Potential profile analysis of health literacy in diabetic periodontitis patients and its correlation with treatment compliance
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摘要:
目的 对糖尿病牙周炎患者的健康素养进行潜在剖面分析，深入探索并识别患者健康素养的不同潜在类别，分析不同潜在类别与治疗依从性之间的关联，以期为制定针对性的健康教育策略和提高治疗依从性提供依据。 方法 选取2023年1月—2024年6月在温州医科大学附属口腔医院治疗的糖尿病牙周炎患者108例为研究对象，采用一般资料调查表、健康素养量表、治疗依从性量表进行调查。基于潜在剖面分析建立健康素养亚组模型，采用多分类logistic回归模型分析健康素养分型的影响因素，并分析糖尿病牙周炎患者健康素养与治疗依从性的相关性。 结果 有效问卷回收率为94.44%(102/108)。糖尿病牙周炎患者健康素养总分为(12.66±1.32)分，潜在剖面显示，3个潜在类别为最优模型，依次分为普遍低素养组(24/102，23.53%)、中等素养-高评判思维组(48/102，47.06%)、高素养-高信息获取组(30/102，29.41%)3组。3组受教育年限、年龄、多重用药占比比较差异均有统计学意义(P < 0.05)。多分类logistic回归显示，年龄、受教育年限为糖尿病牙周炎患者健康素养的影响因素(P < 0.05)。3组治疗依从性比较差异有统计学意义(P < 0.001)。 结论 糖尿病牙周炎患者健康素养存在明显的分类特征，不同类别患者受年龄、受教育年限的影响，且不同类别患者治疗依从性存在差异，可基于糖尿病牙周炎患者健康素养同质群体制定个性化干预方案。 Abstract:Objective To conduct a latent profile analysis of the health literacy of diabetic periodontitis patients, deeply explore and identify different potential categories of patients ' health literacy, analyze the correlation between different potential categories and treatment compliance, in order to provide a basis for the development of targeted health education strategies and improve treatment compliance. Methods A total of 108 patients with diabetic periodontitis treated from January 2023 to June 2024 were selected as the study subjects. General data, health literacy scale, and treatment compliance scale were collected. A subgroup model of health literacy was established based on latent profile analysis. Multi-classification logistic regression model was used to analyze the factors influencing health literacy subtyping, and to analyze the correlation between health literacy and treatment adherence in patients with diabetic periodontitis. Results The recovery rate of valid questionnaires was 94.44% (102/108). The total score of health literacy in patients with diabetic periodontitis was (12.66±1.32). Latent profile analysis showed that a three-class model best fit the data: "universal low literacy group" accounting for 23.53% (24/102), "moderate literacy-high-judged thinking group" accounting for 47.06% (48/102), and "high-literacy-high information acquisition group" accounting for 29.41% (30/102). The number education years, age, and proportion of polypharmacy showed significant differences among the three groups (P < 0.05). Multiple logistic regression analysis showed that age and education years were independent factors influencing health literacy in diabetic periodontitis patients (P < 0.05). There was a statistically significant difference in treatment compliance among the three groups (P < 0.001). Conclusion The health literacy of diabetic periodontitis patients shows clear classification characteristics, influenced primarily by age and education years. Treatment compliance varies significantly across literacy categories. Personalized intervention programs based on the health literacy profiles may improve adherence in diabetic periodontitis patients. -
Key words:
- Diabetic periodontitis /
- Health literacy /
- Treatment compliance /
- Latent profile model
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表 1 102例糖尿病牙周炎患者一般资料
Table 1. General information of 102 patients with diabetic periodontitis
项目 分类 例数(%) 项目 分类 例数(%) 性别 男性 49(48.04) 多重用药 ＜5种 86(84.31) 女性 53(51.96) ≥5种 16(15.69) 年龄 < 60岁 41(40.20) 糖尿病病程 ＜10年 42(41.18) ≥60岁 61(59.80) ≥10年 60(58.82) 吸烟 是 42(41.18) 牙周炎病程 ＜3年 58(43.14) 否 60(58.82) ≥3年 44(56.86) 受教育年限 < 9年 43(42.16) 家庭月收入 ≥5 000元 49(48.04) ≥9年 59(57.84) < 5 000元 53(51.96) 共病数量 1种 82(80.39) 2种及以上 20(19.61) 
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表 2 糖尿病牙周炎患者健康素养潜在剖面分析
Table 2. Latent profile analysis of health literacy in patients with diabetic
类别 AIC BIC aBIC Entropy P值(BLRT) P值(LMR) 1 434.91 450.37 425.25 2 429.35 454.47 413.65 0.988 0.024 0.026 3 402.46 437.23 380.72 0.998 0.012 0.018 4 426.46 440.25 391.25 0.992 0.663 0.665
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表 3 糖尿病牙周炎患者健康素养潜在类别单因素分析
Table 3. Univariate analysis of potential categories of health literacy in diabetic periodontitis patients
项目 普遍低素养组(n=24) 中等素养-高评判思维组(n=48) 高素养-高信息获取组(n=30) 统计量 P值 性别[例(%)] 0.177a 0.915 男性 12(50.00) 22(45.83) 15(50.00) 女性 12(50.00) 26(54.17) 15(50.00) 年龄(x±s，岁) 64.85±5.93 59.54±5.67 58.67±6.04 10.503b < 0.001 共病数量[例(%)] 0.180a 0.914 1种 20(83.33) 38(79.17) 24(80.00) 2种及以上 4(16.67) 10(20.83) 6(20.00) 吸烟史[例(%)] 10(41.67) 19(39.58) 13(43.33) 0.110a 0.946 受教育年限(x±s，年) 6.50±1.69 9.10±1.90 9.30±2.04 18.955b < 0.001 多重用药[例(%)] 7.392a 0.025 ＜5种 16(66.67) 43(89.58) 27(90.00) ≥5种 8(33.33) 5(10.42) 3(10.00) 糖尿病病程(x±s，年) 9.95±3.25 9.19±3.05 9.11±3.10 0.599b 0.552 牙周炎病程(x±s，年) 5.25±1.24 5.18±1.27 5.08±1.34 0.121b 0.886 家庭月收入[例(%)] 0.177a 0.915 ≥5 000元 12(50.00) 22(45.83) 15(50.00) < 5 000元 12(50.00) 26(54.17) 15(50.00) 注：a为χ2值，b为F值。
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表 4 糖尿病牙周炎患者健康素养潜在类别的多分类logistic回归分析
Table 4. Multinomial logistic regression analysis of health literacy latent classes in patients with diabetic periodontitis
组别 变量 B SE Waldχ2 P值 OR值 95% CI 中等素养-高评判思维组 年龄 -0.293 0.081 13.087 0.001 0.746 0.637~0.874 受教育年限 1.042 0.273 14.599 0.001 2.835 1.661~4.837 多重用药 -0.501 0.880 0.324 0.569 0.606 0.108~3.403 高素养-高信息获取组 年龄 -0.329 0.086 14.618 0.001 0.720 0.608~0.852 受教育年限 1.113 0.284 15.345 0.001 3.044 1.744~5.314 多重用药 -0.523 0.997 0.276 0.600 0.593 0.084~4.179
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