|Year : 2015 | Volume
| Issue : 4 | Page : 417-421
Relationship of self-liking, self-competence with self-reported oral health status among 15-year-old children of Davangere city: A cross-sectional survey
Anjan Giriraju1, Nagesh Lakshminarayan2
1 Department of Public Health Dentistry, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
2 Department of Public Health Dentistry, Institute of Dental Sciences, Bareilly, Uttar Pradesh, India
|Date of Web Publication||7-Dec-2015|
Department of Public Health Dentistry, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka
Source of Support: None, Conflict of Interest: None
Introduction: Psychological constructs have been found to have potential effects in the improvement of health. Self-esteem (expressed in the form of sub-constructs: Self-liking and self-competence) is a construct, which makes one realize the self. This in turn will result in positive oral-health-seeking behavior and improvement in oral health status. Aim: To assess the relationship of self-liking, self-competence with self-reported oral health status in children aged 15 years, in Davangere city. Materials and Methods: A descriptive, cross-sectional survey was conducted on 220 15-year-old subjects in Davangere City. Specially designed pro forma containing Romanian self-administered questionnaire to record the self-reported oral health status and Tafarodi's SLC scale to measure self-liking/self-competence was used. Chi-square test was used for statistical analysis. Results: A majority of the participants were found to have moderate self-competence and self-liking and their self-reported oral health status was expressed as "excellent." They reported very less or no untreated decayed teeth and no extracted teeth or gingival bleeding. Conclusion: The participants with better self-competence and self-liking perceived their oral health status as good. They reported lesser incidence of oral diseases and discomfort. Self-esteem and oral health were found to be positively related.
Keywords: Self-competence, self-esteem, self-liking, self-reported oral health status
|How to cite this article:|
Giriraju A, Lakshminarayan N. Relationship of self-liking, self-competence with self-reported oral health status among 15-year-old children of Davangere city: A cross-sectional survey. J Indian Assoc Public Health Dent 2015;13:417-21
|How to cite this URL:|
Giriraju A, Lakshminarayan N. Relationship of self-liking, self-competence with self-reported oral health status among 15-year-old children of Davangere city: A cross-sectional survey. J Indian Assoc Public Health Dent [serial online] 2015 [cited 2020 Jul 2];13:417-21. Available from: http://www.jiaphd.org/text.asp?2015/13/4/417/171175
| Introduction|| |
"Health in this modern era has been considered a fundamental human right and a world-wide social goal; that is essential to the satisfaction of basic human needs and to an improved quality of life; and that is to be attained by all people." Health behavioral management is an important cornerstone of holistic concept and it is one of the approaches in health promotion. It is associated with various psychological characteristics such as self-efficacy, self-esteem, and locus of control. Among all these characteristics, self-esteem has emerged as one of the important central constructs in the field of health research during the past few decades. Self-esteem can be defined as "A personal judgment of an individual's worthiness, derived from the reflected appraisal of others, and having a dimension with positive and negative ends. Among the lay community, it is widely believed that positive self-esteem is healthy and desirable and is evident through the use of self-esteem questionnaire as an out-come measure in studies of health and well-being. Self-esteem has been strongly associated with a positive effect and has an inverse relation to negative emotionality.
Self-esteem is most commonly assessed using the Rosenberg's Self-Esteem Scale, which considers self-esteem as a global evaluation of personal worth. Global self-esteem measures two distinct though related constructs: Self-liking (sense of social worth) and self-competence (sense of personal efficacy). Self-liking is the part of self-esteem that is strongly socially dependent. It is a part of self-esteem, which signifies how one feels about oneself. Self-competence is the overall sense of oneself as capable, effective, and in control. It is often discussed for its motivating role in purposive behavior and for its adaptive role in coping with stress., Self-esteem in recent days has become one of the most efficient tools of psychometric measurements and psychosocial risk marker for self-reported oral health status. Hence, self-esteem may be one of the important constructs, which may result in improvement of oral health.
Exploration of available literature revealed a few studies on self-esteem and its relation to self-reported oral health status being done on European population which showed positive correlation between the self-esteem and self-reported oral health status  and at the same time there were scarcity of studies related to esteem and self-reported oral health status in relation to Indian population. Thus, a survey was conducted with the aim to assess the relationship of self-liking and self-competence with self-reported oral health status among 15-year-old children of Davangere city.
| Materials and Methods|| |
A descriptive, cross-sectional survey conducted among 15-year-old children of Davangere city for the duration of 4 months (June 2012 - September 2012). The synopsis of the proposed study was prepared and submitted to the Chairperson, Institutional Review Board for Ethical approval. After the review and scrutiny by the board members, approval was granted to conduct the study. Data were collected using a specially designed pro forma having a provision for recording socio-demographic data followed by the questionnaires:
- Romanian self-administered questionnaire  was used to record the self-reported oral health status and oral health behaviors. It consisted of two items related to sociodemographic factors (age, gender) and six items related to perceived oral health status (perceived dental health, nontreated caries, current extracted teeth, dental pain, gingival condition, and gum bleeding). The responses were measured on nominal scale
- Self-liking/Self-competence scale  (consisting of 20 items). It measures two dimensions of self-esteem (self-liking and self-competence). The responses were measured on five-point Likert's scale (Strongly disagree – Strongly Agree).
