Oralno in sistemsko zdravje ter potrebe po zdravljenju zobozdravstvenih pacientov: klinična validacija novega modela oralnega zdravja

Aims To clinically validate the new four-dimensional oral health model (4DOHM) by analyzing the level of correlation between oral health-related quality of life (OHRQoL) according to the 4DOHM and health-related quality of life (HRQoL), by analyzing the level of correlation between the Psychosocial Impact dimension of the 4DOHM and depression and anxiety, and by analyzing international dentists’ assessments of how their patients’ problems fit the 4DOHM. Methods We analyzed Oral Health Impact Profile, Patient-Reported Outcomes Measurement Information System Global Health, Depression, and Anxiety questionnaires of adult dental patients attending HealthPartners clinics in Minnesota, USA. We performed structural equation modeling confirmatory factor analysis and path analysis, and an international survey among dentists from all World Health Organization regions. Results Data came from 2,076 dental patients with the mean age 54.7±16.2 years (40.3% females). Correlation coefficients between OHRQoL and HRQoL, OHRQoL and Physical Health, OHRQoL and Mental Health, Psychosocial Impact and depression, and Psychosocial Impact and anxiety, were 0.56, 0.55, 0.51, 0.53, and 0.56, respectively, and they were all “large,” according to Cohen. In total, 1,580 (53.4%) of dentists (54% females) with the mean age of 38.6±10.5 years, from 32 countries, participated in the survey and reported that 94.2% of patients' problems could be categorized into the four dimensions. Conclusions The OHRQoL, according to the 4DOHM, is highly correlated to the HRQoL, and the Psychosocial Impact dimension of 4DOHM is highly correlated to depression and anxiety. Dentists categorized almost all their dental patients’ oral health problems according to the 4DOHM. The 4DOHM is clinically valid. Namen Klinična validacija novega štiridimenzionalnega modela oralnega zdravja (4DMOZ), pri čemer smo: 1. analizirali stopnje povezanosti med »z oralnim zdravjem povezano kakovostjo življenja« (angl. oral health-related quality of life, OHRQoL), opredeljeno po 4DMOZ, in »z zdravjem povezano kakovostjo življenja« (angl. health-related quality of life, HRQoL) 2. analizirali stopnje povezanosti med psihosocialno dimenzijo 4DMOZ in depresijo oz. anksioznostjo in 3. analizirali ocene zobozdravnikov o tem, kako so težave njihovih pacientov uvrščene v 4DMOZ. Metode Analizirali smo vprašalnike Oral Health Impact Profile, Patient-Reported Outcome Measurement Information System’s Adult Global Health, Depression in Anxiety odraslih zobozdravstvenih pacientov klinike HealthPartners v Minnesoti v ZDA. Izvedli smo konfirmatorno faktorsko analizo in analizo poti. Izvedli smo mednarodno anketiranje zobozdravnikov iz vseh regij, ki jih je določila Svetovna zdravstvena organizacija. Rezultati Analizirali smo podatke 2076 zobozdravstvenih pacientov s povprečno starostjo 54,7±16,2 leta (40,3 % žensk). Korelacijski koeficienti so bili: med OHRQoL in HRQoL 0,56 med OHRQoL in telesnim zdravjem 0,55 med OHRQoL in duševnim zdravjem 0,51 med psihosocialno dimenzijo in depresijo 0,53 ter med psihosocialno dimenzijo in anksioznostjo 0,56. Vse korelacije so bile po Cohenu »visoke«. Spletno anketo je izpolnilo 1580 (53,4 %) zobozdravnikov iz 32 držav (54 % žensk) s povprečno starostjo 38,6±10,5 leta. V 4DMOZ so zobozdravniki uvrstili 94,2 % ustno-obraznih težav svojih pacientov. Zaključek Konstrukt OHRQoL, opredeljen po 4DMOZ, je zelo povezan s konstruktom HRQoL. Psihosocialna dimenzija 4DMOZ je zelo povezana z depresijo oz. anksioznostjo. Zobozdravniki so uvrstili skoraj vse težave svojih pacientov v 4DMOZ. Novi 4DMOZ je klinično veljaven.