多元照護方案對慢性精神病患口腔衛生成效之探討

The Effectiveness of a Complex Care Program on Oral Hygiene in a Population of Chronic Psychiatric Patients

劉巧蓮(Chiao‐Lien Liu) ； 林豐裕(Feng‐Yu Lin) ； 胡月娟(Yueh‐Juen Hwu)

《護理暨健康照護研究》 10卷4期 (2014/12) Pp. 286-294

https://doi.org/10.6225/JNHR.10.4.286

摘要

背景：口腔衛生不良會影響精神病患的日常生活與自尊。多元照護措施可以改善口腔衛生，進而提升慢性精神病患的生活品質。目的：探討多元照護方案介入，對慢性精神病患口腔健康與口臭程度之成效。方法：採類實驗設計，實驗組（n=35）接受為期四週的多元照護方案，包括照護指導素材與策略、建置支持性照護情境、與個案的追踪管理，對照組（n=30）採一般照護；以口腔健康狀況評估表和口氣計，在多元照護方案介入前，及方案結束後一週、三週，評值二組病人口腔健康狀況和口臭程度之變化。結果：接受多元照護方案病人，口腔健康改善程度優於對照組［F (1.72, 8.01)=4.91, p＜.05］，且其成效可持續至介入措施結束後三週［F (1.72, 174.82)=107.13, p＜.01］。結論／實務應用：建議精神醫療機構參酌運用多元照護方案，促進慢性精神病患的口腔照護行為，以改善其口腔衛生及生活品質。

關鍵字

多元照護方案 ； 口腔衛生 ； 慢性精神病患

並列摘要

Background: Unhealthy oral hygiene seriously impacts both the daily life and the self‐esteem of psychiatric patients. Complex interventions improve the oral hygiene and promote the quality of life of these patients. Purpose: The purpose of this research was to investigate the effectiveness of a complex care program for oral health and halitosis in a population of chronic psychiatric patients. Methods: This study used a quasi‐experimental research design. The experimental group (n=35) received a complex care program for a period of four weeks. The control group (n=30) received usual care. The complex care program included providing teaching materials and strategies, establishing a supportive care context, and providing regular patient follow‐up. The study gathered data using scales that assess the current status of oral health and of halitosis. Scales were implemented before and after the oral care program at weeks 1 and 3. Results: This study found significant improvements in the experimental group in terms of the oral health assessment [F (1.72, 8.01)=4.91, p ＜ .05]. In addition, the effects of the intervention on oral health lasted for at least 3 weeks after the end of the intervention [F (1.72, 174.82)=107.13, p＜.01]. Conclusions/ Implications for Practice: The results support the application of the complex care program developed for this study in psychiatric institutions in order to promote positive oral care in psychiatric patients and to improve their oral hygiene and quality of life.

並列關鍵字

complex care program ； oral hygiene ； chronic psychiatric patients

參考文獻

蔡伊婷（2010）‧口腔衛生教育介入對一般國小一至三年及特殊教育學生之成效評估(未發表的碩士論文)‧高雄醫學大學科學研究所。[Tsai, Y. T. (2010). The evaluation of oral health education intervention for 1-3 grades special education children in elementary school (Unpublished master’s thesis). Kaohsiung Medical University, Taiwan, ROC.]

鍾馥濃（2009）‧應用結構式教學法於口腔衛生潔牙技巧介入對自閉症兒童降低牙菌斑成效之研究(未發表的碩士論文)‧高雄醫學大學口腔衛生科學研究所。[Chung, F. N. (2009). Research of utilizing TEACCH on the oral hygiene education to reduce dental plaque for the autism children (Unpublished master’s thesis). Kaohsiung Medical University, Taiwan, ROC.]

張樺欣（2008）‧台灣某機構慢性精神病患者口腔健康狀況之探討（未發表的碩士論文）‧高雄醫學大學口腔衛生科學研究所。[Chang, H. H. (2008). Oral health status of institutionalized chronic psychiatric patients in Taiwan (Unpublished master’s thesis). Kaohsiung Medical University, Taiwan, ROC.]

王文志、張自強、文榮光（2005）‧精神病患於日間病房之預後分析‧臺灣職能治療研究與實務雜誌，11，36-43。[Wang, W. C., Chang, T. C., & Wen, J. K. (2005). Outcome analysis of a day care ward for clients with psychiatric disabilities. Journal of Taiwan Occupational Therapy Research and Practice, 11, 36-43.]

謝玉萍、馮瑞珠、張秀如（2006）‧慢性住院精神分裂病患口腔衛生改善專案‧精神衛生護理雜誌，1(2)，51- 56。[Hsieh, Y. P., Feng, J. C., & Chang, H. J. (2006). A program to improve oral hygiene for inpatients with chronic schizophrenia. The Journal of Psychiatric Mental Health Nursing, 1(2), 51-56.]