幼儿口腔健康影响程度量表初步研究

为研制合乎中国国情的《3~6岁儿童口腔健康影响量表》(ECOH IS中文版),评估口腔疾病对3~6岁儿童的日常生活行为及其家庭的影响,采用议题小组和核心小组的程序化决策方式确定初选项目;采取随机抽样方法抽取患者进行调查,应用变异系数法、因子分析法和相关分析方法对调查结果进行统计学分析,对初选条目进行完善。在此基础上研制出ECOH IS中文版,包含躯体功能、心理功能、社会功能、对家庭的影响4个领域,共计23个条目。经现场验证,ECOH IS中文版具有较好的内容效度。     

不同程度错颌畸形对儿童口腔健康相关生活质量的影响

目的观察不同程度错颌畸形对儿童口腔健康相关生活质量的影响。方法选择2012年1月-2015年12月丽水市第二人民医院收治的210例11~14岁错颌畸形汉族儿童作为观察组,同期体检的210例正常颌儿童作为对照组。应用简化11~14岁儿童健康问卷(CPQ11-14)的中文版、正畸治疗需要指数(IOTN)牙齿健康部分(DHC)及一般项目表对其口腔健康生活质量进行调查,得出影响儿童口腔健康相关生活质量的因素。结果 DHC 3级和DHC>3级社交评分高于对照组(DHC 1级)和DHC 2级(P<0.05);DHC 2级、DHC 3级和DHC>3级情感评分高于对照组(P<0.05);女童DHC 2级、DHC 3级和DHC>3级口腔症状评分高于对照组(P<0.05)。男童各组社交评分、情感评分、口腔功能评分、口腔症状评分比较,差异均无统计学意义(P>0.05)。DHC 2级、DHC 3级和DHC>3级社交评分均高于对照组(P<0.05),DHC 3级和DHC>3级社交评分均高于DHC 2级(P<0.05);DHC 2级、DHC 3级和DHC>3级情感评分均高于对照组(P<0.05);DHC 3级和DHC>3级口腔功能评分均高于DHC 2级和对照组(P<0.05);DHC 2级、DHC 3级和DHC>3级口腔症状评分均高于对照组(P<0.05)。女童DHC 2级和DHC 3级CPQ总得分高于男童(P<0.05)。结论儿童错颌畸形对儿童的社交、情感、口腔症状有一定影响,错颌畸形对女童口腔健康相关生活质量的影响较男童严重。     

加强学校口腔健康教育 增进儿童健康意识

本文通过对639名受检儿童回答问题结果分析，口腔龋患不仅和儿童口腔健康行为有关，而且和教师及学生家庭成员的口腔保健知识程度有关，龋患对儿童生长发育的危害牲极大。因此应加强学校口腔保健工作，积极开展健康教育使他们从小重视口腔卫生，保护牙齿。我们认为要从托幼机构、小学抓起，积极开展口腔卫生保健教育，把口腔健康教育推向社会。促进口腔健康，人人受益终身。     

正畸治疗对错颌畸形儿童口腔健康相关生活质量的影响

目的探讨正畸治疗对错颌畸形儿童口腔相关生活质量的影响。方法将217例接受正畸治疗的错颌畸形儿童作为观察组,再选择150例无错颌畸形儿童作为对照组,采用儿童青少年口腔健康影响程度量表(COHIP)对儿童口腔健康相关生活质量进行调查比较,观察组儿童在正畸治疗前、治疗3个月以及治疗6个月分别进行随访调查。结果观察组儿童口腔健康、社会-情感健康、功能健康、自我形象以及COHIP总分均显著低于对照组(P0.05),而两组学校环境评分无显著差异(P0.05);不同性别错颌畸形儿童口腔健康、功能健康、学校环境以及COHIP总分无显著差异(P0.05),但错颌畸形女孩社会-情感健康以及自我形象评分低于男孩(P0.05);不同性别错颌畸形儿童口腔健康、功能健康、学校环境以及COHIP总分无显著差异(P0.05),但错颌畸形女孩社会-情感健康以及自我形象评分低于男孩(P0.05)。结论错颌畸形儿童口腔健康相关生活质量较正常儿童明显降低,且错颌畸形越严重儿童口腔健康相关生活质量越低,正畸治疗对儿童口腔健康生活质量有明显影响,且以治疗初期影响更为明显,需要引起临床医师的关注,采取积极的措施提高正畸治疗初期儿童口腔健康相关生活质量。     

