臺北市國小高年級學童口腔保健行為及其相關因素研究-健康信念模式之應用

Abstract

本研究之主要目的是應用健康信念模式來探討臺北市國小高年級學童口腔保健行為及其相關因素。研究母群體為臺北市國小高年級學童，以比率機率集束抽樣法進行抽樣，並以自編結構式問卷為研究工具進行資料蒐集，共得有效樣本394人，研究之結論如下： 一、 研究對象中五年級、六年級人數各半，以男生居多，家庭社經地位則以高社經地位為主，口腔保健知識屬於中上，而且口腔保健知識越佳者，其採取口腔保健行為的可能性越高。 二、 研究對象自覺齲齒威脅性是屬於中上程度，而且覺得齲齒對於自己來說是嚴重的，但不確定自己齲齒的罹患性。研究對象自覺口腔保健行為可能性是中上程度，得分為正，顯示研究對象認為採取口腔保健行為之「利益」大於「障礙」，而且同意採取口腔保健行為是有利的、但不確定障礙是否會阻礙自己採取口腔保健行為。整體而言，研究對象中自覺口腔保健行為障礙性越低者，其採取口腔保健行為的可能性越高。 三、 研究對象之外部線索訊息以「我的家人曾經提醒我要採取口腔保健行為」、「我曾經在學校上過口腔保健的相關課程」最多、內部線索訊息以「我曾經因為蛀牙而去看牙醫師」最多。研究對象口腔保健行動線索越多，自覺齲齒威脅性也越高，且內、外部線索越多者，自覺齲齒罹患性越高；外部線索越多者，自覺齲齒嚴重性越高。研究對象外部線索越多，自覺口腔保健行為可能性也越高，且外部線索越多者，自覺口腔保健利益性越高；內部線索越多者，自覺口腔保健障礙性越高。 四、 研究對象對於採取口腔保健行為約有50％-75％的把握度，且在無人提醒的情況下、在學校沒有地方放潔牙工具的情況下自己會刷牙，而且每週會在學校使用含氟漱口水；但在家中、學校吃過飯後、時間緊迫的情況下，使用牙線的把握程度較低。研究亦發現口腔保健自我效能越高者，越傾向採取口腔保健行為。 五、 研究對象採取口腔保健行為介於「有時如此」至「經常如此」之間，其中以「我在睡前會刷牙」、「我每天早上起床都會刷牙」及「我每週都會使用含氟漱口水」最多；而以「我會定期接受口腔檢查」、「我在餐後3分鐘內會刷牙」、「我每天都會使用牙線清潔牙齒」最低。從研究中顯示，「自覺口腔保健障礙性」、「口腔保健自我效能」二項是預測研究對象是否採取口腔保健行為最主要的變項，且以「口腔保健自我效能」對口腔保健行為之影響力最大。顯示研究對象對於採取口腔保健行為的自我把握程度越高者、而對於自己採取口腔保健行為可能遭遇到的障礙越低者，採取口腔保健行為就越佳。The purpose of this research is to apply the Health Belief Model to the 5th to 6th grade elementary school students in Taipei City to investigate the relevant factors of oral health behavior. Samples were gathered from the 5th to 6th grade students in Taipei and data were collected with a self-made questionnaire by using probability proportionate to size sampling method. Total valid samples were 394. The conclusion of this research are as follows： I. The survey targets include half of the 5th and another half covered by 6th grade students, and boys are in majority. Most families’ social/economic status are high degree, and the score of oral healthy knowledge is higher than average. The better oral healthy knowledge they has, the higher possibilities of adoption of oral health behavior. II. The perceived caries threat of subjects is above average, and think caries is severe themselves. However they are not sure about if they suffer from caries. They score “positive” on the likelihood of oral health behavior consider that they get more benefits than barriers from oral health behavior. Furthermore, they agree oral health behavior is beneficial, but not certain about if barrier hindering them from adopting oral health behavior. In general, the fewer barriers toward oral health behavior that subjects perceived, the higher possibility of oral health behavior will be. III. The subjects know much on the external cues on oral health behavior because family member's reminder of oral health behavior or lesson on oral health learned from school. For internal cues, they mainly come from “seeing the dentist for dental caries.” Subjects with higher perceived caries threat have more cues to action of oral health behavior. Subjects with higher perceived dental caries have more internal and external cues. Subjects with higher perceived caries severity and possibilities of perceived oral health behavior have more external cues. In addition, subjects with more external cues think the benefit of oral health behavior is high, to those with more internal cues think the barrier of oral health behavior is high. IV. Survey targets have 50-75% confidence in adopting oral health behavior. In a situation where no one remind and no provided tooth apparatus, subject targets still be able to brush teeth and use mouthwash with fluoride. Subjects seldom use dental floss after meals at home or in the school due to lack of time. Study indicates subjects with self-efficacy have better oral health behavior. V. Subjects’ attitude toward the frequency of oral health behavior range from “sometimes” to “often so”, do clean teeth before bedtime and in the morning and use mouthwash with fluoride every week. However, they do not often take periodic oral check-up, brush teeth right after meals, use dental floss on a daily basis. The main predictive variable of oral health behavior are barrier of perceived oral health behavior and self-efficacy on oral health behavior, the second variable has significant effect on oral health behavior. Survey targets, who have high confidence in adopting oral health behavior, and low barrier hindering them from adopting oral health behavior, will have better oral health behavior.