Aleksandra Jokovic

Validity and Reliability of a Questionnaire for Measuring Child Oral-health-related Quality of Life

Oral-health-related quality of life measures that exist are designed for adults. This study aimed to develop and evaluate the CPQ11-14, a self-report measure of the impact of oral and oro-facial conditions on 11- to 14-year-old children. An item pool was generated with the use of a literature review and interviews with health professionals, parents, and child patients. The 36 items rated the most frequent and bothersome by 83 children were selected for the CPQ11-14. Validity testing involved a new sample of 123 children. Test-retest reliability was assessed in a subgroup of these children (n = 65). Mean CPQ11-14 scores were highest for oro-facial (31.4), lower for orthodontic (24.3), and lowest for pedodontic (23.3) patients. There were significant associations between the CPQ11-14 score and global ratings of oral health (p < 0.05) and overall well-being (p < 0.01). The Cronbachs alpha and intraclass correlation coefficient for the CPQ11-14 were 0.91 and 0.90, respectively. These results suggest that the CPQ11-14 is valid and reliable.

Validation of the Child Perceptions Questionnaire (CPQ11-14)

While the use of adult oral-health-related quality-of-life (OHRQoL) measures in supplementing clinical indicators has increased, that for children has lagged behind, because of the difficulties of developing and validating such measures for children. This study examined the construct validity of the Child Perceptions Questionnaire (CPQ11-14) in a random sample of 12- and 13-year-old New Zealanders. It was hypothesized that children with more severe malocclusions or greater caries experience would have higher overall (and subscale domain) CPQ11-14 scores. Children (N = 430) completed the CPQ11-14 and were examined for malocclusion (Dental Aesthetic Index) and dental caries. There was a distinct gradient in mean CPQ11-14 scores by malocclusion severity, but there were differences across the four subscales. Children in the worst 25% of the DMFS distribution had higher CPQ11-14 scores overall and for each of the 4 subscales. The construct validity of the CPQ11-14 appears to be acceptable.

Changes in parent‐assessed oral health‐related quality of life among young children following dental treatment under general anaesthetic

OBJECTIVE To estimate the nature and magnitude of changes in oral health-related quality of life (OHRQoL) among children having dental treatment under general anaesthetic (GA) and to examine the evaluative properties of the Child Oral Health-related Quality of Life Questionnaire (COHQOL). METHODS Data from a consecutive clinical sample of the parents/caregivers of children receiving dental treatment under GA at Wellington and Kenepuru Hospitals were collected from parents using the Parental-Caregivers Perception Questionnaire (P-CPQ) and the Family Impact Scale (FIS), which both form part of the COHQOL Questionnaire. The first questionnaire was completed before treatment or while the participants child was undergoing treatment. The follow-up questionnaire was completed 1-4 weeks afterward. Treatment-associated changes in OHRQoL were determined by comparing baseline and follow-up data for the mean scores and the prevalence of impacts. The discriminative properties of the instrument were confirmed and then its evaluative properties were assessed (by examining its test-retest reliability, responsiveness and longitudinal construct validity). The minimally important difference was determined for the overall scale and subscales. RESULTS Complete baseline and follow-up data were obtained for 202 and 130 participants, respectively (64.4% follow-up rate). The evaluative properties of the P-CPQ and FIS were acceptable. There were substantial and highly statistically significant reductions in mean P-CPQ and FIS scores after treatment, with effect sizes ranging from moderate to large, depending on the subscale being examined. The minimally important difference was shown by almost two-thirds of the children treated. CONCLUSION The provision of dental treatment under GA for young children with severe dental caries experience is associated with substantial and highly significant improvements in both their OHRQoL and in the impact on their families. The P-CPQ and the FIS show promise as evaluative measures for use in dental health services research.

Health-related Quality of Life of children aged 11 to 14 years with orofacial conditions

Objective To assess the health-related quality of life (HRQoL) of 11- to 14-year-old children with orofacial conditions. Design Thirty-nine patients with orofacial conditions were compared with 32 patients with dental caries. Outcome Measure The multidimensional 37-item Child Perceptions Questionnaire for 11- to 14-year-old children (CPQ11–14). This forms one component of the Child Oral Health Quality of Life Questionnaire. Results The orofacial group had slightly higher scores on the CPQ11–14 than the dental group (p < .05). The scores were slightly to moderately higher on the functional limitations (p < .01) and social well-being (p < .01) domains. The groups did not differ with respect to oral symptoms or emotional well-being. Mouth breathing, problems with speech, missing school, being teased, and being asked questions about their condition were the only issues reported more frequently by the orofacial group (p < .01). There was no evidence of social inhibition or withdrawal in the orofacial group. The children with orofacial conditions rated their oral health better than the children with dental decay (p < .05). In both groups, the majority of children reported that their condition had little impact on their life overall. Conclusions Based on CPQ11–14 scores, there were few differences in the HRQoL of 11- to 14-year-old children with orofacial conditions, compared with children with dental caries. This suggests that the majority of these children are well adjusted and able to cope with the adversities they experience as a result of their conditions. This may reflect the quality of the team approach used at the treatment setting at which they were recruited.

Epidemiological evaluation of short-form versions of the Child Perception Questionnaire.

The objective of the study was to compare the performance of four short-form versions of the Child Perceptions Questionnaire (CPQ(11-14)) with that of the long-form version in a random population sample of 12- and 13-yr-old children from New Zealand in order to determine which short-form version was the most valid. Children (n = 430, participation rate 74.1%) completed the 37-item CPQ(11-14). Two separate 8- and 16-item short-form versions were previously developed using (a) item impact and (b) regression methods. The four different short-form scales were compared with the full CPQ(11-14) on their construct validity. The children were examined for malocclusion (using the Dental Aesthetic Index) and for dental caries by a single examiner (L.F.P.). All short-form versions revealed substantial variability in overall oral health-related quality of life (OHRQoL). Cronbachs alpha ranged from 0.73 (Regression Short Form [RSF]-8) to 0.86 (RSF-16). For all short-form versions, mean scores were positively associated with self-rated oral health and overall wellbeing; associations with the latter were stronger. All short-form versions detected OHRQoL gradients, as hypothesized, across ascending categories of caries and malocclusion. These findings suggest that the short-form versions of the CPQ(11-14) all show acceptable properties, but that the 16-item versions perform better (and are essentially equivalent); however, the stronger theoretical underpinning of the item-impact-derived 16-item short-form version suggests that it shows the most promise.