尼日利亚郊区儿童和青少年的不良童年经历、欺凌、自尊、适应力、社会支持、龋齿和口腔卫生之间的关联。
Association between adverse childhood experiences, bullying, self-esteem, resilience, social support, caries and oral hygiene in children and adolescents in sub-urban Nigeria.
机构信息
Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
出版信息
BMC Oral Health. 2020 Jul 11;20(1):202. doi: 10.1186/s12903-020-01160-0.
BACKGROUND
Adverse childhood experiences (ACE) and bullying have negative effects on oral health. Promotive assets (resilience, self-esteem) and resources (perceived social support) can ameliorate their negative impact. The aim of this study was to determine the association between oral diseases (caries, caries complications and poor oral hygiene), ACE and bully victimization and the effect of access to promotive assets and resources on oral diseases.
METHODS
This was a secondary analysis of data collected through a cross-sectional school survey of children 6-16-years-old in Ile-Ife, Nigeria from October to December 2019. The outcome variables were caries, measured with the dmft/DMFT index; caries complications measured with the pufa/PUFA index; and poor oral hygiene measured with the oral hygiene index-simplified. The explanatory variables were ACE, bully victimization, resilience, self-esteem, and social support. Confounders were age, sex, and socioeconomic status. Association between the explanatory and outcome variables was determined with logistic regression.
RESULTS
Of the 1001 pupils with complete data, 81 (8.1%) had poor oral hygiene, 59 (5.9%) had caries and 6 (10.2%) of those with caries had complications. Also, 679 (67.8%) pupils had one or more ACE and 619 (62.1%) pupils had been bullied one or more times. The median (interquartile range [IQR]) for ACE was 1(3), for bully victimization was 1(5), and for self-esteem and social support scores were 22(5) and 64(34) respectively. The mean (standard deviation) score for resilience was 31(9). The two factors that were significantly associated with the presence of caries were self-esteem (AOR: 0.91; 95% CI: 0.85-0.98; p = 0.02) and social support (AOR: 0.98; 95% CI: 0.97-1,00; p = 0.02). No psychosocial factor was significantly associated with caries complications. Self-esteem was associated with poor oral hygiene (AOR: 1.09; 95% CI: 1.09-1.17; p = 0.03).
CONCLUSION
There was a complex relationship between ACE, bully victimization, access to promotive assets and resources by children and adolescents, and oral health. ACE and bully victimization were not associated with oral health problems. Though self-esteem was associated with caries and poor oral hygiene, the relationships were inverse. Promotive assets and resources were not associated with caries complications though resources were associated with lower prevalence of caries.
背景
不良的童年经历（ACE）和欺凌对口腔健康有负面影响。促进因素（韧性、自尊）和资源（感知到的社会支持）可以减轻其负面影响。本研究的目的是确定口腔疾病（龋齿、龋齿并发症和口腔卫生不良）、ACE 和受欺凌与获得促进因素和资源之间的关联，并确定这些因素对口腔疾病的影响。
方法
这是对 2019 年 10 月至 12 月期间在尼日利亚伊费市对 6-16 岁儿童进行的一项横断面学校调查收集的数据进行的二次分析。因变量为龋齿，用 dmft/DMFT 指数衡量；用 pufa/PUFA 指数衡量龋齿并发症；用简化口腔卫生指数衡量口腔卫生不良。解释变量为 ACE、受欺凌、韧性、自尊和社会支持。混杂因素为年龄、性别和社会经济地位。用 logistic 回归法确定解释变量和结果变量之间的关系。
结果
在 1001 名有完整数据的学生中，81 名（8.1%）有不良口腔卫生，59 名（5.9%）有龋齿，6 名（10.2%）有龋齿并发症。此外，679 名（67.8%）学生有一项或多项 ACE，619 名（62.1%）学生曾遭受过一次或多次欺凌。ACE 的中位数（四分位距[IQR]）为 1（3），受欺凌的中位数（IQR）为 1（5），自尊和社会支持得分的中位数（IQR）分别为 22（5）和 64（34）。韧性的平均（标准差）得分是 31（9）。与龋齿存在显著相关的两个因素是自尊（AOR：0.91；95%CI：0.85-0.98；p=0.02）和社会支持（AOR：0.98；95%CI：0.97-1.00；p=0.02）。没有任何社会心理因素与龋齿并发症显著相关。自尊与口腔卫生不良有关（AOR：1.09；95%CI：1.09-1.17；p=0.03）。
结论
儿童和青少年 ACE、受欺凌、获得促进因素和资源之间的关系复杂，与口腔健康有关。ACE 和受欺凌与口腔健康问题无关。虽然自尊与龋齿和口腔卫生不良有关，但这些关系是相反的。资源虽然与龋齿的患病率较低有关，但与龋齿并发症无关。促进因素和资源。
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