慢性牙周炎患者长期牙周治疗失访现状及影响因素研究

Current Status and Influencing Factors of Loss to Follow-up among Chronic Periodontitis Patients with Long-term Periodontal Therapy

目的调查慢性牙周炎患者长期牙周治疗失访现状并分析其影响因素。方法采用便利抽样的方法,抽取天津医科大学口腔医院牙周科2015年4—6月就诊的280例中重度慢性牙周炎患者,采用一般情况调查表、口腔保健自我效能量表(SESS)、牙科畏惧量表(DFS)对患者进行基线调查,随访患者自牙周初诊后20个月内的牙周治疗失访结果。分析SESS及其各维度得分与DFS得分的相关性,采用多因素Logistic回归分析探讨慢性牙周炎患者长期牙周治疗失访的影响因素。结果 280例患者失访160例。SESS得分与定期口腔就诊的自我效能(SE-DC)、正确刷牙的自我效能(SE-B)、平衡饮食的自我效能(SE-DH)得分呈正相关,与DFS得分呈负相关(P<0.05)。DFS得分与SE-B得分呈负相关(P<0.001)。年龄大[OR=1.042,95%CI(1.012,1.074),P=0.006]、病情轻[OR=4.893,95%CI(2.280,10.499),P<0.001]、未接受过牙周手术治疗[OR=11.334,95%CI(2.235,57.472),P=0.003]和口腔保健自我效能水平低[OR=71.899,95%CI(23.926,216.062),P<0.001]是慢性牙周炎患者长期牙周治疗失访的危险因素。结论年龄、疾病严重程度、牙周治疗方式和口腔保健自我效能水平是慢性牙周炎患者长期牙周治疗失访的影响因素。医务人员应加强对年龄大、病情轻、未接受过牙周手术治疗、口腔保健自我效能水平较低患者的关注,及时提供针对性的干预措施,促进患者长期牙周健康的维护。

Objective To investigate and analyze the current status and influencing factors of loss to follow-up among chronic periodontitis patients with long-term periodontal therapy.Methods 280 patients with moderate to severe chronic periodontitis receiving treatment from Department of Periodontology,Tianjin Medical University Dental Hospital during April to June 2015,were recruited by convenient sampling.A self-developed Clinical and Demographic Questionnaire,Self-efficacy Scale for Self-care(SESS),Dental Fear Scale(DFS)were used to obtain data at baseline.The outcome of loss to followup within 20 months after the initial treatment of periodontitis was further recorded.Correlations of SESS score with its dimensions score and DFS score were analyzed.Multivariate Logistic regression analysis was conducted to identify the influencing factors of loss to follow-up in patients with long-term periodontal therapy.Results 160 of 280 patients were lost during follow-up period.The score of SESS was positively correlated with the scores of self-efficacy for dentist consultations(SE-DC),self-efficacy for brushing of the teeth(SE-B),self-efficacy for dietary habits(SE-DH),but negatively correlated with the score of DFS(P<0.05).The score of DFS was negatively correlated with the score of SE-B(P<0.001).Older age〔OR=1.042,95%CI(1.012,1.074),P=0.006〕,mild conditions〔OR=4.893,95%CI(2.280,10.499),P<0.001〕,non-surgical periodontal treatment〔OR=11.334,95%CI(2.235,57.472),P=0.003〕and low-level self-efficacy for oral self-care〔OR=71.899,95%CI(23.926,216.062),P<0.001〕were risk factors of loss to follow-up in chronic periodontitis patients with long-term periodontal therapy.Conclusion Age,severity of periodontitis,the way of periodontal treatment and the level of self-efficacy for oral self-care are influencing factors of loss to follow-up in chronic periodontitis patients with long-term periodontal therapy.Healthcare professionals should provide targeted interventions to improve maintenance of long-term periodontal health for patients with at least one of the following characteristics:older age,mild conditions,non-surgical periodontal therapy and low-level self-efficacy for oral selfcare.