慢性牙周炎患者心理健康与治疗依从性的相关分析

吴园园; 王慧敏; 何阮慧; 朱叶素

doi:10.16766/j.cnki.issn.1674-4152.003288

慢性牙周炎患者心理健康与治疗依从性的相关分析

doi: 10.16766/j.cnki.issn.1674-4152.003288

温州医科大学附属口腔医院牙周科，浙江温州 325000

基金项目:

浙江省教育厅一般科研项目 Y202044307

详细信息

通讯作者:
王慧敏，E-mail：418072209@qq.com

中图分类号: R781.42
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出版历程
- 收稿日期: 2023-06-21
- 网络出版日期: 2024-01-29

Correlation analysis between psychological health and treatment compliance in patients with chronic periodontitis

Department of Dentistry, Affiliated Stomatological Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的分析慢性牙周炎患者心理健康与治疗依从性的现状，并分析两者的相关性。方法采用便利抽样法选取2019年10月—2022年10月温州医科大学附属口腔医院牙周科就诊的慢性牙周炎患者86例为研究对象进行回顾性研究，另按2∶1比例选取同期该院口腔检查健康者43例为对照组，比较2组心理状况(SCL-90评分)的差异。根据Frankl依从量表评估得分将研究组患者分为依从性良好组(39例)、依从性一般组(33例)、依从性差组(14例)，采用多元logistic回归分析研究影响因素，并使用线性回归方程分析依从性与心理状况的相关性。结果研究组SCL-90评分各因子得分[(8.45±2.59)分、(6.98±1.33)分、(8.94±2.45)分、(8.26±1.70)分、(5.08±0.96)分、(4.79±0.98)分、(8.97±2.23)分、(4.83±1.04)分、(4.79±1.06)分、(6.34±1.63)分]均高于对照组[(1.02±0.33)分、(1.08±0.37)分、(1.01±0.34)分、(0.72±0.21)分、(0.62±0.08)分、(0.20±0.05)分、(1.07±0.26)分、(0.36±0.08)分、(0.62±0.09)分、(0.88±0.20))分，均P < 0.05]。多元logistic回归分析显示，初中及以下文化程度、SCL-90各因子得分低均为依从性的危险因素(均P < 0.05)。线性相关分析显示，SCL-90评分各因子得分与依从性显著相关(均P < 0.05)。结论慢性牙周炎患者易存在心理问题，且患者心理状态与治疗依从性密切相关。
- 慢性牙周炎 /
- 心理健康 /
- 治疗依从性 /
- 相关性
Abstract: Objective This study aims to analyze the current status of mental health and treatment compliance in patients with chronic periodontitis, while also investigating the correlation between the two factors. Methods This prospective study employed convenience sampling to enroll 86 patients with chronic periodontitis who sought treatment at the Department of Dentistry, Affiliated Stomatological Hospital of Wenzhou Medical University between October 2019 and October 2022 as the study group. Additionally, a control group consisting of 43 orally healthy individuals who underwent dental examinations during the same period was selected in a 2∶1 ratio. The objective of this study was to compare the psychological status between the two groups, as measured by SCL-90 scores. The patients in the study group were divided into the compliance group (39 cases), general compliance group (33 cases), and poor compliance group (14 cases) according to the Frankl compliance scale assessment scores. Multivariate logistic regression analysis was conducted to identify influencing factors, while linear regression equations were utilized to explore the correlation between treatment compliance and psychological status. Results The study group exhibited significantly higher scores for each factor in the SCL-90 assessment compared to the control group [(8.45±2.59) points, (6.98±1.33) points, (8.94±2.45) points, (8.26±1.70) points, (5.08±0.96) points, (4.79±0.98) points, (8.97±2.23) points, (4.83±1.04) points, (4.79±1.06) points, (6.34±1.63) points vs. (1.02±0.33) points, (1.08±0.37) points, (1.01±0.34) points, (0.72±0.21) points, (0.62±0.08) points, (0.20±0.05) points, (1.07±0.26) points, (0.36±0.08) points, (0.62±0.09) points, (0.88±0.20) points, all P < 0.05]. Multivariate logistic regression analysis revealed that a lower educational level (middle school and below) and lower scores in all SCL-90 factors were significant risk factors for poor treatment compliance (all P < 0.05). Furthermore, a significant correlation was observed between the scores of each factor in the SCL-90 assessment and the treatment compliance through linear correlation analysis (all P < 0.05). Conclusion Patients with chronic periodontitis are prone to psychological problems, and their psychological status is closely related to treatment compliance.
- Chronic periodontitis /
- Psychological health /
- Treatment compliance /
- Correlation

