探究机构老年人口腔知识信念行为与口腔健康相关生活质量的链式中介模型  

Exploration of chain-mediated model of oral knowledge,brief,and behavior and oral health-related quality of life in institutional elderly

作　　者：张颖[1] 王安妮 王晖[1] 瞿柳虹 ZHANG Ying;WANG Anni;WANG Hui;QU Liuhong(Huadong Hospital of Fudan University,Shanghai 200040,China;School of Nursing,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属华东医院,上海200040 [2]复旦大学护理学院,上海200032

出　　处：《护士进修杂志》2023年第4期303-308,共6页Journal of Nurses Training

基　　金：复旦大学-复星护理科研基金项目(编号:FNF202037);复旦大学一流护理学科建设项目-老年与社区护理子项目(编号:FNSYL202005)。

摘　　要：目的探讨机构老年人口腔健康知识、信念、行为对口腔健康相关生活质量(OHRQOL)的作用路径,并分析高龄老年组与低龄老年组的路径差异。方法便利选取2020年6月-2021年3月在上海市3个区6所医院和养老院的440名机构老年人,采用口腔健康影响程度量表(OHIP-14中文版)和老年人口腔健康知信行问卷进行调查,采用结构方程模型进行路径分析及多组群比较。结果机构老年人OHRQOL平均得分为(7.83±8.47)分,疼痛不适维度困扰发生率最高,“吃东西不舒服”负面影响最大,为17.3%;不同年龄组OHRQOL的总分差异有统计学意义(P<0.05)。总样本中,信念、行为在知识和OHRQOL之间起完全链式中介作用,低龄组与高龄组模型间路径系数存在显著差别(Δχ^(2)/Δdf=18.72/5,P=0.002)。低龄组中,口腔知识有显著的间接效应(-0.10)且高于信念的显著间接效应(-0.07)。高龄组中,信念直接和间接均显著(-0.33),而知识间接效应不显著(0.01);口腔健康行为对低龄和高龄的长期住院老年人均有着直接且较大效应(-0.29~-0.26)。结论疼痛不适是机构老年人OHRQOL的主要困扰。对低龄老人需重点加强口腔健康教育以增加其知识水平,对高龄老人应重点加强口腔健康信念正向转变;两者均应鼓励其培养良好的口腔健康行为,以改善OHRQOL。Objective To explore the pathway of knowledge,brief,and practice of oral health on oral health-related quality of life(OHRQOL)among institutional elderly,and analyze the differences of pathway between senior and junior old groups.Methods A total of 440 institutional elderly from 6 hospitals and nursing homes in 3 districts of Shanghai were selected by convenient sampling from June 2020 to March 2021,and were investigated by using Oral Health Impact Profile-14(OHIP-14)and oral health knowledge,brief,and practice questionnaire for the elderly.The structural equation model were applied for pathway analysis and multi-group comparison.Results The average score of OHRQOL in institutional elderly was(7.83±8.47)points,with the incidence of pain and discomfort dimension was the highest,and the incidence of"uncomfortable eating"was 17.3%.The total scores OHRQOL in different age groups were statistically significant(P<0.05).In the total sample,belief,and behavior played a complete chain mediating effect between knowledge and OHRQOL,and there was a significant difference in the pathway coefficients between senior and junior old groups(Δχ^(2)/Δdf=18.72/5,P=0.002).In junior old group,oral knowledge was a significant indirect effect(-0.10)which was higher than that of attitude(-0.07).In senior old group,the direct and indirect effects of attitude were significant(-0.33),while the indirect effect of knowledge were not significant(0.01).Oral health practice had a direct and large effect on both senior and junior elderly who were hospitalized for a long time(from-0.29 to-0.26).Conclusion Pain and discomfort are the main problems of OHRQOL among institutional elderly.For junior elderly,it is necessary to strengthen oral health education to increase their knowledge,and positive change of oral health brief is recommended for the senior elderly.Both of them shall cultivate good oral health behaviors to improve OHRQOL.

关 键 词：老年人 机构照护 知识信念行为 口腔健康 口腔健康相关生活质量 链式中介模型 

分 类 号：R473.59[医药卫生—护理学]