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费城一项针对老年人口腔健康教育中动机性访谈干预的随机临床试验:12 个月非临床结局评估。

Randomised clinical trial of a motivational interviewing intervention to improve oral health education amongst older adults in Philadelphia: 12-month evaluation of non-clinical outcomes.

机构信息

Maurice H Kornberg School of Dentistry, Philadelphia, Pennsylvania, USA.

Helen F. Graham Cancer Center & Research Institute Christiana Care Health System, Newark, Delaware, USA.

出版信息

Gerodontology. 2020 Sep;37(3):279-287. doi: 10.1111/ger.12488. Epub 2020 Jul 8.

DOI:10.1111/ger.12488
PMID:32643211
Abstract

OBJECTIVES

We conducted a trial to assess the treatment fidelity of an individual-based oral health education intervention utilising motivational interviewing (MI) techniques and its efficacy when compared to a group-based traditional oral health education intervention (TOHE) and a standard of care group (SC) in a sample from Philadelphia during a 12-month follow-up.

BACKGROUND

There is lack of information on how different types of oral health educational interventions affect older adults on non-clinical outcomes including changes in oral health-related quality of life (OHRQoL), oral health self-efficacy (SE) and oral health knowledge (OHK).

MATERIALS AND METHODS

One hundred and eighty patients were randomly allocated to TOHE, MI and SC groups. Treatment fidelity was measured in 16 non-study patients. The MI intervention was administered by a public health dental hygienist (PHDH). All interviews were audio-recorded and coded by an expert using the Motivational Interviewing Treatment Integrity (MITI) Code. Multivariable longitudinal regression analyses accounting for baseline demographics and correlated errors due to repeated measures via generalised estimating equation were conducted following an intention to treat approach.

RESULTS

Over the 1-year follow-up, SE and OHRQoL scores significantly improved amongst the MI group whereas both outcomes worsened amongst the SC group. During the same period, SE and OHRQoL did not change in the TOHE group.

CONCLUSION

Findings from the study support the fidelity of this intervention and the improvement of all non-clinical outcomes after 12 months amongst the MI group.

摘要

目的

我们开展了一项试验,以评估一项基于个体的口腔健康教育干预措施的治疗忠实度,该干预措施利用动机访谈(MI)技术,并将其与基于群体的传统口腔健康教育干预(TOHE)和标准护理组(SC)进行比较,在费城的一个样本中进行为期 12 个月的随访。

背景

关于不同类型的口腔健康教育干预措施如何影响非临床结果,包括口腔健康相关生活质量(OHRQoL)、口腔健康自我效能(SE)和口腔健康知识(OHK)的变化,信息不足。

材料和方法

180 名患者被随机分配到 TOHE、MI 和 SC 组。在 16 名非研究患者中测量了治疗忠实度。MI 干预由公共卫生牙科保健师(PHDH)进行。所有访谈均进行录音,并由专家使用动机访谈治疗完整性(MITI)编码进行编码。采用广义估计方程,考虑基线人口统计学和因重复测量而产生的相关误差,对多变量纵向回归分析进行了意向治疗分析。

结果

在 1 年的随访中,MI 组的 SE 和 OHRQoL 评分显著提高,而 SC 组的这两个结果均恶化。在同一时期,TOHE 组的 SE 和 OHRQoL 没有变化。

结论

研究结果支持该干预措施的忠实度以及 MI 组在 12 个月后所有非临床结果的改善。

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