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表 1 2组研究对象一般资料比较

Table 1. Comparison of general information between the two study groups

组别	例数	性别 (男性/女性，例)	年龄(x±s，岁)	BMI(x±s)	文化程度[例(%)]
组别	例数	性别 (男性/女性，例)	年龄(x±s，岁)	BMI(x±s)	初中及以下	高中与中专	大专及以上
研究组	86	41/45	48.65±6.55	23.03±2.16	50(58.14)	23(26.74)	13(15.12)
对照组	43	21/22	49.87±7.07	22.15±2.28	28(65.12)	10(23.26)	5(11.63)
统计量		0.016^a	0.738^b	1.627^b	0.226^c
P值		0.901	0.463	0.108	0.634
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组研究对象心理健康(SCL-90评分)比较(x±s，分)

Table 2. Comparative analysis of mental health (SCL-90 score) between the two study groups(x±s, points)

组别	例数	焦虑	躯体化	抑郁	强迫	偏执	精神病性	人际关系敏感	敌对	恐怖	生活不适
研究组	86	8.45±2.59	6.98±1.33	8.94±2.45	8.26±1.70	5.08±0.96	4.79±0.98	8.97±2.23	4.83±1.04	4.79±1.06	6.34±1.63
对照组	43	1.02±0.33	1.08±0.37	1.01±0.34	0.72±0.21	0.62±0.08	0.20±0.05	1.07±0.26	0.36±0.08	0.62±0.09	0.88±0.20
t值		18.626	28.099	20.959	28.044	27.856	30.299	23.090	28.385	23.741	21.678
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

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表 3 不同依从性慢性牙周炎患者一般资料比较[例(%)]

Table 3. Comparative analysis of general patient data with chronic periodontitis based on different adherence levels [cases(%)]

项目	依从性良好组 (n=39)	依从性一般组 (n=33)	依从性差组 (n=14)	统计量	P值
性别				0.016^a	0.889
男性	19(48.72)	15(45.45)	7(50.00)
女性	20(51.28)	18(54.55)	7(50.00)
年龄				8.893^b	0.003
< 30岁	9(23.08)	6(18.18)	9(64.29)
30~60岁	25(64.10)	24(72.73)	4(28.57)
>60岁	5(12.82)	3(9.09)	1(7.14)
文化程度				8.762^b	0.011
初中及以下	18(46.15)	19(57.58)	13(92.86)
高中与中专	14(35.90)	8(24.24)	1(7.14)
大专及以上	7(17.95)	6(18.18)	0
职业				1.178^a	0.278
体力劳动	12(30.77)	10(30.30)	4(28.57)
脑力劳动	21(53.85)	17(51.52)	8(57.14)
退休或无业	6(15.38)	6(18.18)	2(14.29)
收入情况(元/月)				1.155^b	0.580
< 4 000	10(25.64)	8(24.24)	5(35.71)
4 000~10 000	22(56.41)	20(60.61)	8(57.14)
>10 000	7(17.95)	5(15.15)	1(7.14)
注：^a为χ²值，^b为Z值。

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表 4 不同依从性慢性牙周炎患者心理健康(SCL-90评分)比较(x±s，分)

Table 4. Comparative analysis of mental health (SCL-90 score) in patients with chronic periodontitis based on different adherence levels (x±s, points)

