老年牙周炎患者龈下刮治术治疗的认知度及影响因素^*

Awareness of subgingival scaling therapy and its influencing factors in elderly patients with periodontitis

摘要

目的 探讨老年牙周炎患者的龈下刮治术治疗认知度及影响因素。方法 选取南京大学医学院附属口腔医院2022年—2024年收治的116例老年牙周炎患者作为研究对象, 所有患者行龈下刮治术治疗。采用南京大学医学院附属口腔医院自制调查问卷对患者的龈下刮治术治疗认知度进行评价。收集所有患者的临床资料, 采用单因素和多元线性回归分析老年牙周炎患者龈下刮治术治疗认知度的影响因素。结果 老年牙周炎患者的龈下刮治术治疗认知度调查量表的组内相关系数为0.82, 表明问卷具有良好的重测信度。该量表的内容效度指数为0.92, 各条目的内容效度指数为0.85~1.00, 表明量表内容效度良好。该量表的Cronbach α为0.82, 表明问卷具有良好的内部一致性信度。该量表的KMO值为0.816, 表明量表结构效度良好。116例老年牙周炎患者的龈下刮治术治疗认知度量表总分为(42.56±3.26)分, 得分率为42.56%。单因素分析结果显示, 不同的家庭人均月收入、口腔健康知识水平、社会支持、口腔健康生活质量、文化程度、口腔健康指导、牙科恐惧水平的老年牙周炎患者的龈下刮治术治疗认知度比较, 差异均有统计学意义(P<0.05)。多元线性回归分析结果显示, 口腔健康知识低水平、没有社会支持、口腔健康生活质量高、文化程度在高中及以下、没有口腔健康指导、牙科恐惧水平高、家庭人均月收入≤3000元均是影响老年牙周炎患者龈下刮治术治疗认知度的独立危险因素(P<0.05), 是造成老年牙周炎患者对龈下刮治术治疗认知度偏低的原因。结论 老年牙周炎患者对龈下刮治术治疗认知度偏低, 这可能与口腔健康知识低水平、没有社会支持、口腔健康生活质量高、文化程度在高中及以下、没有口腔健康指导、牙科恐惧水平高、家庭人均月收入≤3000元等因素有关。

Abstract

Objective To investigate the awareness of subgingival scaling and its influencing factors in elderly patients with periodontitis. Methods A total of 116 elderly patients with periodontitis admitted to the Affiliated Stomatological Hospital of Nanjing University Medical College from 2022 to 2024 were selected as the research objects. All patients were treated with subgingival scaling. The self-made questionnaire of the Affiliated Stomatological Hospital of Nanjing University Medical College was used to evaluate the patient's awareness of subgingival scaling. The clinical data of all patients was collected, and the influencing factors of the awareness of subgingival scaling in elderly patients with periodontitis were analyzed by single factor and multiple linear regression. Results The intra-group correlation coefficient of the subgingival scaling treatment awareness survey scale for elderly patients with periodontitis was 0.82, indicating that the questionnaire had good test-retest reliability. The content validity index of the scale was 0.92, and the content validity index of each item was 0.85-1.00, indicating that the content validity of the scale was good. The Cronbach α of the scale was 0.82, indicating that the questionnaire has good internal consistency reliability. The KMO value of the scale was 0.816, indicating that the structure validity of the scale is good. The total scores of the subgingival scaling treatment awareness scale for 116 elderly patients with periodontitis were (42.56±3.26) scores, and the scoring rate was 42.56%. The results of univariate analysis showed that there were statistically significant differences in the awareness of subgingival scaling among elderly periodontitis patients with different family per capita monthly income, oral health knowledge, social support, oral health quality of life, education level, oral health guidance and dental fear level (P<0.05). The results of multiple linear regression analysis showed that low level of oral health knowledge, no social support, high quality of oral health life, education level of high school and below, no oral health guidance, high level of dental fear, and per capita monthly income of family ≤3000 yuan were all independent risk factors affecting the awareness of subgingival scaling in elderly patients with periodontitis (P<0.05), which was the reason for the low awareness of subgingival scaling in elderly patients with periodontitis. Conclusion Elderly patients with periodontitis have a low awareness of subgingival scaling treatment, which may be related to factors such as low level of oral health knowledge, no social support, medium to high level of oral health quality of life, education level of high school or below, no oral health indicators, high level of dental fear, and family per capita monthly income ≤3000 yuan.

关键词

牙周炎 / 龈下刮治术 / 治疗认知度 / 影响因素

Key words

Periodontitis / Subgingival scaling / Treatment awareness / Influencing factors

参考文献

[1] 张娜, 侯鑫, 张文, 等. 甘草甜素通过调控COX—2/NF—kB通路治疗牙周炎的研究[J]. 分子诊断与治疗杂志, 2021, 13(9): 1469-1472.

[2] Zhang N, Hou X, Zhang W, et al. Glycyrrhizin plays a role in the treatment of periodontitis by regulating the COX—2/NF—κB signaling pathway[J]. J Mol Diagn Ther, 2021, 13(9): 1469-1472.

[3] Fischer R G, Lira Junior R, Retamal—Valdes B, et al. Periodontal disease and its impact on general health in Latin America. Section V: Treatment of periodontitis[J]. Braz Oral Res, 2020, 34(supp1 1): e026.

