台灣地區青少年口腔保健行為及其相關因素之探討
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2006
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本研究欲探討台灣地區12-19歲青少年口腔保健行為及其相關之因素,以民國九十年度國家衛生研究院之「國民健康訪問調查」系統進行次級資料庫分析,找出影響台灣地區12-19歲青少年在口腔行為方面的相關因素,並配合以研究對象為主的口腔保健課程內容分析,及台灣地區歷年與口腔健康有關之衛生與教育政策分析,針對影響台灣地區青少年在口腔保健行為方面的因素進行深入探討。
研究工具:本研究所使用之資料,為民國九十年度「國民健康訪問調查」的一部份,為具全國性的樣本,以其中年滿十二歲但未滿二十歲的研究對象為分析族群,並串聯十二歲以上問卷及家戶問卷中相關資料,進行分析。針對研究樣本之背景因素及口腔預防保健行為等變項做人數、百分比、平均值及標準差的描述性統計;在背景因素於口腔預防保健行為的分佈比較,則依序以卡方檢定分析;口腔保健行為及其他危害健康行為相關性部分,輔以邏輯斯迴歸分析。初步挑選出符合本研究目的之研究對象,扣除資料缺漏個案,最後進行分析人共計數為2708人,研究所得重要結果如下:
(一) 台灣地區12-19歲青少年在口腔保健行為方面的表現不甚理想,其中每日刷牙次數以每日兩次居多(65.4%);潔牙時間點以早上起床後(91.6%)與晚上睡覺前(76.5%)為眾;有使用牙線潔牙習慣者佔18.8%;有使用漱口水習慣者佔2.4%;過去半年內有洗牙行為的佔20.0%。
(二) 依照性別分組,則上述四項口腔保健行為達統計上顯著差異的為:有無使用牙線習慣,其中又以女性有使用牙線習慣者較男性多(p=0.018)。
(三) 依照年齡分組(12-15歲組與16-19歲組),則於每日刷牙次數(p=0.001)、使用牙線習慣(p=0.003)、過去半年內有無給牙醫洗牙(p<0.001)達統計上顯著差異。
(四) 危害健康行為:台灣地區12-19歲青少年有飲酒習慣盛行率為25.4%;有抽菸習慣盛行率為27.3%;有嚼檳榔習慣盛行率為5.6%;甜食攝取行為部分,經常吃餅乾、糖果、麵包類的佔25.3%,經常吃蛋糕和麵包類佔41.6%,經常喝可樂和沙士者佔11.5%,經常冰淇淋、奶昔、冰品者佔7.8%,經常喝含糖飲料者佔28.0%。
(五) 依照性別分組,男女於所有危害健康行為均未達統計上顯著差異。
(六) 依照年齡分組(12-15歲組與16-19歲組),以嚼檳榔行為(p<0.001)、吃蛋糕、麵包類(p=0.001)、喝可樂及沙士類(p=0.049)、喝含糖飲料類(p=0.012)達統計上顯著差異。
(七) 影響國內12-19歲青少年口腔保健行為的相關因素,以多變項邏輯斯回歸檢定分析發現:1.每日刷牙次數部分與年齡(0dds ratio=1.21,95%CI:1.088-1.339)、經常喝含糖飲料(0dds ratio=4.12,95%CI:1.678-10.136)有統計上顯著意義;2.使用牙線行為部分以年齡(0dds ratio=0.95, 95%CI: 0.892-0.953)、有飲酒習慣(0dds ratio=0.72,95%CI:0.564-0.909)、經常吃蛋糕和麵包類(0dds ratio=1.26,95%CI:1.020-1.560)、經常喝含糖飲料類(0dds ratio=0.71,95%CI:0.506-0.987)、偶爾喝含糖飲料(0dds ratio=0.65,95%CI:0.503-0.851)達統計上顯著意義;3.使用漱口水習慣與有嚼檳榔習慣(Odds Ratio=0.49,95%CI:0.281-0.853)達統計上顯著意義;4.過去半年內有洗牙行為的部分則與年齡(Odds Ratio=0.99,95%CI:0.912-0.999)、有飲酒習慣(Odds Ratio=0.70,95%CI:0.558-0.887)、有嚼檳榔習慣(Odds Ratio=1.80,95%CI:1.063-3.041)等四項達統計上顯著意義。
根據本研究結果發現,國內青少年口腔保健行為盛行率不如衛生與教育部門
所預期,多數青少年於口腔保健的行為執行上仍以起床後與睡覺前的時間點為潔牙的主要時機,口腔健康課程中談到關於餐後潔牙、定期口腔健康檢查等預防保健行為的執行率也不甚理想,深入檢視相關因素更發現,國內青少年在口腔保健行為與相關危害健康行為的相關性也不一致,針對以上重要研究結果,建議如下:
(一) 強化在學青少年於口腔健康自我管理的能力:有關口腔保健的課程對於行為技巧及對口腔健康態度方面的養成還有調整的空間,正確的潔牙技巧教學在課程內容上佔的比例相形之下很低,飲食對口腔健康的影響也建議於往後口腔保健課程修訂時納入,將飲食中有關甜食、含糖飲料及汽泡碳酸飲料對口腔健康的傷害納入飲食與營養的單元中一併教導,透過不同單元之間的連結教導全面性的口腔預防保健。
(二)由政策面提供青少年口腔保健的支持性環境:多數的國小校園內都能提供支持性的環境(諸如充足的洗手台設備、餐後潔牙制度與含氟漱口水的發放等),但隨著學生升上國中階段以後,口腔健康行為便中斷,建議由國中開始的校園延續國小的口腔健康的支持性環境,制訂校內支持口腔保健行為執行的相關政策(如調整學校課堂作息時間,將用餐時間之後排入足夠的時間提供全校師生進行潔牙等)及多舉辦與口腔保健有關的校內與社區性活動,鼓勵青少年家長一同參與口腔保健的活動,結合鄰近社區與牙醫資源進駐校園提供協助,定期舉辦全校性的口腔疾病篩檢等。
(三)擴充與深化歌健康訪問調查系統的內涵:建議政府可持續定期進行每年度的全國性調查,並嘗試追蹤特定族群的口腔健康狀況與行為,另可納入認知與態度方面的變項及刷牙技巧、牙刷種類選擇、牙膏種類選擇及更換牙刷的時間間距等,提供往後口腔健康方面的研究者能夠更深入地掌握口腔保健行為的現況。
Objectives: The purpose of this study are (1) to estimate the prevalence of oral hygiene behaviors among adolescents in Taiwan, and (2) to investigate the possible related factors for oral hygiene behaviors. Methods: The data used in this study is part of the 2001 National Health Interview Survey. 2,708 adolescents who were aged 12 to 19. Items in questionnaire for adolescents’ oral hygiene behaviors were used. They were also linked to a questionnaire for adults older than 12 years in the same household. The oral hygiene behaviors in this research were defined into 4 categories which were (1)brush teeth frequency per day,(2)floss habit,(3)mouth rinsing habit, and (4)Usage of mouth scaling service in the past 6 months. Results: The prevalence of oral hygiene behaviors are (1) brush teeth per day was 1.96 times,(2)floss habit was 18.8%,(3) mouth rinsing habit was 