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      Oral health knowledge, attitudes, and practices and oral health-related quality of life among stroke inpatients: a cross-sectional study

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          Abstract

          Background

          Stroke patients have poor oral hygiene, experience oral dysfunction due to disease factors, and have impaired oral health-related quality of life (OHRQoL). This study aimed to determine the oral health knowledge, attitudes, and practices of stroke inpatients, assess the OHRQoL of these patients, and identify their correlates.

          Methods

          In this cross-sectional study, 281 stroke inpatients aged between 22 and 88 years (57.94 ± 10.94) were conveniently selected from three hospitals in Guangzhou, China. OHRQoL was measured among these stroke patients using a Chinese version of the Oral Health Impact Profile-14 (OHIP-14). SPSS 26.0 was used for statistical analysis. Mean scores, standard deviations, and frequency distributions were obtained. The Mann–Whitney U test, Kruskal‒Wallis H test, Spearman's correlation, and multiple linear regression were used in the analysis.

          Results

          The mean score of the patients' OHRQoL was 8.37 ± 6.67, with the highest score in the pain or discomfort of the mouth dimension (3.11 ± 2.13) and pain being the most common negative effect (13.5%). In multiple linear regression analysis, significant differences were found between patients only in age ( P = 0.008), toothache ( P < 0.001), self-rated oral health ( P < 0.001), time since last dentist visit ( P = 0.037) and reason for not having visited a dentist in the past year ( P < 0.001).

          Conclusion

          The OHRQoL of patients hospitalised with stroke was moderate, and oral conditions still need to be improved. Increasing age, toothache, a longer time since the last dental visit and the reason for not visiting a dentist in the past year had a negative effect on OHRQoL, and better self-rated oral health had a positive effect. Therefore, in clinical work, greater attention should be given to elderly stroke patients, patients with poor oral status and poor oral health behaviours, timely assessment of patients’ swallowing function, nutritional function, and self-care ability, and early and targeted oral health interventions and guidance.

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          Most cited references59

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          Revisiting the Behavioral Model and Access to Medical Care: Does it Matter?

          The Behavioral Model of Health Services Use was initially developed over 25 years ago. In the interim it has been subject to considerable application, reprobation, and alteration. I review its development and assess its continued relevance.
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            Derivation and validation of a short-form oral health impact profile.

            Growing recognition that quality of life is an important outcome of dental care has created a need for a range of instruments to measure oral health-related quality of life. This study aimed to derive a subset of items from the Oral Health Impact Profile (OHIP-49)-a 49-item questionnaire that measures people's perceptions of the impact of oral conditions on their well-being. Secondary analysis was conducted using data from an epidemiologic study of 1217 people aged 60+ years in South Australia. Internal reliability analysis, factor analysis and regression analysis were undertaken to derive a subset (OHIP-14) questionnaire and its validity was evaluated by assessing associations with sociodemographic and clinical oral status variables. Internal reliability of the OHIP-14 was evaluated using Cronbach's coefficient alpha. Regression analysis yielded an optimal set of 14 questions. The OHIP-14 accounted for 94% of variance in the OHIP-49; had high reliability (alpha = 0.88); contained questions from each of the seven conceptual dimensions of the OHIP-49; and had a good distribution of prevalence for individual questions. OHIP-14 scores and OHIP-49 scores displayed the same pattern of variation among sociodemographic groups of older adults. In a multivariate analysis of dentate people, eight oral status and sociodemographic variables were associated (P < 0.05) with both the OHIP-49 and the OHIP-14. While it will be important to replicate these findings in other populations, the findings suggest that the OHIP-14 has good reliability, validity and precision.
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              Development and evaluation of the Oral Health Impact Profile.

              The capacity of dental clinicians and researchers to assess oral health and to advocate for dental care has been hampered by limitations in measurements of the levels of dysfunction, discomfort and disability associated with oral disorders. The purpose of this research was to develop and test the Oral Health Impact Profile (OHIP), a scaled index of the social impact of oral disorders which draws on a theoretical hierarchy of oral health outcomes. Forty nine unique statements describing the consequences of oral disorders were initially derived from 535 statements obtained in interviews with 64 dental patients. The relative importance of statements within each of seven conceptual subscales was assessed by 328 persons using Thurstone's method of paired comparisons. The consistency of their judgements was confirmed (Kendall's mu, P < 0.05). The reliability of the instrument was evaluated in a cohort of 122 persons aged 60 years and over. Internal reliability of six subscales was high (Cronbach's alpha, 0.70-0.83) and test-retest reliability (intraclass correlation coefficient, 0.42-0.77) demonstrated stability. Validity was examined using longitudinal data from the 60 years and over cohort where the OHIP's capacity to detect previously observed associations with perceived need for a dental visit (ANOVA, p < 0.05 in five subscales) provided evidence of its construct validity. The Oral Health Impact Profile offers a reliable and valid instrument for detailed measurement of the social impact of oral disorders and has potential benefits for clinical decision-making and research.
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                Author and article information

                Contributors
                zhouhz_smu@126.com
                Journal
                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central (London )
                1472-6831
                19 September 2022
                19 September 2022
                2022
                : 22
                : 410
                Affiliations
                [1 ]GRID grid.416466.7, ISNI 0000 0004 1757 959X, Department of Nursing, , Nanfang Hospital, Southern Medical University, ; No.1838 Guangzhou Avenue North, Guangzhou, 510515 China
                [2 ]GRID grid.284723.8, ISNI 0000 0000 8877 7471, School of Nursing, , Southern Medical University, ; Guangzhou, China
                [3 ]GRID grid.284723.8, ISNI 0000 0000 8877 7471, Nanfang Hospital, , Southern Medical University, ; Guangzhou, China
                [4 ]GRID grid.490151.8, Department of Neurology, , Guangdong 999 Brain Hospital, ; Guangzhou, China
                [5 ]GRID grid.416466.7, ISNI 0000 0004 1757 959X, Department of Stomatology, , Nanfang Hospital, Southern Medical University, ; Guangzhou, China
                Article
                2446
                10.1186/s12903-022-02446-1
                9484166
                36123656
                8cbad7ef-153b-4894-9cc6-64b786323726
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 8 June 2022
                : 8 September 2022
                Funding
                Funded by: Science and Technology Program of Guangzhou, Guangdong, China
                Award ID: 201803010084
                Award ID: 201803010084
                Award ID: 201803010084
                Award ID: 201803010084
                Award ID: 201803010084
                Award ID: 201803010084
                Award ID: 201803010084
                Award ID: 201803010084
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Dentistry
                stroke,oral health,knowledge,attitudes,practices,oral health-related quality of life
                Dentistry
                stroke, oral health, knowledge, attitudes, practices, oral health-related quality of life

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