非牙科专业人员用于养老院居民的口腔健康评估工具的开发和心理测量学特性：系统评价。
The development and psychometric properties of oral health assessment instruments used by non-dental professionals for nursing home residents: a systematic review.
机构信息
School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
出版信息
BMC Geriatr. 2021 Jan 9;21(1):35. doi: 10.1186/s12877-020-01989-8.
BACKGROUND
Globally, oral health status of the geriatric population residing in nursing homes is poor. The integration of non-dental professionals is vital to monitor oral health, early identification and triaging of oral health problems, and timely referral to dental professionals. The aims of this systematic review were to provide a summary on the development and characteristics of oral health assessment instruments currently used by non-dental professionals for nursing home residents, and to perform a critical appraisal of their psychometric properties.
METHODS
This review was conducted as per the PRISMA guidelines. CINHAL (EBSCO), Medline (Ovid), and EMBASE (Ovid) were searched systematically. Two reviewers independently screened the title, abstract, and full text of the studies as per the eligibility criteria. Studies describing oral health assessment instruments used to assess oral health of nursing home residents by non-dental professionals were included. Using a methodological framework, each instrument was evaluated for purpose, content, and psychometric properties related to validity, reliability, feasibility, generalisability, and responsiveness. Additionally, the reporting quality assessment of each included study was performed according to the SURGE guidelines.
RESULTS
Out of the 819 screened articles, 10 studies were included in this review. The 10 identified instruments integrated 2 to 12 categories to assess oral health, which was scored on a 2 to 5-point scale. However, the measurement content varied widely, and none were able to comprehensively measure all aspects of oral health. Three measurement approaches were identified: performance- based assessment, direct inspection of the oral health status, and interview measures. Only eight instruments provided quality assessment on the basis of validity, reliability, feasibility and generalisability, whereas three instruments- Brief Oral Health Status Examination, Dental Hygiene Registration, and Oral Health Assessment Tool reported good methodological quality on at least one assessment criteria.
CONCLUSIONS
None of the instruments identified in this review provided a comprehensive assessment of oral health, while three instruments appeared to be valid and reliable. Nonetheless, continuous development of instruments is essential to embrace the complete spectrum of oral health and address the psychometric gaps.
背景
全球范围内，居住在养老院的老年人群的口腔健康状况较差。非牙科专业人员的整合对于监测口腔健康、早期识别和分诊口腔健康问题以及及时转介给牙科专业人员至关重要。本系统评价的目的是总结目前非牙科专业人员用于养老院居民的口腔健康评估工具的发展和特点，并对其心理测量特性进行批判性评估。
方法
本研究按照 PRISMA 指南进行。系统地检索了 CINHAL（EBSCO）、Medline（Ovid）和 EMBASE（Ovid）。两名审查员根据纳入标准独立筛选研究的标题、摘要和全文。纳入了描述非牙科专业人员用于评估养老院居民口腔健康的口腔健康评估工具的研究。使用方法学框架，根据有效性、可靠性、可行性、可推广性和响应性评估每个工具的目的、内容和心理测量特性。此外，根据 SURGE 指南对每个纳入研究的报告质量进行了评估。
结果
在 819 篇筛选出的文章中，有 10 项研究纳入了本综述。这 10 种确定的工具整合了 2 到 12 个类别来评估口腔健康，评分范围为 2 到 5 分。然而，测量内容差异很大，没有一种能够全面衡量口腔健康的所有方面。确定了三种测量方法：基于表现的评估、对口腔健康状况的直接检查和访谈措施。只有八项工具根据有效性、可靠性、可行性和可推广性提供了质量评估，而三项工具——简短口腔健康状况检查、牙科保健登记和口腔健康评估工具至少在一个评估标准上报告了良好的方法学质量。
结论
本综述中确定的工具没有一个提供了口腔健康的全面评估，而有三个工具似乎是有效和可靠的。尽管如此，不断开发工具对于涵盖口腔健康的完整范围和解决心理测量差距仍然至关重要。
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