PRECEDE 모형을 적용한 다문화 성인의 구강건강 관련 요인 분석

Abstract

본 연구는 PRECEDE모형을 근거로 A시의 다문화 성인 300명을 대상으로 다문화 성인의 스트레스와 구강건강 관련 요인을 확인하고, 가설 모형을 설정하여 모형의 적합도 및 관련요인을 분석 하였다. 또한 구강건강행동과 구강건강상태의 관계 분석을 통하여 지속적인 다문화 구강보건 지원 방안을 위한 기초자료로 이용하고자 실시 하였다. 연구결과는 다음과 같다. 1. 다문화 성인의 일반적 특성으로 출신국가는 인도네시아 32.7%(98명), 중국 33.7%(101명), 방글라데시 33.7%(101명)로 나타났으며, 성별은 남성 49.0%(147명), 여성 51.0%(153명)로 나타났다. 연령은 30대가 40.3%(121명)로 가장 많으며, 20대 35.0%(105명), 40대 13.7%(41명), 50대 이상 11.0%(33명) 순으로 나타났다. 직업은 공장 노동자가 33.3%(100명)로 가장 많았으며, 식당(주방요리사, 청소, 서빙) 21.0%(63명), 건설현장 노동자 14.3%(43명) 등으로 나타났다. 2. 일반적 특성에 따른 구강건강상태는 연령, 동거인에 따라 유의한 차이를 보이는 것으로 나타났다. 연령(F=3.840, p<.05)에 따라 구강건강상태가 유의한 차이를 보임에 따라 Scheffé의 사후분석 결과, 50대 이상(M=2.89±0.648) 보다 20대(M=3.31±0.958)가 높은 것으로 나타났다. 동거인(F=14.435. p<.001)에 따라 구강건강상태가 유의한 차이를 보이는 것으로 나타나 Scheffé의 사후분석 결과, 자녀(M=2.54±0.601)와 형제자매(M=2.18±0.328) 보다 배우자(M=3.25±0.798), 직장동료(M=3.83±0.994), 기타(M=3.14±0.682)가 높은 것으로 나타났다. 3. 일반적 특성에 따라 PRECEDE 모형의 요인별 차이 분석한 결과 한국거주기간이 길수록 자기효능감(F=2.644. p<.05), 구강건강행동지수(F=4.221, p<.01), 구강건강실천행태(F=6.041, p<.01)가 유의하게 높게 나타났고, 한국거주기간이 길수록 환경요인(스트레스(F=5.258, p<.01))는 낮아지는 것으로 나타났다. 4. 본 연구모형의 적합도는 =552.433 (df=153, p<.001)로 부적합 했으나, 은 모형의 복잡성과 표본 크기 등에 따라 영향을 받는 한계를 지니고 있어 통계량만을 절대적으로 신뢰하는 것은 적절하지 않으며 다른 적합도 지수를 고려할 필요가 있으며, 다른 적합도 지수는 CFI=.912, RMSEA=.093, SRMR=.088로서 기준치에 적합한 것으로 나타났다. 5. 경로분석 결과, 자기효능감(β=0.440, t=5.936 p<.001), 구강보건지식(β=0.211, t=3,706 p<.001)이 높을수록 구강건강행동지수가 높았고, 환경요인(스트레스)(β=-0.181, t=-3,346, p<.001)이 낮아질수록 구강건강행동지수는 높아지는 것으로 나타났다. 자기효능감(β=0.533, t=7.550, p<.001)이 높을수록, 구강건강실천행태는 높아지고, 환경요인(β=-0.108, t=-2,216 p<.05)이 낮을수록, 구강건강실천행태가 높아지는 것으로 나타났다. 구강건강행동지수(β=0.309, t=4,691 p<.001), 구강건강실천행태(β=0.178,t=2,771 p<.01)가 높을수록 구강건강상태가 높아지고, 환경요인(스트레스)(β=-0.169, t=-2,552, p<.05)이 낮을수록 구강건강상태가 높아지는 것으로 확인되었다. 가능요인(β=-0.171, t=-2,548 p<.05)이 높을수록 환경요인이 낮아지는 것으로 확인되었다. 다문화 성인의 구강건강관련 요인 분석을 통하여 지속적인 다문화 구강보건 지원 방안을 위한 기초자료가 될 것이다. ;Based on the PRECEDE model, this study identified factors related to stress and oral health of 300 multicultural adults in A city, and established a hypothetical model to determine the fitness of the model and the effect of related factors. In addition, through the analysis of the relationship between oral health behavior and oral health status, it was conducted to use as basic data for continuous multicultural oral health support plans. The results of the study are as follows. 1. As for the general characteristics of multicultural adults, the country of origin was Indonesia 98(32.7%), China 101(33.7%), and Bangladesh (101), and gender was 147(49.0%) male and 153(51.0%) female. By age, 121(40.3%) were in their 30s, followed by 105(35.0%) in their 20s, 41(13.7%)in their 40s, and 33(11.0%) in their 50s or older. As for occupation, factory workers accounted for the most with 100(33.3%), followed by restaurants (kitchen cook, cleaning, serving) with 63 and construction site workers with 43. As for occupation, factory workers accounted for the most with 100 people, followed by restaurant workers(kitchen cook, cleaning, serving) with 63(21.0%) and construction site workers with 43(14.3%). 