The study pro forma prepared in English was translated into Kannada language (Local language) and retranslated to English to check the validity of translation by translation experts (Back translation method). A pilot study was conducted on 50 subjects (later not included in the survey) to assess the internal consistency of the questionnaire using test-retest criteria. Internal consistency α (Cronbach alpha) value of 0.6 was obtained.
Subjects aged 15 years residing in Davangere city for 10 or more years were included, and subjects who are mentally incapacitated to give a valid response to questions were excluded. The sample size was calculated based on the data of a previously published scientific article which had assessed the relationship of self-liking and self-competence with dental caries. In that study, the prevalence of dental caries was found roughly to be 50%.
α was fixed at 0.05 (5%); β was fixed at 0.2 (20%); power of the test = 1 – β =1 − 0.2 = 0.8 (80)
Formula for sample size determination 
n = Zα2pq/L 2
Where, Zα= 1.96 = 2 (approximate); n = sample size
P = 50% (prevalence of dental caries); q = (1 − p) = (1 − 0.5) = 0.5 = 50%
L = permissible error = 20% of P = 20 × 50/100 = 10
Minimum sample size = 200
Total sample size = n = 200 + 10% of the minimum sample size (anticipated nonresponse or partial response).
n = 200 + 20 = 220
Davangere city has been divided into four zones (Northeast, Northwest, Southeast, and Southwest) for administrative purpose. The same division was used to select the subjects for the study. Required permission to conduct the survey was obtained from the Deputy Director for Public Instruction (DDPI) and from the school authorities selected for this study. List of schools was obtained from the DDPI office, Davangere. Fifty-five 15-years–olds were selected from two schools of each zone using simple random sampling technique (Lottery method).
A detailed schedule of the survey was prepared well in advance. A prior appointment was taken from concerned authorities of selected schools. It was scheduled to meet all the school children of all selected schools during the working hours (9.00 a.m. to 5 p.m.). The data collection was done during leisure hours so that their academic activities were not disturbed.
WHO Informed Consent Protocol for Qualitative studies was followed. Consent was obtained from the concerned teacher, as children were legally not competent to give valid consent. Assent was obtained from each child just before administering the questionnaire. The investigator administered the questionnaires (Kannada or English language depending on subject's convenience of understanding). The subjects were then instructed to answer the questions in the questionnaire. They were informed to feel free and raise any questions to clarify their doubts. On an average, it took 20–30 min for subjects to answer all the questions in the questionnaire. The answered questionnaires were received from the subjects after they finished answering on the same day.
The data were compiled and organized systematically. The dataset was subdivided and distributed meaningfully in individual tables. Statistical analyses were performed using Statistical Package For Social Sciences Software Version 17, SPSS Inc., 233, S. Wacker Dr, 11th Floor, Chicago, IL 60606-6307. Significance level was fixed at P ≤ 0.05. The data collected and the outcomes measured were categorical by nature and were nonparametric. Hence, Chi-square test was applied for analysis.
| Results|| |
Of 220 subjects surveyed in the group of 15-year-olds, only 206 responses were considered in the analysis, because other 14 subjects had provided partial response while answering the questionnaire. The response rate found in the survey was 93.63%.
About 45% of subjects showed moderate self-competence. About 41% of the 15-year-oldss showed moderate self-liking [Table 1].
|Table 1: Distribution of study population based on self-competence levels and self-liking levels|
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[Table 2] and [Table 3] show the relationship between self-competence and self-reported oral health status variables. Of 206 subjects, 138 (67%) perceived their dental health status to be excellent. The majority of subjects, that is 180 (87.4%, had not reported nontreated caries, whereas 26 (12.6%) had self-reported the presence of nontreated caries. About 176 (85.4%) subjects had not reported extracted teeth, whereas 30 (14.6%) reported extracted teeth. In same manner, 132 (64.1%) subjects reported not remembering when toothache last occurred and 105 (51%) subjects perceived their gingival condition to be very good with 153 (74.3%) subjects reporting no gum bleeding.
|Table 2: Distribution of study population based on self-competence levels in relation to perceived dental health, current dental caries, and current extracted teeth|
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|Table 3: Distribution of study population based on self-competence levels in relation to last time tooth ache occurred, self-reported gingival condition, and gingival bleeding|
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[Table 4] and [Table 5] show the relationship between self-liking and self-reported oral health status. Of 206 subjects, 144 (70%) showed excellent perceived dental health. The majority of subjects, that is 180 (87.4%), had not reported nontreated caries, while 163 (79%) subjects had not reported extracted teeth. Nearly 120 (58.2%) subjects reported not remembering when toothache last occurred. Almost 111 (53.8%) subjects perceived their gingival condition to be very good with 168 (81.5%) subjects reporting no gum bleeding.
