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Yon MJY, Chen KJ, Gao SS, Duangthip D, Lo ECM, Chu CH. An Introduction to Assessing Dental Fear and Anxiety in Children. Healthcare (Basel) 2020; 8:healthcare8020086. [PMID: 32260395 PMCID: PMC7348974 DOI: 10.3390/healthcare8020086] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/26/2020] [Accepted: 04/01/2020] [Indexed: 01/30/2023] Open
Abstract
Fear and anxiety constitute an important theme in dentistry, especially with children. Anxiety and the fear of pain during dental treatment can lead to avoidance behaviour, which contributes to perpetuating fear and anxiety of dental care. Understanding and assessing dental fear and anxiety in children is important for delivering successful dental care with high satisfaction in this age group. Among the vast assessment method options available today, self-report assessment, parental proxy assessment, observation-based assessment, and physiological assessment are the four major types for dental fear and anxiety in children. Each method has its own merits and limitations. The selection of a method should be based on the objectives, validity, and setting of the assessment. The aim of this paper is to review and discuss the assessment methods for dental fear and anxiety in children.
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Kim G, Carrico C, Ivey C, Wunsch PB. Impact of sensory adapted dental environment on children with developmental disabilities. SPECIAL CARE IN DENTISTRY 2019; 39:180-187. [PMID: 30729554 DOI: 10.1111/scd.12360] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/18/2018] [Accepted: 01/18/2019] [Indexed: 11/29/2022]
Abstract
AIMS This was a pilot study assessing the impact of a sensory adapted dental environment (SADE) on children with developmental disabilities (DD) receiving routine dental care. METHODS A crossover study of 22 children with DD, aged 6 through 21, was conducted at a University Pediatric Dental clinic. Each participant was randomized to a sequence of two dental cleanings on a 3- to 4-month recall schedule, one with a regular dental environment (RDE) and one with SADE. Outcomes included physiological measures (heart rate and oxygen saturation) and cooperation (Frankl scores). RESULTS Study subjects completed 36 visits. None of the physiological measures differed at either time point between the two treatment settings. The Frankl scores were significantly higher with SADE setting than RDE (P = 0.0368). Forty-six percent of parents strongly agreed that they would prefer the SADE for their child's next visit. CONCLUSION SADE may be associated with improved behavior in children with DD.
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Affiliation(s)
- Gail Kim
- Department of Pediatric Dentistry, Virginia Commonwealth University, Richmond, Virginia.,Private Practice, Charlottesville, Virginia
| | - Caroline Carrico
- Department of Oral Health Promotion and Community Outreach, Virginia Commonwealth University, Richmond, Virginia
| | - Carole Ivey
- Department of Occupational Therapy, Virginia Commonwealth University, Richmond, Virginia
| | - Patrice B Wunsch
- Department of Pediatric Dentistry, Virginia Commonwealth University, Richmond, Virginia
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Ghadimi S, Estaki Z, Rahbar P, Shamshiri AR. Effect of visual distraction on children's anxiety during dental treatment: a crossover randomized clinical trial. Eur Arch Paediatr Dent 2018; 19:239-244. [PMID: 29949082 DOI: 10.1007/s40368-018-0352-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 05/14/2018] [Indexed: 02/05/2023]
Abstract
AIM This was to evaluate the effect of visual distraction on anxiety of children during dental treatment. MATERIALS AND METHODS This randomized, crossover clinical trial study was conducted on 28 children (aged 4-5 years) randomly divided into two groups of 14 each. Group 1, treatment procedure in the first visit was completed while the patients were watching a cartoon as a visual distraction tool, at the second visit, the procedure was carried out with conventional tell-show-do. Group 2, had visual distraction in their second visit and conventional tell-show-do during the first visit. Treatment procedures were similar in both groups during two sessions. The anxiety level was determined using Venham picture test and pulse rate (PR) at the beginning and the end of each appointment. Patient behaviour was also scored using Frankl behaviour rating scale (FBRS). RESULTS Self-reported dental anxiety was reduced significantly by visual distraction (p-value < 0.001) compared to conventional tell-show-do, but it did not change FBRS scores significantly (p-value = 0.24). CONCLUSION Use of visual distraction improves self-reported anxiety and decreases PR of children but does not change their behaviour.