佛山市老年人口腔健康相关生活质量状况及影响因素分析

目的：了解佛山市老年人口腔健康相关生活质量状况,并探讨相关影响因素。方法：于2016—2017年对143名佛山市老年人开展口腔健康流行病学调查,采用多因素logistic回归分析模型分析老年人口腔健康相关生活质量的影响因素。结果：143名佛山市老年人因口腔健康影响生活质量的发生率为82.5%,口腔生理功能、疼痛与不适、心理社会不适3个方面影响生活质量的发生率分别为61.1%、65.0%和31.3%;残根数多、牙结石牙数多均是导致口腔健康相关生活质量低下的危险因素;余留牙数多、每天保持刷牙2次以上、自评总体口腔健康好、已参加商业保险等是保护因素。结论：老年人群因口腔健康问题影响生活质量的情况较普遍,建议相关部门制订促进计划时,重视老年人近端的客观生理健康和主观感受,兼顾考虑远端的社会因素及健康行为。     

萎缩性舌炎患者口腔健康相关生活质量分析

目的探讨萎缩性舌炎患者口腔健康相关生活质量状况。方法以60例萎缩性舌炎患者为病例组,取同期就诊其他口腔疾病患者或患者陪同人员为对照组,采用口腔健康影响程度量表（OHIP-14中文版）进行问卷调查并行统计学处理。结果病例组口腔健康相关生活质量总分偏高,与对照组相比较差异有统计学意义（Z=2.196,P〈0.05）。其中,对生理性疼痛、心理不适、功能障碍这三个领域影响程度较大,与对照组比较差异有显著性（均P〈0.05）。结论萎缩性舌炎很大程度上影响了患者的口腔健康相关生活质量,主要体现在生理性疼痛、心理不适、功能障碍等方面。     

重庆市学龄前儿童口腔健康教育调查

目的　了解重庆市学龄前儿童对口腔健康知识的知晓情况。方法　于 2 0 0 1年 9～ 10月对重庆市主城区 6所小学 484名学前班儿童进行了共 8学时、为期 2个月的儿童口腔健康教育课程 ,并对授课前后口腔健康知识进行问卷调查。结果　儿童对口腔健康知识回答平均正确率由授课前的 61 92 %增加到授课后的 90 19% ,授课前后比较有显著性差异 (P <0 0 0 5)。结论　采取对儿童进行口腔健康教育和宣传牙病预防知识 ,把预防牙病从医院延伸到课堂 ,对培养儿童良好的口腔卫生习惯 ,树立牙病预防的正确观念 ,提高儿童口腔健康水平具有重要意义     

口腔健康干预对幼儿园儿童口腔健康和家长口腔卫生认知的影响

目的 了解口腔健康干预项目对儿童刷牙行为和家长口腔卫生知识、态度的影响。 方法 对461名儿童开展了口腔健康干预项目的幼儿园大班儿童家长和453名未开展项目的幼儿园大班儿童家长进行问卷调查,比较儿童刷牙相关行为、口腔卫生清洁水平和家长口腔卫生知识、态度。 结果 项目幼儿园儿童刷牙率、含氟牙膏使用率、口腔卫生清洁水平高于非项目幼儿园儿童（分别为97.4% vs 94.7%,40.2% vs 31.0%,89.4% vs 77.9%,均P＜0.05）。家长口腔知识正确知晓率项目幼儿园高于非项目幼儿园（83.1% vs 78.2%,P＜0.0001）。家长的9种口腔卫生知识来源中,仅“孩子从幼儿园带回的知识”两组间存在差异（62.8% vs 50.3%,P＜0.0001）。 结论 口腔健康项目提高了儿童的刷牙、含氟牙膏使用和家长口腔卫生认知水平。     

南宁市幼儿母亲对儿童口腔健康行为干预的影响因素分析

目的 研究南宁市幼儿母亲对儿童口腔健康行为干预的影响因素,为制定面向南宁市社区2.5~4.5岁儿童母亲的口腔卫生健康教育方案,及构建南宁市母子口腔卫生健康促进社区网络提供数据支持。方法 采用随机整群抽样的方法,抽取南宁市两个社区的6所幼儿园中2.5~4.5岁幼儿834名,对其母亲进行问卷调查,Logistic多因素回归分析儿童口腔健康行为干预影响因素。结果 38.5%的儿童每天刷牙两次及以上,34.0%的儿童有过口腔就诊,20.9%的儿童使用含氟牙膏,74.1%的儿童有睡前吃甜食。幼儿母亲的文化程度、帮助儿童刷牙、检查刷牙效果、定期口腔检查认知、含氟牙膏对牙齿影响认知等因素与儿童口腔健康行为干预有关。结论 南宁市幼儿口腔健康行为尚不完善,有针对性的提高母亲口腔保健知识,加强母亲干预儿童口腔卫生行为的预防措施。     

