Association of Oral Health Impact With Psychosocial and Dentist-Patient Factors
Objectives: Oral health is an essential component of overall health and well-being. In the biopsychosocial model of oral health, psychosocial factors and dentist-patient relationships (DPR) play a significant role in shaping oral health outcomes. This study aimed to examine the relationships between psychosocial factors, DPR, and oral health-related quality of life (OHRQoL) using a distal-to-proximal framework. Methods: A random sample of 12,245 adults aged 18 years and above living in South Australia participated in the study. Data were collected through self-administered questionnaires in 2015-2016. Explanatory variables were categorized into psychosocial and DPR domains. The psychosocial domain consisted of well-being, social support, and health self-efficacy. The DPR domain comprised trust in dentists, satisfaction with dental care, and dental fear. The outcome variable was oral health impact, which measured OHRQoL. Results: Data were analysed from 3,767 participants after screening and preparing responses (adjusted valid response rate 37.4%). Confirmatory factor analyses produced acceptable model fits and validity/reliability of each domain and full measurement model (GFI=0.95, CFI=0.98, RMSEA=0.04). The structural model in path analysis indicated trust was mediated by satisfaction (β=–0.14) and fear (β=0.19) for oral health impact. Well-being and self-efficacy had direct effects to the outcome with β=–0.12 and –0.07, respectively along with intermediate effects on DPR variables. The invariance of the final model was confirmed through cross-validation and multi-group analyses on participants’ diverse characteristics except for the time since the last dental visit. Conclusions: This study found the direct and indirect effects of psychosocial factors and DPR variables on OHRQoL in the conceptual framework. Psychosocial determinants are warranted for the promotion of health beyond clinical behaviour changes in the biomedical model.
2023 British Division meeting (London, England) London, England
2023
Behavioral, Epidemiologic and Health Services Research
Song, Youngha
( Seoul National University
, Seoul
, Korea (the Republic of)
; University of Adelaide
, Adelaide
, South Australia
, Australia
)