医患信息不对称影响牙周疾病防治的研究

A study on information asymmetry and its influence on the prevention and treatment of periodontal diseases

目的分析普通人群对自身牙周健康评价与医生诊断信息的一致性,探讨医患信息不对称对牙周疾病防治和预后的影响。方法采用随机整群抽样的方法,抽取高等院校学生992人和社区居民1 010人作为调查对象;应用口腔健康影响量表(OHIP)测量调查对象对自身牙周健康状况评价,与医生牙周检查结果进行比较,分析信息对称情况及对牙周病预防、治疗和预后的影响。结果调查2 002人,其中牙周健康状况自我评价与医生诊断信息不对称994人,占49.65%,社区居民与大学生人群信息不对称比例分别为58.12%和41.03%,两组比较差异有统计学意义(P<0.05);信息不对称者中,大学生治疗贻误356人,占87.47%;治疗过度51人,占12.53%。社区居民治疗贻误540人,占91.99%;治疗过度47人,占8.00%;两组比较差异有统计学意义(P<0.05);信息对称与信息不对称者OHIP值在口腔功能限制、心理的不适、心理障碍等3个方面比较差异均有统计学意义(P<0.05)。结论牙周健康状况的自我评价和医生诊断结果存在信息不对称,易导致牙周疾病,应加强口腔卫生保健和定期检查。

Objective To identify the consistency between self - perception of the periodontal health status in the general population and the oral examination of the dentists. Furthermore, the information asymmetry was analyzed to provide the basis for prevention and treatment of periodontal disease. Methods 992 undergraduates from three colleges and 1010 citizens from 2 communities in Hangzhou were randomly selected and a cross - sectional study was carried out. Oral health impact profile （OHIP） was used to determine the self - perception of the periodontal health status. Periodontal examinations were carried out by the oral specialists. Compared self - perception of the periodontal health status with the examination result by dentists, and analyzed the influence of asymmetry information on the prevention and treatment of periodontal diseases. Results 994 subjects were judged with inconsistency between self - perception and the Results of periodontal examination, accounted for 49.65%. The inconsistency between self- perception and the results of periodontal examination was 41.0% for undergraduates and 59. 2% for community population, with a significant difference （ P 〈 0. 05）. In the cases who had disagreements between self - perception and oral examination, 94. 14% cases had delayed treatment, which was higher than those who had over - treated （ P 〈 0. 05 ）. There were significant differences on oral function limit, mental discomfort, physiological disorders and mental disorder in the OHIP between the inconsistency group and consistency group （ P 〈 0. 05 ）. Conclusion Information asymmetry in the periodontal health status between self - perception and oral examination could affect the prevention and treatment of periodontal diseases, so that oral health care and regular inspection should be strengthened.