Latent profile analysis of oral health self-efficacy in maintenance hemodialysis patients and its impact on oral health.

OBJECTIVE

To investigate the heterogeneity of oral health self-efficacy among patients undergoing maintenance hemodialysis (MHD) and its influencing factors, and to compare the discrepancies in oral health-related quality of life (OHRQoL) across different patient subgroups, thereby furnishing evidence for the formulation of targeted interventions.

METHODS

A convenience sampling approach was adopted to recruit 352 MHD patients from three tertiary hospitals in Guangzhou from June 2023 to April 2024. Data were collected using a general information questionnaire, the Self-Efficacy Scale for Oral health (SESS), and the Oral Health Impact Profile-14 (OHIP-14). Latent profile analysis (LPA) was employed to identify latent classes of oral health self-efficacy. Univariate analysis and multivariate logistic regression analysis were performed to explore the influencing factors of class membership, and differences in OHRQoL among the classes were compared.

RESULTS

The total score of SESS was 49.60 ± 11.91, and that of the OHIP-14 was 12.61 ± 9.51. LPA identified three latent classes: C1 "low self-efficacy group" (17.3%), C2 "moderate self-efficacy group" (44.9%), and C3 "high self-efficacy group" (37.8%). The three-class model demonstrated optimal comprehensive fit indices and practical interpretability (Entropy = 0.966). Multivariate logistic regression analysis indicated that age, place of residence, monthly household income, number of comorbidities, daily tooth brushing frequency, and self-rated oral health status were significant influencing factors of oral health self-efficacy levels in MHD patients (all p < 0.05). There were statistically significant differences in OHRQoL scores among the different classes of MHD patients (p < 0.001). Improving oral health self-efficacy could effectively ameliorate patients' OHRQoL.

CONCLUSION

Oral health self-efficacy in MHD patients exhibits significant heterogeneity and can be categorized into three latent classes, with notable differences in OHRQoL across classes. Healthcare providers ought to develop class-specific stratified intervention strategies: focusing on improving basic oral care skills in the low self-efficacy group, correcting cognitive biases in the moderate self-efficacy group, and facilitating dental visit behaviors in the high self-efficacy group, so as to improve patients' overall oral health-related quality of life.