Lindén Ingela Grönbeck, Wenemark Marika, Andersson Pia, Dahlin-Ivanoff Synneve, Gahnberg Lars, Hägglin Catharina
Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Centre of Gerodontology, Public Dental Service, Gothenburg, Sweden.
Gerodontology. 2025 Sep;42(3):329-341. doi: 10.1111/ger.12796. Epub 2024 Nov 6.
To evaluate the validity of the newly developed Oral Hygiene Ability Instrument (OHAI), created to assess the cause of any inability of older adults to perform oral hygiene, and to revise the instrument based on the results.
Good oral hygiene is among the most important prophylactic measures for oral health. This applies especially to older adults, among whom risk factors and physical and cognitive barriers are more common and can hamper oral hygiene.
The OHAI contains (I) an interview, (II) clinical examination, (III) observation of oral hygiene activities and a summarising part. In the study, 149 older adults in three groups participated: stroke, cognitive disorder and general dental patients. Inclusion criteria were to be ≥65 years old, have at least one tooth and to manage oral hygiene without assistance. For criterion validity, sensitivity and specificity were calculated using eight reference instruments. To determine construct validity, we used known group validity, factor analysis and Rasch analysis.
The criterion and construct validity of the OHAI were found to be acceptable to good. In the stroke group, balance and fine motor skills were assessed to affect oral hygiene most; in the cognitive disorder group, it was balance, coordination, spatial ability and cognitive functions. Analyses revealed that one item had no added value and that some response options were not optimal.
The OHAI proved to be valid for the group it is intended for, with only minor revisions needed, resulting in a 32-item instrument. The OHAI could be a valuable person-centred tool in prophylactic work with older adults with failing oral hygiene.
评估新开发的口腔卫生能力工具（OHAI）的有效性，该工具旨在评估老年人无法进行口腔卫生护理的原因，并根据结果对该工具进行修订。
良好的口腔卫生是口腔健康最重要的预防措施之一。这尤其适用于老年人，他们中危险因素以及身体和认知障碍更为常见，可能会妨碍口腔卫生。
OHAI包括（I）访谈、（II）临床检查、（III）口腔卫生活动观察以及一个总结部分。在该研究中，三组共149名老年人参与：中风患者、认知障碍患者和普通牙科患者。纳入标准为年龄≥65岁、至少有一颗牙齿且能在无协助的情况下进行口腔卫生护理。对于标准效度，使用八种参考工具计算敏感性和特异性。为确定结构效度，我们使用了已知组效度、因子分析和拉施分析。
发现OHAI的标准效度和结构效度为可接受至良好。在中风组中，评估发现平衡和精细运动技能对口腔卫生影响最大；在认知障碍组中，是平衡、协调、空间能力和认知功能。分析表明有一项没有附加价值，且一些回答选项并非最佳。
事实证明，OHAI对其目标群体有效，只需进行少量修订，最终形成一个包含32个条目的工具。OHAI可能是为口腔卫生不佳的老年人提供预防性护理的一种有价值的以人为本的工具。
