Department of Orthodontics, Faculty of Dentistry, Mahidol University, 6 Yothi Road, Ratchathewi, Bangkok, 10400, Thailand.
BMC Oral Health. 2024 Oct 8;24(1):1196. doi: 10.1186/s12903-024-04926-y.
Halitosis appears to have significant impacts on quality of life, necessitating reliable assessment tools. The Halitosis Associated Life-Quality Test (HALT) has been validated in various populations, but not among Thai people. While HALT provides a valuable foundation, there is a need for a culturally adapted and expanded instrument for the Thai context. Consequently, this study aimed to develop and validate a comprehensive questionnaire for assessing halitosis-related quality of life in Thai populations, incorporating a Thai version of HALT (T-HALT) as a core component.
This cross-sectional study involved 200 dental patients at Mahidol University. The original HALT was translated into Thai using forward-backward translation. Cultural adaptation and psychometric properties of T-HALT were evaluated through multiple approaches. Content validity was ensured through expert reviews, while face validity was assessed by patient feedback. Reliability was examined via test-retest and internal consistency measures. Criterion and discriminant validity was evaluated by correlating T-HALT scores with self-perceived halitosis and volatile sulfur compound (VSC) measurements, respectively. VSCs were quantified using the OralChroma™ device, which analyzes breath samples collected directly from patients' mouths. Construct validity was assessed through exploratory (EFA) and confirmatory factor analysis (CFA), providing insights into the questionnaire's underlying structure.
T-HALT demonstrated excellent internal consistency (Cronbach's alphas = 0.940-0.943) and test-retest reliability (ICC = 0.886). Criterion validity was supported by a significant correlation between T-HALT scores and self-perceived halitosis (r = 0.503, P < 0.001). Discriminant validity was confirmed by the absence of a significant correlation between T-HALT scores and VSC levels (r = 0.071, P = 0.32). EFA revealed a four-factor structure, which was subsequently confirmed by CFA. However, Items 1 and 7 were excluded due to poor standardized factor loadings.
T-HALT demonstrates good reliability and validity for assessing halitosis-related quality of life in Thai populations. It performs well as a unidimensional measure, but its multidimensional application requires modifications. Future research should validate a modified version excluding Items 1 and 7 across diverse Thai populations, potentially enhancing its cultural specificity.
口臭对生活质量有明显影响，因此需要可靠的评估工具。Halitosis Associated Life-Quality Test（HALT）已在各种人群中得到验证，但尚未在泰国人群中进行验证。虽然 HALT 提供了一个有价值的基础，但需要为泰国背景开发和验证一种文化适应性和扩展的工具。因此，本研究旨在开发和验证一种用于评估泰国人口口臭相关生活质量的综合问卷，该问卷将泰国版 HALT（T-HALT）作为核心组成部分。
这是一项横断面研究，涉及玛希隆大学的 200 名牙科患者。使用正向-反向翻译法将原始 HALT 翻译成泰语。通过多种方法评估 T-HALT 的文化适应性和心理测量特性。内容有效性通过专家审查得到保证，而表面有效性则通过患者反馈进行评估。通过测试-重测和内部一致性测量来检查可靠性。通过将 T-HALT 评分与自我感知的口臭和挥发性硫化合物（VSC）测量值分别相关联来评估标准和判别有效性。使用 OralChroma™设备定量测量 VSCs，该设备分析直接从患者口中采集的呼吸样本。通过探索性（EFA）和验证性因素分析（CFA）评估结构有效性，提供对问卷潜在结构的见解。
T-HALT 表现出极好的内部一致性（Cronbach's alphas = 0.940-0.943）和测试-重测可靠性（ICC = 0.886）。T-HALT 评分与自我感知的口臭之间存在显著相关性（r = 0.503，P < 0.001），支持标准有效性。T-HALT 评分与 VSC 水平之间无显著相关性（r = 0.071，P = 0.32），确认了判别有效性。EFA 显示出四因素结构，随后通过 CFA 得到确认。然而，由于标准化因子负荷较差，第 1 项和第 7 项被排除。
T-HALT 可用于评估泰国人口口臭相关生活质量，具有良好的可靠性和有效性。它作为一种一维测量工具表现良好，但多维应用需要进行修改。未来的研究应在不同的泰国人群中验证排除第 1 项和第 7 项的修改版本，可能会增强其文化特异性。
