School of Dentistry, University of Dundee, UK.
Dental Health Services Research Unit School of Dentistry, University of Dundee, UK.
Community Dent Health. 2021 May 28;38(2):119-126. doi: 10.1922/CDH_00295Alharbi08.
To identify the directions, strength and associations between dental anxiety, COHRQoL and self-esteem in children and adolescents.
PRISMA guidelines were followed and the review registered (PROSPERO CRD42019140037). MEDLINE, Cochrane Library, Scopus, Science Direct, CINAHL, Joanna Briggs Institute (JBI), Grey Literature Report, and British Library EThOS using MeSH terms and keywords were searched. Three reviewers examined the abstracts of all articles, excluded duplicates and those not meeting inclusion criteria. All full-text papers were read by all reviewers. Meta-analysis association data including Pearson's or Spearman's correlation coefficient were extracted and effect sizes estimated.
Twelve papers met the inclusion criteria, 7 assessed the relationship between child dental anxiety and COHRQoL; four between COHRQoL and self-esteem and one between child dental anxiety and self-esteem. Significant relationships were found between COHRQoL and the other child-related outcomes measures. An inverse relationship was shown for dental anxiety and COHRQoL. The meta-analysis found small associations between child dental anxiety and COHRQoL and moderate associations between COHRQoL and self-esteem. High heterogeneity between COHRQoL and self-esteem was noted. The association between child dental anxiety and self-esteem was limited. No source reported associations between all three variables.
The studies were of varying quality and the degree of heterogeneity meant that only limited conclusions were possible. There is a need for high-quality evidence to underpin intervention designs to promote COHRQoL and self-esteem to reduce child dental anxiety.
确定儿童和青少年的牙科焦虑症、COHRQoL 和自尊之间的方向、强度和关联。
遵循 PRISMA 指南，并对综述进行了注册（PROSPERO CRD42019140037）。使用 MeSH 术语和关键词搜索了 MEDLINE、Cochrane 图书馆、Scopus、Science Direct、CINAHL、乔安娜·布里格斯研究所（JBI）、灰色文献报告和大英图书馆 EThOS。三位评审员检查了所有文章的摘要，排除了重复的和不符合纳入标准的文章。所有全文论文均由所有评审员阅读。提取了元分析关联数据，包括皮尔逊或斯皮尔曼相关系数，并估计了效应大小。
符合纳入标准的有 12 篇论文，其中 7 篇评估了儿童牙科焦虑症与 COHRQoL 之间的关系；4 篇评估了 COHRQoL 与自尊之间的关系，1 篇评估了儿童牙科焦虑症与自尊之间的关系。发现 COHRQoL 与其他儿童相关结果测量之间存在显著关系。牙科焦虑症与 COHRQoL 呈负相关。元分析发现，儿童牙科焦虑症与 COHRQoL 之间存在较小的关联，COHRQoL 与自尊之间存在中等程度的关联。注意到 COHRQoL 和自尊之间存在高度异质性。儿童牙科焦虑症与自尊之间的关联是有限的。没有来源报告所有三个变量之间的关联。
这些研究的质量参差不齐，异质性程度意味着只能得出有限的结论。需要高质量的证据来支持干预设计，以提高 COHRQoL 和自尊，从而降低儿童的牙科焦虑症。