[4] Xie Y, Peng Y, Zhou T, et al. Study on the mechanism of Nd:YAG laser—assisted therapy on the changes of subgingival flora in periodontitis[J]. Oral Health Prev Dent, 2024, 22: 547-556.

[5] 李彦霏, 莫芸赢, 张文珍, 等. 基于知信行理论的护理模式在牙周病患者护理中的应用效果[J]. 中国社区医师, 2025, 41(3): 105-107.

[6] Li Y F, Mo Y Y, Zhang W Z, et al. Application effect of nursing mode based on knowledge—attitude—practice theory in nursing for patients with periodontal disease[J]. Chin Comm Doct, 2025, 41(3): 105-107.

[7] Tonetti M S, Greenwell H, Kornman K S. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition[J]. J Periodontol, 2018, 89(Suppl 1): S159-S172.

[8] 叶盛, 陈利群. 社区老年人口腔健康知信行问卷的编制及信效度检验[J]. 护理学杂志, 2018, 33(7): 84-87.

[9] Ye S, Chen L Q. Development and reliability and validity test of oral health knowledge, attitude and practice questionnaire for the community elderly[J]. Chin J Nurs, 2018, 33(7): 84-87.

[10] 肖水源. 《社会支持评定量表》的理论基础与研究应用[J]. 临床精神医学杂志, 1994, (2): 98-100.

[11] Xiao S Y. Theoretical basis and research application of the Social Support Rating Scale[J]. J Clin Psych, 1994, (2): 98-100.

[12] Ikebe K, Hazeyama T, Enoki K, et al. Comparison of GOHAI and OHIP—14 measures in relation to objective values of oral function in elderly Japanese[J]. Community Dent Oral Epidemiol, 2012, 40(5): 406-414.

[13] Kleinkenecht R A, Thorndike R M, Mcglynn F D, et al. Factor analysis of the dental fear survey with cross—validation[J]. J Am Dent Assoc, 1984, 108(1): 59-61.

[14] Zhang Y, Tang P, Yang Q, et al. Efficacy of scaling and root planing with and without adjunct Nd:YAG laser therapy on glucose control and periodontal microecological imbalance in periodontitis patients with type 2 diabetes mellitus: a randomized controlled trial[J]. Clin Oral Investig, 2024, 28(2): 143.

[15] Machado V, Botelho J, ProençA L, et al. Self—reported illness perception and oral health—related quality of life predict adherence to initial periodontal treatment[J]. J Clin Periodontol, 2020, 47(10): 1209-1218.

[16] 林婷婷, 林天翔, 王慧敏. 口腔门诊就诊患者口腔健康知识、态度、行为特征及影响因素分析[J]. 现代预防医学, 2023, 50(2): 371-375.

[17] Lin T T, Lin T X, Wang H M. Characteristics and influencing factors of oral health knowledge, attitude and practice in dental outpatients[J]. Mod Prevent Med, 2023, 50(2): 371-375.

[18] 于虹, 胡洁, 杜欣玥, 等. 老年人口腔健康相关生活质量现状及影响因素[J]. 护理研究, 2021, 35(15): 2766-2771.

[19] Yu H, Hu J, Du X Y, et al. Status quo and influencing factors of oral health—related quality of life in the elderly[J]. Nurs Res, 2021, 35(15): 2766-2771.

[20] Ígm C, Ferreira B, Miranda G P, et al. Oral—health—related quality of life in adolescents: umbrella review[J]. BMC Public Health, 2023, 23(1): 1603.

[21] 李小梅, 陈永恒, 苏永珍, 等. 南宁市某社区老年人口腔健康知信行现状及影响因素[J]. 暨南大学学报(自然科学与医学版), 2025, 46(1): 109-116.

[22] Li X M, Chen Y H, Su Y Z, et al. Current status and influencing factors of oral health knowledge, attitude and practice among the elderly in a community in Nanning city[J]. J Jinan Univ(Natural Science & Medicine Edition), 2025, 46(1): 109-116.

[23] 张瑞, 陈晓东, 史宝欣. 老年慢性牙周炎患者口腔健康自我效能现状及影响因素分析[J]. 天津护理, 2024, 32(3): 292-297.

[24] Zhang R, Chen X D, Shi B X. The status and influencing factors of oral self—efficacy in elderly patients with chronic periodontitis[J]. Tianjin J Nur, 2024, 32(3): 292-297.

[25] 刘倩, 田淳, 李娜. 牙周炎病人疾病感知现状及影响因素[J]. 护理研究, 2024, 38(17): 3143-3148.

[26] Liu Q, Tian C, Li N. Status quo and influencing factors of disease perception in patients with periodontitis[J]. Chin Nurs Res, 2024, 38(17): 3143-3148.

[27] 周银双, 欧晓艳, 周小军, 等. 江西省35岁以上居民口腔健康与知信行现状分析[J]. 中国健康教育, 2020, 36(4): 291-295.

[28] Zhou Y S, Ou X Y, Zhou X J, et al. Oral health and status of knowledge, attitudes, practice and the health education strategies of residents over 35 years old in Jiangxi Province[J]. Chin J Health Educa, 2020, 36(4): 291-295.

基金资助

^*国家自然科学基金(82001051)