腦中風病人之口腔健康狀態與口腔衛生行為及其影響因素

Factors Associated With Oral Health Status and Oral Hygiene Behavior in Patients With Stroke

背景：口腔健康與全身疾病有密切關係，口腔衛生不佳易導致齲齒及牙周病，亦會增加心血管疾病的風險。腦中風病人可能會再復發，好的口腔健康將有助於中風病人的整體健康狀態，但是探討中風族群的口腔健康及口腔衛生行為，護理研究仍然不足。目的：探討腦中風病人之口腔健康狀態與口腔衛生行為及其影響因素。方法：採橫斷式研究設計，以方便取樣自南部某教學醫院門診腦中風之個案，收集人口學資料、健康促進行為、口腔衛生行為、口腔健康狀態，並以逐步迴歸分析影響中風病人口腔健康狀態之因素。結果：共有185位個案參與本計畫，真牙顆數為11.3，口腔健康狀態4分。年齡65歲以上、國小教育以下、巴氏量表得分越低、整體功能狀態越差、無刷牙與使用牙線、無定期洗牙、健康促進得分越低者及水分攝取不足，其口腔健康狀態得分越差。經逐步迴歸分析顯示健康促進行為得分、年齡、刷牙次數及水分攝取對口腔健康狀態可解釋總變異量約28.5%。結論：研究結果顯示參與本研究的中風病人，其口腔健康狀態、口腔衛生行為及健康促進行為相當不理想。建議臨床照護應及早推動健康促進行為，尤其應將口腔衛生落實於日常照護中。

Background: Studies have shown that oral health is closely related to systemic diseases. Poor oral hygiene may lead to dental caries and periodontal disease and also increase the risk of cardiovascular disease. Patients with stroke have a possibility of recurrence, and good oral health is expected to benefit their general health. Nevertheless, nursing research exploring the oral health and oral hygiene behaviors of stroke patients has been rare. Purpose: To explore the factors significantly associated with oral health status and oral hygiene behaviors in patients with stroke. Method: A cross-sectional research design with convenient sampling was used. Information on health promoting behaviors and oral health status was collected in a teaching hospital in southern Taiwan. A multivariate linear regression model was applied to explore the factors associated with oral health status in patients with stroke. Results: One hundred and eight-five patients with stroke were enrolled in this study. The average number of real teeth was 11.3 and the average score for oral health status was 4. The univariate analysis showed that being 65 years of age or older, having an education level below primary school, having a lower Barthel index score, having a higher modified Rankin scale score, not brushing and flossing, not having a regular tooth cleaning, having a lower of health promotion score, and having insufficient water intake levels were all associated with a worse oral health status. The stepwise regression analysis showed that factors affecting oral health status include health promotion behaviors, age, tooth brushing, and water intake, which, together, accounted for 28.5% of the total variance. Conclusions/Implications for Practice: The findings indicate that oral health status, oral hygiene behaviors, and health promoting behaviors are inadequate among patients with stroke. Clinicians should promote health-related behaviors early to their patients with stroke, specifically in terms of implementing proper oral hygiene behaviors in daily routine care.