The role of psychological distress in the relationship of financial strain with oral health and dental attendance in Dutch adults: A mediation analysis based on cross-sectional data

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology Pub Date : 2024-05-15 DOI:10.1111/cdoe.12974

Naichuan Su, Denise Duijster, Geert J. M. G. van der Heijden, Joost Oude Groeniger, Mariëlle A. Beenackers

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Abstract

Objectives

The study aimed to assess whether psychological distress mediates the association between financial strain and oral health and dental attendance in the Dutch adult population.

Methods

The study followed a cross-sectional design based on 2812 participants from the 2014 wave of the Dutch population-based GLOBE study. Financial strain was considered the exposure, while psychological distress measured with the Mental Health Inventory-5 (MHI-5) was the mediator. The outcomes included self-reported number of teeth, self-rated oral health, and self-reported dental attendance. Generalized regression analyses were used for the mediation analysis adjusted for several covariables.

Results

Greater financial strain was significantly associated with poorer self-rated oral health (total effect: 0.09, 95%CI: 0.05; 0.14) and restorative or no dental attendance (i.e. participants never visiting a dentist or only visiting a dentist for regular treatments or when they have complaints with their mouth, teeth, or prosthesis) (total effect: 0.05, 95%CI: 0.02; 0.09). Greater financial strain was not significantly associated with self-reported number of teeth (total effect: −0.14, 95%CI: −0.91; 0.64). Psychological distress significantly mediated the association of financial strain with self-rated oral health (average causal mediation effect [ACME]: 0.02, 95%CI: 0.01; 0.03) and self-reported dental attendance (ACME: 0.01, 95%CI: 0.00; 0.02), respectively. However, it did not significantly mediate the association of financial strain with self-reported number of teeth (ACME: −0.11, 95%CI: −0.25; 0.02). The estimated proportion of the total effect of financial strain on self-rated oral health and self-reported dental attendance that could be explained by psychological distress was respectively 24% (95%CI: 14%; 48%) and 19% (95%CI: 6%; 62%).

Conclusions

Psychological distress partly explains the association of financial strain with self-rated oral health and dental attendance, but not with self-reported number of teeth. Future studies using longitudinal data are necessary to confirm the results.

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心理压力在荷兰成年人的经济压力与口腔健康和牙科就诊率之间的关系中的作用：基于横截面数据的中介分析。

研究目的该研究旨在评估心理压力是否能调节荷兰成年人群中经济压力与口腔健康和牙科就诊之间的关系：研究采用横断面设计，以2014年荷兰GLOBE人口研究的2812名参与者为基础。经济压力被视为暴露因素，而心理健康量表-5（MHI-5）测量的心理压力则是中介因素。研究结果包括自我报告的牙齿数量、自我评价的口腔健康状况以及自我报告的牙科就诊情况。在进行中介分析时使用了广义回归分析，并对几个协变量进行了调整：较大的经济压力与较差的自评口腔健康状况（总效应：0.09，95%CI：0.05；0.14）和修复性或无牙科就诊率（即参与者从不看牙医或仅在定期治疗或对口腔、牙齿或修复体有不满时才看牙医）明显相关（总效应：0.05，95%CI：0.02；0.09）。较大的经济压力与自我报告的牙齿数量无明显关联（总效应：-0.14，95%CI：-0.91; 0.64）。心理压力对自我口腔健康评分（平均因果中介效应[ACME]：0.02，95%CI：0.01；0.03）和自我报告的牙科就诊率（ACME：0.01，95%CI：0.00；0.02）的影响有明显的中介作用。然而，它并没有明显地调解经济压力与自我报告的牙齿数量之间的关联（ACME：-0.11，95%CI：-0.25；0.02）。在经济压力对自我口腔健康评分和自我报告的牙科就诊率的总影响中，可由心理困扰解释的估计比例分别为 24% (95%CI: 14%; 48%) 和 19% (95%CI: 6%; 62%)：心理困扰可以部分解释经济压力与自我口腔健康和牙科就诊率之间的关系，但不能解释与自我报告的牙齿数量之间的关系。今后有必要使用纵向数据进行研究，以证实上述结果。

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来源期刊

Community dentistry and oral epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.40

自引率

8.70%

发文量

审稿时长

6 months

期刊介绍： The aim of Community Dentistry and Oral Epidemiology is to serve as a forum for scientifically based information in community dentistry, with the intention of continually expanding the knowledge base in the field. The scope is therefore broad, ranging from original studies in epidemiology, behavioral sciences related to dentistry, and health services research through to methodological reports in program planning, implementation and evaluation. Reports dealing with people of all age groups are welcome. The journal encourages manuscripts which present methodologically detailed scientific research findings from original data collection or analysis of existing databases. Preference is given to new findings. Confirmations of previous findings can be of value, but the journal seeks to avoid needless repetition. It also encourages thoughtful, provocative commentaries on subjects ranging from research methods to public policies. Purely descriptive reports are not encouraged, nor are behavioral science reports with only marginal application to dentistry. The journal is published bimonthly.