儿童口腔健康相关生活质量随时间变化的决定因素。
Determinants of children's oral-health-related quality of life over time.
出版信息
Community Dent Oral Epidemiol. 2014 Jun;42(3):206-15. doi: 10.1111/cdoe.12080.
OBJECTIVE
To identify clinical and psychosocial predictors of oral-health-related quality of life (OHQoL) in Thai children over time.
METHODS
OHQoL data were collected from 510 students aged 10–14 years at baseline and 3, 6 and 9-month follow-up using the Child Perceptions Questionnaire (CPQ11-14), and sense of coherence (SOC), dental coping beliefs (DCB) and socioeconomic status (maternal educational attainment, paternal educational attainment and parental income), together with clinical variables (untreated caries, gingival health, malocclusion, dental opacities), were collected at baseline. The data were analysed with structural equation modelling (SEM) guided by the Wilson and Cleary model (J Am Med Assoc 1995;273:59).
RESULTS
Mean DMFT was 1.97 (SD=1.81). Most students had healthy gingivae (54.3%) and 68.9% scored IOTN 1–4. The SEM model fitted the data well [CMIN/DF=2.574, SRMR=0.0561, CFI=0.974 and RMSEA=0.059 (90% CIs=0.039–0.079)]. Higher SOC, DCB and socioeconomic status (SES) at baseline consistently predicted better OHQoL at all three time points. Untreated caries at baseline predicted worse OHQoL at 6-month follow-up only. Malocclusion and dental opacities were unrelated to OHQoL at any time point.
CONCLUSIONS
Individual factors, particularly SOC, were important influences on OHQoL, suggesting that interventions designed to promote SOC may present an opportunity to enhance children's experience of oral health in their daily lives. Clinical factors were not consistently related to OHQoL. This could be attributed to weak relationships between the two, the low level of disease and/or the sensitivity and discriminant validity of the CPQ11-14.
目的
确定泰国儿童口腔健康相关生活质量（OHQoL）的临床和心理社会预测因素随时间的变化情况。
方法
使用儿童感知问卷（CPQ11-14），在基线和 3、6 和 9 个月随访时收集 510 名 10-14 岁学生的 OHQoL 数据，并收集社会认知感（SOC）、牙科应对信念（DCB）和社会经济地位（母亲教育程度、父亲教育程度和父母收入）以及临床变量（未经治疗的龋齿、牙龈健康、错牙合畸形、牙釉质混浊）。数据采用结构方程模型（SEM）进行分析，模型由 Wilson 和 Cleary 模型（J Am Med Assoc 1995;273:59）指导。
结果
DMFT 平均值为 1.97（SD=1.81）。大多数学生的牙龈健康状况良好（54.3%），68.9%的学生的 IOTN 评分为 1-4。SEM 模型拟合数据效果良好[CMIN/DF=2.574，SRMR=0.0561，CFI=0.974，RMSEA=0.059（90%置信区间为 0.039-0.079）]。基线时 SOC、DCB 和社会经济地位（SES）较高，始终能预测三个时间点的 OHQoL 更好。基线时未经治疗的龋齿仅预测 6 个月随访时的 OHQoL 更差。错牙合畸形和牙釉质混浊在任何时间点均与 OHQoL 无关。
结论
个体因素，特别是 SOC，对 OHQoL 有重要影响，这表明设计旨在促进 SOC 的干预措施可能为提高儿童日常生活中的口腔健康体验提供机会。临床因素与 OHQoL 并不始终相关。这可能归因于两者之间的关系较弱、疾病程度较低以及 CPQ11-14 的敏感性和判别效度。
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