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Affiliation(s)
- S Ghadimi
- Laser Research Centre of Dentistry, Dental Research Institute, Department of Paediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, North Kargar St, Tehran, 14399-55991, Iran
| | - Z Estaki
- Department of Paediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, North Kargar St, Tehran, 14399-55991, Iran.
| | - P Rahbar
- Department of Paediatric Dentistry, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzistan Province, 6135715775, Iran
| | - A R Shamshiri
- Research Centre for Caries Prevention, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, North Kargar St, Tehran, 14399-55991, Iran
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Seligman LD, Hovey JD, Chacon K, Ollendick TH. Dental anxiety: An understudied problem in youth. Clin Psychol Rev 2017; 55:25-40. [PMID: 28478271 DOI: 10.1016/j.cpr.2017.04.004] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 04/10/2017] [Accepted: 04/14/2017] [Indexed: 12/16/2022]
Abstract
Dental anxiety and dental phobia typically emerge during childhood; the associated avoidance of dental care can result in oral health problems and is associated with lower quality of life. In this review, we discuss the definition of dental phobia and dental anxiety and issues related to their differentiation. We then review the literature on dental anxiety and dental phobia, including its prevalence, assessment, and sequalae. Moreover, we provide a synthesis of findings on the etiology and maintenance of dental phobia and propose a comprehensive cognitive behavioral model to guide further study. We also present a systematic qualitative and a quantitative review of the treatment literature, concluding that although we have made strides in learning how to prevent dental anxiety in youth, the methods effective in preventing anxiety may not be equally effective in treating youth with dental phobia. We propose a multidisciplinary approach, including those with expertise in pediatric anxiety as well as pediatric dentistry, is likely required to move forward.
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Affiliation(s)
- Laura D Seligman
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX 78539, USA.
| | - Joseph D Hovey
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX 78539, USA
| | - Karina Chacon
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX 78539, USA
| | - Thomas H Ollendick
- Child Study Center, Department of Psychology, Virginia Tech, Blacksburg, VA 24060, USA
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Cermak SA, Stein Duker LI, Williams ME, Dawson ME, Lane CJ, Polido JC. Sensory Adapted Dental Environments to Enhance Oral Care for Children with Autism Spectrum Disorders: A Randomized Controlled Pilot Study. J Autism Dev Disord 2016; 45:2876-88. [PMID: 25931290 DOI: 10.1007/s10803-015-2450-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This pilot and feasibility study examined the impact of a sensory adapted dental environment (SADE) to reduce distress, sensory discomfort, and perception of pain during oral prophylaxis for children with autism spectrum disorder (ASD). Participants were 44 children ages 6-12 (n = 22 typical, n = 22 ASD). In an experimental crossover design, each participant underwent two professional dental cleanings, one in a regular dental environment (RDE) and one in a SADE, administered in a randomized and counterbalanced order 3-4 months apart. Outcomes included measures of physiological anxiety, behavioral distress, pain intensity, and sensory discomfort. Both groups exhibited decreased physiological anxiety and reported lower pain and sensory discomfort in the SADE condition compared to RDE, indicating a beneficial effect of the SADE.
