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研究生:蔡宛容
研究生(外文):Wan-Jung Tsai
論文名稱:機構老人與照顧服務員對口腔衛生的知識、態度、行為調查
論文名稱(外文):Research and Investigation of Knowledge, Attitude and Practices on Oral Health for Elder and Nursing assistant in the long term care facility
指導教授:林麗嬋林麗嬋引用關係
指導教授(外文):Li-Chan Lin
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:臨床暨社區護理研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:132
中文關鍵詞:長期照護機構老人照顧服務員口腔衛生知識口腔衛生態度口腔衛生行為
外文關鍵詞:long-term care facilityeldernursing assistantoral hygiene knowledgeoral hygiene attitudeoral hygiene behavior
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本研究目的為調查機構老人及照顧服務員之口腔衛生知識、態度、行為,以及與口腔健康狀態的關係。研究個案來自台北縣市五所養護機構163位老人和68位照顧服務員。所得資料以單變項分析、類別變項分析、連續變項分析、多變項分析及Mixed model進行檢定。
研究結果顯示機構老人的口腔衛生知識與年齡呈顯著負相關但對簡易智能狀態測驗(MMSE)呈顯著正相關,而教育程度越高口腔衛生知識得分越高。口腔衛生態度與MMSE、日常活動能力(ADL)、疾病診斷數呈顯著正相關。教育程度越高、沒有抽菸史、慣用手點對點準確性測試正常者其口腔衛生態度較佳。口腔衛生行為在MMSE、ADL呈現顯著正相關。女性、教育程度高、慣用手點對點準確性及刷齒模污垢的測試正常者口腔衛生行為較佳。其口腔衛生知識、態度、行為三者之間呈顯著相關。MMSE和教育程度達高中以上對口腔衛生知識有顯著預測力;口腔衛生知識及抽菸史對口腔衛生態度有顯著預測力;女性、高中以上教育程度、口腔衛生知識及態度對口腔衛生行為有顯著預測力;而口腔衛生行為對口腔健康狀態有顯著預測力。
機構照服員的口腔衛生知識和年齡呈顯著正相關。參加過口腔衛生教育訓練的照服員口腔衛生態度顯著較佳。口腔衛生行為對年齡呈顯著負相關,教育程度較高行為得分也較高。照服員的口腔衛生行為可以有效預測其所照顧的失能老人之口腔健康狀態。
建議機構應加強對於照服員口腔衛生照護的教育訓練,宣導老人口腔健康教育,注意缺牙老人的營養狀態。在政策面上,應提高長照機構對老人口腔衛生的重視,增加相關評鑑指標,以保障養護機構住民的口腔健康。
The aim of this study was to investigate the knowledge, attitude and behavior on oral hygiene for elder and nursing assistant (NA) and their relationship with oral health status in the long term care facility. One hundred sixty-three elders and 68 nursing assistants were reunited from five long-term care facilities in Taipei. All data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson’s Correlation, stepwise regression and linear mixed model.
Study results showed elder’s oral hygiene knowledge was statistically having significant negative correlation with age, it was also having a significant positive correlation with MMSE, and the higher education level of the elder would obtain the higher score on oral hygiene knowledge. Elder’s oral hygiene attitude was significantly positive correlated with MMSE, activates of daily living (ADL) and the number of diagnosis. For the elder who had the higher education level, no smoking history, normal on finger-nose-finger (FNF) test had scored better on oral hygiene attitude scale. Elder’s oral hygiene behavior had statistically significant positive correlation with MMSE, and ADL. For female, higher education level, normal on FNF test and brush debris on the tooth mold test had higher scores on oral hygiene behavior scale. There were significantly positive correlation between their knowledge, attitude and behavior on oral hygiene. Stepwise regression showed that MMSE and education level were significant predictors for oral hygiene knowledge. Smoking history and oral hygiene knowledge were significant predictors for oral hygiene attitude. Female, education level, oral hygiene knowledge and oral hygiene attitude were also significant predictors for oral hygiene behavior. Oral hygiene behavior were also significant predictors for oral health.
For NAs, study results showed oral hygiene knowledge had a significant positive correlation with age. NAs had better oral hygiene attitude if had already attended any oral health training class. NAs’ oral hygiene behavior had statistically significant negative correlation with their age and had statistically significant positive correlation with their education level. The oral hygiene behavior of NAs was a significant predictor for oral health status of functionally dependent elders who they cared.
In order to protect and ensure the oral health of residents in long-term care facility, it is suggested that to enhance oral hygiene care training for NAs, to propagate about oral health education for elders, strictly watch over nutrition status with loss-teethed elders. Politically, increase the motivation for long-term care facility to treat it seriously with oral hygiene and increasing relevant evaluate index with oral care to protect oral health.
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論文審定同意書
誌謝………………………………………………………………………i
中文摘要…………………………………………………………………ii
英文摘要…………………………………………………………………v
目錄………………………………………………………………………vi
圖目錄…………………………………………………………………vii
表目錄…………………………………………………………………viii
第壹章 緒論………………………………………………………………1
第一節 研究動機………………………………………………………2
第二節 研究重要性……………………………………………………4
第貳章 文獻查證…………………………………………………………9
第一節 機構老人的口腔概況…………………………………………9第二節 口腔問題的病理機轉及症狀…………………………………10
第三節 口腔問題及其危險因子………………………………………15
第四節 口腔疾病對老人生理造成的影響……………………………23
第五節 與口腔衛生有關的知識………………………………………26
第六節 與口腔衛生有關的態度………………………………………33
第七節 與口腔衛生有關的行為………………………………………37
第參章 研究方法………………………………………………………43
第一節 研究假設………………………………………………………43
第二節 研究架構………………………………………………………44
第三節 名詞解釋………………………………………………………44
第四節 研究設計………………………………………………………47
第五節 研究對象與場所………………………………………………47
第六節 研究工具與信效度檢定………………………………………47
第七節 研究步驟………………………………………………………53
第八節 資料處理及分析方法…………………………………………54
第肆章 研究結果………………………………………………………56
第一節 社會人口學特性及身體機能描述……………………………56
第二節 機構老人口腔知識、態度、行為及其相關因素分析………61
第三節 機構照服員口腔知識、態度、行為描述及其相關因素分析…69
第四節 機構老人口腔健康狀態描述及其相關因素分析……………76

