Ernst Bero Luke Vincent, Kreher Deborah, Patschan Daniel, Haak Rainer, Ebert Thomas, de Fallois Jonathan, Schmalz Gerhard
Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
intHERCon GmbH, Goettingen, Germany.
BMC Nephrol. 2024 Dec 2;25(1):441. doi: 10.1186/s12882-024-03889-0.
Aim of this questionnaire-based cross-sectional study was to compare self-efficacy, social support, oral hygiene-related self-efficacy (OHRSE) and oral health-related quality of life (OHRQoL) between patients under chronic hemodialysis (HD) and patients after kidney transplantation (KTx) as well as a healthy comparison group (HC).
Patients under HD were recruited during their routine outpatient dialysis therapy, KTx patients during their maintenance appointment and HC patients during their regular dental check-up in the dental clinic. General self-efficacy, the OHRSE, social support (F-SozU-K14) and the OHRQoL (OHIP-G5) were assessed by specific validated questionnaires. The survey was performed by one experienced dentist.
44 HD, 40 KTx and 45 HC patients were included, between which the age and gender distribution was comparable (p > 0.05). With a median of 1.5 [IQR: 0-3], HD patients showed higher OHIP-G5 than the participants in KTx group (p < 0.01). Similarly, a significant difference was found between KTx (0, [0-0.5]) and HC (0, [0-3]; p < 0.01). HD patients showed a lower sum score of OHRSE, tooth-brushing, interdental-cleaning and dental-visit self-efficacy than the HC (p < 0.01). Similarly, HD patients had a lower sum score of OHRSE, tooth-brushing and dental-visit self-efficacy than the KTx group (p < 0.01). Moreover, the KTx group had a lower interdental-cleaning self-efficacy (p < 0.01) and sum score (p = 0.02) than the HC. The sum score of the general self-efficacy was comparable between the three groups (p = 0.19). The F-SozU-K14 revealed higher values in KTx (65.40 ± 5.33) compared with HD (60.95 ± 9.28) and HC group (61.71 ± 9.24; p = 0.03). Only in the KTx group, a significant association between F-SozU-K14 and OHIP-G5 was revealed (p = 0.05).
Patients under HD show a reduced OHRSE compared to KTx and HC and a slightly reduced OHRQoL compared to KTx patients. While general self-efficacy was comparable between groups, social support of HD patients was lower than of KTx patients. The OHRSE and OHRQoL might receive increased attention in dental care of HD patients.
这项基于问卷的横断面研究旨在比较慢性血液透析（HD）患者、肾移植（KTx）患者以及健康对照组（HC）之间的自我效能感、社会支持、口腔卫生相关自我效能感（OHRSE）和口腔健康相关生活质量（OHRQoL）。
HD患者在其常规门诊透析治疗期间招募，KTx患者在其维持预约期间招募，HC患者在牙科诊所进行定期牙科检查时招募。通过特定的有效问卷评估一般自我效能感、OHRSE、社会支持（F-SozU-K14）和OHRQoL（OHIP-G5）。调查由一名经验丰富的牙医进行。
纳入了44名HD患者、40名KTx患者和45名HC患者，三组之间的年龄和性别分布具有可比性（p>0.05）。HD患者的OHIP-G5中位数为1.5[四分位间距：0 - 3]，高于KTx组的参与者（p<0.01）。同样，KTx组（0，[0 - 0.5]）和HC组（0，[0 - 3]；p<0.01）之间存在显著差异。HD患者的OHRSE、刷牙、牙间隙清洁和看牙自我效能感总分低于HC组（p<0.01）。同样，HD患者的OHRSE、刷牙和看牙自我效能感总分低于KTx组（p<0.01）。此外，KTx组的牙间隙清洁自我效能感（p<0.01）和总分（p = 0.02）低于HC组。三组之间的一般自我效能感总分具有可比性（p = 0.19）。F-SozU-K14显示，KTx组（65.40±5.33）的值高于HD组（60.95±9.28）和HC组（61.71±9.24；p = 0.03）。仅在KTx组中，F-SozU-K14与OHIP-G5之间存在显著关联（p = 0.05）。
与KTx患者和HC相比，HD患者的OHRSE降低，与KTx患者相比，OHRQoL略有降低。虽然各组之间的一般自我效能感具有可比性，但HD患者的社会支持低于KTx患者。在HD患者的牙科护理中，OHRSE和OHRQoL可能需要更多关注。
