School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.
School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
BMC Oral Health. 2021 Apr 1;21(1):172. doi: 10.1186/s12903-021-01532-0.
There is limited discussion on the influence of psychosocial factors on the oral health of patients with a facial burn injury. This report investigated the relationship between oral health and psychosocial distress in patients with facial burns and the role of oral health behaviour in mediating the relationship.
The data were part of a cross-sectional study that had systematically and randomly selected patients with > 10% total burn surface area from a burn centre in Pakistan. The oral health status (DMFT, CPI, OHI-S) and severity of facial disfigurement were assessed. Validated instruments in the Urdu language were self-administered and information relating to oral health behaviour (brushing and dental visits), oral health-related quality of life (OHIP-14), satisfaction with appearance, self-esteem, anxiety and depression, resilience, and social support were collected. The statistical analyses included simple linear regression, Pearson correlation, t-test, and ANOVA. Mediation analysis was carried out to examine the indirect effect by oral health behaviour.
From a total of 271 participants, the majority had moderate to severe facial disfigurement (89%), low self-esteem (74.5%), and moderate to high levels of social support (95%). The level of satisfaction with appearance was low, whereas anxiety and depression were high. Disfigurement and satisfaction with appearance were associated with lower self-esteem and social support (p < 0.05). Greater severity of disfigurement, higher levels of anxiety and dissatisfaction with appearance, and lower levels of self-esteem and social support were associated with greater DMFT and OHIP-14 scores, worse periodontal and oral hygiene conditions, and less frequent tooth brushing and dental visits (p < 0.05). The main barriers to oral healthcare utilization were psychological and social issues (p < 0.05). The indirect effect by oral health behaviour was not significant for anxiety but was significant for disfigurement, satisfaction with appearance, self-esteem, and social support.
There is an association between the psychosocial factors and oral health of patients with facial burns through a direct effect and mediation by oral health behaviour.
关于心理社会因素对面部烧伤患者口腔健康的影响，目前的讨论还很有限。本报告调查了面部烧伤患者的口腔健康与心理困扰之间的关系，以及口腔健康行为在其中的中介作用。
本研究的数据来自于一项横断面研究，该研究从巴基斯坦的一个烧伤中心系统地和随机地选择了总烧伤面积大于 10%的患者。评估了口腔健康状况（DMFT、CPI、OHI-S）和面部畸形的严重程度。使用乌尔都语验证过的工具进行了自我管理，并收集了与口腔健康行为（刷牙和看牙医）、口腔健康相关生活质量（OHIP-14）、对外观的满意度、自尊、焦虑和抑郁、适应力和社会支持相关的信息。统计分析包括简单线性回归、皮尔逊相关、t 检验和方差分析。进行中介分析以检验口腔健康行为的间接效应。
在总共 271 名参与者中，大多数人有中度至重度面部畸形（89%）、低自尊（74.5%）和中度至高度社会支持（95%）。对外观的满意度较低，而焦虑和抑郁程度较高。畸形和对外观的满意度与较低的自尊和社会支持相关（p<0.05）。畸形程度越严重、焦虑和对外观的不满程度越高、自尊和社会支持水平越低，与 DMFT 和 OHIP-14 评分越高、牙周和口腔卫生状况越差、刷牙和看牙医的频率越低相关（p<0.05）。口腔保健利用的主要障碍是心理和社会问题（p<0.05）。口腔健康行为对焦虑的间接效应不显著，但对畸形、对外观的满意度、自尊和社会支持有显著影响。
心理社会因素与面部烧伤患者的口腔健康之间存在关联，这种关联是通过直接效应和口腔健康行为的中介作用产生的。