组别	例数	焦虑	躯体化	抑郁	强迫	偏执	精神病性	人际关系敏感	敌对	恐怖	生活不适
依从性良好组	39	6.38±1.32	6.40±1.16	7.30±1.31	7.62±1.46	4.69±0.80	4.16±0.77	8.09±1.89	4.31±0.84	4.15±0.85	5.34±1.31
依从性一般组	33	9.43±1.71^a	7.14±1.24^a	9.47±1.65^a	8.41±1.53^a	5.20±0.86^a	4.91±0.83^a	9.08±2.00^a	4.93±0.86^a	4.88±0.86^a	6.81±1.31^a
依从性差组	14	11.72±2.34^ab	8.18±1.34^ab	11.93±2.39^ab	9.59±1.71^ab	5.84±0.95^ab	5.64±0.81^ab	10.87±2.11^ab	5.70±0.96^ab	5.63±0.98^ab	7.82±1.37^ab
F值		62.605	11.449	43.787	8.872	10.069	19.683	10.445	14.088	16.248	22.072
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001
注：与依从性良好组比较，^aP < 0.05；与依从性一般组比较，^bP < 0.05。

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表 5 变量赋值情况

Table 5. Status of variable assignment

变量	赋值方法
因变量
依从性	依从性良好=0，依从性一般=1，依从性差=2
自变量
年龄	< 30岁=0，30~60岁=1，>60岁=2
文化程度	初中及以下=0，高中与中专=1，大专及以上=2
焦虑	以实际值赋值
躯体化	以实际值赋值
抑郁	以实际值赋值
强迫	以实际值赋值
偏执	以实际值赋值
精神病性	以实际值赋值
人际关系敏感	以实际值赋值
敌对	以实际值赋值
恐怖	以实际值赋值
生活不适	以实际值赋值

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表 6 慢性牙周炎患者治疗依从性影响因素的logistic回归分析

Table 6. Logistic regression analysis of factors influencing treatment adherence in patients with chronic periodontitis

变量	B	SE	Wald χ²	P值	OR值	95% CI
年龄	1.609	1.193	1.821	0.177	5.000	0.483~51.771
文化程度	20.979	1.097	365.559	< 0.001	1 290 825 825.056	150 281 765.091~11 087 381 823.192
焦虑	1.896	0.361	27.647	< 0.001	6.661	3.285~13.507
躯体化	1.084	0.314	11.895	0.001	2.956	1.597~5.472
抑郁	1.630	0.318	26.336	< 0.001	5.103	2.738~9.509
强迫	0.800	0.234	11.686	0.001	2.226	1.407~3.521
偏执	1.560	0.449	12.063	0.001	4.761	1.974~11.484
精神病性	1.846	0.456	16.431	< 0.001	6.337	2.595~15.476
人际关系敏感	0.738	0.205	12.937	< 0.001	2.091	1.399~3.125
敌对	1.584	0.419	14.316	< 0.001	4.873	2.145~11.067
恐怖	1.434	0.396	13.091	< 0.001	4.196	1.929~9.123
生活不适	1.522	0.364	17.440	< 0.001	4.580	2.242~9.356

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表 7 慢性牙周炎患者依从性与心理健康线性回归方程

Table 7. Linear regression equation of compliance and mental health in patients with chronic periodontitis

变量	B	SE	β	t值	P值
焦虑	-0.241	0.043	-0.721	-5.598	< 0.001
躯体化	-0.048	0.070	-0.074	-3.687	0.009
抑郁	-0.202	0.045	-0.575	-4.485	< 0.001
强迫	-0.140	0.057	-0.276	-2.462	0.016
偏执	-0.054	0.096	-0.060	-2.559	0.015
精神病性	-0.120	0.103	-0.137	-1.162	0.025
人际关系敏感	-0.005	0.043	-0.014	-1.123	0.032
敌对	-0.108	0.100	-0.131	-1.077	0.038
恐怖	-0.142	0.104	-0.175	-1.367	0.028
生活不适	-0.025	0.062	-0.048	-1.409	0.026

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