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. 2023 Dec 4;21(1):130.
doi: 10.1186/s12955-023-02214-x.

Psychosocial factors, dentist-patient relationships, and oral health-related quality of life: a structural equation modelling

Youngha Song  1   2   3 , Liana Luzzi  4 , David Brennan  4
Affiliations

Psychosocial factors, dentist-patient relationships, and oral health-related quality of life: a structural equation modelling

Youngha Song et al. Health Qual Life Outcomes. .

Abstract

Background: Psychosocial factors and dentist-patient relationships (DPR) have been suggested to be associated with oral health outcomes. This study aimed to test a conceptual model which hypothesised relationships among psychosocial factors, DPR variables, and oral health-related quality of life (OHRQoL) in the 'distal-to-proximal' framework.

Methods: A total of 12,245 adults aged 18 years or over living in South Australia were randomly sampled for the study. Data were collected from self-complete questionnaires in 2015-2016. The outcome variable of Oral Health Impact Profile was used to measure OHRQoL. Psychosocial domain consisted of psychological well-being, social support, and health self-efficacy. DPR domain included trust in dentists, satisfaction with dental care, and dental fear. The hypothesised model was tested using the two-step approach in structural equation modelling.

Results: Data were analysed from 3767 respondents after the screening/preparing process (adjusted valid response rate 37.4%). In the first step of the analysis, confirmatory factor analyses produced acceptable measurement models for each of the six latent variables (GFI = 0.95, CFI = 0.98, RMSEA = 0.04). The final structural model indicated that better well-being, higher self-efficacy, and more satisfaction were associated with lower oral health impact (β = - 0.12, - 0.07, - 0.14, respectively) whereas fear was positively associated (β = 0.19). Among intermediates, support was positively associated with satisfaction within a small effect size (β = 0.06) as compared to self-efficacy with trust (β = 0.22). The invariance of the final model was also confirmed on participants' SES and dental service characteristics except the variable of 'last dental visit'.

Conclusions: Psychosocial factors and DPR variables were associated with oral health impact in both direct and indirect paths. The framework of 'distal-to-proximal' actions is empirically supported from psychosocial factors via DPR variables to OHRQoL.

Keywords: Dentist-patient relations; Health-related quality of life; Oral health; Psychosocial; South Australia.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Initial hypothesised conceptual model Shaded boxes indicate each domain in the ‘distal-to-proximal’ framework (error terms not presented); +/− signs for positive/negative associations among variables
Fig. 2
Fig. 2
Final structural equation model Path analysis with imputed composite scores for CMB-adjusted values (error terms not presented); p-value < 0.01 for all standardised regression weights and correlations on arrow lines; squared multiple correlations on top right edge of each endogenous variable
See this image and copyright information in PMC

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