Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Craniomaxillofac Surg. 2020 Aug;48(8):779-785. doi: 10.1016/j.jcms.2020.06.005. Epub 2020 Jun 27.
The patient-reported outcome measures are endorsed for better evaluation of disease impact and treatment outcomes. Temporomandibular joint (TMJ) ankylosis has been observed to adversely impact the quality of life (QoL) of the patients, affecting both the physical and psychosocial aspects of their lives. The study was conducted to develop and validate a TMJ ankylosis specific QoL questionnaire (TMJAQoL). It had two phases. Phase 1 was associated with the development of the questionnaire while phase 2 examined its psychometric properties and validated the instrument. In phase 1, a 65 item pool was generated and was eventually reduced to a 37 item pool after sequential evaluation by two expert groups. The 37 item draft was subjected to item reduction by the impact method, resulting in a 12 item draft divided into 4 domains, which formed the TMJAQoL questionnaire. In phase 2, the TMJAQoL was completed by 51 TMJ ankylosis patients and was found to have optimum validity, reliability and internal consistency. 44 of these patients completed the TMJAQoL again after the surgery. A significant change in mean cumulative TMJAQoL scores (pre-op = 14.10, post op = 4.05, p = .001) was found after the surgery. This change was significantly correlated to the improvement in the maximal incisal opening and the right and left lateral movements (r > .30). Amongst the TMJAQoL domains, significant improvement was seen in functional limitation (p = .026), psychological well being (p = .017) and social wellbeing domains (p = .038). Overall, improved QoL was observed after the TMJ surgery. The TMJAQoL demonstrated optimum psychometric properties and promises to be an effective QoL instrument for the TMJ ankylosis patients.
患者报告的结局测量指标得到了认可，可以更好地评估疾病的影响和治疗结果。颞下颌关节（TMJ）强直已被观察到对患者的生活质量（QoL）产生不利影响，影响他们生活的身体和社会心理方面。该研究旨在开发和验证一种 TMJ 强直特异性 QoL 问卷（TMJAQoL）。它分为两个阶段。第一阶段与问卷的开发相关，第二阶段则检查其心理测量特性并验证该工具。在第一阶段，生成了一个 65 项的条目池，经过两个专家组的连续评估后，最终减少到 37 项条目池。37 项草案通过影响方法进行了条目删减，得到了 12 项草案，分为 4 个领域，形成了 TMJAQoL 问卷。在第二阶段，51 名 TMJ 强直患者完成了 TMJAQoL，结果发现该问卷具有最佳的有效性、可靠性和内部一致性。其中 44 名患者在手术后再次完成了 TMJAQoL。手术后，TMJAQoL 的平均累积得分（术前=14.10，术后=4.05，p=0.001）有显著变化。这种变化与最大开口度和右侧及左侧侧向运动的改善显著相关（r>.30）。在 TMJAQoL 各领域中，功能受限（p=0.026）、心理幸福感（p=0.017）和社会幸福感领域（p=0.038）均有显著改善。总体而言，TMJ 手术后 QoL 得到了改善。TMJAQoL 表现出最佳的心理测量特性，有望成为 TMJ 强直患者有效的 QoL 工具。