第伍章 討論……………………………………………………………79
第一節 研究結果摘要…………………………………………………79
第二節 研究結果討論…………………………………………………80
第三節 研究限制……………………………………………………87
第四節 護理實務、研究、教學的應用………………………………89
參考文獻
中文文獻……………………………………………………………94
英文文獻……………………………………………………………97

附錄一 受訪者同意書………………………………………………114
附錄二 機構老人問卷………………………………………………116
附錄三 機構照顧服務員問卷………………………………………126

圖目錄
圖一 研究架構圖…………………………………………………………………46
圖二 研究流程圖…………………………………………………………………55

表目錄
表一 牙及其支持組織之疾病於各年齡層每十萬人口就診率………………… 5
表二 機構老人的人口特性分佈描述……………………………………………57
表三 機構照顧服務員的人口特性分佈描述……………………………………60
表四 機構老人的口腔衛生知識、態度、行為總分描述…………………………61
表五 機構老人的年齡、認知功能與口腔衛生知識、態度、行為分析…………64
表六 機構老人性別、抽菸史、教育程度與口腔衛生知識分析…………………64
表七 機構老人性別、抽菸史、教育程度與口腔衛生態度分析…………………64
表八 機構老人性別、抽菸史、教育程度與口腔衛生行為分析…………………65
表九 機構老人疾病診斷數及日常活動能力與口腔衛生態度、行為分析………65
表十 機構老人慣用手肌肉關節活動能力與口腔衛生態度分析………………66
表十一 機構老人口腔衛生知識、態度、行為分析………………………………66
表十二 預測老人口腔衛生知識之因素…………………………………………67
表十三 預測老人口腔衛生態度之因素…………………………………………68
表十四 預測老人口腔衛生行為之因素…………………………………………68
表十五 機構照服員的口腔衛生知識、態度、行為總分描述……………………69
表十六 機構照服員基本屬性與口腔衛生知識、態度、行為分析………………72
表十七 機構照服員參加教育訓練、教育程度與口腔衛生知識分析……………72
表十八 機構照服員參加教育訓練、教育程度與口腔衛生態度分析……………72
表十九 機構照服員參加教育訓練、教育程度與口腔衛生行為分析……………73
表二十 機構照服員口腔衛生知識、態度、行為分析……………………………73
表二十一 照服員口腔衛生知識之預測因素……………………………………73
表二十二 照服員口腔衛生態度之預測因素……………………………………74
表二十三 照服員口腔衛生行為之預測因素……………………………………74
表二十四 照服員的口腔清潔行為對機構老人的影響…………………………75
表二十五 照服員的口腔衛生行為對機構老人的影響…………………………75
表二十六 照服員口腔衛生行為對無法自行刷牙洗臉的老人之影響…………75
表二十七 機構老人的口腔健康狀態分佈描述…………………………………76
表二十八 口腔健康狀態與機構老人的口腔衛生知識、態度、行為分析………77
表二十九 預測機構老人口腔健康狀態之因素…………………………………78
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