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研究生:王淑瑤
研究生(外文):Shu-Yao Wang
論文名稱:影響矯正病患就診之社會心理因素與口腔衛教介入對牙菌斑控制之成效探討
論文名稱(外文):The Effect of Sociopsychological Factors on Orthodontic Treatment and Oral Hygiene Instruction Intervention on Plaque Control for Orthodontic Patients
指導教授:張宏博楊奕馨楊奕馨引用關係
指導教授(外文):Hong-Po ChangYi-Hsin Yang
學位類別:碩士
校院名稱:高雄醫學大學
系所名稱:口腔衛生科學研究所
學門:醫藥衛生學門
學類:牙醫學類
論文種類:學術論文
論文出版年:2001
畢業學年度:89
語文別:中文
論文頁數:111
中文關鍵詞:牙菌斑控制矯正學口腔衛教社會心理因素
外文關鍵詞:plaque controlorthodonticsoral hygienesociopsychological factor
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近年來世界各國,包括台灣,齒顎矯正治療有越來越普及之趨勢,原因除了經濟狀況好轉之外,社會對顏面美觀之要求增加也是重要原因。然而臨床上伴隨著治療普及而來之問題,例如齲齒、牙齦炎以及對治療之瞭解不足而有不實際之治療期望等,往往造成臨床上之困擾。為了對這些問題有所瞭解並尋求解決之道,本研究設計為兩大部分:矯正病患之問卷調查研究與口腔衛教介入研究。兩部分樣本均來自於教學醫院之齒顎矯正科病患,問卷調查還包括病患的家長。問卷調查部分發現病患求診之動機主要為了顏面外觀與口腔功能。青少年治療之主要決定者為母親,成人則多為自己作決定,然而兩者均受牙醫師的建議影響甚大。對治療之社會期望,包括更容易找到較好的工作或得到升遷機會,擁有更成功之職業生涯,更容易結交朋友,更有自信等,家長明顯高於孩子;女性高於男性。選擇治療地點主要依據牙醫師推薦、就近之方便性及親友介紹。對顏面外觀之自我評價,滿意度從上臉部往下臉部遞減,最不滿意的部分為牙齒外貌,其次為牙齒健康狀況。
口腔衛教介入研究的部分將樣本隨機分為試驗組與控制組。比較項目有牙菌斑指數及牙齦炎指數,以顯示劑染色之後記錄。試驗組於第一次記錄之後立即進行口腔衛教,並於往後兩次約診日再記錄且再加強衛教。而控制組則只進行染色與記錄。將三次記錄進行配對t檢定,發現試驗組之牙菌斑指數與牙齦炎指數均明顯下降,而控制組則無明顯變化。顯示我們所用的衛教方法可有效控制牙菌斑。
Two parts are in this study: one is the questionnaire investigation for the orthodontic patients and their parents, the other one is the intervention study of oral hygiene instruction for the orthodontic patients. The samples are all from the Orthodontic Department of two medical centers. The questionnaire study revealed the primary motives for orthodontic treatment were appearance and oral function. Most of the adolescents were accepted treatment by their mothers’ wishes, and the adults made the treatment decision themselves. However, the dentist plays an important role in the decision process. The expectations of parents about orthodontic treatment were more than those of adolescents. Females expected more than males. The social expectation included better job, more successful carrier, more friend attractive, and more self-confident. As regards seeking orthodontist, the dentist demand and the convenient factors were most important. The self-evaluation about the health condition of teeth by adolescents is the same as by their parents, but is better than adult patients’ self-evaluation significantly. Excluding teeth, the self-evaluation about appearance by parents was significantly better than by adolescents.
The samples of the intervention study are random assigned to the trial group or the control group. Plaque index, buccal plaque index, lingual plaque index, gingival index, buccal gingival index and lingual gingival index are recorded and compared between the trial and the control group with using disclosant. The samples in the trial group accepted complete oral hygiene instruction just after the baseline recording. Two more records were taken on the next two appointments, and oral hygiene instruction again and again. However, the index of the samples in the control group were recorded with disclosant only, no oral hygiene instruction was introduced. The matched paired t test revealed every index recorded was significantly decreasing in the trial group. No significantly change was found in the control group .
目錄
頁次
致謝 i
中文摘要 ii
英文摘要 iv
第一章 緒論 1
第一節 研究背景 1
第二節 研究目的 3
第二章 文獻探討 5
第一節 牙齒與身體形象 ( body image ) 及自我概念
( self-concept ) 5
第二節 牙齒與顏面美觀
第三節 矯正病患治療之配合度 7
第四節 矯正治療對口腔狀況之影響 8
第五節 排列不整齊的牙齒與牙菌斑 10
第六節 各種潔牙工具效果之探討 11
第七節 有關矯正病患之口腔衛生研 12
第三章 材料與方法 14
第一節 研究對象 14
第二節 研究工具 14
第三節 研究流程 17
第四節 介入研究之衛教內容 18
第五節 統計方法 19
第四章 結果 20
第一節 問卷調查樣本之基本資料 20
第二節 問卷調查病患樣本之統計結果 21
第三節 不同性別病患樣本問卷調查之結果與比較 26
第四節 不同年齡層樣本問卷調查之結果與比較 27
第五節 病患與其家長問卷調查之結果與比較 31
第六節 不同所得樣本之問卷調查結果與比較 33
第七節 城市與郊區樣本之問卷調查之結果與比較 34
第八節 口腔衛教介入研究樣本之基本資料 35
第九節 口腔衛教介入對試驗組與控制組之影響 36
第十節 口腔衛教介入對不同性別樣本之影響 37
第十一節 口腔衛教介入對不同年齡層樣本之影響 38
第五章 討論 40
第一節 矯正治療之社會心理層面探討 40
第二節 治療之狀況與評價 42
第三節 身體形象與自覺健康狀況之評估 45
第四節 口腔衛教介入對矯正病患口腔健康之影響 46
第六章 結論與建議 49
參考文獻 52
表格目錄 59
圖目錄 86
附錄 92
參考文獻
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