Relationship between oral health and mental health in rural older people with chronic diseases and mediating role of sleep quality
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摘要:
目的 探讨睡眠质量、口腔健康与农村慢性病老年人心理健康之间的关系及内在作用机制。 方法 于2020年7 — 8月,运用5条目口腔健康影响程度量表(OHIP-5)、Kessler心理困扰量表(K10)、匹兹堡睡眠质量指数量表(PSQI),多阶段分层整群抽取山东省2064名 ≥ 60岁农村慢性病老年人进行随访调查,应用IBM SPSS 24.0进行数据分析。 结果 农村慢性病老年人睡眠质量得分[M(P25~P75)]为9(6 ~13)分,口腔健康得分为2(0~5)分,心理健康得分为18(12~25)分。睡眠质量得分(rs = 0.43,P < 0.001)、口腔健康得分(rs = 0.20,P < 0.001)与心理健康得分均呈正相关;睡眠质量得分与口腔健康得分呈正相关(rs = 0.17,P < 0.001)。中介效应结果显示,中介作用的95%CI = 0.09~0.17,睡眠质量在口腔健康与心理健康之间起部分中介作用,其中中介效应占总效应的比例为32.50%。 结论 睡眠质量是农村慢性病老年人口腔健康与心理健康之间的中介因素;关注口腔健康,减少睡眠障碍,有助于提高其心理健康水平。 Abstract:Objective To explore the relationship and internal mechanism between sleep quality, oral health and mental health of the older people with chronic diseases in rural Shandong, China. Methods Using stratified multistage cluster sampling, face-to-face interviews were conducted among 2 064 rural people aged 60 years and above and with chronic diseases in Shandong province during July – August 2020. Oral Health Impact Profile-5 (OHIP-5), Kessler Psychological Distress Scale (K10) and Pittsburgh Sleep Quality Index (PSQI) were adopted in the survey. Statistical analyses were performed with IBM SPSS 24.0. Results For all the respondents, the median score (25th percentile, 75th percentile) was 9 (6, 13) for PSQI, 2 (0, 5) for OHIP, and 18 (12, 25) for K10. The sleep quality and oral health were positively correlated with mental health (rs = 0.43, P < 0.001; rs = 0.20, P < 0.001); sleep quality was positively correlated with oral health (rs = 0.17, P < 0.001). The results of mediating effect analysis revealed that sleep quality played a partial mediation effect on the association between oral health and mental health, with an effect value of 95% confidence interval of 0.09 – 0.17 and accounting for 32.50% of the total effect. Conclusion Sleep quality is a mediator between oral health and mental health among rural older people with chronic diseases; improving oral health and reducing sleep disorders may improve mental health in the population. -
Key words:
- sleep quality /
- oral health /
- mental health /
- chronic disease /
- older people
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表 1 不同人口学特征农村慢性病老年人各量表得分比较
变量 心理健康 睡眠质量 口腔健康 M P25~P75 Z/H 值 P 值 M P25~P75 Z/H 值 P 值 M P25~P75 Z/H 值 P 值 年龄(岁) 1.98 0.370 5.40 0.067 30.87 < 0.001 60~69 17 11~24 9 6~13 1 0~5 70~79 18 12~24 9 6~12 2 0~5 80~ 10 7~13 10 7~13 4 0.25~6 性别 7.91 < 0.001 12.26 < 0.001 4.41 < 0.001 男性 15 10~22 7 5~11 1 0~5 女性 19 13~26 10 7~13 2 0~5 受教育程度 31.63 < 0.001 44.12 < 0.001 25.35 < 0.001 文盲/半文盲 19 13~26 10 7~13 3 0~6 小学 17 12~24 9 6~12 2 0~5 初中及以上 15 10~22 8 5~11 1 0~5 婚姻状况 – 2.87 0.004 – 3.11 0.002 – 2.38 0.017 已婚 17 11~24 9 6~12 3 0~5 非再婚 19 13~26 10 7~13 2 0~5 家庭人均年收入(元) 31.32 < 0.001 9.26 0.026 17.85 < 0.001 ≤ 4 200 19 13~26 9 6~13 3 0~6 4201~7328.75 19 12~25 10 6~12 2 0~5 7328.76~13994 18 11~24 9 6~13 2 0~5 >13 994 15 10~22 9 5~12 1 0~5 是否空巢 – 0.25 0.806 – 1.98 0.047 1.81 0.070 是 18 12~24 9 6~13 2 0~5 否 18 12~25 9 5.5~12 3 0~5 注:家庭人均年收入按百分位数划分为四类。 表 2 农村慢性病老年人口腔健康、睡眠质量、心理健康回归分析
因变量 自变量 β $S_{\bar x}$ t 值 P 值 95%CI 心理健康 a 性别 2.20 0.383 5.74 < 0.001 1.45~2.95 年龄 – 0.03 0.031 – 0.90 0.368 – 0.09~0.03 受教育程度 – 0.38 0.252 – 1.51 0.131 – 0.88~0.11 婚姻状况 – 0.57 0.422 – 1.34 0.181 – 1.39~0.26 年人均收入 – 0.75 0.161 – 4.68 < 0.001 – 1.07~– 0.44 是否空巢 – 0.22 0.478 – 0.47 0.641 – 1.16~0.71 口腔健康 0.40 0.048 8.32 < 0.01 0.31~0.50 睡眠质量 b 性别 2.14 0.196 10.94 < 0.001 4.36~9.85 年龄 0.001 0.016 0.07 0.946 – 0.03~0.03 受教育程度 – 0.30 0.129 – 2.36 0.018 – 0.56~– 0.05 婚姻状况 – 0.28 0.216 – 1.31 0.189 – 0.71~0.14 年人均收入 – 0.06 0.082 – 0.79 0.432 – 0.22~0.10 是否空巢 – 0.88 0.244 – 3.58 < 0.001 – 1.35~− 0.40 口腔健康 0.17 0.025 6.94 < 0.001 0.12~0.22 心理健康 c 性别 0.58 0.364 1.60 0.109 – 0.13~1.30 年龄 – 0.03 0.029 – 1.00 0.316 – 0.09~0.03 受教育程度 – 0.15 0.233 – 0.65 0.517 – 0.61~0.31 婚姻状况 – 0.35 0.389 – 0.90 0.367 – 1.11~0.41 年人均收入 – 0.70 0.148 – 4.74 < 0.001 – 0.99~– 0.41 是否空巢 0.44 0.442 0.99 0.322 – 0.43~1.31 口腔健康 0.27 0.045 6.05 < 0.001 0.18~0.36 睡眠质量 0.76 0.040 18.97 < 0.001 0.68~0.83 注:a 表示方程1;b 表示方程2;c 表示方程3。 -
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