常需要使用行為誘導方法。制訂行為誘導策略，不再只由牙醫師單方面決定，需要考量家長的態度。雖然社會對行為誘導的態度已經改變，但是關於家長對行為誘導之態度的研究仍然有限。
本研究的目的在於調查一般家長對六種不同行為誘導的態度，分別為聲音控制法(Voice control)、張口器（Mouth prop）、改良式束縛帶法（Modified papoose board）、父母及助手固定法（Restraint by parent/assistant）、分離法（Separation）、蓋口消音法（Hand-over-mouth）。這些家長的孩子不一定接受過以上六種行為誘導方法，可能曾經接受過其中某些方法。研究方法為門診問卷，請家長填寫對六種不同行為誘導方法的接受度。研究對象為93年9月~94年1月間，陪伴兒童到兒童牙科門診就診的父母，共有184位。資料收集後，使用卡方檢定分析與接受度顯著相關的因素。
結果顯示大部分的家長，約有72%，都可以接受父母及助手固定法。將近一半的家長可以接受聲音控制法，超過1/3的人可以接受分離法、束縛帶法、張口器。可以接受蓋口消音法的家長所佔的比例最少，只有19.47%。經卡方檢定顯示與家長接受度有顯著相關的因素為兒童的年齡與家長對兒童行為的認知。除了蓋口消音法以外，兒童年齡和其他五種方法的接受度有顯著相關性（P <0.05）；並且對照兒童年齡層和家長接受度，發現年齡層下降，所對應的家長接受度升高。不過在分離法方面，兒童年齡層越低，對應的家長接受度也越低。除了父母及助手固定法以外，家長對兒童行為的認知和其他五種行為誘導的接受度有顯著相關性（P <0.05）。家長認為兒童行為是不合作的，其接受度會比認為兒童是合作的家長高。
本研究所調查的六種行為誘導方法中，家長最接受的方法是父母及助手固定法。蓋口消音法是最不被家長接受的方法。越侵犯性的行為誘導，家長的接受度就越低。超過半數家長希望能在場陪同孩子接受牙科治療。大部分的家長對於醫師的告知及施行的行為誘導感到滿意。

關鍵字：家長態度，行為誘導，牙科治療

關鍵字

牙科治療 ； 行為誘導 ； 家長態度

並列摘要

Pedodontists usually used behavior management during dental treatment. The selection of the technique of behavior management was no longer up to the dentist. Although societal attitude toward behavior
management is changing, research data regarding parental attitudes toward behavior management techniques, however, was still lacking.
The purpose of this study was to investigate parents’ attitudes toward various behavior management techniques applied to their children during dental treatment. The samples consisted of the 184 parents who accompanied their children to the Department of Pediatric Dentistry at the Kaohsiung Medical University in Taiwan. The participants were asked to complete a questionnaire requesting demographic, behavior, and stress information regarding the parents and children. And they rated their acce-
ptability of the behavior management techniques.
Most parents, about 72%, accepted restraint by assistants/parents. Nearly half of the parents were in favor of voice control. 39.67% of the parents accepted separation. 38.58% of the parents approved restraint by modified papoose board. 38.04% of the parents accepted mouth prop. Least parents, 19.47%, accepted Hand-over-mouth (HOM). The demogra-
phic and behavior variables were not found to be associated with parents’ expressed attitudes toward of the behavior management techniques. Excluding HOM, there was significant association between parents’ acceptance of the behavior management techniques and children’s age (p<0.05). Except restraint by assistants/parents, parents’ acceptance of the other behavior management techniques was significantly associated with parental evaluation of child's behavior to dental treatment (p<0.05).
Restraint by assistants/parents was the most acceptable technique among the behavior management techniques in our study. HOM was least accepted by the parents. Over half of the parents expressed a wish to be present in the operatory (60.66%).

Key words : Parents’ attitudes, behavior management techniques, dental
treatment

並列關鍵字

Parents’ attitudes ； dental ； behavior management techniques

參考文獻

參考文獻

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3. Murphy MG, Fields HW, Jr., Machen JB. Parental acceptance of pediatric dentistry behavior management techniques. Pediatr Dent 1984;6:193-8.

4. Fields HW, Jr., Machen JB, Murphy MG. Acceptability of various behavior management techniques relative to types of dental treatment. Pediatr Dent 1984;6:199-203.