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標題: | 台北地區牙周病統合照護計劃執行滿意度調查 Patient Satisfaction Survey on Comprehensive Periodontal Treatment Project in Taipei |
作者: | TSUEI-YU JU 朱翠玉 |
指導教授: | 陳秀熙(Hsiu-Hsi Chen) |
關鍵字: | 牙周病,病人滿意度,醫療照護服務品質,牙周病統合照護計劃,相關因子, Periodontal disease,patient satisfaction,quality of medical care services,Comprehensive Periodontal Treatment Project,related factors, |
出版年 : | 2019 |
學位: | 碩士 |
摘要: | 背景與目的:民國101年全民健康保險開始給付牙周病統合(簡稱牙統)照護治療計畫,主要希望透過給付方案提升牙周病照護品質,增加就醫公平性及降低口腔疾病的醫療花費。然而目前對於牙統照護治療計畫執行滿意度、治療成效及影響治療成效的相關因素的相關研究仍相當缺乏。因此希望透過實習方式達到下列主要目的,包含(1)了解民眾對於牙周病統合照護治療的滿意程度(2)牙周病統合照護治療是否有顯著改善牙周狀況及(3)病患之牙科疾病史、生活習慣及飲食習慣等是否為影響牙周病統合照護成效的重要因素。
研究方法:本研究採橫斷式研究於台大醫院牙周病科進行收案,研究對象為參與牙周病統合照護計劃的病患,以問卷的方式進行資料蒐集與調查。問卷內容主要分為三大面向,第一面向為探討牙周病統合照護治療的滿意程度;第二面向為探討牙周病統合照護治療是否有顯著改善牙周狀況;第三面向為探討病患之牙科疾病史、生活習慣及飲食習慣,收集病患之牙科疾病史。收案期程分為二個時期(2016年5月15日至2016年6月15日與2017年5月20日至2017年6月20日進行),期間共計發放200份問卷,回收192份(回收率為96%)。 研究結果:所有192名患者中,有39.3%的患者直系或旁系親屬具有牙周疾病史,19.4%的患者有糖尿病家族史。71.2%的患者有缺牙情形,65.5%的患者沒有半年定期於牙科診所洗牙的習慣,多數患者沒有吸菸(84.8%),喝酒(82.2%)及嚼檳榔(95.3%)的習慣。67%的患者曾偏好較硬的食物,而28.3%則偏好含糖飲料。 針對牙統照護治療前後,牙周改善狀況評估結果,其中具統計學明顯改善的項目包含牙齦紅腫、刷牙流血的情形 (治療前後平均分數降低1.12(標準差為1.02),其p值為<.0001);牙齒鬆動的情形(治療前後平均分數降低0.70 (標準差1.01),其p值為<.0001);牙齒冷熱敏感的情形(平均分數降低0.30 (標準差1.01),其p值為0.0002);口臭的情形(平均分數降低0.63 (標準差0.85),其p值為<.0001);牙齦退縮的情形(平均分數降低0.77 (標準差0.88),其p值為<.0001)。 對於牙統照護治療計畫滿意程度填答結果顯示,97.9%的患者認為在接受牙統照護治療時,牙醫師提供了完整的說明;81.6%的患者在接受牙統治療後,能更加了解牙周病。96.3%患者在接受牙統治療後,其整體滿意程度達到滿意/非常滿意。97.9%患者認為在接受牙統治療時,牙醫師是有提供完整/非常完整的良好口腔衛教。48.2%患者在牙統治療中感覺到輕微不舒服,15.7%感到中等嚴重不舒服,13.6%感到非常嚴重的不舒服。接受牙統治療時,有95%以上的病患對於牙醫師提供清楚的說明,提供良好的口腔衛教及整體滿意度感到滿意。有81.6%的患者在接受牙統治療後,對於更加了解牙周病的知識感到滿意。 結論:牙統照護治療計畫能夠有效改善病患的牙周狀況,特別在牙齦紅腫、刷牙流血的情形的改善上。病人在接受牙統照護治療計畫後,有相當好的滿意度。然而,未來可以針對如何舒緩治療程序上的疼痛進行改善,並關注特定病人的特質對於照護成效的影響以作為未來臨床治療或政策給付的參考。 Background and Objective: The National Health Insurance began to pay for Comprehensive Periodontal Treatment Project. It is mainly intended to improve the quality of periodontal care through the payment program, increase the fairness of medical treatment and reduce the medical expenses of oral diseases. However, there is still a lack of relevant research on the implementation satisfaction of the dental care treatment plan, the effectiveness of treatment, and the related factors affecting the effectiveness of treatment. Therefore, we hope to achieve the following main objectives through practicum, including (1) understanding the satisfaction of the comprehensive periodontal treatment (2) whether comprehensive periodontal treatment has a significant improvement in periodontal disease and (3) Whether the disease history, living habits and eating habits of patients are important factors affecting the effectiveness of comprehensive periodontal treatment. Methods: In this study, a cross-sectional study was conducted at the Department of Periodontology, National Taiwan University Hospital. The subjects were patients who participated in the comprehensive periodontal treatment project, and data collection and investigation were conducted by questionnaire. The content of the questionnaire is mainly divided into three aspects. The first aspect is to discuss the satisfaction degree of comprehensive periodontal treatment. The second aspect is to explore whether the comprehensive periodontal treatment can significantly improve the periodontal