透過您的圖書館登入
IP:44.204.218.79
  • 學位論文

機構老人口腔健康狀況及系統性疾病 與口腔健康相關生活品質影響之探討

The Association of Oral Health Condition and Systematic Diseases with Oral Health-Related Quality of Life in Institutionalized Elderly

指導教授 : 楊奕馨

摘要


人口結構的老化是世界性趨勢,台灣地區自民國八十二年起邁入高齡化社會以來65歲以上老年人口已佔總人口之7.09%,已達聯合國世界衛生組織所訂的高齡化社會指標,至98年底已達10.63%,人們所面臨的老化問題,不僅發生在身體及生理功能的退化,也間接影響了生活作息,使得生活品質也會隨之下滑。 本研究目的在探討台灣地區安養機構65歲以上老人基本人口學特質、存留齒數狀況、贗復物配戴狀況及需求與行動能力及系統性疾病對於生理、心理、社會三個層面所造成之口腔健康相關生活品質(Oral Health-Related Quality of Life, OHRQoL)影響。由於口腔健康相關生活品質(OHRQoL)的研究多半以口腔問題為主,對於系統性疾病與口腔問題之間的關聯性少有文獻加以討論,因此本研究亦將針對機構老人系統性疾病與口腔問題關聯性做進一步探討。 本研究抽樣設計首先依據劉介宇城鄉都市化分層,將台灣地區分成七個地區/城鄉,並針對其中之安養及養護機構65歲以上意識清楚老人進行面對面調查,以結構式問卷與OHIP-49量表評估口腔健康相關生活品質影響,並由牙醫師進行口腔檢查。問卷調查項目,包括居住地區、性別、年齡、婚姻狀況、教育程度、經濟來源、經濟狀況、行動能力、系統性疾病罹患種類及口腔健康相關生活品質量表(OHIP-49)。共有658位參與研究調查,652位完成問卷及口腔檢查資料。統計分析利用t-test / ANOVA、卡方檢定及複迴歸分析法(Multiple Regression)來探討社會人口學、口腔健康狀況、系統性疾病及罹病數對口腔健康相關生活品質(OHIP-49)的影響差異分析。 結果顯示,OHIP-49總分與不同的教育程度、經濟狀況、行動能力、存留齒數、贗復狀況、贗復需求以及罹患風濕性疾病均達到統計顯著差異(p<0.05)。而在複迴歸分析中,在調整過社會人口學以及系統性疾病變項後,贗復狀況與OHIP-49仍維持顯著相關,顯示口腔問題本身與口腔健康相關生活品質,不受其他疾病因素干擾而改變其口腔生活品質。另外,在調整社會人口學以及口腔狀況變項後,風濕性疾病及腸胃道吸收不良與OHIP-49呈現顯著相關,顯示系統性疾病雖與口腔問題無直接之相關性,但對於患者的口腔生活品質仍會造成些許的變化。 結論:本研究所探討的機構老人口腔健康相關生活品質差異不單是由口腔狀況所引起,也可能受到直接來自系統性疾病方面的作用而產生變化。

並列摘要


Background: Issues of gerontology have become a common problem in many countries of the world. The elderly (65 years old and older) reached 7.09% of the total population of Taiwan at 1993. This made the aging society index of WHO. To the end of 2009, the figure is now 10.63%. Aging happens in not only the body and physical functions, but also impacts performances and health-related quality of life. Objective: The objective of this study was to assess the remaining teeth, prosthetic status, needs for prosthetic treatment, mobility and systemic diseases, and to investigate their relationship with oral health-related quality of life (OHRQoL) among institutionalized elderly (65 years old and older) in Taiwan. Methods: The study samples were from seven areas of Taiwan. Subjects with serious mental or cognitive problems were excluded from this study. Each participant received a personal interview and an oral examination. The structured questionnaire items included living area, gender, age, marriage, education, financial status, mobility, systemic diseases and Oral Health Impact Profile (OHIP-49). Descriptive statistics including frequencies, means and standard deviations were performed using SPSS. Categorical variables were analyzed by Chi-square test, t-test,and ANOVA. Multiple Regression Models were used to assess the association of health quality of life (OHIP-49) with demography, oral condition, systemic diseases and the count of systemic diseases. The significance level was set at p<0.05. Results: The effect of education, financial status, mobility, remaining teeth, prosthetic status, needs for prosthetic treatment and rheumatics was significantly associated with OHIP-49 scores. Multiple Regression Models indicates that OHIP-49 scores were associated with prosthetic status after adjusting for sociodemographic and systemic diseases variables. It means that oral problems are associated with OHIP, and are not affected by systemic diseases. In addition, rheumatics and gastrointestinal tract digestive diseases are associated with OHIP, after adjusting for sociodemographic and oral conditions variables. This means that some systemic diseases impact OHRQoL of patients, although systemic diseases may not be associated with oral conditions. Conclusions: The oral health-related quality of life among institutionalized elderly in this study is impacted by oral conditions, and some systemic diseases might affect OHRQoL directly.

參考文獻


1.內政部統計處。九十九年第十週內政統計通報-98年底人口結構
分析。
2.行政院衛生署國民健康局。92-94年台灣地區成年與老年人口腔
健康調查。口腔保健網站︰
http://www.bhp.doh.gov.tw/BHP/index.jsp

被引用紀錄


劉正良(2005)。創新異常現象: 從創新效率與內部人交易論析〔碩士論文,中原大學〕。華藝線上圖書館。https://doi.org/10.6840%2fcycu200500142
劉奕孜(2007)。從企業生命週期探討應計項目異常現象〔碩士論文,國立中央大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0031-0207200917344668
Cheng, K. H. (2014). EARNINGS MANIPULATION AND STOCK RETURNS: THE EMPIRICAL RESULTS OF THE TAIWAN STOCK MARKET [master's thesis, National Chung Cheng University]. Airiti Library. https://www.airitilibrary.com/Article/Detail?DocID=U0033-2110201613580213

延伸閱讀