Fukai Kakuhiro, Yoshino Koichi, Ohyama Atsushi, Takaesu Yoshinori
Fukai Institute of Health Science, 3-86 Hikonari, Misato, Saitama 341-0003, Japan.
Bull Tokyo Dent Coll. 2012;53(2):59-66. doi: 10.2209/tdcpublication.53.59.
In economics, the concept of utility refers to the strength of customer preference. In health care assessment, the visual analogue scale (VAS), the standard gamble, and the time trade-off are used to measure health state utilities. These utility measurements play a key role in promoting shared decision-making in dental care. Individual preference, however, is complex and dynamic. The purpose of this study was to investigate the relationship between patient preference and educational intervention in the field of dental health. The data were collected by distributing questionnaires to employees of two companies in Japan. Participants were aged 18-65 years and consisted of 111 males and 93 females (204 in total). One company (Group A) had a dental program of annual check-ups and health education in the workplace, while the other company (Group B) had no such program. Statistical analyses were performed with the t-test and Chi-square test. The questionnaire items were designed to determine: (1) oral health-related quality of life, (2) dental health state utilities (using VAS), and (3) time trade-off for regular dental check-ups. The percentage of respondents in both groups who were satisfied with chewing function, appearance of teeth, and social function ranged from 23.1 to 42.4%. There were no significant differences between groups A and B in the VAS of decayed, filled, and missing teeth. The VAS of gum bleeding was 42.8 in Group A and 51.3 in Group B (p<0.05). The percentage of persons having a regular dental check-up every three months was 34.1 and 31.3% in Groups A and B respectively. These results suggest that low preference results from lack of opportunity or utilization of dental care in the worksite. Ascertaining the factors involved in patient preference may have significant potential benefits in shared decision-making.
在经济学中，效用概念指的是消费者偏好的强度。在医疗保健评估中，视觉模拟量表（VAS）、标准博弈法和时间权衡法被用于测量健康状态效用。这些效用测量在促进牙科护理中的共同决策方面发挥着关键作用。然而，个人偏好是复杂且动态的。本研究的目的是调查牙科健康领域中患者偏好与教育干预之间的关系。数据通过向日本两家公司的员工发放问卷收集。参与者年龄在18 - 65岁之间，共有111名男性和93名女性（总计204人）。一家公司（A组）在工作场所设有年度口腔检查和健康教育的牙科项目，而另一家公司（B组）没有此类项目。采用t检验和卡方检验进行统计分析。问卷项目旨在确定：（1）与口腔健康相关的生活质量，（2）牙科健康状态效用（使用VAS），以及（3）定期牙科检查的时间权衡。两组中对咀嚼功能、牙齿外观和社交功能满意的受访者比例在23.1%至42.4%之间。A组和B组在龋齿、补牙和缺牙的VAS方面没有显著差异。牙龈出血的VAS在A组为42.8，在B组为51.3（p<0.05）。A组和B组中每三个月进行一次定期牙科检查的人员比例分别为34.1%和31.3%。这些结果表明，偏好较低是由于工作场所缺乏牙科护理机会或未充分利用牙科护理所致。确定患者偏好所涉及的因素在共同决策中可能具有重大潜在益处。