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Affiliation(s)
- Sharon A Cermak
- Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, 1540 Alcazar St, CHP 133, Los Angeles, CA, 90089, USA,
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Baker-Ward L, Quinonez R, Milano M, Lee S, Langley H, Brumley B, Ornstein PA. Predicting Children's Recall of a Dental Procedure: Contributions of Stress, Preparation, and Dental History. APPLIED COGNITIVE PSYCHOLOGY 2015. [DOI: 10.1002/acp.3152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Lynne Baker-Ward
- Department of Psychology; North Carolina State University; Raleigh USA
| | - Rocio Quinonez
- Department of Pediatric Dentistry, School of Dentistry; University of North Carolina at Chapel Hill; Chapel Hill USA
| | - Michael Milano
- Department of Pediatric Dentistry, School of Dentistry; University of North Carolina at Chapel Hill; Chapel Hill USA
| | - Seungjin Lee
- Department of Psychology; University of North Carolina at Chapel Hill; Chapel Hill USA
| | - Hillary Langley
- Department of Psychology; University of North Carolina at Chapel Hill; Chapel Hill USA
| | - Benjamin Brumley
- Department of Psychology; University of North Carolina at Chapel Hill; Chapel Hill USA
| | - Peter A. Ornstein
- Department of Psychology; University of North Carolina at Chapel Hill; Chapel Hill USA
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Warren JJ, Weber-Gasparoni K, Tinanoff N, Batliner TS, Jue B, Santo W, Garcia RI, Gansky SA. Examination criteria and calibration procedures for prevention trials of the Early Childhood Caries Collaborating Centers. J Public Health Dent 2015; 75:317-26. [PMID: 26011444 DOI: 10.1111/jphd.12102] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 04/03/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To summarize diagnostic criteria and examiner training and calibration of the National Institute of Dental and Craniofacial Research-funded Early Childhood Caries Collaborating Centers (EC4) and report examiner calibration results from 2010 to 2014. The EC4 at Boston University, University of Colorado, and University of California San Francisco are performing randomized controlled early childhood caries (ECC) prevention trials with caries as the main outcome measure. METHODS The EC4 with University of Iowa consultants developed standardized tooth and tooth surface status examination criteria for use in field conditions, examiner training materials, and examiner calibration and re-calibration methodologies. Calibration and re-calibration were performed with 1- to 5-year-old children in the San Francisco Mission District in which assessments from each examiner to be calibrated were compared with those from a single gold standard examiner from 2010 to 2014. Cohen's kappa statistic was used to determine inter-examiner agreement. RESULTS A total of seven examiners were successfully (re)calibrated during that period, examining a total of 231 children. Overall unweighted Cohen's kappas for 10 surface conditions exceeded the criterion of 0.70. However, separate agreement for assessment of noncavitated lesions, as in other studies, was lower. CONCLUSIONS An experienced multidisciplinary and multi-institutional team was able to develop criteria and training materials to anticipate situations and field conditions the main trials would encounter. Examiners were successfully trained and (re)calibrated.
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Affiliation(s)
- John J Warren
- University of Iowa College of Dentistry, Iowa City, IA, USA
| | | | - Norman Tinanoff
- University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Terence S Batliner
- School of Dental Medicine, University of Colorado-Anschutz Medical Campus, Denver, CO, USA
| | - Bonnie Jue
- University of California, San Francisco School of Dentistry, San Francisco, CA, USA
| | - William Santo
- University of California, San Francisco School of Dentistry, San Francisco, CA, USA
| | - Raul I Garcia
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
| | - Stuart A Gansky
- University of California, San Francisco School of Dentistry, San Francisco, CA, USA
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Al-Namankany A, Ashley P, Petrie A. Development of the first Arabic cognitive dental anxiety scale for children and young adults. World J Meta-Anal 2014; 2:64-70. [DOI: 10.13105/wjma.v2.i3.64] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 05/27/2014] [Accepted: 06/27/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To validate the Arabic version of abeer children dental anxiety scale.
METHODS: Two ethical approvals for this study were obtained from United Arab Emirates, Ministry of Health and Dubai Health Authority; reference number: 2011/57. The Abeer children dental anxiety scale (ACDAS) was translated from English to Arabic by the native speaker chief investigator, and then back translated by another native speaker in Dubai (AS) to ensure comparability with the original one. Part C of ACDAS was excluded for the schoolchildren because those questions were only applicable for children at the dentist with their parents or legal guardian. A total of 355 children (6 years and over) were involved in this study; 184 in Dubai, 96 from the Religious International Institute for boys and 88 from Al Khansaa Middle School for girls. A sample of 171 children was assessed for external validity (generalizability) from two schools in different areas of London in the United Kingdom.
RESULTS: Receiver operating characteristic curve showed that the cut-off ≥ 26 for ACDAS gave the optimal results for sensitivity = 90% (95%CI: 81.2%- 95.6%), and specificity = 86.6% (95%CI: 78.2%- 92.7%), with AUROC = 0.93 (95%CI: 0.90-0.97). Cronbach’s Alpha (α) was 0.90 which indicated good internal consistency. Results of the external validity assessing the agreement between ACDAS and dental subscale of the children's fear survey schedule was substantial for the East London school (κ = 0.68, 95%CI: 0.53-0.843); sensitivity = 92.9% (95%CI: 82.7%-98.0%); specificity = 73.5% (95%CI: 55.6%-87.1%) and almost perfect for the Central London school (κ = 0.79; 95%CI: 0.70-0.88); sensitivity = 96.4% (95%CI: 81.7%-99.9%); specificity = 65.9%, (95%CI: 57.4%-73.8%).
