健康素养在社会支持与牙周病患者治疗依从性间的中介效应

何阮慧; 任曼曼; 朱叶素

doi:10.16766/j.cnki.issn.1674-4152.004489

健康素养在社会支持与牙周病患者治疗依从性间的中介效应

doi: 10.16766/j.cnki.issn.1674-4152.004489

温州医科大学附属口腔医院牙周科，浙江温州 325000

基金项目:

浙江省自然科学基金项目 GF19H140005

详细信息

通讯作者:
任曼曼, E-mail：965390026@qq.com

中图分类号: R781.4
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- 文章访问数: 8
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- 被引次数: 0
出版历程
- 收稿日期: 2025-11-25
- 网络出版日期: 2026-10-23

Mediating effect of health literacy on the relationship between social support and treatment compliance of periodontal disease patients

Department of Periodontics, Affiliated Stomatology Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的牙周病作为常见慢性口腔疾病，其治疗效果高度依赖患者长期规范的治疗依从性，本研究旨在探讨健康素养在社会支持与牙周病患者治疗依从性间的中介效应，揭示社会支持影响患者治疗依从性的潜在作用路径，为临床制定针对性干预措施、提升牙周病患者治疗依从性及改善预后提供理论依据。方法选取2023年4月—2025年4月在温州医科大学附属口腔医院接受治疗的220例牙周病患者，采用一般资料问卷、健康素养量表、社会支持量表及治疗依从性量表，分别收集患者的一般人口学信息、健康素养水平、社会支持状况及治疗依从性情况。采用Pearson相关分析探讨健康素养、社会支持与治疗依从性之间的相关性；进一步通过结构方程模型与Bootstrap法（5 000次抽样）构建中介效应模型，分析健康素养在社会支持与治疗依从性之间的中介作用。结果最终纳入有效样本212例，有效回收率为96.36%。健康素养、社会支持、治疗依从性间呈两两正相关关系（P < 0.05）；中介效应模型显示：社会支持可直接影响治疗依从性，也可通过健康素养间接影响治疗依从性（P < 0.001）；健康素养在社会支持与治疗依从性之间的中介效应占总效应的38.25%（0.210/0.549）。结论牙周病患者治疗依从性受多个因素影响，健康素养在牙周病患者家庭社会支持与治疗依从性间起部分中介作用。
- 牙周病 /
- 健康素养 /
- 社会支持 /
- 治疗依从性 /
- 中介效应
Abstract: Objective Periodontal disease, as a prevalent chronic oral condition, requires long-term standardized treatment adherence from patients for optimal therapeutic outcomes. This study aims to explore the mediating effect of health literacy on the relationship between social support and treatment compliance in patients with periodontal disease, in order to reveal the underlying pathways through which social support influences adherence. The findings are expected to provide a theoretical basis for developing targeted clinical interventions, enhancing treatment compliance, and improving prognosis in this patient population. Methods From April 2023 to April 2025, 220 patients with periodontal disease received treatment at the Affiliated Stomatology Hospital of Wenzhou Medical University. The study collected general demographic information, health literacy levels, social support status, and treatment adherence using a general data questionnaire, health literacy scale, social support scale, and treatment adherence scale. Pearson correlation analysis was employed to explore the relationships between health literacy, social support, and treatment adherence. Furthermore, a structural equation model and Bootstrap method (with 5 000 bootstrap samples) were used to construct a mediation effect model, analyzing the mediating role of health literacy between social support and treatment adherence. Results A total of 212 valid samples were ultimately included, with a recovery rate of 96.36%. There was a positive correlation between health literacy, social support, and treatment compliance (P < 0.05). The results of the mediation effect model showed that social support could directly influence treatment adherence and could indirectly influence treatment adherence through health literacy (P < 0.001). The mediation effect of health literacy between social support and treatment adherence accounted for 38.25% of the total effect (0.210/0.549). Conclusion The treatment compliance of periodontal disease patients is affected by many factors, and health literacy plays a partial mediating role between family social support and treatment compliance of periodontal disease patients.
- Periodontal disease /
- Health literacy /
- Social support /
- Treatment compliance /
- Mediating effect

HTML全文

图 1 健康素养在社会支持与牙周病患者治疗依从性间的中介效应结构方程模型图

注：a为社会支持对健康素养的直接效应；b为健康素养对治疗依从性的直接效应；c为社会支持对治疗依从性的总效应；c’为社会支持对治疗依从性的直接效应。

Figure 1. Structural equation model for the mediating effect of health literacy between social support and treatment compliance in patients with periodontal disease

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表 1 212例牙周病患者一般资料

Table 1. Characteristics of 212 patients with periodontal disease

项目	例数	占比(%)
人口学特征
性别
男性	96	45.28
女性	116	54.72
年龄
18~45岁	48	22.64
46~65岁	120	56.60
>65岁	44	20.76
吸烟
是	88	41.51
否	124	58.49
教育水平
小学及以下	58	27.36
中学	88	41.51
大学及以上	66	31.13
家庭人均月收入
≥5 000元	102	48.11
＜5 000元	110	51.89
疾病特征
共病数量
无	70	33.02
1种	108	50.94
2种及以上	34	16.04
病程
≥5年	68	32.08
＜5年	144	67.92
疾病严重程度
轻度	80	37.74
中度	132	62.26

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表 2 牙周病患者健康素养、社会支持、治疗依从性的相关性分析

Table 2. Correlations among health literacy, social support, and treatment compliance in patients with periodontal disease

变量	评分(x±s，分)	r值
变量	评分(x±s，分)	健康素养	社会支持	治疗依从性
健康素养	9.26±2.69	1
社会支持	54.08±12.56	0.667^a	1
治疗依从性	72.25±8.66	0.796^a	0.784^a	1
注：^aP＜0.05。

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表 3 牙周病患者治疗依从性影响因素的线性回归分析

Table 3. Factors associated with treatment compliance in patients with periodontal disease

变量	治疗依从性		社会支持		治疗依从性
变量	非标准化β	标准化β	非标准化β	标准化β	非标准化β	标准化β
常数	48.911		25.283		40.345
健康素养	2.520	0.784^a	3.110	0.667^a	1.466	0.456^a
社会支持					0.339	0.492^a
R²	0.615		0.445		0.749
调整R²	0.613		0.442		0.746
F值	335.092		168.229		311.626
P值	0.001		0.001		0.001
注：与非标准化β比较，^aP＜0.05。第一个为间接：社会支持-健康素养-治疗依从性；第二个为直接：社会支持-治疗依从性。

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表 4 健康素养在社会支持与治疗依从性间的中介效应与总效应分析

Table 4. Analysis of the mediating and total effects of health literacy between social support and treatment compliance

效应类型	路径	效应值	标准误	Z值	P值	Bootstrap 95% CI
直接效应	X→Y	0.339	0.032	10.566	＜0.001	0.276~0.402
间接效应	X1→M→Y	0.210	0.611	9.808	＜0.001	0.114~0.352
总效应	X→Y(直接+间接)	0.549	0.072	7.630	＜0.001	0.408~0.690

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