2.1 Scale and Dimension Scores
Table 1 shows that OHL levels of the older adults were moderate. The lowest score was observed to be in the dimension of acceptance capacity, while social support was at a low level and the level of self-efficacy was moderate.
Table 1
Overall scores of OHL, social support, and self-efficacy of the elderly and scores for each dimension [M (P25, P75)].
Item | Score | Average score of entries |
OHL total score | 37 (31,41) | 2.64(2.21,2.93) |
Dimension of acceptance capacity | 5 (3,6) | 2.5(1.5,3) |
Dimension of understanding | 5 (4,6) | 2.5(2,3) |
Dimension of support | 6 (4,7) | 3.0(2,3.5) |
Dimension of economic burden | 6 (4,6) | 3(2,3) |
Dimension of medical care | 5 (4,6) | 2.5(2,3) |
Dimension of communication | 5 (4,6) | 2.5(2,3) |
Dimension of application | 6 (4,7) | 3(2,3.5) |
Total score of social support | 22 (20,27.25) | 2.2(2,2.73) |
Dimension of objective support | 6 (6,8) | 2(2,2.67) |
Dimension of subjective support | 9 (7,11) | 2.25(1.75,2.75) |
Dimension of support utilization | 6.5 (5,8) | 2.17(1.67,2.67) |
Total score of self-efficacy | 26 (21,30) | 2.6(2.1,3) |
2.2 Preliminary Analysis
Table 2 illustrates the socio-demographic characteristics and distribution of OHL among the elderly. The average age of the participants was 72.49 (standard deviation = 10.06) years, with a predominance of females (53.6%). The majority of the participants were married (98.2%), and a significant proportion had an educational background of junior high school or below (78.4%). Most had medical insurance or coverage for medical expenses (72.1%), and more than half (66.2%) had a monthly household income below 6000 yuan. Many of the participants lived with more than two cohabitants (51.4%) and the majority (84.7%) resided in urban areas. A significant proportion of the elderly (68.5%) had not received any oral health education. The results indicated significant differences in OHL in terms of age (χ2 value = 9.195, P = 0.010), educational level (χ2 value = 14.751, P = 0.001), monthly household income (χ2 value = 11.814, P = 0.003), place of residence (χ2 value = -2.052, P = 0.040), and history of receiving oral health education (χ2 value = -3.556, P < 0.001).
Table 2
Comparison of OHL indicators among elderly individuals with different characteristics [M (P25, P75)].
Item | Number of cases (%) | Score | χ2 value | P value |
Age (years) | | | 9.195 | 0.010 |
60–70 | 104 (46.8) | 38.5 (31.25,42.75) | | |
70–80 | 47 (21.2) | 32 (27,39) | | |
> 80 | 71 (32.0) | 36 (33,40) | | |
Gender | | | -0.421 | 0.674 |
Male | 103 (46.4) | 37 (30,41) | | |
Female | 119 (53.6) | 37 (31,42) | | |
Marital status | | | -0.578 | 0.563 |
Married | 218 (98.2) | 37 (31,41) | | |
Single | 4 (1.8) | 34.5 (18,41.25) | | |
Educational level | | | 14.751 | 0.001 |
Junior high school and below | 174 (78.4) | 36 (29,40) | | |
High school/technical secondary school | 38 (17.1) | 41 (34.75,43.25) | | |
University and above | 10 (4.5) | 44 (36.75,49.75) | | |
Medical payment method | | | -1.243 | 0.214 |
Medical insurance and public expenses | 160 (72.1) | 37(31,42) | | |
Self-pay and other | 62 (27.9) | 35.5(29.75,40) | | |
Monthly household income (Yuan) | | | 11.814 | 0.003 |
< 6000 | 147 (66.2) | 36(29,40) | | |
6000–8000 | 50 (22.5) | 37(33,44) | | |
> 8000 | 25 (11.3) | 39(36,44.50) | | |
Number of co-residents (PCS) | | | -1.023 | 0.306 |
> 2 | 114 (51.4) | 37 (29,43) | | |
≤ 2 | 108 (48.6) | 36.5 (32,40) | | |
Place of residence | | | -2.052 | 0.040 |
Urban area | 188 (84.7) | 37 (32,41) | | |
Rural area | 34 (15.3) | 35 (24.75, 41.25) | | |
History of receiving oral health education | | | -3.556 | < 0.001 |
Yes | 70 (31.5) | 40 (33,44.25) | | |
No | 152 (68.5) | 36 (30,40) | | |
2.3 Correlation Analysis Between Variables
The results of the correlation analysis between the variables is presented in Table 3. The total OHL score in the elderly was found to be significantly correlated with the total social support score (r = 0.222), the subjective support dimension (r = 0.217), and the support utilization dimension (r = 0.114). The dimension of acceptance ability in OHL showed significant correlations with the total social support score (r = 0.215), objective support dimension (r = 0.154), and subjective support dimension (r = 0.182). The understanding dimension in OHL was significantly correlated with the total social support score (r = 0.255), objective support dimension (r = 0.204), and subjective support dimension (r = 0.230). The support dimension in OHL was found to be significantly associated with both the support utilization dimension (r = 0.124) and the total self-efficacy score (r=-0.234). The economic burden dimension in OHL was significantly correlated with the total social support score (r = 0.126) and the subjective support dimension (r = 0.176), while the medcal care dimension was significantly associated with both the total social support score (r = 0.137) and the support utilization dimension (r = 0.135). The communication dimension of OHL was significantly correlated with the total social support score (r = 0.203), subjective support dimension (r = 0.225), and support utilization dimension (r = 0.139). The application dimension was significantly correlated with the total social support score (r = 0.188), subjective support dimension (r = 0.228), and support utilization dimension (r = 0.168).
