Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
PLoS One. 2020 Dec 17;15(12):e0243805. doi: 10.1371/journal.pone.0243805. eCollection 2020.
This study aimed to update and, if necessary, revise the Gothenburg Trismus Questionnaire (GTQ), the only existing trismus-specific questionnaire, and retest its psychometric properties. Semi-structured interviews were performed with 10 trismus patients of which 5 had head and neck cancer (HNC) and 5 suffered from benign temporomandibular disorders. Trismus was defined as a maximal incisal opening of ≤ 35mm. An expert panel discussed and revised the GTQ based on interview information, expertise knowledge and the original questionnaire. The revised questionnaire was then tested in a study sample consisting of benign jaw-related conditions (n = 26), patients treated for HNC (n = 90) and an age- and gender-matched control group with no trismus (n = 116). The revised version of the GTQ (GTQ 2) was well accepted by patients. The original three domains continued to show high internal consistency (Cronbach's alpha 0.74-0.94) and construct validity. Two dually posed single items were split into four questions and the wording was altered in another three items. Moreover, a new domain (Facial pain) was identified, which had excellent internal consistency (α = 0.96) and good construct validity. The revision of the original Gothenburg Trismus Questionnaire (GTQ 1) with inclusion of patient-input, resulted in splitting of ambiguous items, identifying a fourth domain named Facial pain and the recall time shortened for some items. Additionally, the remaining domains and items were re-confirmed as strong in the psychometric analysis. Henceforth, the new version, GTQ 2 should be used.
本研究旨在更新并在必要时修订唯一存在的特定于牙关紧闭症的问卷——哥德堡牙关紧闭症问卷（GTQ），并重新测试其心理测量特性。对 10 名牙关紧闭症患者进行了半结构式访谈，其中 5 名患有头颈部癌症（HNC），5 名患有良性颞下颌关节紊乱症。牙关紧闭症定义为最大切牙开口≤35mm。一个专家小组根据访谈信息、专业知识和原始问卷讨论并修订了 GTQ。修订后的问卷随后在一个由良性颌骨相关疾病患者（n=26）、接受 HNC 治疗的患者（n=90）和无牙关紧闭症的年龄和性别匹配对照组（n=116）组成的研究样本中进行了测试。修订后的 GTQ（GTQ 2）得到了患者的认可。原来的三个领域继续表现出较高的内部一致性（Cronbach's alpha 0.74-0.94）和结构有效性。两个双重提出的单项被分为四个问题，另外三个项目的措辞也发生了变化。此外，还确定了一个新的领域（面部疼痛），该领域具有出色的内部一致性（α=0.96）和良好的结构有效性。通过纳入患者输入对原始哥德堡牙关紧闭症问卷（GTQ 1）进行修订，导致模糊项目的拆分，确定了第四个领域，命名为面部疼痛，并且一些项目的回忆时间缩短。此外，在心理测量分析中，其余领域和项目仍然被确认具有较强的作用。因此，应使用新版本 GTQ 2。
