Rodakowska Ewa, Wilczyńska-Borawska Magdalena, Fryc Justyna, Baginska Joanna, Naumnik Beata
Department of Restorative Dentistry, Medical University of Bialystok, Bialystok, Poland.
Department of Social and Preventive Dentistry, Medical University of Bialystok, Bialystok, Poland.
Patient Prefer Adherence. 2018 Jun 1;12:955-961. doi: 10.2147/PPA.S161638. eCollection 2018.
The aims of the study were to determine oral health-related quality of life (OHRQoL) in chronic hemodialysis (HD) patients and to estimate which scale describing OHRQoL, Oral Health Impact Profile (OHIP-14) or Geriatric/General Oral Health Assessment Index (GOHAI), was more useful in this particular group.
This was a cross-sectional study conducted by means of a census survey. The Polish versions of OHIP-14 and GOHAI were used to assess OHRQoL. The oral examination included decayed, missing and filled teeth (DMF-T) Index; Oral Hygiene Index simplified; Plaque Index and Gingival Index. In the statistical analysis, the Kruskal-Wallis test, Mann-Whitney test, Pearson's test and Spearman's rank correlation coefficients were used as appropriate.
The final sample consisted of 72 patients (mean age 63.2±15.2 years). The mean duration of HD treatment was 43.8 months. The mean number of teeth was 10.9. The majority of participants (81.9%) were dentate; only 22.2% of the respondents had >20 teeth. Among the dentate subjects, 44.1% wore removable dental prostheses (60.7% women). The most prevalent items for GOHAI (mean 14.71; SD 7.21) were uncomfortable to swallow, discomfort when eating and unhappy with appearance. The most prevalent items for OHIP-14 (mean 8.87; SD 10.95) were uncomfortable to eat foods, and diet has been unsatisfactory. The internal reliability (Cronbach's alpha) was 0.637 for GOHAI and 0.918 for OHIP-14. Chewing problems were significantly related to GOHAI (=0.001) and OHIP-14 (<0.001) scales. Higher OHIP-14 scores were significantly associated with dental treatment needs (=0.029) and poor self-rated oral status (=0.001).
The HD patients had an unsatisfactory oral status, but using only OHRQoL scale was insufficient to capture all their oral health problems. The scales did not fully reflect poor oral health in HD patients. The oral problems were not a major concern for this group of patients, which could indicate the adaptation to impaired oral health or a change in health priorities. Regular dental examinations together with the assessment of OHRQoL in HD patients are required for a comprehensive patients' state. In our study, more variables were significantly related to the OHIP-14 scale than to the GOHAI scale. Thus, the OHIP-14 scale may be more useful in assessing OHRQoL in HD patients.
本研究旨在确定慢性血液透析（HD）患者的口腔健康相关生活质量（OHRQoL），并评估哪种描述OHRQoL的量表，即口腔健康影响量表（OHIP - 14）或老年/一般口腔健康评估指数（GOHAI），在这一特定群体中更有用。
这是一项通过普查进行的横断面研究。使用OHIP - 14和GOHAI的波兰语版本来评估OHRQoL。口腔检查包括龋失补牙（DMF - T）指数；简化口腔卫生指数；菌斑指数和牙龈指数。在统计分析中，根据情况使用了Kruskal - Wallis检验、Mann - Whitney检验、Pearson检验和Spearman等级相关系数。
最终样本包括72名患者（平均年龄63.2±15.2岁）。HD治疗的平均持续时间为43.8个月。平均牙齿数为10.9颗。大多数参与者（81.9%）有牙；只有22.2%的受访者牙齿数超过20颗。在有牙受试者中，44.1%佩戴可摘义齿（女性占60.7%）。GOHAI最常见的项目（平均14.71；标准差7.21）是吞咽不适、进食时不适和对外表不满意。OHIP - 14最常见的项目（平均8.87；标准差10.95）是吃食物不舒服和饮食不尽人意。GOHAI的内部信度（Cronbach's alpha）为0.637，OHIP - 14为0.918。咀嚼问题与GOHAI量表（P = 0.001）和OHIP - 14量表（P < 0.001）显著相关。较高的OHIP - 14得分与牙科治疗需求（P = 0.029）和自我评估的口腔状况差（P = 0.001）显著相关。
HD患者的口腔状况不尽人意，但仅使用OHRQoL量表不足以捕捉他们所有的口腔健康问题。这些量表没有充分反映HD患者口腔健康不佳的情况。口腔问题并非该组患者的主要关注点，这可能表明他们已适应口腔健康受损或健康优先事项发生了变化。为全面了解患者状况，需要对HD患者进行定期口腔检查并评估OHRQoL。在我们的研究中，与OHIP - 14量表显著相关的变量比与GOHAI量表的更多。因此，OHIP - 14量表在评估HD患者的OHRQoL方面可能更有用。
