澳大利亚心血管疾病患者获得口腔保健服务的障碍及相关预测因素。

Barriers and Predictors Associated With Accessing Oral Healthcare Among Patients With Cardiovascular Disease in Australia.

机构信息

Paula Sanchez, BN(Hons), GradDipNurs(AcuteCare), GradCert(IntCareNurs), RN PhD Candidate, Lecturer, School of Nursing and Midwifery, Western Sydney University; South Western Sydney Local Health District; Centre for Oral Health Outcomes & Research Translation (COHORT), Liverpool; and Ingham Institute for Applied Medical Research, Liverpool, Australia. Yenna Salamonson, PhD, GradDipNEd, MA(Ed&Work), BSc, RN, CCU Cert Professor, School of Nursing and Midwifery, Western Sydney University; Ingham Institute for Applied Medical Research, Liverpool; and Centre for Applied Nursing Research, Liverpool, Australia. Bronwyn Everett, PhD, MSc(Hons), BAppSc(Nurs), RN Associate Professor, School of Nursing and Midwifery, Western Sydney University; Ingham Institute for Applied Medical Research, Liverpool; and Centre for Applied Nursing Research, Liverpool Australia. Ajesh George, PhD, MPH, BDS Associate Professor, School of Nursing and Midwifery, Western Sydney University; South Western Sydney Local Health District; and Director, Centre for Oral Health Outcomes & Research Translation (COHORT), Liverpool; Ingham Institute for Applied Medical Research, Liverpool; and Honorary Associate Professor, The University of Sydney, Australia.

出版信息

J Cardiovasc Nurs. 2019 May/Jun;34(3):208-214. doi: 10.1097/JCN.0000000000000559.

DOI:10.1097/JCN.0000000000000559

PMID:30589656

Abstract

BACKGROUND

Periodontal disease is associated with cardiovascular disease, and patients should be aware of this risk and seek dental care.

OBJECTIVE

In this study, the authors sought to identify the barriers and predictors for seeking oral healthcare among patients with cardiovascular disease.

METHODS

With the use of a cross-sectional descriptive study design, 307 patients with cardiovascular disease attending cardiac rehabilitation/outpatient cardiac clinics were surveyed between 2016 and 2017 in Sydney, Australia. Survey items included the prevalence of accessing dental services and a new "barriers to seeking frequent dental care" scale.

RESULTS

Most respondents (81%) reported at least 1 oral health problem, yet only 10% received any oral health information and more than half (58%) saw a dentist in the preceding 12 months. The barriers to seeking frequent dental care scale was internally consistent (Cronbach's α = 0.82) with 2 subscales, identified as personal-related and system-related barriers to accessing oral healthcare. Respondents were more likely to have seen a dentist in the previous 12 months if they received oral health information (adjusted odds ratio [AOR], 5.08; 95% confidence interval [CI], 1.62-15.93), had private health insurance (AOR, 3.33; 95% CI, 1.91-5.83), reported low barriers (AOR, 2.68; 95% CI, 1.61-4.47), or were born overseas (AOR, 2.13; 95% CI, 1.25-3.63).

CONCLUSIONS

The accessibility and affordability of dental care, as well as lack of oral health awareness, are key barriers and predictors for patients with cardiovascular disease accessing dental care. Greater emphasis on oral health is needed in the cardiac setting, along with appropriate dental referral pathways.

摘要

背景

牙周病与心血管疾病有关，患者应意识到这种风险并寻求口腔保健。

目的

本研究旨在确定心血管疾病患者寻求口腔保健的障碍和预测因素。

方法

采用横断面描述性研究设计，2016 年至 2017 年在澳大利亚悉尼，对 307 名参加心脏康复/门诊心脏诊所的心血管疾病患者进行了调查。调查项目包括获得牙科服务的患病率和新的“寻求经常口腔保健的障碍”量表。

结果

大多数受访者（81%）报告至少存在 1 个口腔健康问题，但只有 10%接受过任何口腔健康信息，超过一半（58%）在过去 12 个月内看过牙医。寻求经常口腔保健的障碍量表具有内部一致性（Cronbach's α = 0.82），包括 2 个子量表，分别确定为获取口腔保健的个人相关和系统相关障碍。在过去 12 个月内看过牙医的受访者，如果他们接受了口腔健康信息（调整后的优势比[OR]，5.08；95%置信区间[CI]，1.62-15.93）、拥有私人医疗保险（OR，3.33；95%CI，1.91-5.83）、报告障碍较低（OR，2.68；95%CI，1.61-4.47）或出生在海外（OR，2.13；95%CI，1.25-3.63），则更有可能看过牙医。