Gaber Amal, Galarneau Chantal, Feine Jocelyne S, Emami Elham
Faculty of Dentistry, McGill University, Montréal, QC, Canada.
Faculty of Dentistry, Université de Montréal, Montréal, QC, Canada.
Community Dent Oral Epidemiol. 2018 Apr;46(2):132-142. doi: 10.1111/cdoe.12344. Epub 2017 Sep 21.
OBJECTIVES: The objective of this population-based cross-sectional study was to estimate rural-urban disparity in the oral health-related quality of life (OHRQoL) of the Quebec adult population. METHODS: A 2-stage sampling design was used to collect data from the 1788 parents/caregivers of schoolchildren living in the 8 regions of the province of Quebec in Canada. Andersen's behavioural model for health services utilization was used as a conceptual framework. Place of residency was defined according to the Statistics Canada Census Metropolitan Area and Census Agglomeration Influenced Zone classification. The outcome of interest was OHRQoL measured using the Oral Health Impact Profile (OHIP)-14 validated questionnaire. Data weighting was applied, and the prevalence, extent and severity of negative oral health impacts were calculated. Statistical analyses included descriptive statistics, bivariate analyses and binary logistic regression. RESULTS: The prevalence of poor oral health-related quality life (OHRQoL) was statistically higher in rural areas than in urban zones (P = .02). Rural residents reported a significantly higher prevalence of negative daily-life impacts in pain, psychological discomfort and social disability OHIP domains (P < .05). Additionally, the rural population showed a greater number of negative oral health impacts (P = .03). There was no significant rural-urban difference in the severity of poor oral health. Logistic regression indicated that the prevalence of poor OHRQoL was significantly related to place of residency (OR = 1.6; 95% CI = 1.1-2.5; P = .022), perceived oral health (OR = 9.4; 95% CI = 5.7-15.5; P < .001), dental treatment needs factors (perceived need for dental treatment, pain, dental care seeking) (OR = 8.7; 95% CI = 4.8-15.6; P < .001) and education (OR = 2.7; 95% CI = 1.8-3.9; P < .001). CONCLUSION: The results of this study suggest a potential difference in OHRQoL of Quebec rural and urban populations, and a need to develop strategies to promote oral health outcomes, specifically for rural residents. Further studies are needed to confirm these results.
目的：这项基于人群的横断面研究旨在评估魁北克成年人口在口腔健康相关生活质量（OHRQoL）方面的城乡差异。 方法：采用两阶段抽样设计，从加拿大魁北克省8个地区的1788名学童家长/照顾者中收集数据。将安德森卫生服务利用行为模型用作概念框架。根据加拿大统计局人口普查大都市区和普查集聚影响区分类来定义居住地点。感兴趣的结果是使用经过验证的口腔健康影响概况（OHIP）-14问卷测量的OHRQoL。应用数据加权，并计算负面口腔健康影响的患病率、程度和严重程度。统计分析包括描述性统计、双变量分析和二元逻辑回归。 结果：农村地区口腔健康相关生活质量差（OHRQoL）的患病率在统计学上高于城市地区（P = 0.02）。农村居民报告在疼痛、心理不适和社会残疾OHIP领域中，日常生活负面影响的患病率显著更高（P < 0.05）。此外，农村人口的负面口腔健康影响数量更多（P = 0.03）。口腔健康状况差的严重程度在城乡之间没有显著差异。逻辑回归表明，OHRQoL差的患病率与居住地点显著相关（OR = 1.6；95% CI = 1.1 - 2.5；P = 0.022）、感知的口腔健康（OR = 9.4；95% CI = 5.7 - 15.5；P < 0.001）、牙科治疗需求因素（感知的牙科治疗需求、疼痛、寻求牙科护理）（OR = 8.7；95% CI = 4.8 - 15.6；P < 0.001）以及教育程度（OR = 2.7；95% CI = 1.8 - 3.9；P < 0.001）。 结论：本研究结果表明魁北克农村和城市人口在OHRQoL方面可能存在差异，并且需要制定策略来改善口腔健康结果，特别是针对农村居民。需要进一步研究来证实这些结果。
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