行为转变理论口腔健康教育方案在5~6岁儿童中的应用效果

袁梦; 张欣; 段小燕

doi:10.16835/j.cnki.1000-9817.2025040

行为转变理论口腔健康教育方案在5~6岁儿童中的应用效果

doi: 10.16835/j.cnki.1000-9817.2025040

袁梦¹,
张欣¹,
段小燕^2, ,

1.
重庆医科大学附属口腔医院护理部，重庆 400016
2.
重庆医科大学附属口腔医院医务科

详细信息

作者简介:
袁梦(1998-)，女，四川达州人，在读硕士，主要研究方向为儿童口腔保健

通讯作者:
段小燕，E-mail：1159883673@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R788 R181.3⁺⁷
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出版历程
- 收稿日期: 2024-10-16
- 修回日期: 2024-11-06
- 网络出版日期: 2025-03-05
- 刊出日期: 2025-02-25

Application effect of oral health management program based on behavior change wheel theory for children aged 5-6 years

1.
Department of Nursing, Affiliated Stomatological Hospital of Chongqing Medical University, Chongqing (400016), China

摘要

摘要: 目的验证基于行为转变(BCW)理论构建的儿童口腔健康教育方案的应用效果，为提高儿童口腔自我管理意识、养成健康的口腔行为习惯提供参考。方法 2023年9月—2024年3月，采用方便抽样方法选取重庆市渝北区2所幼儿园共120名5~6岁儿童，按学校分为试验组和对照组(各60名)。试验组儿童在常规口腔健康教育的基础上实施基于BCW理论的口腔健康教育方案(促进健康意识、培养健康行为能力、强化意识与能力、提供机会)，对照组儿童给予常规口腔健康教育；分别于干预前及干预后3个月收集研究对象资料。使用Mann-Whitney U检验、χ²检验进行组间比较。结果干预前，试验组和对照组菌斑指数[2.00(1.00, 2.00)，2.00(1.00, 2.00)]、充填牙数[0.00(0.00, 1.00)，0.00(0.00, 1.00)]差异均无统计学意义(Z值分别为-0.88，-0.42，P值均>0.05)；干预后，试验组菌斑指数[1.00(0.00, 1.00)]低于对照组[1.00(0.25, 2.00)]和干预前，试验组充填牙数[1.00(0.00, 2.00)]高于对照组[1.00(0.00, 1.00)]和干预前，差异均有统计学意义(Z值分别为-3.14，-5.48；-2.08，-3.02，P值均<0.05)。干预前，两组儿童的口腔健康行为报告率和口腔健康知识掌握率差异均无统计学意义(χ²值分别为0.30~0.91，0.15~1.43，P值均>0.05)；干预后，试验组健康刷牙(方法、次数、时长)、预防行为(使用含氟牙膏、有进行窝沟封闭预防和涂氟预防)报告率均优于对照组和干预前，差异均有统计学意义(χ²值分别为4.88~9.38，9.13~22.63，P值均<0.05)；试验组口腔健康知识掌握率均优于对照组，差异均有统计学意义(χ²=4.62~8.54，P值均<0.05)。结论基于BCW理论的口腔健康教育方案更有利于改善儿童口腔卫生状况，提升儿童口腔基础知识以及促进其口腔健康行为的养成。
- 行为 /
- 口腔保健 /
- 干预性研究 /
- 儿童
Abstract: Objective To evaluate the application effect of oral health management program based on behavior change wheel (BCW) theory, so as to provide a reference for improving children's awareness of oral self-management and the development of healthy oral behaviors. Methods A total of 120 children aged 5-6 from 2 kindergartens in Yubei District in Chongqing City, selected by convenience sampling method from September 2023 to March 2024, were divided into a experimental group and a control group (60 each). Children in the experimental group were given an oral health education programme based on BCW theory (promoted health awareness, cultivated healthy behavior ability, strengthened awareness and ability, and provided opportunitiess) on the basis of conventional oral health education, and children in the control group were given conventional oral health education; data were collected before and 3 months after the intervention, respectively. Comparisons between groups were made using the Mann-Whitney U test and χ² test. Results Before intervention, there were no significant differences in plaque index [2.00(1.00, 2.00), 2.00(1.00, 2.00)] and the number of filled teeth [0.00(0.00, 1.00), 0.00(0.00, 1.00)] between the experimental group and the control group (Z=-0.88, -0.42, P>0.05). After intervention, the plaque index of the experimental group [1.00(0.00, 1.00)] was lower than that of the control group [1.00(0.25, 2.00)] and before intervention, and the number of filling teeth in the experimental group [1.00(0.00, 2.00)] was higher than that of the control group [1.00(0.00, 1.00)] and before intervention, the differences were statistically significant (Z=-3.14, -5.48; -2.08, -3.02, P<0.05). Before intervention, there were no significant differences in oral health behavior report rate and oral health knowledge mastery rate between the two groups (χ²=0.30-0.91, 0.15-1.43, P>0.05). After intervention, the report rates of health tooth brushing (method, frequency and duration) and preventive behavior (using fluoride toothpaste, pit and fissure sealing prevention and fluoride application prevention) in the experimental group were better than those in the control group and before intervention, and the differences were statistically significant (χ²=4.88-9.38, 9.13-22.63, P<0.05). The mastery rates of oral health knowledge in the experimental group were better than that in the control group, and the differences were statistically significant (χ²=4.62-8.54, P<0.05). Conclusion Oral health management programs based on the BCW theory are more conducive to improving children's oral hygiene, as well as enhancing children's basic oral knowledge and promoting the development of oral health behaviors.
- Behavior /
- Oral health /
- Intervention studies /
- Child
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表 1 干预前后两组儿童口腔健康状况指标比较[M(P₂₅, P₇₅)]

