Path-analysis of factors influencing oral health-related quality of life in older hospitalized patients: a cross-sectional survey

BACKGROUND: Oral health is a critical component of overall well-being, particularly in older hospitalized patients. There is growing interest in how oral conditions and interventions affect oral health-related quality of life (OHRQoL). This study aimed to identify oral-health variables that influence OHRQoL in older hospitalized patients. METHODS: A cross-sectional survey was conducted with 214 older inpatients by using the Oral Health Impact Profile-14 (OHIP-14), Oral Health Assessment Tool (OHAT), and Self-Efficacy Scale for Self-Care (SESS). Data were analyzed using SPSS (version 26.0) and structural equation modeling in AMOS, guided by the Andersen oral-health outcome model. Correlation analyses were also performed to identify factors associated with OHRQoL. RESULTS: Oral self-care efficacy, the number of remaining teeth, and oral-health status significantly influenced OHRQoL. The mean OHIP score was 10.19 ± 5.96, the mean SESS score was 56.41 ± 9.49, and the mean OHAT score was 3.22 ± 1.02. Oral self-care efficacy exerted both direct (-0.21) and indirect (-0.023) effects on OHRQoL. The number of remaining teeth had a direct effect of -0.26 and an indirect effect of -0.076 on OHRQoL. CONCLUSIONS: Multiple interrelated factors influence OHRQoL in older hospitalized patients. Health education aimed at improving oral-health awareness, beliefs, and self-care efficacy should be prioritized by nurses and physicians. Timely interventions addressing oral-health status, including tooth preservation and treatment, can further enhance quality of life. Further research should examine the social and cultural determinants of OHRQoL in this population.