家庭照护者口腔护理实践与康复病房吞咽困难患者口腔健康状况之间的关联

文献信息

中文摘要

目的： 探讨在康复病房中需要日常口腔卫生协助的吞咽困难住院患者中，家庭照护者口腔护理实践与口腔健康状况之间的关系。
方法： 研究对象为韩国一家康复医院的25对患者-家庭照护者配对。采用改良多维行为口腔评估（M-BOE）工具评估患者口腔健康。家庭照护者完成关于口腔护理频率、持续时间、技术和产品使用的结构化访谈。数据分析采用描述性统计、Spearman相关、Kruskal-Wallis和Mann-Whitney U检验；非参数回归（LOWESS）探索潜在的非线性关联。
结果： 每日接受三次或以上口腔护理的患者表现出显著更低（更好）的M-BOE评分。改善最明显的是牙龈和颊黏膜湿度、舌卫生和义齿清洁度。家庭照护者使用口腔护理产品与患者吞咽能力和黏膜状况呈正相关。有趣的是，将护理持续时间从一分钟延长至两分钟反而与更高（更差）的M-BOE评分相关，提示技术质量比花费的时间更重要。口腔健康与患者认知功能（MMSE）、功能独立性（K-MBI）或药物数量之间未发现显著关系。
结论： 家庭照护者口腔护理实践显著影响无法独立进行口腔自我护理的吞咽困难住院患者的口腔健康状况。教育干预应优先考虑最佳频率、适当的产品使用和有效的技术培训。这些发现强调了以家庭照护者为中心的项目对于改善功能受限的康复患者口腔健康结局的重要性。

英文摘要

OBJECTIVES: To examine the relationship between family caregiver oral care practices and oral health status among inpatients with dysphagia who require assistance with daily oral hygiene in a rehabilitation ward.
METHODS: Twenty-five patient-family caregiver pairs at a South Korean rehabilitation hospital were studied. Patient oral health was assessed via a modified Multi-dimensional Behavioral Oral Evaluation (M-BOE) tool. Family caregivers completed structured interviews on oral care frequency, duration, techniques, and product use. Data were analyzed using descriptive statistics, Spearman's correlation, Kruskal-Wallis, and Mann-Whitney U tests; nonparametric regression (LOWESS) explored potential nonlinear associations.
RESULTS: Patients receiving oral care three or more times daily exhibited significantly lower (better) M-BOE scores. Improvements were most pronounced in gingival and buccal mucosal moisture, tongue hygiene, and denture cleanliness. Family caregiver use of oral care products correlated positively with patient swallowing ability and mucosal condition. Interestingly, extending care duration from one to two minutes was paradoxically associated with higher (worse) M-BOE scores, suggesting that technique quality outweighs time spent. No significant relationships were found between oral health and patient cognitive function (MMSE), functional independence (K-MBI), or number of medications.
CONCLUSIONS: Family caregiver oral care practices substantially influence oral health status among inpatients with dysphagia who are unable to perform oral self-care independently. Educational interventions should prioritize optimal frequency, appropriate product use, and effective technique training. These findings highlight the importance of family caregiver-focused programs to improve oral health outcomes in rehabilitation patients with functional limitations.