臺灣博碩士論文加值系統

本研究的主要目的是在探討長期照護機構內老人，其口腔健康生活品質之現況與其相關因子。
本研究針對台北市兩家安養護中心，以立意取樣方式，收集橫斷式資料，個案均為65歲以上意識清楚，可接受口腔檢查及問卷訪談之住民，共224位。資料包含有臨床資料與問卷調查。臨床資料有齒列狀況、牙周狀況、咬合狀況及贗復狀況。問卷內容有基本人口學特性、身體疾病功能狀況及進食狀況及老人口腔健康生活品質測量。
結果顯示，整體口腔健康相關生活品質平均分數50.07(±7.90)，50分以下者佔44.2%，多變相複迴歸分析顯示，在控制人口學因素後，以咬合分類、進食的種類及失能程度和口腔健康生活品質分數有顯著相關，預測整體口腔健康生活品質的總解釋變異量17.5％。若更進一步將整體口腔健康生活品質分為三個功能層面(生理、社會心理及疼痛不適)，咬合分類在生理功能層面有較大影響力，納入其他變項，共可解釋 30.2%的變異性。在其他心理社會及疼痛不適的層面解釋力較少。
影響老年人的口腔健康相關生活品質，以咬合分類指標(Eichner index)是影響的重要因素，建議使用客觀及自評的口腔健康評估量表，提早發現失能老人潛在的口腔咀嚼的問題，做為口腔重建及照護介入計劃的依據。

The purpose of this research was to assess the oral-health related quality of life among the institutionalized elderly and to identify its relevant factors. Cognitively coherent residents in two institutions in Taipei were recruited into the study using a convenient sampling technique and cross-sectional data was collected. A total of 224 subjects participated in this study. Demographic characteristics, chronic conditions, physical function, cognitive function, and geriatric oral- health related quality of life assessment (Geriatric Oral Health Assessment Index；GOHAI) were collected through face-to-face interviews, while information regarding dentition status, periodontal status, occlusion status and prosthetic status were collected through clinical examination.
Results showed that the average GOHAI score was 50.7 out of 100, with 44.2% of subjects scored less than 50. Multivariate linear regression showed that, after controlling for demographic characteristics, the Eichner index, kinds of eating food and functional dependency are significant predictors of GOHAI scores. The model explained 17.5% of the total variance. Examining the three domains (physiological, social, and discomfort) of GOHAI individually, results showed that the Eichner index was highly correlated with the physiological domain of GOHAI, but not with the social or discomfort domains. The model explained 30.2% of the variance in the physiological domain.
Eichner index is the most important predictor of oral-health related quality of life among the institutionalized elderly. Dental health policy should emphasize on using an objective and self-reported assessment for screening subjects in need of early intervention.

目 錄

致 謝 ………………………………………………………I
中文摘要 ………………………………………………………II
英文摘要 ………………………………………………………IV
目 錄 ………………………………………………………Ⅵ
圖表目次 ………………………………………………………Ⅷ

第一章 緒論
第一節 研究背景……………………………………….. 1
第二節 研究目的……………………………………….. 4
第三節 名詞定義……………………………………….. 5
第二章 文獻查証
第一節 長期照護的界定……………………………….. 8
第二節 老人口腔健康狀況........................ 11
第三節 國內、外照護機構老人口腔健康狀況……….. 13
第四節 咀嚼能力之相關研究………………………….. 15
第五節 口腔健康相關生活品質之研究.............. 19
第六節 咀嚼能力與口腔健康生活品質……………….. 23
第三章 研究材料與方法
第一節 研究架構……………………………………….. 24
第二節 研究設計及工具……………………………….. 25
第三節 研究變項的操作行定義及測量方法………….. 30
第四節 統計分析……………………………………….. 38
第四章 分析與結果
第一節 樣本人口學特性描述………………………….. 39
第二節 口腔健康與咀嚼能力狀況…………………….. 42
第三節 口腔健康生活品質之相關分析……………….. 44
第四節 影響口腔健康生活品質之因素迴歸分析…….. 46
第五章 討論
第一節 重要發現與討論……………………………….. 48
第二節 研究限制……………………………………….. 52
第六章 結論與建議
第一節 結論…………………………………………….. 54
第二節 建議…………………………………………….. 55
參考資料
中文部份 ……………………………………………… 56
英文部份 ……………………………………………… 57
附錄
附錄一 人體試驗志願書………………………………… 73
附錄二 老人口腔健康檢查表…………………………… 75
附錄三 老人口腔健康評估表…………………………… 77
附錄四 專家會議討論名單……………………………… 78
圖表目錄
第一部份 圖
圖 1-3 Eichner 分類………………………………………….61
圖 3-1 研究架構圖…………………………………………… 62
第二部份 表
表 3-3 研究變項之操作型定義與測量方法………………..63
表 4-1 人口學特性分布情形表……………………………..66
表 4-1-1 口腔健康生活品質分數及分項統計分析…………..67
表 4-2 口腔健康狀況及咀嚼能力分布情形表……………..68
表 4-3 口腔健康生活品質與基本人口學相關性分析……..69
表 4-3-1 口腔健康生活品質與口腔健康狀況、咀嚼能力
相關性分析…………………………………………..70
表 4-4-1 預測口腔健康生活品質總分迴歸分析……………..71
表 4-4-2 預測口腔健康生活品質的生理功能層面迴歸分析..71
表 4-4-3 預測口腔健康生活品質的社會心理功能層面
迴歸分析…………………………………………….72
表 4-4-4 預測口腔健康生活品質的疼痛不適層面迴歸分析..72

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3.蔡秀霞 長期照護機構住民口腔健康狀況之研究 高雄醫學大學口
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4.劉秀麗 榮民機構住民缺牙與口腔相關生活品質之探討 高雄醫學
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5.梁金麗 社區老人生活品質及其相關因素之探討 國立台北護理學
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