口腔健康識能新式量表發展暨相關影響因素的探討

Exploring related factors and validating an oral health literacy instrument

目標：口腔健康識能與個案口腔健康行為與口腔健康狀態有關。本研究目標為發展口腔健康識能量表及探討影響相關因子。方法：本研究經人體研究委員會同意後，以橫斷式研究，收集244位個案。口腔健康識能量表包含字彙理解能力、功能性與互動性口腔健康識能。量表經專家內容效度檢定外，以曼惠特尼U檢定與皮爾森迴歸分別檢定鑑別度與信度。另以一般或邏輯式逐步迴歸分析選取口腔健康識能量表相關因素。結果：三種口腔健康識能量表均具鑑別度與各自相關性。逐步迴歸結果顯示，個案教育程度越高，互動性口腔健康識能分數也越高（全模型調整判定係數為0.21，p<0.001）。功能性口腔健康識能分數增加，有較高比值個案使用正確牙縫清潔工具（p=0.04）或每天清潔牙縫（p<0.001）行為。結論：本研究以驗證口腔健康識能量表探勘影響因子，除年齡與社經地位為重要影響因子外，口腔健康識能與口腔衛生清潔行為顯著相關。本研究結果可應用於深入探討口腔健康識能導致口腔健康行為中介因子，達到口腔疾病預防。

Objectives: Oral health literacy and oral health behavior have an impact on one’s oral health status. The aim of this study is to validate the oral health literacy instrument and explore influencing factors. Methods: A cross-sectional study involving 244 clients was conducted. Three oral health literacy instruments assessed vocabulary comprehension, functional literacy, and interactive literacy, respectively. The content of the instruments was reviewed by professionals with expertise in oral health literacy and dentistry. Discrimination and reliability were assessed using the Mann-Whitney U test and Pearson correlation coefficient, respectively. Stepwise linear and logistic regression were used to select factors. Results: Every domain of the oral health literacy instrument displays discrimination and correlations with the others. The results from the Stepwise analysis reveal that clients with higher educational levels or younger ones are more likely to achieve higher scores in interactive oral health literacy (model R-square 0.21, p<0.001). Clients with higher scores in functional oral health literacy are more likely to use the correct interdental cleaning tools (p=0.04) and engage in daily interdental cleaning (p<0.001). Conclusions: In this study, the oral health literacy instrument has been validated and utilized to investigate related factors. Besides socioeconomic status, which has been identified as an important influencing factor, oral health literacy also proves to have a significant relationship to a subjects’oral health cleaning behavior. The results of this study can be used to further explore the mediating factors that lead to oral health literacy and oral health behaviors that achieve oral disease prevention.