重症非插管老年患者口腔清洁现状及影响因素的有序Logistic回归分析

Ordered Logistic Regression Analysis of Oral Cleaning Status and Influencing Factors in Severe Elderly Patients with Non-intubation

目的:了解三级甲等综合医院的重症非插管老年患者入院前后口腔清洁频次及影响因素,为有针对性的制定老年患者入院后健康教育方案提供参考。方法:采取便利抽样法选取山西省6地市6家三级甲等综合医院神经内科、神经外科284名非插管重症老年患者为研究对象,采用WHO口腔健康流行病学方案进行问卷调查。结果:(1)入院前后口腔卫生措施:刷牙、漱口每天≥2次占比分别为:26.5%、19.0%,有使用木质牙签、塑料牙签、牙线习惯的分别为23.1%、2.6%、1.9%;入院后分别为:16.0%、23.9%、17.2%、1.5%、1.9%;(2)入院前后刷牙频次比较差异具有统计学意义(χ~2=221.741,P<0.01),有序多因素logistic回归分析表明,文化水平、经济水平和自理能力(activties of daily living,ADL)对重症非插管老年患者入院后的刷牙频次有显著影响(P<0.05)。结论:重症非插管老年患者入院前后口腔清洁除漱口外均减弱,文化水平、经济水平和ADL对老年患者入院后刷牙频次有显著影响,实施健康教育时应重点关注文化水平、经济水平和ADL不足的老年患者。

Objective: To understand the frequency and influence factors of oral cleansing in severe elderly patients with non-intubation in tertiary general hospitals before and after admission, and to provide reference for the development of post-hospital health education programs for elderly patients. Methods: A total of 284 non-intubated elderly patients in neurology and neurosurgery of 6 tertiary general hospitals in 6 cities of Shanxi Province were selected by convenient sampling method. The WHO oral health epidemiological survey program was used for questionnaire survey. Results:(1) Oral hygiene measures before admission:≥ 2 times per day for brushing and gargle were 26.5% and 19.0%, respectively, and the use of wooden toothpicks, plastic toothpicks, and dental floss habits were 23.1%, 2.6%, and 1.9%, respectively. After admission, the correspondences were 16.0%, 23.9%, 17.2%, 1.5%, and 1.9%, respectively.(3) The frequency of brushing before and after admission was statistically significant ( P <0.01). Ordered multivariate logistic regression analysis showed that the cultural level, economic level, and self-care ability score (activities of daily Living, ADL) had a significant effect on the frequency of oral cleansing in severe elderly patients with non-intubation after admission ( P <0.05). Conclusion: The severe elderly patients with non-intubation are weakened before and after admission. The cultural level, economic level, and self-care ability score have significant influence on the frequency of brushing teeth after admission. The health education should focus on the elderly patients with low cultural level, low economic level, and low self-care ability.