| PART 1: DEVELOPMENT OF THE ORAL HEALTH IMPACT PROFILE FOR CHRONIC PERIODONTITIS(INITIAL VERSION)Objective: This study aims to develop a specific measure for assessment of the Oral Health-Related Quality of Life(OHRQo L)of patients with chronic periodontitis(initial version),according to the standard measuremnet development methods.Methods: The item pool of the measure was firstly established based on the widely used Oral health impact profile-49(OHIP-49),literature review and patient interview.Second,based on the suggestions of the members of the research group,the item pool was summed up: the items with similar meanings or similar items were merged,and the items in the original OHIP-49 scale which were not related to chronic periodontitis were deleted.Next,a total of 18 experts were selected to take part in the two round Delphi study.They were asked to evaluate the importance of the items and give suggestions on the amendments to the items.According to the results of the second round of expert consultation,the preliminary selection of items was accomplished.Results: Based on the results of literature review,patient interviews,and suggestions of the members of the research group,an item pool with 50 items was initially developed.For the positive coefficient of experts,the first and second rounds of the response rates of the quesionnnaries were 81.8% and 88.9%,respectively.For the expert authority coefficients,the first round and second round expert authority coefficients(Cr)were 0.87 and 0.88,respectively.For the expert coordination coefficients,the first round and second rounds of expert coordination coefficients Kendall's W values were 0.396(P < 0.01)and 0.410(P < 0.01),respectively.According to the standard,23 items were retained to form the intial measurement.Conclusion: The oral health impact profile for chronic periodontitis(initial version)consisting of 23 items was successfully developed.PART 2: DEVELOPMENT OF THE ORAL HEALTH IMPACT PROFILE FOR CHRONIC PERIODONTITIS(FINAL VERSION)Objective: To develop the final version of the oral health impact profile for chronic periodontitis.Methods: 130 chronic periodontitis patients were investigated using the initial version of the oral health impact profile for chronic periodontitis.We used the critical ratio,correlation analysis,internal consistency and factor analysis to re-evaluate the items of the scale.The remainging items formed the final measurement.Then,the factor analysis of the final scale is re-tested to ensure the rationality of the retention items and to perform the preliminary study of the dimension structure of the scale.Results: We used the five kinds of statistics produced by four statistical methods to re-evaluate the items.A total of 5 items were deleted and 18 items were retained to form the final measurement.The results of the preliminary study on the dimension structure of the scale showed that the scale included 3 dimensions,including oral function restriction,oral pain,psychological and social impact,and the cumulative variance contribution rate was 65.270%.Conclusion: The oral health impact profile for chronic periodontitis(final version)consisting of three dimensions and 18 items was successfully developed.PART 3: RELIABILITY AND VALIDITY OF THE ORALHEALTH IMPACT PROFILE FOR CHRONIC PERIODONTITISObjective: To evaluate the reliability and validity of the oral health impact profile for chronic periodontitis.Methods: A total of 238 patients with chronic periodontitis were enrolled in our hospital to complete the questionnaire.The validity of the scale was evaluated by content validity,construct validity,discriminant validity and convergent validity.In addition,the reliability of the scale was evaluated by the internal consistency reliability,the split half reliability and the test-retest reliability.The response rate and completion rate of the sacle were 100%,and the average completion time was 9.2±4.5 minutes.For the content vality of the scale,our study is based on the relevant standards,two rounds of Delphi methods and four statistical methods to select and modify items,which can ensure that the scale has a good content validity.For the construct vality of the scale,the results of the confirmatory factor analysis showed that the three-factor model met the relevant standard,and the standardized path coefficient of each item of the scale was between 0.50 and 0.91.For the discriminant vality of the scale,the OHIP-CP scores in the mild,moderate and severe chronic periodontitis were statistically significant.The OHIP-49 scores in the mild and severe chronic periodontitis were statistically significant,however,the OHIP-49 scores in the mild and moderate chronic periodontitis and in the moderete and severe chronic periodontitis were not statistically significant.For the convergence validity of the scale,the Spearman's rank correlation coefficient for the total and subscale of the OHIP-CP are between 0.424 and 0.505.For the internal consistency reliability of the scale,the Cronbach's values for the total and subscales of the OHIP-CP were between 0.830-0.936.For the split half reliability the scale,the half-confidence coefficients for the total and the subscales of the OHIP-CP were between 0.796-0.890.For the test-retest reliability of the scale,the intraclass correlation coefficient values(ICC)for the total and subscales of the OHIP-CP were between 0.803 and 0.884.Conclusion: The OHIP-CP has good reliability and validity,and it can be further applied in the population of chronic periodontitis.PART 4: AN EPIDEMIOLOGICAL SURVEY ON ORAL HEALTH-RELATED QUALITY OF LIFE OF PEOPLE WITH CHRONIC PERIODONTITIS IN CHONGQINGObjective: To investigate the association between chronic periodontitis and oral health-related quality of life in the general population of Chongqing,and to provide some advices for the public health policy development.Methods: Based on the 4th National Oral Health Survey of China,three age groups(35-to 44-,55-to 64-and 65-to 74-year-olds)were covered by the PPS sampling method.A total of 432 people were recruited.The CPI probe was used for periodontal examination.Residents were divided into periodontal health group and chronic periodontitis group using the CPI score criteria recommended by the World Health Organization(WHO).After periodontal examination,people were asked to complete the OHIP-CP.The internal consistency reliability of the scale is calculated by Cronbach's coefficients.The measurement data and numeration data were described by the ±s and constituent ratio,respectively.The univariate analysis of influence factors of the scores of OHIP-CP was performed by the Mann-Whitney U test or one-way ANOVA.The multivariate analysis of influence factors of the scores of OHIP-CP was carried out by the Logistic regression.Results: A total of 408 valid questionnaires were collected.The scores of the OHIP-CP were 30.46±10.96 in the people with chronic periodontitis,and the scores of the OHIP-CP were 21.84±11.59 in the periodontal healthy people.The Cronbach's a values for the total score and subscales of the OHIP-CP were between 0.817 and 0.947.The results of the univariate analysis of influence factors of the scores of OHIP-CP showed that there were significant differences in oral helth-related quality of life between different age,educational level,family income,smoking status,brushing frequency and remaining number of teeth(P <0.05).The results of the multivariate analysis of influence factors of the scores of OHIP-CP showed that participants with chronic periodontitis had 2.89-fold higher odds for the OHIP-CP scores compared with participants without chronic periodontitis.In addition,age,education level,smoking history,brushing frequency,the remaining teeth are the main influce factors of the quality of life.Conclusion: Chronic periodontitis was associated with poorer quality of life in Chongqing adults.Certain socio-demographic variables,including higher age,lower educational level,current smokers,lower brushing frequency and number of missing teeth,had negative associations with OHRQo L. |
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