Semantic equivalence of the Brazilian version of the Early Childhood Oral Health Impact Scale

The North American instrument Early Childhood Oral Health Impact Scale (ECOHIS) was created to assess the oral health-related quality of life of preschool children and their families. Its use in Brazil requires prior cultural adaptation, and semantic equivalence is one step in this process. The objective of this study was to evaluate the semantic equivalence between the ECOHIS and its Brazilian version. The methodology included six steps: translation of the ECOHIS into Portuguese, done by two translators; a pre-test, in which the two translations were tested in a group of 20 parents/guardians of children 2-5 years of age; unification of the two versions; two back-translations done independently by two translators; review of the translations and back-translations; and production of a final version of the questionnaire. The two translated versions were very similar, and after completion of all steps a final version of the ECOHIS was obtained. The use of translations and back-translations carefully evaluated by experts and incorporating suggestions from the target population allowed the development of a Brazilian version of the ECOHIS that is semantically equivalent to the original instrument.     

Validations of the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS)

This study aimed to evaluate the psychometric properties of the Brazilian version of the Early Childhood Oral Health Impact Scale (ECOHIS). A total of 247 children aged 2 to 5 years and their parents/guardians participated in this study. A clinical oral examination was performed and the parents/guardians completed the ECOHIS questionnaire. Within a period of four-weeks, 20% of the participants repeated the ECOHIS questionnaire. Construct validity was determined using Spearman's rank correlation. Discriminant validity, internal consistency and test-retest reliability were also evaluated. The children were divided into 2 groups: group 1 (with dental caries) and group 2 (caries-free). Children with caries showed higher mean ECOHIS scores than the caries-free children. The child impact section (p < 0.01), family impact section (p < 0.01) and total ECOHIS scores (p < 0.01) were significantly correlated with tooth decay. Cronbach's alpha coefficients demonstrated satisfactory internal consistency. The Brazilian version of the ECOHIS is a valid instrument for assessing oral health-related quality of life in preschool children with Brazilian Portuguese-speaking primary caregivers.     

Validation of a French language version of the Early Childhood Oral Health Impact Scale (ECOHIS)

Background

The Pictorial Representation of Illness and Self Measure (PRISM) has been introduced as a visual measure of suffering. We explored the validity of a revised version, the PRISM-RII, in diabetes patients as part of the annual review.

Methods

Participants were 308 adult outpatients with either type 1 or type 2 diabetes. Measures: (1) the PRISM-RII, yielding Self-Illness Separation (SIS) and Illness Perception Measure (IPM); (2) the Problem Areas in Diabetes (PAID) scale, a measure of diabetes-related distress; (3) the WHO-5 Well-Being Index; (4) and a validation question on suffering (SQ). In addition, patients' complication status, comorbidity and glycemic control values(HbA1c) were recorded.

Results

Patients with complications did have marginally significant higher scores on IPM, compared to patients without complications. Type 2 patients had higher IPM scores than Type 1 patients. SIS and IPM showed low intercorrelation (r = -.25; p < .01). Convergent validity of PRISM-RII was demonstrated by significant correlations between IPM and PAID (r = 0.50; p < 0.01), WHO-5 (r = -.26; p < 0.01) and SQ (r = 0.36; p < 0.01). SIS showed only significant correlations with PAID (r = -0.28; p < 0.01) and SQ (r = -0.22; p < 0.01). Neither IPM nor SIS was significantly associated with HbA1c. The PRISM-RII appeared easy to use and facilitated discussion with care providers on coping with the burden of diabetes.

Conclusion

PRISM-RII appears a promising additional tool to assess the psychological burden of diabetes.     

Parental perceptions of children's oral health: The Early Childhood Oral Health Impact Scale (ECOHIS)

Background  

Dental disease and treatment experience can negatively affect the oral health related quality of life (OHRQL) of preschool aged children and their caregivers. Currently no valid and reliable instrument is available to measure these negative influences in very young children. The objective of this research was to develop the Early Childhood Oral Health Impact Scale (ECOHIS) to measure the OHRQL of preschool children and their families.     

