Modification and psychometric evaluation of the child perceptions questionnaire (CPQ 11–14 ) in assessing oral health related quality of life among Lithuanian children

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Abstract

Background

Oral health related quality of life (OHRQoL) research among children and adolescents in Lithuania is just starting and no measures have been validated to date. Therefore, this study aimed to validate a Lithuanian version of the full (37 items) Child Perceptions Questionnaire (CPQ _11–14) within a random sample of children aged 11 to 14.

Methods

A cross-sectional survey among a randomly selected sample of schoolchildren ( N = 307) aged 11 to14 was conducted. An anonymous questionnaire included the full CPQ _11–14 and items on global life satisfaction, oral health and oral life quality self-rating. The questionnaire was translated into Lithuanian using translation guidelines. In addition, an item on the oral pain was modified identifying the pain location. Standard tests (Cronbach’s α, construct validity and discriminant validity), supplemented with both exploratory and confirmatory factor analyses, were employed for psychometric evaluation of the instrument. The questionnaire was also tested by comparison students’ and their parents’ ( N = 255) responses about oral symptoms and functional limitations.

Results

The modified Lithuanian version of CPQ _11–14 revealed good internal consistency reliability (Cronbach’s alpha for the total scale was 0.88). The measure showed significant associations with perceived oral health status and oral well-being, as well as with global life satisfaction ( p < 0.01). Discriminant validity of the instrument was approved by comparison of children’s groups defined by self-reported caries experience and malocclusion. Factor analysis revealed a complex structure with two or three factors in each of four domains of the CPQ _11–14. Excellent or acceptable levels of indices of model fitting with the given data were obtained for oral symptoms, functional limitations and emotional well-being domains, but not for the social well-being domain. A significant association between child and parental responses was found (intraclass correlation coefficient was 0.56 and 0.43, correspondingly in domains of oral symptoms and functional limitations).

Conclusion

The Lithuanian version of the CPQ _11–14 (with a modified item that identifies location of oral pain) appears to be a valid instrument to be used in further studies for measuring OHRQoL among 11 to 14 year old children in Lithuania.

Electronic supplementary material

The online version of this article (10.1186/s12903-018-0701-5) contains supplementary material, which is available to authorized users.

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Despite its relatively recent emergence over the past few decades, oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research. OHRQoL is a multidimensional construct that includes a subjective evaluation of the individual's oral health, functional well-being, emotional well-being, expectations and satisfaction with care, and sense of self. It has wide-reaching applications in survey and clinical research. OHRQoL is an integral part of general health and well-being. In fact, it is recognized by the World Health Organization (WHO) as an important segment of the Global Oral Health Program (2003). This paper identifies the what, why, and how of OHRQoL and presents an oral health theoretical model. The relevance of OHRQoL for dental practitioners and patients in community-based dental practices is presented. Implications for health policy and related oral health disparities are also discussed. A supplemental Appendix contains a Medline and ProQuest literature search regarding OHRQoL research from 1990-2010 by discipline and research design (e.g., descriptive, longitudinal, clinical trial, etc.). The search identified 300 articles with a notable surge in OHRQoL research in pediatrics and orthodontics in recent years.

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Validity and reliability of a questionnaire for measuring child oral-health-related quality of life.

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Oral-health-related quality of life measures that exist are designed for adults. This study aimed to develop and evaluate the CPQ(11-14), 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 CPQ(11-14). Validity testing involved a new sample of 123 children. Test-retest reliability was assessed in a subgroup of these children (n = 65). Mean CPQ(11-14) 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 CPQ(11-14) score and global ratings of oral health (p < 0.05) and overall well-being (p < 0.01). The Cronbach's alpha and intraclass correlation coefficient for the CPQ(11-14) were 0.91 and 0.90, respectively. These results suggest that the CPQ(11-14) is valid and reliable.

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Author and article information

Contributors

Aistė Kavaliauskienė:

ORCID: http://orcid.org/0000-0003-0013-153X

aiste.kavaliauskiene@lsmuni.lt

Antanas Šidlauskas: antanas.sidlauskas@lsmuni.lt

Apolinaras Zaborskis: apolinaras.zaborskis@lsmuni.lt

Journal

Journal ID (nlm-ta): BMC Oral Health

Journal ID (iso-abbrev): BMC Oral Health

Title: BMC Oral Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6831

Publication date (Electronic): 5 January 2019

Publication date PMC-release: 5 January 2019

Publication date Collection: 2019

Volume: 19

Electronic Location Identifier: 1

Affiliations

[1 ]ISNI 0000 0004 0432 6841, GRID grid.45083.3a, Faculty of Odontology, Clinic of Orthodontics, , Lithuanian University of Health Sciences, Medical Academy, ; J.Luksos-Daumanto street, 6, LT-50106 Kaunas, Lithuania

[2 ]ISNI 0000 0004 0432 6841, GRID grid.45083.3a, Faculty of Public Health, Health Research Institute and Department of Public Health, , Lithuanian University of Health Sciences, Medical Academy, ; Tilzes street, 18, LT-47181 Kaunas, Lithuania

Author information

Aistė Kavaliauskienė http://orcid.org/0000-0003-0013-153X

Article

Publisher ID: 701

DOI: 10.1186/s12903-018-0701-5

PMC ID: 6320629

PubMed ID: 30611272

SO-VID: db24350c-2135-4167-977b-66516c65258f

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 3 January 2018

Date accepted : 19 December 2018

Custom metadata

ScienceOpen disciplines: Dentistry

Keywords: oral health,quality of life,child perceptions questionnaire,psychometric analysis,factorial validity,children,lithuania

Data availability:

ScienceOpen disciplines: Dentistry

Keywords: oral health, quality of life, child perceptions questionnaire, psychometric analysis, factorial validity, children, lithuania