Normative values and psychometric properties of questionnaires for assessing oral health related quality of life, orofacial aesthetics and chewing function in the population of the Republic of Kosovo

Abstract

Instrumenti za mjerenje OHRQoL nisu validirani u populaciji Kosova. Svrha ovog rada bila je validirati 3 upitnika: proširenu i skraćenu verziju OHIP upitnika, CFQ upitnik i OES upitnik. Za tumačenje rezultata mjerenja OHRQoL potrebne su tzv. normativne vrijednosti. Prvo su ispitana i potvrĎena psihometrijska svojstva; valjanosti, pouzdanosti i primjerenosti za OHIP-ALB49, OHIP-ALB14, OES-ALB i CFQ-ALB upitnike, a potom su izračunate normativne vrijednosti za ozubljenu populaciju, nositelje fiksnih protetskih radova i nositelje mobilnih proteza u Republici Kosova. Podaci su statistički analizirani programom MS Excel (Microsoft Office, Windows 2007, SAD) i SPSS 19 for Windows (© Copyright 1989, 2010 SPSS, Inc., an IBM Company, Chicago, Illinoiss, SAD). Primijenjene metode bile su deskriptivna statistika, jednosmjerna analiza varijance (Sheffe post-hoc), t test za nezavisne uzorke, faktorska analiza i korelacijska regresijska analiza. Normativne vrijednosti su izračunate u intervalima pouzdanosti od 10 percentila, uključujući decile i kvartile. Podaci prikupljeni OHIP-ALB49 i OHIP-ALB14 upitnicima pokazali su značajno poboljšanje OHRQoL kod pacijenata nakon završene protetske terapije. Efekt terapije protetskim fiksnim ili mobilnim radovima očitovao se poboljšanjem estetike (OES), funkcije ţvakanja (CFQ) i OHRQoL vrijednostima većim od 0,8 prema Cohenu. Rezultati istraţivanja pokazuju da su oralni zdravstveni problemi Kosovskog stanovništva izraţeniji nego u MaĎarskoj, Njemačkoj i Švedskoj. Populacija s prirodnim zubima i ona s fiksnim protetskim radovima zadovoljnija je svojom orofacijalnom estetikom, nego populacija s mobilnim protetskim radovima. Normativne vrijednosti OES-ALB slične su vrijednostima švedske populacije. Rezultati su pokazali da znatan dio opće populacije s prirodnim zubima i populacije s fiksnim protetskim radovima i manji dio s mobilnim protetskim radovima skoro nikad nema poteškoća sa ţvačnom funkcijom. Znatan dio populacije s mobilnim protetskim radovima ima povremene do česte poteškoće sa ţvačnom funkcijom, a manji dio populacije ima jako česte poteškoće sa ţvačnom funkcijom.The aim of this study was to measure psychometric properties of three questionnaires: expanded and shortened version of the OHIP, OES and CFQ. For the interpretation of the results of OHRQoL instrument references known as normative values are required. Materials and Methods: Therefore, after good psychometric properties for all questionnaires were confirmed (OHIP-ALB49, OHIP-ALB14, OES-ALB and CFQ-ALB), normative values were calculated using the above questionnaire for natural teeth population, fixed and removable dentures for the population of the Republic of Kosovo. Statistical analysis was performed by using SPSS version 19.0 for Windows (© Copyright 1989, 2010 SPSS, Inc., an IBM Company, Chicago, Illinoiss, SAD) and MS Excel (Microsoft Office, Windows 2007, SAD). Descriptive statistics, one-way ANOVA (Sheffe post-hoc), independent t-tests, factor analysis, regression and correlation analysis were performed. Normative values were calculated at a confidence interval of 10 percentile, including deciles and quartiles. Results: The results showed a significant improvement of OHRQoL in prosthodontics patients involved in the research after the completion of prosthetic treatment, using OHIP-ALB49 and OHIP-ALB14 questionnaires. The effect of the therapy with fixed or removable prosthetic was observed in a significant improvement of aesthetic (OES), chewing (CFQ) and OHRQoL, with values above 0.8 of the Cohen scale. As the status of prosthetic restoration is still the main factor affecting the perception of oral health, our results indicate that oral health problems are present in the Kosovo population to a higher extent compared with Hungary, Germany and Sweden. Normative values of OES were similar to those of the Swedish population where general population with natural teeth and population with fixed restorations were more satisfied with their orofacial aesthetics than the population with removable restorations. The results of normative values in the general population with natural teeth and prosthodontics fixed restorations for CFQ-ALB showed that a substantial portion of the adult population has almost no difficulties during chewing, while a smaller portion has rare problems. Normative values in the population with removable dentures for CFQ-ALB showed that a significant portion of the adult population has almost none to rare problems during chewing, while a significant portion of the population has occasional to frequent problems during chewing and a smaller part of the population has frequent difficulties during chewing. Conclusions: The OHIP-ALB49, OHIP-ALB14, OES-ALB and CFQ-ALB have shown excellent psychometric properties among Albanian population in Kosovo. They proved that the instruments are appropriate for the assessment of the Oral Health Related Quality of Life, orofacial easthetic and chewing function in Kosovo. As the questionnaires OHIP-ALB49, OHIP-ALB14, OES-ALB and CFQ-ALB, showed good psychometric properties, normative values for general population and prothodontic patients were also established.The adaptation of OHIP-ALB49, OHIP-ALB14, OES-ALB and CFQ-ALB will also enable a comparison of the results from Kosovo with the results obtained in more developed countries and specific cultures, as differences in norms and values across cultures may exist