社区健康服务对儿童早期保健的影响

目的增强社区保健人员的儿童早期保健服务能力,提高儿童父母的育儿保健意识,促进儿童早期健康发展。方法通过社区健康干预为儿童提供早期保健服务,比较干预前后的社区医师的儿童早期保健专业技能、儿童父母的育儿知识、儿童父母对社区提供的儿童早期保健服务的认可度。结果通过儿童早期社区健康干预保健计划,社区医师的儿童早期保健专业技能有显著提高,儿童父母的育儿保健知识有所增加,儿童父母对社区提供的儿童早期保健服务的认可度有显著提升。结论儿童早期社区健康干预保健计划实施可提高社区儿童早期保健服务提供能力,增强儿童父母的儿童早期保健意识,有利于促进儿童早期健康发展。     

The Impact of Government Regulations on Early Childhood Services: Perceptions of Early Childhood Professionals in the South West of England

This study investigated the impact of government regulations pertaining to the operation of a range of early childhood services on day to day practice within such services. A non random sample of twenty four early childhood service managers in the south west of England participated in structured interviews in order to assess their awareness of existing government regulations and to what extent existing regulations were used to guide day to day practice. Qualitative content analyses of the interview data revealed that the majority of managers were aware of a range of documents pertaining to regulations but considerable confusion existed about which regulations were considered to be imperative. The majority of respondents considered government regulations to be related more to meeting minimum standards rather than to quality assurance. Quality was perceived to be related to the commitment to good practice. The data indicate that government regulations have a minimal impact upon the day to day practice of early childhood professionals, pointing to the need for in-service opportunities to assist early childhood professionals to make greater connections between regulations, practice and quality.     

Immigrant Caregivers of Young Children: Oral Health Beliefs,Attitudes, and Early Childhood Caries Knowledge

The incidence of early childhood caries (ECC) is a global public health concern. The oral health knowledge of a caregiver can affect a child’s risk for developing ECC. An exploratory study of the oral health knowledge and behaviors among caregivers of children 6 years of age and younger was conducted with a convenience sample of adults (n = 114) enrolled in English language or high school equivalency examination courses. The majority of study participants were born in Asia (47 %). Other birth regions included South America (16 %), Caribbean (16 %), Africa (10 %), and Central America (6 %). Study findings showed caregivers with low oral health knowledge were more likely to engage in behaviors that increase a child’s risk for developing ECC. A statistically significant relationship was found between participants’ rating of their child’s dental health as poor and the belief that children should not be weaned from the nursing bottle by 12 months of age (P = 0.002), brushing should not begin upon tooth eruption (P = 0.01), and fluoride does not strengthen teeth and prevent dental caries (P = 0.005). Subjects who pre-chewed their child’s food also exhibited behaviors including sharing eating utensils or a toothbrush with their child (P < 0.001). Additional caregiver behaviors included providing their child with a bottle containing cariogenic liquids in a crib (P < 0.001). As a result of this research, it is pertinent that culturally sensitive oral health promotion programs are developed and implemented to raise awareness and reduce the risk of dental disease among immigrant populations.     

Developing an Australian utility value set for the Early Childhood Oral Health Impact Scale-4D (ECOHIS-4D) using a discrete choice experiment

Purpose

Preference-based quality of life measures (PBMs) are used to generate quality-adjusted life years (QALYs) in economic evaluations. A PBM consists of (1) a health state classification system and (2) a utility value set that allows the instrument responses to be converted to QALYs. A new, oral health-specific classification system, the Early Childhood Oral Health Impact Scale-4D (ECOHIS-4D) has recently been developed. The aim of this study was to generate an Australian utility value set for the ECOHIS-4D.

Methods

A discrete choice experiment with duration (DCE_TTO) was used as the preference elicitation technique. An online survey was administered to a representative sample of Australian adults over 18 years. Respondents were given 14 choice tasks (10 tasks from the DCE design of 50 choice sets blocked into five blocks, 2 practice tasks, a repeated and a dominant task). Data were analyzed using the conditional logit model.

Results

A total of 1201 respondents from the Australian general population completed the survey. Of them, 69% (n = 829) perceived their oral health status to be good, very good, or excellent. The estimated coefficients from the conditional logit models were in the expected directions and were statistically significant (p < 0.001). The utility values for health states defined by the ECOHIS-4D ranged from 0.0376 to 1.0000.

Conclusions

This newly developed utility value set will enable the calculation of utility values for economic evaluations of interventions related to oral diseases such as dental caries among young children. This will facilitate more effective resource allocation for oral health services.