2.4%, and(4) usage of mouth scaling in the past 6 months was 20.0%. Factors considered as possibly related to oral hygiene behaviors included (1)brush teeth per day: age, frequent sugar-sweetened beverage intake , (2) floss habit: age, drinking habit, frequent cake and bread intake, frequent sugar-sweetened beverages intake, sometimes sugar-sweetened beverage intake(3) mouth rinsing habit: betel chewing habit,(4) usage of mouth scaling in the past 6 months: age, dinking habit, betel chewing habits, Conclusions: Although there were not significant consistent among the 4 indicators of oral hygiene behaviors in this investigate results. We still could find out that the oral hygiene habits among adolescents in Taiwan had been improved. Even though the oral hygiene’s knowledge had been set into the elementary and junior high school courses for about 25 years. The problem which we have to consider next is to last the linkage of adolescents oral hygiene habits from elementary stage to the junior stage above. About the second-data base usage, we suggest increasing the items of oral hygiene behaviors questionnaire, for example frequence of brush changing, choosing of brush’s kind, and so on.
Objectives: The purpose of this study are (1) to estimate the prevalence of oral hygiene behaviors among adolescents in Taiwan, and (2) to investigate the possible related factors for oral hygiene behaviors. Methods: The data used in this study is part of the 2001 National Health Interview Survey. 2,708 adolescents who were aged 12 to 19. Items in questionnaire for adolescents’ oral hygiene behaviors were used. They were also linked to a questionnaire for adults older than 12 years in the same household. The oral hygiene behaviors in this research were defined into 4 categories which were (1)brush teeth frequency per day,(2)floss habit,(3)mouth rinsing habit, and (4)Usage of mouth scaling service in the past 6 months. Results: The prevalence of oral hygiene behaviors are (1) brush teeth per day was 1.96 times,(2)floss habit was 18.8%,(3) mouth rinsing habit was 2.4%, and(4) usage of mouth scaling in the past 6 months was 20.0%. Factors considered as possibly related to oral hygiene behaviors included (1)brush teeth per day: age, frequent sugar-sweetened beverage intake , (2) floss habit: age, drinking habit, frequent cake and bread intake, frequent sugar-sweetened beverages intake, sometimes sugar-sweetened beverage intake(3) mouth rinsing habit: betel chewing habit,(4) usage of mouth scaling in the past 6 months: age, dinking habit, betel chewing habits, Conclusions: Although there were not significant consistent among the 4 indicators of oral hygiene behaviors in this investigate results. We still could find out that the oral hygiene habits among adolescents in Taiwan had been improved. Even though the oral hygiene’s knowledge had been set into the elementary and junior high school courses for about 25 years. The problem which we have to consider next is to last the linkage of adolescents oral hygiene habits from elementary stage to the junior stage above. About the second-data base usage, we suggest increasing the items of oral hygiene behaviors questionnaire, for example frequence of brush changing, choosing of brush’s kind, and so on.
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青少年, 口腔保健行為, 危害健康行為, adolescents, oral hygiene behaviors, risk behaviors