Oral health literacy and oral health-related quality of life among inpatients: the mediating effects of oral health-related self-efficacy: a cross-sectional study

Abstract

Background: Oral diseases can affect organs throughout the body. A healthy oral condition is an important part of maintaining overall health. Oral health literacy and self-efficacy contribute to promoting oral health. However, few studies have reported the oral health literacy and oral health-related self-efficacy of inpatients and the influence mechanism on the oral health-related quality of life is also unclear.

Aims: To explore the mediating effect of oral health-related self-efficacy (OHRSE) of inpatients on oral health literacy (OHL) and oral health-related quality of life (OHRQoL).

Methods: In January 2025, a cross-sectional survey was conducted among 449 inpatients in 10 public hospitals in eastern Sichuan (Guang 'an and Dazhou), western Sichuan (Chengdu and Deyang), southern Sichuan (Neijiang, Leshan, Panzhihu and Zigong), and northern Sichuan (Guangyuan and Nanchong) using the Short Form of Health Literacy Dental Scale (HeLD-14), the Geriatric Self-Efficacy Scale for Oral Health (GSEOH) and the Geriatric Oral Health Assessment Index (GOHAI). T-test and ANOVA were used for inter-group comparison, Pearson correlation analysis was used to explore the relationship among OHL, OHRSE and OHRQoL, and linear regression and Model 4 of Process v4.2 macro program were used to conduct significance test on the mediating effect of OHRSE between inpatients' OHL and OHRQoL.

Results: Among 449 inpatients,71.8% were female, and 80.3% of the inpatients reported no oral related diseases. The scores of their OHL, OHRSE and OHRQoL were 51.14 ± 9.97, 58.67 ± 10.27 and 49.60 ± 9.61 respectively. The Pearson correlation coefficients of patients' OHL andOHRSE, OHL and OHRQoL, OHRSE and OHRQoL are 0.608, 0.383, 0.383, and p < 0.001. OHRSE was the mediating variable of OHL and OHRQoL, the direct effect (β = 0.229, 95% CI: 0.127-0.331, p < 0.001) and the mediating effect (β = 0.140, 95% CI: 0.074-0.217, p < 0.001) accounted for 62.15% and 37.85% of the total effect (β = 0.369, 95% CI: 0.286-0.451, p < 0.001), respectively.

Conclusion: Medical institutions and medical staff can promote inpatients' oral health-related quality of life by taking measures to improve the inpatients' oral health literacy or enhance their oral - related self - efficacy.

Keywords: Inpatients; Mediating effect; Oral health literacy; Oral health-related quality of life; Oral-related self-efficacy.