condition. The third aspect is to explore the risk factor affecting the efficacy such as history of dental diseases, living habits and eating habits, the history of dental diseases of patients. The collection process is divided into two periods (from May 15, 2016 to June 15, 2016 and May 20, 2017 to June 20, 2017). During the period, a total of 200 questionnaires were distributed and 192 copies were collected. (The recovery rate is 96%). Results: Of all 192 patients, 39.3% had a history of periodontal disease in the immediate or collateral family, and 19.4% had a family history of diabetes. 71.2% of the patients had missing teeth, and 65.5% of the patients did not have the habit of regularly cleaning their teeth in the dental clinic for half a year. Most patients did not smoke (84.8%), drink alcohol (82.2%) and chew betel nut (95.3%). 67% of patients prefer hard food, while 28.3% prefer sugary drinks. For the evaluation of periodontal improvement before and after the treatment of dental care, the items with statistically significant improvement included gingival redness and brushing bleeding (average score before and after treatment decreased by 1.12 (standard deviation was 1.02), and its p value was <. 0001); tooth loosening (average score before and after treatment decreased by 0.70 (standard deviation 1.01), its p value was <.0001); teeth were hot and cold sensitive (average score decreased by 0.30 (standard deviation 1.01), and its p value was 0.0002. In the case of bad breath (the average score decreased by 0.63 (standard deviation 0.85), its p value was <.0001); the case of gingival recession (the average score decreased by 0.77 (standard deviation 0.88), and its p value was <.0001). According to the satisfaction degree of comprehensive periodontal treatment project, 97.9% of the patients thought that the dentist provided a complete explanation when receiving the dental care treatment; 81.6% of the patients could understand the teeth after receiving the dental treatment. 96.3% of patients had satisfactory/very satisfied on overall satisfaction after receiving dental treatment. 97.9% of patients believe that the dentist has a complete/very complete good oral education when receiving dental treatment. 48.2% of patients felt mild discomfort during the treatment, 15.7% felt moderately uncomfortable, and 13.6% felt very uncomfortable. More than 95% of patients receiving dental care are satisfied with the dentist's clear instructions and good oral education and overall satisfaction. 81.6% of patients were satisfied with the knowledge of periodontal disease after receiving dental treatment. Conclusion: The dentate care treatment program can effectively improve the periodontal condition of patients, especially in the improvement of gingival swelling and brushing bleeding. The patient had a good satisfaction after receiving the dental care treatment plan. However, the future can be improved on how to relieve pain in the treatment program, and to focus on the impact of specific patient characteristics on the effectiveness of care as a reference for future clinical treatment or policy payments. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/74902 |
DOI: | 10.6342/NTU201904125 |
全文授權: | 有償授權 |
顯示於系所單位: | 健康政策與管理研究所 |
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