Effect of oral health management program based on root cause analysis in elderly stroke patients with oral frailty

doi:10.3877/cma.j.issn.1673-9248.2026.02.006

Abstract

Abstract:

Objective

To explore the effect of a root cause analysis (RCA)-based oral health management program in elderly stroke patients with oral frailty.

Methods

Using convenience sampling, 297 elderly stroke patients with oral frailty hospitalized in the Seventh Medical Center, Chinese People's Liberation Army General Hospital from January to October 2025 were selected as the study subjects. According to the admission time, 140 patients from January to April 2025 were set as the control group, and 157 patients from May to October 2025 were set as the treatment group. The control group received routine oral health management, while the treatment group received an RCA-optimized oral health management program in addition to the basic routine care. Repeated measures ANOVA was employed to compare the differences in oral health literacy, oral health-related quality of life, and chronic disease stigma between the two groups, with effect sizes (Cohen's d) reported.

Results

After 4 weeks of intervention, the total score of the oral health literacy scale in the treatment group was significantly higher than that in the control group (90.73±8.76 vs 79.24±9.12, t=16.543, P＜0.001, Cohen's d=0.82), the total score of the oral health impact scale (29.58±8.62 vs 39.19±9.23, t=-6.543, P＜0.001, Cohen's d=0.98) and the total score of the chronic disease stigma scale (55.44±8.31 vs 69.63±9.21, t=-9.321, P＜0.001, Cohen's d=0.98) in the treatment group were significantly lower than those in the control group; all these differences were statistically significant.

Conclusion

The implementation of an RCA-based oral health management program in elderly stroke patients with oral frailty can significantly improve patients' oral health literacy, enhance oral health-related quality of life, and effectively reduce chronic disease stigma.

Key words: Root cause analysis, Elderly, Stroke, Oral frailty, Oral health, Stigma

Junjie Cao, Fang Wang, Lili Dong, Chenchen Lyv, Jingjing Yi, Jiatian Hou, Yanjie Xiong, Yonghua Huang. Effect of oral health management program based on root cause analysis in elderly stroke patients with oral frailty[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2026, 20(02): 148-156.

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Figures/Tables 4

项目	对照组（n=140）	试验组（n=157）	统计值	P值
年龄（岁， $x ¯$ ±s）	72.41±5.11	71.92±4.81	t=0.892	0.371
性别[例（%）]			χ²=0.049	0.821
男	78（55.71）	89（56.69）
女	62（44.29）	68（43.31）
学历[例（%）]			χ²=1.228	0.751
小学及以下	42（30.00）	48（30.57）
初中	58（41.43）	64（40.77）
高中/中专	30（21.43）	35（22.29）
大专及以上	10（7.14）	10（6.37）
婚姻状况[例（%）]			χ²=0.867	0.649
未婚/离异/丧偶	42（30.00）	45（28.66）
已婚	98（70.00）	112（71.34）
自理能力（分， $x ¯$ ±s）	89.24±0.76	88.95±1.05	t=-0.422	0.673
病程（年， $x ¯$ ±s）	1.55±0.89	1.42±0.97	t=-0.848	0.389
脑卒中性质[例（%）]			χ²=0.178	0.907
出血性	19（13.57）	21（13.38）
缺血性	121（86.43）	136（86.62）
既往病史[例（%）]
冠心病	45（32.14）	51（32.48）	χ²=0.437	0.811
高血压	112（80.00）	124（78.98）	χ²=0.529	0.678
糖尿病	68（48.57）	76（48.41）	χ²=1.713	0.721
慢性阻塞性肺疾病	23（16.43）	27（17.20）	χ²=1.806	0.790

