Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
Community Dent Oral Epidemiol. 2013 Dec;41(6):565-73. doi: 10.1111/cdoe.12048. Epub 2013 Apr 1.
To develop a new unidimensional questionnaire for patients' self-assessment of their chewing function (chewing function questionnaire: CFQ) and to test its psychometric properties.
A focus group of 7 dentists and 15 prosthodontic patients generated a pool of 30 relevant items. A 5-point Likert scale (0-4) was used. A focus group reduced some redundant items, and 21 items remained for pilot testing after which additional four items were eliminated. Then, the 17-item questionnaire was tested on a larger sample (200 participants). Factor analysis was obtained to investigate the dimensionality of the questionnaire. Finally the 10 items remained, and the CFQ was unidimensional. To test the psychometric properties, the CFQ was administrated to 224 individuals: 100 patients were already removable denture wearers (RDWs), 24 patients needed a removable prosthodontic treatment, and 100 individuals had natural teeth (NT group). Discriminative validity was tested between the RDWs and the NT groups. Convergent validity and internal consistency were tested on 200 subjects. The internal consistency was assessed by calculating the Cronbach's alpha coefficient and the average interitem correlation. The test-retest reliability was tested on 60 subjects. Responsiveness was tested on 24 patients who received new removable prosthodontic treatment.
The initial factor analysis revealed that the items had been grouped in three different dimensions. By eliminating items with complexities greater than one, additional six questions were eliminated. One more item with the lowest correlation was further eliminated. The final questionnaire included 10 items. Discriminative validity showed significant differences between the NT group and the RDWs, as predicted (P < 0.001). Convergent validity was confirmed by the Spearman's rank correlation. A significant positive association (P < 0.001) was found between the CFQ and one general question about chewing difficulties, as well as between the CFQ and five items from the OHIP49 related to chewing. The test-retest reliability showed high intraclass correlation and no significant differences between the two administrations of the CFQ (P > 0.05). The internal consistency showed satisfactory Cronbach's alpha values (0.916 for all subjects, 0.742 for the NT group, and 0.852 for the RDWs). Responsiveness was confirmed by a significant difference between the baseline and the follow-up score (P < 0.001) and a high effect size (0.95).
The developed CFQ provides an assessment instrument of the hypothetical construct invoked to explain the chewing function. Psychometric properties are satisfactory demonstrating that the instrument is suitable for the assessment of a self-perceived chewing function.
开发一种新的用于评估患者咀嚼功能的自评问卷（咀嚼功能问卷：CFQ），并对其进行心理计量学特性评估。
一个由 7 名牙医和 15 名修复科患者组成的焦点小组生成了 30 个相关项目的池。采用 5 分制（0-4）。一个焦点小组减少了一些冗余的项目，在试点测试后留下了 21 个项目，然后又删除了另外 4 个项目。然后，对更大的样本（200 名参与者）进行了 17 项问卷测试。进行因子分析以研究问卷的维度。最终保留了 10 个项目，CFQ 为单维。为了测试心理计量学特性，将 CFQ 施用于 224 名个体：100 名患者已经佩戴可摘义齿（RDWs），24 名患者需要进行可摘义齿修复治疗，100 名个体有天然牙齿（NT 组）。在 RDWs 和 NT 组之间测试判别效度。在 200 名受试者中测试收敛效度和内部一致性。内部一致性通过计算 Cronbach's alpha 系数和平均项目间相关性来评估。在 60 名受试者中测试重测信度。在接受新的可摘义齿修复治疗的 24 名患者中测试反应度。
初步因子分析表明，项目已分为三个不同的维度。通过消除复杂性大于一的项目，又消除了另外六个项目。进一步消除了一个相关性最低的项目。最终问卷包括 10 个项目。判别效度显示 NT 组和 RDWs 之间存在显著差异，正如预测的那样（P <0.001）。收敛效度通过 Spearman 秩相关得到证实。CFQ 与一个关于咀嚼困难的一般性问题以及与 OHIP49 中五个与咀嚼相关的项目之间存在显著正相关（P <0.001）。重测信度显示两次 CFQ 测试之间的内类相关系数较高，且无显著差异（P >0.05）。内部一致性显示 Cronbach's alpha 值令人满意（所有受试者为 0.916，NT 组为 0.742，RDWs 为 0.852）。反应度通过基线和随访评分之间的显著差异（P <0.001）和高效应量（0.95）得到证实。
开发的 CFQ 提供了一种用于评估假设的咀嚼功能构建的评估工具。心理计量学特性令人满意，表明该工具适用于自我感知咀嚼功能的评估。
