目的 探索在农村地区有效提高乳恒牙交替期儿童口腔健康认知、促进良好卫生行为养成及改善口腔卫生状况的持续干预方法。方法 2021年3—10月,基于PDCA口腔健康管理方法,对贵阳市某乡镇学校二年级儿童开展口腔健康教育与行为干预,在两个阶段(3个月时、6个月时)观察干预对象口腔健康认知、行为习惯与口腔卫生状况变化情况。结果 基线调查时,口腔健康知识总知晓率、良好行为习惯报告率、菌斑指数、龋态值分别为48.1%、52.7%、1.86±1.12、1.53±0.62,持续干预3个月后,分别达到81.3%、75.6%、0.94±0.67、1.39±0.68,与基线时相比差异均有统计学意义(χ2=175.072、123.768,t=8.800,2.381,P<0.05);在6个月时,口腔健康总体认知率、良好行为习惯报告率分别为76.9%、71.2%,与3个月时相比差异有统计学意义(χ2=4.170、5.193、P<0.05),菌斑指数为(1.07±0.73),与3个月时相比差异无统计学意义(P>0.05)。结论 持续干预能有效提高儿童口腔保健意识、促进健康行为习惯养成,但长期效果的保持还需不断强化,未来可能还需从组织形式、评价体系等方面来改进干预方案。
Abstract
Objective To explore continuous intervention methods to effectively improve oral health cognition, promote healthy behaviors, and improve the oral health status of children with primary and permanent tooth alternation in rural areas. Methods From March to October 2021, oral health education and behavioral interventions based on the Plan-Do-Check-Action (PDCA) cycle were carried out for second-grade children in a township school in Guiyang City for 6 months. The changes in oral health cognition, behavior habits and oral hygiene status of the children were observed in 3 months and 6 months after intervention. Results At the baseline survey, the total awareness rate of oral health knowledge, the rate of self-reported good behavior habits, plaque index and caries status value were 48.1%, 52.7%, 1.86±1.12, 1.53±0.62, respectively, which were 81.3%, 75.6%, 0.94±0.67, 1.39±0.68 in three months after intervention, and the difference was significant (χ2=175.072, 123.768, t=8.800, 2.381,P<0.05). At six months, the total awareness rate of oral health knowledge and the rate of self-reported good behavior habits were 76.9% and 71.2%, respectively, which were significantly different from those in three months after intervention(χ2=4.170, 5.193, P<0.05).The plaque index in six months after intervention was 1.07±0.73, which was not significantly different compared with that in three months. Conclusions Continuous intervention can effectively improve children's oral health awareness and promote the development of healthy behavior, but the maintenance of long-term effects needs to be continuously strengthened. Besides, it is suggested to improve the intervention program in the future from the perspective of organizational form and evaluation system.
关键词
乳恒牙交替期 /
口腔健康 /
社区干预 /
农村地区
Key words
alternate period of primary and permanent teeth /
oral health /
community intervention /
rural areas
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 郇建立.慢性病的社区干预:芬兰北卡项目的经验与启示[J].中国卫生政策研究,2016,9(7):8-14.
[2] Bryant LL, Quissell DO, Braun PA,et al. A community-based oral health intervention in navajo nation head start: Participation factors and contextual challenges[J].J Community Health,2016,41(2):340-353.
[3] 齐小秋.第三次全国口腔健康流行病学调查报告[M].北京:人民卫生出版社,2008,6:21.
[4] 王兴.第四次全国口腔健康流行病学调查报告[M].北京:人民卫生出版社,2018.8:22.
[5] DeSilva AM, Hegde S, Akudo B,et al. Community-based population-level interventions for promoting child oral health[J]. Cochrane Database Syst Rev, 2016,9(9):CD009837.
[6] 冉芳,郭华. 牙周病患者应用延续性护理干预的效果分析[J]. 护理实践与研究,2019,16(9):110-112.
[7] 卞金有.我国口腔健康科学人文的历史、现状与未来发展趋势——回顾百年中国牙防发展历程[J].中国实用口腔科杂志,2021,14(5):513-518.
[8] 杨晓霞,吴林梅,范卫华,等.广东省口腔预防保健状况调查研究[J].现代医院管理,2019,17(1):13-17.
[9] 袁学锋,王艳. 口腔公共卫生管理实践与探索[C]//2019年中华口腔医学会口腔医疗服务分会第十三次全国口腔医院管理学术会议论文汇编,2019:433-438.
[10] 肖希娟,陈康照,于艳萍. 提高基层牙病防治网点规范化水平的探索[C]//2019年中华口腔医学会口腔预防医学专业委员会第十九次全国学术年会资料汇编,2019:67.
[11] 郑锦川,林杭,丘东海,等.不同方法预防儿童第一恒磨牙龋坏的效果评价[J].中国儿童保健杂志,2021,29(9):1034-1037.
[12] Starr JR, Ruff RR, Palmisano J,et al. Longitudinal caries prevalence in a comprehensive, multicomponent, school-based prevention program[J]. J Am Dent Assoc, 2021,152(3):224-233.
[13] Babaei A, Pakdaman A, Hessari H. Effect of an oral health promotion program including supervised toothbrushing on 6 to 7-year-old school children: A randomized controlled trial[J]. Front Dent, 2020,17(19):1-9.
[14] Dos APP, Oliveira BH, Nadanovsky P. A systematic review of the effects of supervised toothbrushing on caries incidence in children and adolescents[J]. Int J Paediatr Dent, 2018,28(1):3-11.
[15] Petersen PE, Hunsrisakhun J, Thearmontree A,et al. School-based intervention for improving the oral health of children in southern Thailand[J].Community Dent Health, 2015,32(1):44-50.
[16] 王轶.社区儿童口腔保健中口腔健康教育的应用进展[J].中国城乡企业卫生,2020,35(11):58-60.
[17] Flório FM, Santos KL, Brandão AP,et al. Use of water by schoolchildren: Impact of indirectly supervised daily toothbrushing-a pilot study[J]. Int J Clin Pediatr Dent, 2020,13(5):513-517.
[18] Blake H, Dawett B, Leighton P,et al. School-based educational intervention to improve children's oral health-related knowledge[J]. Health Promot Pract, 2015,16(4):571-582.
[19] 彭春梅,邢秀莲,张李明等.健康教育对小学生口腔卫生及行为改善的效果评价[J].中国学校卫生,1999,20(2):126-127.
基金
贵阳市科技计划项目(筑科合同[2018]1-53号)