项目	对照组（n=140）	试验组（n=157）	统计值	P值
年龄（岁， $x ¯$ ±s）	72.41±5.11	71.92±4.81	t=0.892	0.371
性别[例（%）]			χ²=0.049	0.821
男	78（55.71）	89（56.69）
女	62（44.29）	68（43.31）
学历[例（%）]			χ²=1.228	0.751
小学及以下	42（30.00）	48（30.57）
初中	58（41.43）	64（40.77）
高中/中专	30（21.43）	35（22.29）
大专及以上	10（7.14）	10（6.37）
婚姻状况[例（%）]			χ²=0.867	0.649
未婚/离异/丧偶	42（30.00）	45（28.66）
已婚	98（70.00）	112（71.34）
自理能力（分， $x ¯$ ±s）	89.24±0.76	88.95±1.05	t=-0.422	0.673
病程（年， $x ¯$ ±s）	1.55±0.89	1.42±0.97	t=-0.848	0.389
脑卒中性质[例（%）]			χ²=0.178	0.907
出血性	19（13.57）	21（13.38）
缺血性	121（86.43）	136（86.62）
既往病史[例（%）]
冠心病	45（32.14）	51（32.48）	χ²=0.437	0.811
高血压	112（80.00）	124（78.98）	χ²=0.529	0.678
糖尿病	68（48.57）	76（48.41）	χ²=1.713	0.721
慢性阻塞性肺疾病	23（16.43）	27（17.20）	χ²=1.806	0.790

维度	对照组（n=140）	试验组（n=157）	t值	P值	Cohen's d值
口腔基本知识与理念
干预前	21.89±4.72	22.15±4.56	0.487	0.627
干预4周后	22.21±3.89^a	25.67±3.42^b	15.324	＜0.001	0.98
相关技能
干预前	18.05±3.18	18.32±3.21	0.674	0.501
干预4周后	21.45±2.78^a	23.08±1.56^b	14.876	＜0.001	1.02
相关行为与生活方式
干预前	24.43±3.76	24.67±3.89	0.492	0.623
干预4周后	27.89±3.45^a	33.21±3.12^b	11.234	＜0.001	0.89
经济支持意愿
干预前	7.31±2.08	7.45±2.13	0.532	0.595
干预4周后	7.69±2.01^a	8.77±1.23^b	8.765	＜0.001	0.78
总分
干预前	71.68±9.62	72.59±9.87	0.721	0.471
干预4周后	79.24±9.12^a	90.73±8.76^b	16.543	＜0.001	0.82

维度	对照组（n=140）	试验组（n=157）	t值	P值	Cohen's d值
独立性减弱
干预前	12.32±3.01	12.45±3.22	0.345	0.730
干预4周后	10.24±2.83^a	7.83±2.51^b	-5.678	＜0.001	0.89
心理不适
干预前	10.61±2.59	10.78±2.78	0.412	0.681
干预4周后	8.92±2.41^a	6.53±2.19^b	-6.123	＜0.001	0.92
身体功能不适
干预前	11.19±2.81	11.21±3.01	0.387	0.699
干预4周后	9.53±2.64^a	7.21±2.33^b	-5.987	＜0.001	0.88
口腔疼痛和不适
干预前	11.03±1.99	10.87±2.02	0.321	0.748
干预4周后	10.50±2.91^a	8.01±2.61^b	-5.432	＜0.001	0.94
总分
干预前	45.15±10.03	45.31±10.52	0.432	0.666
干预4周后	39.19±9.23^a	29.58±8.62^b	-6.543	＜0.001	0.98

维度	对照组（n=140）	试验组（n=157）	t值	P值	Cohen's d值
外在病耻感
干预前	37.83±5.33	38.22±5.59	0.432	0.666
干预4周后	32.11±4.79^a	25.61±4.17^b	-8.765	＜0.001	0.95
内在病耻感
干预前	44.92±5.98	45.31±6.22	0.398	0.691
干预4周后	37.52±5.48^a	29.83±5.08^b	-8.432	＜0.001	1.01
总分
干预前	82.75±10.51	83.53±10.78	0.456	0.649
干预4周后	69.63±9.21^a	55.44±8.31^b	-9.321	＜0.001	0.98

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