2. Oral health status according to general characteristics showed significant differences according to age and cohabitant. According to Scheffe's post-hoc analysis, as there was a significant difference in oral health status according to age(F=3.840, p<.05), it was found that those in their 20s(M=3.31±0.958) were higher than those in their 50s(M=2.89±0.648) or older. As a result of Scheffe's post-hoc analysis, there was a significant difference in oral health status depending on the cohabitant(F=14.435. p<.001), and it was found that spouse(M=3.25±0.798), co-worker(M=3.83±0.994), and others(M=3.14±0.682) were higher than children(M=2.54±0.601) and siblings(M=2.18±0.328). 3. As a result of analyzing the difference by factor of the PRECEDE model according to general characteristics, the longer the period of residence in Korea, the more self-efficacy (F=2.644, p<.05), oral health behavior index (F=4.221, p<.01), oral health practice behavior (F=6.041, p<.01) was significantly higher, and the longer the period of residence in Korea, the lower the environmental factor (stress (F=5.258, p<.01)). 4. As for the goodness of fit of this research model, chi-square = 552.433 (df=153, p<.001), which was inappropriate, but chi-square has limitations that are affected by the complexity of the model and the sample size. Therefore, it is not appropriate to absolutely trust only the chi-square statistic, and other goodness-of-fit indices need to be considered, and the other goodness-of-fit indices are CFI=.912, RMSEA=.093, and SRMR=.088, which were found to be suitable for the standard values. 5. As a result of path analysis, the higher the self-efficacy (β=0.440, t=5.936 p<.001) and oral health knowledge (β=0.211, t=3,706 p<.001), the higher the oral health behavior index. And the lower the environmental factor (stress) (β=-0.181, t=-3,346, p<.001), the higher the oral health behavior index. The higher the self-efficacy (β=0.533, t=7.550, p<.001), the higher the oral health practice behavior, and the lower the environmental factor (β=-0.108, t=-2,216, p<.05), It was found that the oral health practice behavior increased. The higher the oral health behavior index (β=0.309, t=4,691, p<.001) and oral health practice behavior (β=0.178, t=2,771, p<.01), the higher the oral health status, It was confirmed that the lower the environmental factor (stress) (β=-0.169, t=-2,552, p<.05), the higher the oral health status. It was confirmed that the higher the possible factor (β=-0.171, t=-2,548, p<.05), the lower the environmental factor. Through the analysis of oral health related factors of multicultural adults, it will be basic data for continuous multicultural oral health support plan.