Effects of Diversified Health Education on Quality of Life and Anxiety in Patients Undergoing Periodontal Accelerated Osteogenic Orthodontic Surgery
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摘要:
目的 探究在牙周加速成骨正畸（periodontally accelerated osteogenic orthodontics，PAOO）术后应用多元化健康教育对患者生活质量及焦虑的影响效果，为探索更好的健康教育模式提供临床依据。 方法 选择2022年4月至2023年12月期间在昆明医科大学附属口腔医院正畸科就诊且需要做PAOO手术的患者作为研究对象，通过随机分配法分为对照组和观察组，各纳入42例。对照组只接受标准的常规健康教育，包括术前口头宣教、术中沟通和术后指导。实验组患者则在常规健康教育的基础上建立多元化健康宣教小组，在围手术期进行一对一指导。在术前及术后对2组患者的焦虑（SAS、MDAS）、疼痛（VAS）、术后临床表现（如出血、恶心程度、睡眠等）、口腔健康自我管理效能（SESS）、口腔内菌斑指数（PLI）进行评估和比较。在PAOO术前术后对两组患者的焦虑、恐惧、疼痛、生活质量以及口腔健康自我管理能力进行评估比较。 结果 观察组患者在术后3天SAS评分显著低于对照组，MDAS评分显著降低（P < 0.001）。术后7 d VAS评分显示，观察组较对照组显著降低（P < 0.001）。观察组患者术后出血和恶心程度显著低于对照组（P < 0.001）。此外，观察组的口腔健康自我效能在术后1个月显著提升（P < 0.001），菌斑指数显著下降（P < 0.05），在生活质量方面，观察组在术后1个月的总体生活质量评分显著高于对照组（P < 0.001）。 结论 在PAOO围手术期的护理工作中，结合多元化健康教育措施能够有效减轻患者的不适，缓解其焦虑，提升患者围手术期生活质量以及口腔健康自我管理能力。 Abstract:Objective To investigate the impact of diverse health education on patients' quality of life and anxiety after periodontally accelerated osteogenic orthodontics （PAOO） surgery, providing clinical evidence for exploring better health education models. Methods Patients who visited the Orthodontics Department of Kunming Medical University's Affiliated Stomatology Hospital and required PAOO surgery from April 2022 to December 2023 were selected for this study. They were randomly assigned into a control group and an experimental group, each consisting of 42 patients. The control group received standard health education, which included preoperative verbal guidance, intraoperative communication, and postoperative instructions. In contrast, the experimental group, in addition to the regular health education, had a diversified health education group established, providing one-on-one guidance during the perisurgical period. Anxiety （SAS, MDAS）, pain （VAS）, postoperative clinical manifestations （such as bleeding, nausea, sleep issues, etc.）, self-management efficacy for oral health （SESS）, and dental plaque index （PLI） were assessed and compared between the two groups before and after surgery. Before and after the PAOO surgery, comparisons were also made regarding anxiety, fear, pain, quality of life, and self-management abilities for oral health between the two groups. Results The patients in the observation group had significantly lower SAS scores three days post-surgery compared to the control group, with MDAS scores also showing a significant decrease （P < 0.001）. Seven days post-surgery, the VAS scores indicated a significant reduction in the observation group compared to the control group （P < 0.001）. The level of post-operative bleeding and nausea in the observation group was significantly lower than in the control group （P < 0.001）. Additionally, the self-efficacy regarding oral health in the observation group significantly improved one month after surgery （P < 0.001）, with a notable reduction in the plaque index （P < 0.05）. In terms of quality of life, the overall quality of life scores for the observation group were significantly higher than those for the control group one month after surgery （P < 0.001）. Conclusion In the perioperative care of PAOO, incorporating diverse health education measures can effectively reduce patient discomfort, alleviate anxiety, and improve patients' quality of life during the perioperative period as well as their ability to manage oral health independently. -
表 1 2组基线资料比较[n（%）/（$ \bar x \pm s $）]
Table 1. Comparison of baseline characteristics between the two groups[n（%）/（$ \bar x \pm s $）]
指标 对照组（n = 42） 观察组（n = 42） χ2/t P 性别 0.525 0.473 男 6（7.1） 5（6） 女 36（42.9） 37（44） 学历 0.587 0.746 大专 7（8.3） 5（6） 本科 30（35.7） 33（39.2） 研究生 5（6） 4（4.8） 年龄（岁） 25.857±3.726 26.357±4.27 −0.572 0.569 PD（mm） 1.688±0.961 1.862±0.811 −0.897 0.372 CAL（mm） 0.921±0.671 1.025±0.559 −0.767 0.445 BOP（%） 3.295±2.105 3.793±2.409 −1.009 0.316 
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表 2 2组手术后疼痛VAS评分对比分（$ \bar x \pm s $）
Table 2. Comparison of postoperative pain scores between the two groups（$ \bar x \pm s $）
组别 n 术后3 d 术后7 d 对照组 42 5.762±1.897 3.262±1.515* 观察组 42 4.762±1.872 2±1.21* t 2.432 4.218 P <0.001* <0.001* *P < 0.05。
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表 3 2组手术前后焦虑评分对比分（$ \bar x \pm s $）
Table 3. Comparison of preoperative and postoperative anxiety scores between the two groups（$ \bar x \pm s $）
组别 n SAS术前 SAS术后3 d MDAS术前 MDAS术后3 d 对照组 42 49.786±9.054 39.929±3.403* 11.881±2.596 11.071±2.373 观察组 42 49.238±8.162 34.595±5.166* 11.238±2.272 8.69±1.906* t 0.291 5.587 1.208 5.07 P 0.772 <0.001* 0.231 <0.001* *P < 0.05。
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表 4 2组手术后临床表现评分对比分（$ \bar x \pm s $）
Table 4. Comparison of postoperative clinical menifestition scores between the two groups（$ \bar x \pm s $）
组别 n 术后肿胀 术后出血 术后恶心 口腔异味 影响咀嚼 影响说话 影响睡眠 影响工作 对照组 42 3.143±0.783 3.833±0.853 4.595±0.734 3.595±0.912 3.333±0.902 3.595±1.037 4.048±0.825 3.048±0.854 观察组 42 2.881±.772 3.119±0.803 4.084±0.697 3.214±0.898 3.048±0.962 3.571±0.941 3.5±1.018 2.405±0.701 t 1.544 3.953 3.505 1.929 1.405 0.11 2.708 3.772 P 0.126 <0.001* <0.001* 0.057 0.164 0.164 <0.05* <0.001* *P < 0.05。
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表 5 2组手术前后SESS评分对比分（$ \bar x \pm s $）
Table 5. Comparison of preoperative and postoperative oral health self-efficacy scores between the two groups（$ \bar x \pm s $）
组别 n 术前 术后1个月 对照组 42 52.667±3.654 55.167±2.677* 观察组 42 53.095±3.184 63.976±4.497* t −0.573 −10.91 P 0.568 <0.001* *P < 0.05。
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表 6 2组患者PLI评分对比分（$ \bar x \pm s $）
Table 6. Comparison of plaque index scores between the two groups（$ \bar x \pm s $）
组别 n 术前 术后 对照组 42 3.163±0.336 2.976±0.305* 观察组 42 3.111±0.329 2.821±0.346* t 0.711 2.175 P 0.479 <0.05* *P < 0.05。
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