评估患有颞下颌关节紊乱病的儿童和青少年的口腔健康相关生活质量测量。
Evaluating oral health-related quality of life measure for children and preadolescents with temporomandibular disorder.
机构信息
Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba/SP, Brazil.
出版信息
Health Qual Life Outcomes. 2011 May 12;9:32. doi: 10.1186/1477-7525-9-32.
BACKGROUND
Oral health-related quality of life (OHRQoL) in children and adolescents with signs and symptoms of temporomandibular disorder (TMD) has not yet been measured. This study aimed to evaluate the validity and reliability of OHRQoL measure for use in children and preadolescents with signs and symptoms of TMD.
METHODS
Five hundred and forty-seven students aged 8-14 years were recruited from public schools in Piracicaba, Brazil. Self-perceptions of QoL were measured using the Brazilian Portuguese versions of Child Perceptions Questionnaires (CPQ)8-10 (n = 247) and CPQ11-14 (n = 300). A single examiner, trained and calibrated for diagnosis according to the Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD), examined the participants. A self-report questionnaire assessed subjective symptoms of TMD. Intraexaminer reliability was assessed for the RDC/TMD clinical examinations using Cohen's Kappa (κ) and intraclass correlation coefficient (ICC). Criterion validity was calculated using the Spearman's correlation, construct validity using the Spearman's correlation and the Mann-Whitney test, and the magnitude of the difference between groups using effect size (ES). Reliability was determined using Cronbach's alpha, alpha if the item was deleted and corrected item-total correlation.
RESULTS
Intraexaminer reliability values ranged from regular (κ = 0.30) to excellent (κ = 0.96) for the categorical variables and from moderate (ICC = 0.49) to substantial (ICC = 0.74) for the continuous variables. Criterion validity was supported by significant associations between both CPQ scores and pain-related questions for the TMD groups. Mean CPQ8-10 scores were slightly higher for TMD children than control children (ES = 0.43). Preadolescents with TMD had moderately higher scores than the control ones (ES = 0.62; p < 0.0001). Significant correlation between the CPQ scores and global oral health, as well as overall well-being ratings (p < 0.001) occurred, supporting the construct validity. The Cronbach's alphas were 0.93 for CPQ8-10 and 0.94 for CPQ11-14. For the overall CPQ8-10 and CPQ11-14 scales, the corrected item-total correlation coefficients ranged from 0.39-0.76 and from 0.28-0.73, respectively. The alpha coefficients did not increase when any of the items were deleted in either CPQ samples.
CONCLUSIONS
The questionnaires are valid and reliable for use in children and preadolescents with signs and symptoms of temporomandibular disorder.
背景
目前尚未对有颞下颌关节紊乱症状和体征的儿童和青少年的口腔健康相关生活质量（OHRQoL）进行测量。本研究旨在评估用于有颞下颌关节紊乱症状和体征的儿童和青少年的 OHRQoL 测量工具的有效性和可靠性。
方法
从巴西皮拉西卡巴的公立学校招募了 547 名 8-14 岁的学生。使用巴西葡萄牙语版本的儿童感知问卷（CPQ）8-10（n=247）和 CPQ11-14（n=300）自我评估生活质量。一位经过培训和校准的单一检查者根据颞下颌关节紊乱的研究诊断标准（RDC/TMD）的轴 I 对参与者进行了检查。一份自我报告问卷评估了颞下颌关节紊乱的主观症状。使用 Cohen's Kappa（κ）和组内相关系数（ICC）评估 RDC/TMD 临床检查的内部检查者可靠性。使用 Spearman 相关系数计算标准效度，使用 Spearman 相关系数和 Mann-Whitney 检验计算结构效度，使用效应量（ES）计算组间差异的大小。使用 Cronbach's alpha、删除项目后的 alpha 和校正项目总分相关性来确定可靠性。
结果
对于分类变量，内部检查者可靠性值范围为常规（κ=0.30）至优秀（κ=0.96），对于连续变量，内部检查者可靠性值范围为中度（ICC=0.49）至良好（ICC=0.74）。CPQ 评分与 TMD 组的疼痛相关问题之间存在显著相关性，支持了标准效度。有 TMD 的儿童的 CPQ8-10 平均得分略高于对照组儿童（ES=0.43）。有 TMD 的青少年的得分比对照组青少年高，具有中等程度的差异（ES=0.62；p<0.0001）。CPQ 评分与全球口腔健康和整体幸福感评分之间存在显著相关性（p<0.001），支持结构效度。CPQ8-10 的 Cronbach's alpha 为 0.93，CPQ11-14 的 Cronbach's alpha 为 0.94。对于整体 CPQ8-10 和 CPQ11-14 量表，校正项目总分相关系数分别为 0.39-0.76 和 0.28-0.73。在任何 CPQ 样本中删除任何项目时，alpha 系数均未增加。
结论
问卷在有颞下颌关节紊乱症状和体征的儿童和青少年中具有有效性和可靠性。
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