| 摘要: | 研究背景：
社會資本為個人可於社會關係中取得之有形與無形資產，在高度凝聚力之社會關係網絡中，投入於公共事務將有利於資產的流動，進而影響身處社會網絡中之個人，過往研究已證實社會資本與犯罪率、自殺率、健康有關。幼兒口腔健康已經國內研究證實與照顧者社會人口學背景有關，然而仍尚未以社會資本洞見口腔健康。此外，照顧者理解口腔保健資訊並運用於不同生活情境的能力，亦影響保健行為施展。因此，為擴展幼兒口腔健康影響因子，本研究旨在探討主要照顧者社會資本、口腔健康識能與3-6歲幼兒口腔健康關係。
研究對象與方法：
本研究採橫斷式研究設計，目標族群為3至6歲幼兒與其主要照顧者，藉便利取樣抽樣方式，在台北市、桃園市與台南市尋找可協助問卷發放之幼兒園，研究收案期間為2022年8月18日至2023年4月7日，總計162份有效樣本。結果變相為照顧者自評幼兒口腔健康，控制變項為照顧者與幼兒社會人口學變項，自變項為照顧者社會資本、口腔健康知識、口腔健康識能、幼兒開始刷牙年齡與口腔保健相關行為等。本研究採取卡方檢定、獨立樣本t檢定、ANOVA分析法檢視雙變項關係，以階層式回歸模型檢視多變項關係。
結果：
社會資本與照顧者年齡、教育、收入、幼兒口腔健康有關；口腔健康識能與照顧者教育、收入、幼兒口腔健康有關；女性照顧者口腔健康知識得分較高，口腔健康知識與幼兒口腔健康有正向關係；主要照顧者口腔保健行為與幼兒口腔保健行為有正向關係；幼兒含糖飲品攝取與口腔健康有負向關係；照顧者教育程度越高，幼兒更可能曾使用牙科照護資源；不曾使用牙科照護資源之幼兒，更晚建立刷牙習慣；女性照顧者更能掌握幼兒口腔健康狀況；在控制社會人口學變項後，社會資本、口腔健康識能、牙刷使用頻率正向影響口腔健康，幼兒開始刷牙年齡、夜奶攝取、口腔保健資訊來源數量負向影響口腔健康。整體模型中20個自變項整體可解釋25%幼兒口腔健康變異，且整體模型可有效預測幼兒口腔健康（p < 0.001）。
結論：
本研究擴展台灣3-6歲幼兒口腔健康社會決定因素。研究發現公共參與、社會信任、社會支持等廣泛的照顧者社會資本與口腔健康識能可影響3-6歲幼兒口腔健康。
Background:
Social capital refers to tangible and intangible properties that individuals could access from social relations. Located in a society with high social cohesion, individuals indulging in social participation are helpful for those properties to deliver among individuals. Evidence shows the link between social capital and criminality, suicide, and health. Researchers have found children's oral health is associated with caregivers’ social background in Taiwan. However, researchers haven’t explored oral health from the perspective of social capital in Taiwan. Also, the performance of oral health behaviors is affected by whether caregivers could understand oral health information and apply it in different situations. The study aims to explore the relationship between caregivers’ social capital, oral health literacy, and children's oral health.
Methods:
A cross-sectional study was conducted among 162 children aged 3 to 6 years old and their caregivers in Taipei, Taoyuan, and Tainan City. Data were collected with convenience sampling using questionnaires that were completed by their caregivers between 18th August 2022 and 7th April 2023. The outcome was caregiver-reported children's oral health status, controlling variables were caregiver and child sociodemographic factors, and independent variables were caregiver’s social capital, oral health literacy, oral health knowledge, initial age for children to brush teeth, and oral health behaviors. Univariate analyses were used with chi-square, independent t-test, and ANOVA, and hierarchical regression was used to analyze the relationship between variables.
Results:
The caregiver’s social capital was significantly associated with the caregiver’s age, education, income, and child's oral health status. Oral health literacy was significantly associated with the caregiver’s education, income, and the child's oral health status. Female caregivers possess higher oral health knowledge, and oral health knowledge was positively associated with the child's oral health status. The caregiver’s oral health behaviors were positively associated with the child's oral health behaviors. The frequency of drink intake was negatively associated with the child's oral health status. Children whose caregivers possess higher education tend to utilize dental care services. Children who never utilize dental care services tend to build up the habit of brushing late. Female caregivers knew the child's oral health condition well than male caregivers. After controlling the sociodemographic factors, caregivers’ social capital, oral health literacy, and frequency of brushing positively affected child oral health, initial age for children to brush, intake of night-bottle milk, and oral health information sources negatively affected child oral health. Within the regression model, 20 independent variables could explain 25% variance of children oral health, and the model could significantly predict oral health of children aged 3 to 6.
Conclusions:
This study adds to the growing body of literature on the social determinants of children's oral health in Taiwan. Our findings show that a broad concept of social capital including social participation, social trust, and social support, and oral health literacy may affect 3-6 aged children's oral health. |