Table 3
Correlation analysis of OHL with social support and self-efficacy in the elderly.
Item | OHL total score | Dimension of acceptance capacity | Dimension of understanding | Dimension of support | Dimension of economic burden | Dimension of medical care | Dimension of communication | Dimension of application |
Total score of social support | 0.222** | 0.215** | 0.255** | -0.018 | 0.126* | 0.137** | 0.203** | 0.188** |
Dimension of objective support | 0.094 | 0.154** | 0.204** | -0.078 | 0.014 | 0.066 | 0.031 | 0.045 |
Dimension of subjective support | 0.217** | 0.1818* | 0.230** | -0.038 | 0.176** | 0.088 | 0.225** | 0.228** |
Dimension of support utilization | 0.114* | 0.097 | 0.048 | 0.124* | 0.065 | 0.135** | 0.139** | 0.168** |
Total score of self-efficacy | 0.036 | 0.053 | 0.161** | -0.234** | 0.031 | 0.009 | 0.059 | 0.015 |
Note: **P < 0.001; *P < 0.05. |
2.4 Determinants of OHL in the Elderly |
Next, the significant variables (age, educational level, monthly household income, place of residence, history of receiving oral health education, social support) in the univariate and correlation analyses were taken as independent variables, and the OHL total score of the elderly was taken as the dependent variable for multiple linear regression analysis. This analysis resulted in a Durbin-Watson score of 1.689, indicating independence among the observed values. Collinearity diagnostics revealed a tolerance range of 0.758 to 0.936 and a variance inflation factor between 1.069 and 1.320, suggesting the absence of multicollinearity among the independent variables.
This study met the acccpeted multiple linear regression analysis requirements for robust analysis: F = 12.910, P < 0.001. The regression analysis showed that monthly household income (t = 2.342, p = 0.02), place of residence (t=-3.572, p<0.001), oral health education (t=-3.192, p = 0.002), and social support (t = 4.859, p<0.001) were the main influencing factors of OHL in the elderly, accounting for 24.4% of the variation (Tables 4 & 5).
Table 4
Assignment methods of independent variables.
Item | Assignment method |
Age | < 70 years = 1 70 ~ 80 years = 2 >80 years = 3 |
Educational level | Junior high school and below = 1 High school/technical secondary school = 2 University and above = 3 |
Monthly household income | < 6000 yuan = 1 6000–8000 yuan = 2 >8000 yuan = 3 |
Place of residence | Urban area = 1 Rural area = 2 |
History of receiving oral health education | Yes = 1 No = 2 |
Social support score | Substitution of the original value |
Table 5
Multiple linear regression analysis of OHL influencing factors in the elderly.
Item | Regression coefficient | Standard error | Standardized regression coefficient | T value | P value |
Constant | 33.673 | 3.422 | | 9.840 | < 0.001 |
Age | 0.630 | 0.656 | 0.063 | 0.960 | 0.338 |
Education level | 1.476 | 1.097 | 0.090 | 1.346 | 0.180 |
Monthly household income | 1.840 | 0.786 | 0.146 | 2.342 | 0.02 |
Place of residence | -5.208 | 1.458 | -0.216 | -3.572 | < 0.001 |
History of receiving oral health education | -3.677 | 1.152 | -0.197 | -3.192 | 0.002 |
Social support score | 0.348 | 0.072 | 0.319 | 4.859 | < 0.001 |
Note: F = 12.910, P < 0.001; R2 = 0.265, and adjusted R2 = 0.244. |