CONCLUSION: The Arabic ACDAS is a valid cognitive scale to measure dental anxiety for children age 6 years or over.
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Physiological and behavioral stress and anxiety in children with autism spectrum disorders during routine oral care. BIOMED RESEARCH INTERNATIONAL 2014; 2014:694876. [PMID: 25114916 PMCID: PMC4119730 DOI: 10.1155/2014/694876] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 06/03/2014] [Indexed: 12/28/2022]
Abstract
BACKGROUND Children with autism spectrum disorders (ASD) commonly exhibit uncooperative behaviors which impede oral care. Previous studies have utilized dentist-report measures of uncooperative behaviors in children with ASD but none have utilized an objective measure of children's behavior or a physiological measure of distress. This study investigated behavioral and physiological distress in children with ASD during routine oral care and examined factors associated with this distress. METHODS Participants were 44 children (n=22 typical, n=22 ASD) aged 6-12 receiving routine dental cleanings. Behavioral and physiological measures of stress and anxiety were collected during dental cleanings. RESULTS Children with ASD exhibited greater distress, compared to the typical group, on dentist-report and researcher-coded measures of overt distress behaviors and on physiological measures. Correlations between physiological and behavioral measures of distress were found in the ASD but not in the typical group. Behavioral distress was correlated with age in the typical group and with expressive communication ability and sensory processing difficulties in the ASD group; physiological distress was correlated with parent-report of anxiety in the typical group and sensory processing difficulties in the ASD group. CONCLUSIONS Novel strategies may be required to decrease behavioral and physiological distress in children with ASD in the dental clinic.
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Porritt J, Buchanan H, Hall M, Gilchrist F, Marshman Z. Assessing children's dental anxiety: a systematic review of current measures. Community Dent Oral Epidemiol 2012; 41:130-42. [DOI: 10.1111/j.1600-0528.2012.00740.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 07/07/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Jenny Porritt
- Academic Unit of Oral Health and Development; School of Clinical Dentistry, University of Sheffield; Sheffield; S10 2TA; UK
| | - Heather Buchanan
- Institute of Work, Health & Organisations, University of Nottingham; Nottingham; NG8 1BB; UK
| | - Melanie Hall
- Academic Unit of Oral Health and Development; School of Clinical Dentistry, University of Sheffield; Sheffield; S10 2TA; UK
| | - Fiona Gilchrist
- Academic Unit of Oral Health and Development; School of Clinical Dentistry, University of Sheffield; Sheffield; S10 2TA; UK
| | - Zoe Marshman
- Academic Unit of Oral Health and Development; School of Clinical Dentistry, University of Sheffield; Sheffield; S10 2TA; UK
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Evidence-based dentistry: analysis of dental anxiety scales for children. Br Dent J 2012; 212:219-22. [PMID: 22402535 DOI: 10.1038/sj.bdj.2012.174] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2011] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To review paediatric dental anxiety measures (DAMs) and assess the statistical methods used for validation and their clinical implications. METHOD A search of four computerised databases between 1960 and January 2011 associated with DAMs, using pre-specified search terms, to assess the method of validation including the reliability as intra-observer agreement 'repeatability or stability' and inter-observer agreement 'reproducibility' and all types of validity. RESULTS Fourteen paediatric DAMs were predominantly validated in schools and not in the clinical setting while five of the DAMs were not validated at all. The DAMs that were validated were done so against other paediatric DAMs which may not have been validated previously. Reliability was not assessed in four of the DAMs. However, all of the validated studies assessed reliability which was usually 'good' or 'acceptable'. None of the current DAMs used a formal sample size technique. Diversity was seen between the studies ranging from a few simple pictograms to lists of questions reported by either the individual or an observer. CONCLUSION To date there is no scale that can be considered as a gold standard, and there is a need to further develop an anxiety scale with a cognitive component for children and adolescents.