Table 1. Comparison of oral health status between two groups of children before and after intervention[M(P₂₅, P₇₅)]

干预前后	组别	人数	统计值	dmft	菌斑指数	充填牙数
干预前	试验组	60		1.00(0.00, 3.00)	2.00(1.00, 2.00)^a	0.00(0.00, 1.00)^a
	对照组	60		1.50(0.00, 4.00)	2.00(1.00, 2.00)	0.00(0.00, 1.00)
			Z值	-0.62	-0.88	-0.42
			P值	0.54	0.38	0.68
干预后	试验组	60		2.00(0.00, 3.00)	1.00(0.00, 1.00)	1.00(0.00, 2.00)
	对照组	60		2.00(1.00, 4.00)	1.00(0.25，2.00)	1.00(0.00, 1.00)
			Z值	-1.11	-3.14	-2.08
			P值	0.27	<0.01	0.04
注： ^a试验组干预前与干预后比较，P<0.05。

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表 2 干预前后儿童口腔健康知识掌握率组间比较

Table 2. Comparison of mastery rates of oral health knowledge between groups of children before and after intervention

条目	干预前				干预后
条目	试验组(n=60)	对照组(n=60)	χ²值	P值	试验组(n=60)	对照组(n=60)	χ²值	P值
1.口腔健康会影响我们全身健康	45(75.0)^a	39(65.0)^b	1.43	0.23	55(91.7)	50(83.3)	1.91	0.17
2.牙齿好坏是天生的，与自己的保护无关	38(63.3)^a	40(66.7)	0.15	0.70	54(90.0)	45(75.0)	4.68	0.03
3.保护“六龄齿”很重要	18(30.0)^a	22(36.7)^b	0.60	0.44	58(96.7)	51(85.0)	4.90	0.03
4.喝碳酸饮料会损害牙齿健康	51(85.0)^a	47(78.3)^b	0.89	0.35	60(100.0)	57(95.0)	3.08	0.24
5.吃太多甜食会长蛀牙	53(88.3)	56(93.3)	0.90	0.34	56(93.3)	60(100.0)	4.14	0.13
6.“窝沟封闭”能有效预防“六龄齿”龋坏	15(25.0)^a	19(31.7)^b	0.66	0.42	54(90.0)	41(68.3)	8.54	<0.01
7.乳牙坏了要及时到医院检查治疗	52(86.7)^a	49(81.7)^b	0.56	0.45	60(100.0)	58(96.7)	2.03	0.48
8.牙龈炎常表现为牙龈红肿、牙龈出血	22(36.7)^a	26(43.3)^b	0.56	0.46	55(91.7)	43(71.7)	8.02	0.01
9.吃完东西后漱口或刷牙是非常重要的	49(81.7)^a	44(73.3)^b	1.20	0.27	60(100.0)	55(91.7)	5.22	0.07
10.儿童应该用含氟儿童牙膏	43(71.7)^a	48(80.0)^b	1.14	0.29	57(95.0)	60(100.0)	3.08	0.24
11.保持口腔清洁，能起到预防龋齿、牙龈炎的作用	36(60.0)^a	33(55.0)^b	0.31	0.58	56(93.3)	48(80.0)	4.62	0.03
注：()内数据为掌握率/%；^a试验组干预前与干预后比较，P<0.05；^b对照组干预前与干预后比较，P<0.05。

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表 3 儿童干预前后口腔健康行为报告率组间比较

Table 3. Comparison of reporting rates of oral health behaviors between the groups of children before and after intervention

条目	干预前				干预后
条目	试验组(n=60)	对照组(n=60)	χ²值	P值	试验组(n=60)	对照组(n=60)	χ²值	P值
1.刷牙方法(竖刷或转圈法)	28(46.7)^a	23(38.3)	0.85	0.36	47(78.3)	31(51.7)	9.38	<0.01
2.每天刷牙次数(≥2次)	37(61.7)^a	41(68.3)	0.59	0.44	56(93.3)	45(75.0)	7.57	0.01
3.每天刷牙时长(≥3 min)	30(50.0)^a	33(55.0)	0.30	0.58	51(85.0)	37(61.7)	8.35	<0.01
4.使用含氟牙膏	39(65.0)^a	35(58.3)	0.56	0.45	53(88.3)	42(70.0)	6.11	0.01
5.晚上睡前不进食甜点和饮料	46(76.7)	50(83.3)	0.83	0.36	52(86.7)	54(90.0)	0.32	0.57
6.进食糖果等含糖点心(每周≤1次)	27(45.0)	22(36.7)	0.86	0.35	33(55.0)	29(48.3)	0.53	0.47
7.饮用可乐、果汁等甜饮料(每周≤1次)	34(56.7)	38(63.3)	0.56	0.46	40(66.7)	46(76.7)	1.48	0.22
8.有进行窝沟封预防	19(31.7)^a	24(40.0)	0.91	0.34	45(75.0)	31(51.7)	7.03	0.01
9.有进行涂氟预防	24(40.0)^a	29(48.3)	0.85	0.36	48(80.0)	37(61.7)	4.88	0.03
10.有定期去医院进行口腔预防检查	16(26.7)	19(31.7)	0.36	0.55	24(40.0)	21(35.0)	0.32	0.57
注： ()内数据为报告率/%；^a试验组干预前与干预后比较，P<0.05。

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