驗證台灣版老人口腔健康評估（GOHAI）量表

Validation of the Geriatric Oral Health Assessment Index in Taiwan

周俞辰(Yu-Chan Chou)

指導教授 ： 楊奕馨

高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/碩士(2010年)

https://doi.org/10.6832/KMU.2010.00119

摘要

研究背景：
口腔問題一直是老人最常見疾病之一，然而過去研究指出在老年族群中，大家所關注的焦點均在生理、心理健康情形，相較之下，對於口腔疾病則較少論述。而GOHAI僅有12個問題，相當簡便且適合用於大規模老人健康篩檢，並且除了能評估老人整體性健康外，同時也能夠作為將來老人牙科醫療治療的指標。國內針對口腔問題與老人口腔健康測量指標之研究相當有限，因此台灣地區更需要發展適合用在口腔健康相關生活品質的鑑別工具。

研究目的:
發展驗證老人口腔健康評估量表(Geriatric Oral Health Assessment Index, GOHAI)，在台灣地區的使用及信效度檢測，及探討老人口腔健康相關生活品質的因素。

研究方法：
針對台灣地區65歲以上老人為對象，分七個地域代表性分層抽樣，針對GOHAI共12題3個範疇進行信效度評估，使用迴歸分析方法找出影響口腔健康相關生活品質之影響因素。

研究結果：
本研究共有1137人完成問卷及口檢資料，資料顯示男性佔42.9%，女性有57.1%；年齡層65-74歲及75歲以上約佔各半（42.3%，57.7%）；GOHAI量表再測信度檢測ICC介於0.50-0.95，內部一致性Cronbach’s alpha系數為0.88，效度方面發現在存留齒數、赝復狀況及赝復需求與GOHAI分數均達顯著相關（P<0.05），證明此量表具有良好之信效度。機構老人以赝復狀況及存留齒數對口腔健康生活品質是有關聯性，社區老人則是以存留齒數對口腔健康生活品質有關聯性。

結論：
本研究證實翻譯版的GOHAI展現可接受的信效度，並且可以當作國內大規模機構老人口腔健康相關生活品質之篩檢測量工具。再者赝復狀況對於GOHAI影響差在有無裝置，在赝復需求分面則隨著赝復需求量越多而持續降低分數。因此建議赝復需求者應更新補綴物，來改善口腔健康相關生活品質。在社區及機構老人中，GOHAI平均分數有顯著差異，可在多種樣本中作為口腔狀況對機能與生活所造成的影響指標。

關鍵字

GOHAI ； 生活品質 ； 老年人

並列摘要

Background:
Oral health issues have been one of the most common diseases of the elderly; however, previous studies in elderly populations of major concern have focused on physical and mental health cases, and in comparison, oral disease has been less discussed. The GOHAI fields only 12 questions, both simply worded and suitable for large-scale health screening of the elderly, and in addition to assessing the overall health of the elderly, can also be used as a future indicator of their dental treatment. Research on domestic problems and oral measures of oral health in the elderly is very limited. Taiwan needs to develop more suitable instruments for use in oral health-related quality of life identification tools.

Study objectives:
Development of the elderly Oral Health Assessment Scale (Geriatric Oral Health Assessment Index, GOHAI) Chinese version in conjunction with reliability and validity testing for the Taiwan area, and the examination of oral health-related QOL factors.

Study methods:
A sample population of over 65-year-old Taiwanese subjects was divided into seven geographical representative areas using stratified sampling, and a total of 12 questions for GOHAI in three areas (of reliability and validity of assessment) were applied, using multiple linear regression to identify the impact of oral health-related quality of life (QOL) factors.

Results:
In this study, a total of 1137 people completed a questionnaire and oral examination data; 42.9% were male, 57.1% were female; ages ranged from 65-74 years, and 75-year-olds accounted for about half of each gender (42.3%, 57.7% respectively). The GOHAI scale test-retest ICC ranged from 0.50-0.95, internal consistency Cronbach's alpha coefficient was 0.88, while measures of retained teeth, prosthetic status and prosthetic needs and GOHAI scores reached significant correlation (P <0.05), demonstrating that the scale had good reliability and validity. Institutions for the elderly advising on the situation and retention of prosthetic teeth for oral health QOL is relevant, particularly for those institution-based elders as well as those who are community-based.

Conclusion:
This study confirms the Chinese version of the GOHAI shows acceptable reliability and validity and can be used in domestic large-scale institutions for the elderly oral health-related quality of life as a measurement tool for screening. Furthermore, the GOHAI shows difference in prosthetic status, and the lower scores implies continuing demand for prostheses. Therefore, prosthetic restorations should be updated to improve oral health-related quality of life. For the elderly in the community and institutions, GOHAI average scores are significantly different in a variety of oral conditions acting as a functional impact on life indicators.

並列關鍵字

GOHAI ； quality of life ； the elderly

參考文獻

高雄醫學大學口腔醫學院. (2003). 台灣地區成人口腔檢查表實行準則.

劉介宇, 洪永泰, 莊義利, 陳怡如, 翁文舜, 劉季鑫, et al. (2006). 台灣地區鄉鎮市區發展類型應用於大型健康調查抽樣設計之研究. Journal of Health Management, 4(1), 1-22.

劉秀麗. (2005). 榮民機構住民缺牙與口腔相關生活品質之探討. 高雄醫學大學口腔醫學院口腔衛生學系碩士論文.

顧建娟. (2007). 台北市長期照護機構老人咀嚼能力與口腔健康相關生活品質之探討. 台北醫學大學口腔醫學院牙醫學系碩士論文.

Abud, M. C., dos Santos, J. F. F., da Cunha, V. P. P., & Marchini, L. (2009). TMD and GOHAI indices of Brazilian institutionalised and community-dwelling elderly. Gerodontology, 26(1), 34-39.