辽宁5市中老年牙缺失患者对口腔种植意愿及相关因素的调查

A survey of the willingness and influencing factors for dental implants among middle-aged and elderly patients with missing teeth in five cities of Liaoning

目的调查辽宁5市中老年人牙缺失后对于口腔种植的意愿及其相关因素,促进口腔种植行业的规范开展,为卫生指导机构指导口腔种植治疗决策提供依据,切实有效并因地制宜地探讨中老年患者口腔种植医疗行业的规范化长效机制。方法采用人口比例概率(population proportionate sampling,PPS)三阶段抽样的方法,选择辽宁省沈阳市、抚顺市、锦州市、盘锦市、朝阳市5市中老年牙缺失患者作为研究对象并进行问卷调查。采用t检验、方差分析和结构方程模型探究种植意愿的影响因素。结果中老年牙缺失患者对口腔种植的治疗效果预期在不同教育水平间比较,差异有统计学意义(P<0.05);媒介途径(中老年患者了解口腔种植的方式)在不同月收入间比较,差异有统计学意义(P<0.05);种植意愿、种植治疗效果预期、媒介途径、价格阻碍和风险性在不同地区类型间比较,差异有统计学意义(P<0.05),其中城镇患者的种植意愿(x=3.37)、种植治疗效果预期(x=3.76)、媒介途径(x=3.52)得分显著高于农村患者(2.91,3.35,3.12),而价格阻碍(x=2.71)、风险性(x=2.67)得分显著低于农村患者(2.94,3.01)。为进一步研究中老年牙缺失患者的口腔种植意愿,建立结构方程模型的路径系数检验,以此为根据可以看出,种植治疗效果预期(β=0.185)、媒介途径(β=0.277)对种植意愿具有显著正向影响,价格阻碍(β=-0.212)、风险性(β=-0.127)、地域差别(β=-0.227)对种植意愿具有显著负向影响。结论价格阻碍、风险性、地域差别等是造成辽宁5市中老年牙缺失患者口腔种植意愿低的重要因素。因此,需要从医院、公众以及厂家多角度来增强口腔种植的宣传推广和应用普及。

Objective To investigate the willingness and influencing factors for dental implants among middle-aged and elderly patients with missing teeth in five cities of Liaoning Province.Methods Using population proportionate sampling(PPS)and a three-stage random sampling method,middle-aged and elderly patients with missing teeth in Shenyang,Fushun,Jinzhou,Panjin,and Chaoyang in Liaoning Province were selected as research subjects for a questionnaire survey.T-tests,analysis of variance,and structural equation modeling were used to explore the factors influencing implant willingness.Results There were statistically significant differences in the expected treatment outcomes of dental implants among patients with different educational levels(P<0.05).Media channels used by patients to learn about implants also varied significantly across different income levels(P<0.05).Significant differences were found in implant willingness,expected treatment outcomes,media channels,price barriers,and perceived risks between urban and rural patients(P<0.05).Urban patients had higher scores for implant willingness(3.37),expected treatment outcomes(3.76),and media channels(3.52)compared to rural patients(2.91,3.35,3.12,respectively),while rural patients had higher scores for price barriers(2.94)and perceived risks(3.01)compared to urban patients(2.71 and 2.67,respectively).Structural equation modeling revealed that expected treatment outcomes(β=0.185)and media channels(β=0.277)had a significant positive impact on implant willingness,while price barriers(β=-0.212),perceived risks(β=-0.127),and geographical limitations(β=-0.227)had a significant negative impact.Conclusion Price barriers,perceived risks,and geographical limitations are important factors contributing to the low willingness for dental implants among middle-aged and elderly patients with missing teeth in Liaoning Province.Therefore,it is necessary to promote dental implants through coordinated efforts from hospitals,the public,and manufacturers,in order to increase the application of dental implants.