国际口腔医学杂志

国际口腔医学杂志 ›› 2025, Vol. 52 ›› Issue (6): 783-790.doi: 10.7518/gjkq.2025083

• 论著 • 上一篇    下一篇

应用Rodgers演化概念分析法界定口腔衰弱

曾欣1(),邓思成2,黄姝绮1,陈燕茹3,刘帆1()   

  1. 1.口腔疾病防治全国重点实验室;国家口腔医学中心 国家口腔疾病临床医学研究中心;四川大学华西口腔医院护理部 成都 610041
    2.四川大学华西护理学院 成都 610041
    3.口腔疾病防治全国重点实验室;国家口腔医学中心 国家口腔疾病临床医学研究中心;四川大学华西口腔医院牙体牙髓病科 成都 610041
  • 收稿日期:2024-12-05 修回日期:2025-06-03 出版日期:2025-11-01 发布日期:2025-10-23
  • 通讯作者: 刘帆
  • 作者简介:曾欣，护士，硕士，Email：2735741194@qq.com
  • 基金资助:
    四川省科技厅项目(2024JDKP0106)

Defining oral frailty based on Rodgers’ evolutionary concept analysis

Xin Zeng1(),Sicheng Deng2,Shuqi Huang1,Yanru Chen3,Fan Liu1()   

  1. 1.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Nursing, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.West China School of Nursing, Sichuan University, Chengdu 610041, China
    3.State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Cariology and En-dodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2024-12-05 Revised:2025-06-03 Online:2025-11-01 Published:2025-10-23
  • Contact: Fan Liu
  • Supported by:
    Science & Technology Department of Sichuan Province(2024JDKP0106)

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摘要：

目的 分析口腔衰弱的定义属性及概念内涵。 方法 系统检索中国知网、万方数据知识服务平台、维普中文科技期刊数据库、中国生物医学文献数据库、PubMed、Web of Science和Embase数据库2013年1月到2024年11月发表的相关文献，采用Rodgers演化概念分析法进行分析。 结果 口腔衰弱经历了概念摸索、内涵丰富、本质探寻和完善3个阶段，包含“与年龄密切相关”及“以口腔功能下降为核心”两大关键属性，具有预测性、中间性、可逆性、多维性和复杂交叠性这五大特征，多以咀嚼能力、吞咽能力及口腔运动能力等作为测量指标，受多种因素影响且与老年人多种不良健康结局密切相关。 结论 通过概念分析明确口腔衰弱的定义属性及概念内涵可为开展相关研究奠定理论基础，对促进口腔衰弱的有效管理十分必要。

关键词: 口腔衰弱, 老年人, 概念分析

Abstract:

Objective To analyze the attributes and connotations of oral frailty concept. Methods We systematically searched relevant literature published between January 2013 and November 2024 in CNKI, WanFang, VIP, SinoMed, PubMed, Web of Science, and Embase databases and analyzed them through Rodgers’ evolutionary concept analysis. Results Oral frailty went through phases of conceptual exploration, content enrichment, essence searching and refinement, including “age-related” and “with a center on the decline of oral function” attributes, and was predictive, intermediate, reversible, multidimensional, and overlapping. It was mostly measured via mastication, swallowing function, and oral motility. In addition, oral frailty was influenced by multiple factors and resulted in multiple adverse health outcomes in older adults. Conclusion Clarifying the attributes and connotations of oral frailty through conceptual analyses can provide a theoretical basis for conducting related research and is necessary to promote the effective management of such a condition.

Key words: oral frailty, older adults, concept analysis

中图分类号: 

  • R78

表 1

口腔衰弱概念的演化过程"

阶段年份作者内容
概念摸索期2013日本国家老年病学中心提出口腔衰弱一词，与口腔功能相关，概念不明[4]
2014日本国家老年病学中心“口腔衰弱”是指仅表现在口腔的衰弱，其症状或体征具体为发音下降、进食时轻微窒息或溢出，以及不可咀嚼的食物数量增加[12]
2018Naruishi[13]口腔状况不佳，如口不能紧闭、舌活动受阻和后咬合功能丧失
2018Tanaka等[14]累积的不良口腔健康状况，将增加不良健康结局的风险
2019Hihara等[15]口腔功能轻微下降，位于口腔功能减退的早期阶段，包括舌功能减退、食物外溢和轻度呛咳等
内涵丰富期2020日本牙科学会随着年龄增长所导致各种口腔状况（牙齿数量、口腔功能和口腔卫生等）改变的一系列现象和过程，且对口腔健康的兴趣下降，身体和心理储备能力下降，以及口腔衰弱导致的进食功能障碍，其整体效应是身心功能恶化[16]
本质探寻与完善期2020Morley[17]“口腔衰弱”可定义为咀嚼困难，伴有与年龄相关的吞咽变化
2022Parisius等[18]与年龄相关的口腔颌面部结构及功能衰退
2024日本口腔衰弱联合工作委员会口腔衰弱是介于“口腔健康”和“口腔功能衰退”之间的一种口腔功能状态[19]

表 2

口腔衰弱及其相关概念特征比较"

名称与年龄密切相关以口腔功能下降为核心预测性中间状态可逆性多维性复杂交叠性
口腔衰弱√√√√√√√
口腔功能减退√√
口腔健康不佳√√

表 3

口腔衰弱评估工具中的评测指标"

文献量表名称指标
Tanaka等[14]口腔衰弱检查表牙齿数量、舌压、咀嚼能力、舌唇运动能力、主观吞咽情况、主观咀嚼情况
Tanaka等[50]口腔衰弱指数-5牙齿数量、口干、口腔运动能力、吞咽能力、咀嚼能力
Tanaka等[51]口腔衰弱指数-8是否使用义齿、吞咽能力、社会参与度、口腔健康相关行为、咀嚼能力
Choi等[52]口腔和颌面衰弱指数咀嚼能力、吞咽能力、口腔运动能力、发音能力以及面部肌肉协调能力
Hihara等[15]口腔衰弱问卷口腔问题、口干、口腔运动能力、咀嚼能力、吞咽能力
Esenkaya等[53]Kihon检查表咀嚼能力、吞咽能力和口干
Belafsky等[54]进食评估问卷吞咽能力
Su等[55]口腔衰弱筛查工具牙齿数量、吞咽能力、咀嚼能力、口腔运动能力、口干和口腔疼痛
So等[56]口腔衰弱筛查问卷体重、进食能力、总体健康水平、咀嚼能力、吞咽能力（异物感、窒息史、声音嘶哑、食物溢出）、进食时间、发音能力
口腔衰弱诊断标准咀嚼能力、咬合力、舌压、口腔干燥、吞咽困难、口腔卫生

图 1

口腔衰弱的概念框架"

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