Fudan University School of Public Health, Fudan University, Shanghai, Shanghai, China.
Minhang Branch of Fudan University School of Public health, Fudan University, Shanghai, Shanghai, People's Republic of China.
BMJ Open. 2022 Dec 15;12(12):e062170. doi: 10.1136/bmjopen-2022-062170.
Achieving good oral health-related quality of life (OHRQOL) is of particular concern in children. The inter-relations among oral health knowledge, self-efficacy, behaviours and OHRQOL in children groups remain unclear. This study aimed to explore the inter-relations between these oral health behaviour-related factors and OHRQOL in primary school children.
In this cross-sectional study, 651 children in grades 2 and 3 were recruited in October 2020 from two primary schools in Minhang District, Shanghai, China. Data were collected through self-reported questionnaires, consisting of demographic characteristics, oral health knowledge, self-efficacy, oral health behaviours and OHRQOL. Pearson's correlation analyses were used to analyse the relationship between study variables. Structural equation models were used to test the inter-relations between OHRQOL and oral health behaviour-related factors.
Four hypothetical structural equation models were tested and one of them was selected as the most appropriate model, which explained 15.0% of the variance in OHRQOL. This selected model showed that oral health behaviours were directly related to OHRQOL. Oral health knowledge was indirectly associated with OHRQOL through both self-efficacy and oral health behaviours. Self-efficacy was directly associated with OHRQOL or was indirectly associated with OHRQOL through oral health behaviours.
This study revealed a pathway of association between children's oral health knowledge and their OHRQOL, in which children's oral health self-efficacy and behaviours had indirect effects. This provides a basis for understanding the mechanism of oral health promotion interventions to improve children's OHRQOL and helps to identify direct or indirect intervention targets.
儿童的口腔健康相关生活质量（OHRQOL）尤其受到关注。儿童群体中口腔健康知识、自我效能、行为与 OHRQOL 之间的相互关系尚不清楚。本研究旨在探讨这些口腔健康行为相关因素与小学生 OHRQOL 之间的相互关系。
本横断面研究于 2020 年 10 月在上海市闵行区的两所小学招募了 651 名 2 年级和 3 年级的学生。数据通过自我报告问卷收集，包括人口统计学特征、口腔健康知识、自我效能、口腔健康行为和 OHRQOL。采用 Pearson 相关分析研究变量之间的关系。采用结构方程模型检验 OHRQOL 与口腔健康行为相关因素之间的相互关系。
共检验了四个假设结构方程模型，其中一个模型被选为最合适的模型，该模型解释了 OHRQOL 变异的 15.0%。该选定模型表明，口腔健康行为直接与 OHRQOL 相关。口腔健康知识通过自我效能和口腔健康行为与 OHRQOL 间接相关。自我效能与 OHRQOL 直接相关，或通过口腔健康行为与 OHRQOL 间接相关。
本研究揭示了儿童口腔健康知识与其 OHRQOL 之间的关联途径，其中儿童的口腔健康自我效能和行为具有间接影响。这为理解促进儿童 OHRQOL 的口腔健康干预措施的机制提供了依据，并有助于确定直接或间接的干预目标。
