口腔機能照護介入對中高齡中風患者的口腔機能與生活品質成效評估

背景：隨著台灣進入高齡化社會，針對中高齡中風患者的照護策略也愈發重要。中風患者若是口腔機能不佳，可能增加心血管疾病的風險，甚至提高再度復發的可能性，也影響生活品質。口腔衛教課程的介入可以改善長者的口腔機能，但對於中高齡中風患者的口腔機能以及生活品質的改善效果，以及兩者之間的關聯性，則較缺少實證性的研究結果。目的：本研究將針對中高齡的中風患者，檢視執行口腔機能照護；含執行口腔衛教、健口操，以及臉部按摩等介入措施對其口腔機能與生活品質改善的效果與影響。方法：本研究採類實驗性研究設計。於台灣中部某醫學中心之復健科病房收案，採非隨機分成介入組及對照組。本研究收案146位，介入組49位、對照組97位。介入組與對照組皆在出院前三天完成前測，介入組給予口腔機能照護執行，控制組則常規照護無介入活動。兩組於出院後三個月進行後測。資料進行編碼，再以SPSS進行統計分析；敘述性與推論性分析含pair-t test與two-way ANOVA。結果：研究結果顯示：介入組在接受口腔機能照護介入後，其口腔機能總分於出院後三個月顯著提升(p < .05)，在發音、吞嚥與口腔肌力等項目皆有進步，對照組則未見顯著變化。在生活品質方面，介入組於整體生活品質總分呈現正向改善，但與對照組比較，組間未達統計顯著(p > .05)。此外，口腔機能改善量與生活品質改善量之間呈現顯著正相關，尤以生理與環境面向的相關性最高（r > 0.7）。結論：口腔機能照護介入可有效改善中高齡中風患者之口腔機能，並有助於提升其主觀生活品質。本研究結果顯示，透過結合口腔衛教、健口操與臉部按摩等措施，能在短期內產生具臨床意義的改善效果，建議未來將口腔機能照護納入出院準備及長期照護機構常規照護中。

Background: Taiwan is becoming an aging society. Long term care strategies for middle-age to older patients are increasingly important, especially for those with stroke. Poor oral function in stroke patients not only increases the risks of cardiovascular diseases and aspiration pneumonia but also the likelihood of stroke re-attack. This will ultimately impact their quality of life. Although educational programs to the elders have been shown to be helpful in improving oral function, there is limited research on their effectiveness in enhancing oral function and improving quality of life.Objective: This study aims to examine the effects and impact of oral function care interventions—including oral health education, oral exercises, and facial massages—on the oral function and quality of life of middle-aged and older stroke patients.Methods: A quasi-experimental study design was adopted. The study was conducted at the rehabilitation ward of a medical center in central Taiwan. A total of 146 participants were enrolled, with 49 in the experimental group and 97 in the control group. They were assigned to either intervention or control group, to receive oral function care or not, respectively. Both groups completed a baseline survey three days before being discharged from the hospital. The intervention group received oral function care, including oral health education, oral exercises, and facial massages, while the control group received only routine care without any additional interventions. A final survey was conducted three months after discharge. Data were coded and analyzed using SPSS. Descriptive and inferential statistical analyses included pair-t tests and two-way ANOVA.Results: The findings showed that participants in the intervention group had a significant improvement in their oral function scores three months after discharge (p < .05), with notable progress in articulation, swallowing, and oral muscle strength. In contrast, no significant improvement was observed in the control group. Regarding quality of life, the intervention group showed a positive trend in overall quality of life scores; however, the between-group difference did not reach statistical significance (p > .05). Correlation analysis further revealed a significant positive relationship between improvements in oral function and quality of life, particularly in the physical and environmental domains (r > 0.7).Conclusion: The oral function care intervention effectively improved oral function in middle-aged and older stroke patients and positively influenced their perceived quality of life. The study supports the integration of oral health education, oral exercises, and facial massages into discharge planning and long-term care practices to promote functional and psychosocial well-being in this population.