小学生自述与父母代述性牙科焦虑的差异性研究

Study on differences between elementary school students’ self-reported and their parents’ proxy-reported dental anxieties

目的探讨小学生自述与父母代述性牙科焦虑的发生频率以及两者之间的差异性。方法选择2017-10~2018-03在该院口腔科就诊的小学生及其父亲或母亲各60例,采用改良版牙科焦虑量表(MDAS)进行问卷调查,计算牙科焦虑分值和焦虑等级,采用Kappa一致性检验分析小学生自述与其父亲或母亲代述性牙科焦虑的一致性情况。结果自述和代述性牙科焦虑普遍存在,且代述性牙科焦虑分值低于自述性牙科焦虑分值(MDAS-问题1-5,P <0. 05)。MDAS-问题5是自述性和代述性牙科焦虑一致性人数和比例最高的问题(Kappa系数=0. 551,P <0. 001),但代述性仍低估33. 3%的自述性牙科焦虑。结论小学生自述与父母代述性牙科焦虑存在显著不一致性,提示牙科焦虑的诊断应以小学生自述为主,以家长代述为辅,以便全面了解小学生牙科焦虑情况。

Objective To investigate the frequency of the occurrence of elementary school students′ self-reported and their parents′ proxy-reported dental anxieties, and to study the differences between them. Methods Sixty elementary school students and their fathers or mothers were enrolled for the separate investigation by the Modified Dental Anxiety Scale(MDAS). The interrater agreement on individual question scores was analyzed using percentage agreement and linear weighted Kappa coefficient. Results Self-reported and proxy-reported dental anxieties were common in the elementary school students and their parents. However, the scores of the students′ self-reported dental anxieties were higher than those of their parents′ proxy-reported dental anxieties(MDAS-Q 1-5, P <0.05). MDAS-Q5 was the most agreed question with Kappa coefficient of 0.551 and P value of less than 0.001. However, 33.3% of the students′ self-reported dental anxieties were underestimated for MDAS-Q5. Conclusion Elementary school students′ self-reported dental anxieties differs from their parents′ proxy-reported dental anxieties, which suggests that self-reported dental anxieties by children should be encouraged and adopted.