农村慢性病老年人口腔健康与心理健康关系及睡眠质量的中介作用

Relationship between oral health and mental health in rural older people with chronic diseases and mediating role of sleep quality

目的探讨睡眠质量、口腔健康与农村慢性病老年人心理健康之间的关系及内在作用机制。方法于2020年7-8月,运用5条目口腔健康影响程度量表(OHIP-5)、Kessler心理困扰量表(K10)、匹兹堡睡眠质量指数量表(PSQI),多阶段分层整群抽取山东省2064名≥60岁农村慢性病老年人进行随访调查,应用IBM SPSS 24.0进行数据分析。结果农村慢性病老年人睡眠质量得分[M(P25~P75)]为9(6~13)分,口腔健康得分为2(0~5)分,心理健康得分为18(12~25)分。睡眠质量得分(r_(s)=0.43,P<0.001)、口腔健康得分(r_(s)=0.20,P<0.001)与心理健康得分均呈正相关;睡眠质量得分与口腔健康得分呈正相关(r_(s)=0.17,P<0.001)。中介效应结果显示,中介作用的95%CI=0.09~0.17,睡眠质量在口腔健康与心理健康之间起部分中介作用,其中中介效应占总效应的比例为32.50%。结论睡眠质量是农村慢性病老年人口腔健康与心理健康之间的中介因素;关注口腔健康,减少睡眠障碍,有助于提高其心理健康水平。

Objective To explore the relationship and internal mechanism between sleep quality,oral health and mental health of the older people with chronic diseases in rural Shandong,China.Methods Using stratified multistage cluster sampling,face-to-face interviews were conducted among 2064 rural people aged 60 years and above and with chronic diseases in Shandong province during July-August 2020.Oral Health Impact Profile-5(OHIP-5),Kessler Psychological Distress Scale(K10)and Pittsburgh Sleep Quality Index(PSQI)were adopted in the survey.Statistical analyses were performed with IBM SPSS 24.0.Results For all the respondents,the median score(25th percentile,75th percentile)was 9(6,13)for PSQI,2(0,5)for OHIP,and 18(12,25)for K10.The sleep quality and oral health were positively correlated with mental health(r_(s)=0.43,P<0.001;r_(s)=0.20,P<0.001);sleep quality was positively correlated with oral health(r_(s)=0.17,P<0.001).The results of mediating effect analysis revealed that sleep quality played a partial mediation effect on the association between oral health and mental health,with an effect value of 95%confidence interval of 0.09-0.17 and accounting for 32.50%of the total effect.Conclusion Sleep quality is a mediator between oral health and mental health among rural older people with chronic diseases;improving oral health and reducing sleep disorders may improve mental health in the population.