|Table 4: Distribution of study population based on self-liking levels in relation to perceived dental health, current nontreated caries, and current extracted teeth|
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|Table 5: Distribution of study population based on self-liking levels in relation to last time tooth ache occurred, self-reported gingival condition, and gingival bleeding|
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| Discussion|| |
This study was conducted on 220, 15-year-old subjects after scientifically determining the sample size based on the findings of a scientific article. At the end of the study, only 206 subjects' responses could be used for final analysis of the data as the remaining 14 subjects had given partial response in the study, which accounted for 93.63% response rate. This difference did not affect the power of the study because while determining the sample size anticipating the partial response rate, a 10% increase was done to the sample size.
The result of this study showed that the majority of the study subjects had moderate self-competence and self-liking. These findings can be explained by the concept of latent growth curve analyses, which uses the quadratic curve to explain life trajectory of self-esteem. It explains that self-esteem increases during young and middle adulthood and reaches the peak at about age 60 years and declines in the old age. The magnitude of the increase in adulthood corresponds to medium-sized effect. As the age of subjects in the present study lie at almost middle part of the quadratic curve, self-competence, and self-liking in the majority of subjects can be expected to be moderate. This finding is in line with the studies conducted by Dumitrescu, Locker, Dumitrescu (2007), where it was found that as age increased there was increase in self-esteem. In this study, 15-year-old children were selected because this was the indicator age group as recommended by WHO in basic oral health surveys methods. 15 years is the age when children complete their schooling and enter Pre-University Colleges, especially under state syllabus schools. It is a transitional period which brings in a lot of changes in their attitudes and behavior.
The majority of the study subjects perceived their dental status to be excellent. These finding are in line with the studies conducted by Dumitrescu, Locker (2009), Dumitrescu et al. (2007), Dumitrescu et al., where majority of the study subjects had higher level of self-esteem and perceived their dental health to be excellent. The finding of the present study indicates that good level of self-competence and self-liking will generate a feeling of worthiness and self-confidence, which can promote self-care. Promotion of self-care results in improved oral health status, which in turn makes the individuals to perceive their dental status to be excellent.
The majority of the study subjects rep9orted no untreated carious teeth. This finding is in line with the studies conducted by Dumitrescu, Dumitrescu et al. (2007), and Dumitrescu et al., where majority of subjects had good self-esteem and also reported less number of untreated carious teeth. The observation of this study indicates that increase in self-competence and self-liking will result in better oral-health-seeking behavior. Thus, subjects with higher self-competence and self-liking may seek oral health care before the onset of the disease or at the initial stages of the disease. Such an oral-health-seeking behavior may be the reason for very few un-treated dental caries in the subjects.
The majority of the study subjects reported no extracted teeth. This finding is in line with the studies conducted by Dumitrescu, Locker (2008), Dumitrescu et al. (2007), and Dumitrescu et al., where majority of study subjects possessed good self-esteem and reported no extracted teeth. A better oral-health-seeking behavior enables prevention of oral disease at its initial stage and reduces the ultimate consequences of the disease. Thus, only a few subjects in the present study reported a history of extracted teeth.
The majority of the study subjects reported not remembering when teeth ache last occurred. These finding are in line with the studies conducted by Dumitrescu, Dumitrescu et al. (2007), Dumitrescu et al., where study subjects who participated in those studies had good self-esteem and majority did not remember the time tooth ache last occurred. The majority of the subjects in the present study had moderate self-competence and self-liking and reported few untreated carious teeth; few extracted teeth, and perceived their dental health to be excellent. This probably may be the reason why the majority of subjects reported not remembering the last time toothache occurred because they had good oral health status and never experienced any discomfort due to dental problems since long time.
The majority of the study subjects reported their gingival condition to be very good and reported no gum bleeding. These findings are in line with the studies conducted by Dumitrescu, Locker (2008), Dumitrescu et al. (2007), Dumitrescu et al., where majority of subjects had good self-esteem and reported very good to excellent gingival condition.
Limitations of the study
- In the present study, oral health status was assessed subjectively. This in turn may have resulted in some subjective biases. However, a study has shown that self-reported oral health status has a similar outcome as clinically assessed oral health status 
- The cross-sectional design of the present study can provide a glimpse of the possible association existing between self-competence, self-liking, and self-reported oral health status. To understand the cause-effect dynamics between these variables, analytical epidemiological studies are required.
| Conclusion|| |
Moderate self-competence and self-liking were common occurrences in the study population. A majority of the subjects reported no untreated carious lesions and no history of extracted teeth, which suggests a good dental health. Very few subjects reported gum bleeding and majority had fair gingival health. Moderate self-competence and self-liking observed in these subjects might have positively influenced their oral health.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]