Health-Related Quality of Life in Maxillectomy Patients Rehabilitated with Obturator Prostheses: A Literature Review

The prosthetic rehabilitation of the maxillectomy defect is important to restore oral functions and facial contours as well as to improve patients’ health-related quality of life (HRQOL). This literature review aims to assess the HRQOL of maxillectomy patients rehabilitated with obturator prostheses and their determinants as well as to identify the most commonly used HRQOL measures. A literature search has been performed using PubMed, EMBASE, and Google Scholar to identify studies published before October 10, 2016. Twenty-three studies were identified. Most studies are cross-sectional. The most frequently used HRQOL measures were the Obturator Functioning Scale and the University of Washington Quality of Life scale version 4. Studies showed that postoperative radiation therapy, residual dentition, obturator functioning, impairment of ingestion, speech, appearance, the extent of therapy, and pain were important factors affecting patients’ HRQOL. This review provides valuable information for clinicians and researchers in determining patients’ needs, selecting HRQOL measure, planning future studies, as well as planning and developing comprehensive prosthetic rehabilitation programs. Well-designed clinical, multicenter, longitudinal studies with a larger sample are needed to evaluate the impacts of different reconstruction and retention methods as well as several determinants including sociodemographic, clinical, and psychological on patients’ HRQOL

Cross - cultural adaptation and preliminary validation of the Turkish version of the Early Childhood Oral Health Impact Scale among 5-6-year-old children

<p>Abstract</p> <p>Background</p> <p>In Turkey, formal pre-primary education for children 5- 6 years old provides the ideal setting for school-based oral health promotion programs and oral health care services. To develop effective oral health promotion programs, there is a need to assess this target group's subjective oral health needs as well as clinical needs. The Early Childhood Oral Health Impact Scale (ECOHIS) is a well-known instrument for assessing oral health quality of life in children aged 0-5 years old and their families. This study aimed to adapt the ECOHIS for children 5-6 years old in a Turkish-speaking community and to undertake a preliminary investigation of its psychometric properties.</p> <p>Methods</p> <p>The Turkish version of the ECOHIS was obtained with forward/backward translations, expert panels and pre-testing and it was tested in a convenience sample of 121 parents of 5- 6 year-old children attending nursery classes of three public schools. Data were collected through clinical examinations and self-completed questionnaires. The main analyses were carried out on the imputed data set. The validity of content, face, construct, discriminant and convergent and as well as the reliability of internal and test-retest of the ECOHIS were evaluated. Sensitivity analysis was performed to examine the effect of the complete case analysis for managing "Don't know" responses on the validity and reliability of the ECOHIS.</p> <p>Results</p> <p>The analysis of the imputed data set showed that Cronbach's alphas for the child and family sections were 0.92 and 0.84 respectively, and for the whole scale was 0.93. The intraclass correlation coefficient for test-retest was 0.86. The scale scores on the child and parent sections indicating worse quality of life were significantly associated with poor parental ratings of their child's oral health, high caries experience, higher gingival index scores and problem-orientated dental attendance, supporting its construct, convergent and discriminant validity. Sensitivity analysis showed that the mean imputation method and the complete case analysis did not have differing effects on the validity and reliability of the ECOHIS.</p> <p>Conclusions</p> <p>This study provided preliminary evidence concerning validity and reliability of the Turkish version of the scale among 5-6-year-old children. Future studies should be conducted on the ECOHIS to evaluate fully its psychometric properties in both community- based and clinically-based studies among parents of children younger than five. This study provides initial evidence that the ECOHIS aimed at children aged 0-5 years may be a useful tool for assessing the oral health quality of life in 6 year - old preschool children.</p

Variations in concerns reported on the Patient Concerns Inventory (PCI) in head and neck cancer patients from different health settings across the world

Background: The aim was to collate and contrast patient concerns from a range of different head and neck cancer follow-up clinics around the world. Also, we sought to explore the relationship, if any, between responses to the patient concerns inventory (PCI) and overall quality of life (QOL). Methods: Nineteen units participated with intention of including 100 patients per site as close to a consecutive series as possible in order to minimize selection bias. Results: There were 2136 patients with a median total number of PCI items selected of 5 (2-10). “Fear of the cancer returning” (39%) and “dry mouth” (37%) were most common. Twenty-five percent (524) reported less than good QOL. Conclusion: There was considerable variation between units in the number of items selected and in overall QOL, even after allowing for case-mix variables. There was a strong progressive association between the number of PCI items and QOL