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Jindal R, Kaur R. Can We Tune Our Pediatric Patients? Int J Clin Pediatr Dent 2011; 4:186-9. [PMID: 27678224 PMCID: PMC5034076 DOI: 10.5005/jp-journals-10005-1107] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 04/18/2011] [Indexed: 12/03/2022] Open
Abstract
For the pedodontic team, a child’s dental anxiety poses major management problems. Previously, wide variety of aversive techniques have been used with varying success rates to manage anxious child patients. The present trend advocates the use of nonaversive techniques like distraction in the management of anxious pediatric patients. So the aim of this study is to compare the effect of audio distraction with the normal set up operatory. Thirty patients of age between 4 and 8 years were included in the study. Each patient had gone through four dental visits. Anxiety was measured using Venham’s picture test. The values obtained were tabulated and statistical analysis and concluded that audio distraction did decrease the level of anxiety in anxious pediatric dental patients to a significant level during the restorative procedure visit (3rd) and invasive procedure visit (4th).
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Affiliation(s)
- Ritu Jindal
- Professor and Head, Department of Pedodontics, National Dental College and Hospital, Dera Bassi, Punjab, India
| | - Rajwinder Kaur
- Postgraduate Student, Department of Pedodontics, National Dental College and Hospital, Dera Bassi, Punjab, India
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Cremeens J, Eiser C, Blades M. Characteristics of Health-related Self-report Measures for Children Aged Three to Eight Years: A Review of the Literature. Qual Life Res 2006; 15:739-54. [PMID: 16688506 DOI: 10.1007/s11136-005-4184-x] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2005] [Indexed: 11/30/2022]
Abstract
AIMS To review and make recommendations about the format and quality of health-related self-report measures for children aged 3-8 years. METHODS Literature searches used to identify measures of QOL, self-esteem, self-concept and mental health. The format (i.e., scale type, presentation style) and quality (i.e., item generation, reliability, validity, responsiveness) of measures were compared and evaluated. RESULTS Fifty three measures were identified: QOL (n = 25, 47%), self-esteem/concept (n = 15, 28%), mental health (n = 13, 25%). Likert scales were used most frequently to represent response choices (n = 34, 64%). The authors of 11 (21%) measures provided justification for their scale choice. Items were most commonly presented in written format (n = 24, 45%). Item content was generated from the respondent population in only 21 (40%) measures. Twenty-seven (51%) measures reported internal reliability between 0.70 and 0.90, and 12 (23%) reported reproducibility in this range. Although validity was reported for 48 (91%) measures, evidence for three or more aspects occurred for only 9 (17%). Eleven (21%) measures evidenced responsiveness to change. CONCLUSION Authors should provide clearer evidence for reliability and responsiveness. Newly developed instruments need to meet established standards, and further studies should assess the impact of scale and presentation types on the psychometrics of measures.
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Affiliation(s)
- Joanne Cremeens
- Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, TN 38105-2794, USA.
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Nakai Y, Hirakawa T, Milgrom P, Coolidge T, Heima M, Mori Y, Ishihara C, Yakushiji N, Yoshida T, Shimono T. The Children's Fear Survey Schedule-Dental Subscale in Japan. Community Dent Oral Epidemiol 2005; 33:196-204. [PMID: 15853842 DOI: 10.1111/j.1600-0528.2005.00211.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aims of this research are to examine the reliability and validity of the Japanese version of the Dental Subscale of Children's Fear Survey Schedule (CFSS-DS), and to examine the responses of children in the dental setting and in the community. METHODS The CFSS-DS was translated into Japanese and administered to three samples. The first sample comprised 134 child patients aged 8-15 years, of whom 100 were assigned for test-retest analysis, and the behavior of the remaining 34 additional children were rated during their dental appointments, and compared with their questionnaire results. A second sample of 532 child patients aged 8-15 years, completed the CFSS-DS and also one additional item measuring fear of returning to the dentist. A third sample of 1250 school children aged 8-15 years was surveyed using the CFSS-DS and the additional item measuring fear of returning to the dentist. RESULTS The Japanese version of the CFSS-DS showed good internal consistency (alpha=0.91) and test-retest reliability (r=0.90), as well as good criterion validity assessed by the relationship with actual child behavior (r(s)=0.51). It also showed good construct validity assessed by correlation with willingness to return to the dentist. Fear levels were higher in the school sample than in the clinic sample (27.7 versus 24.6). Girls reported more fear than boys (26.2 versus 23.2 in the clinic sample, and 30.7 versus 24.8 in the school sample). Injections, choking, having a stranger touch them, and drilling were the most common fears. Factor analyses demonstrated a factor pattern similar to the results found in other cultures. CONCLUSION The results suggest that the CFSS-DS is reliable and valid and operates in Japan as it does in other cultures.
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Affiliation(s)
- Yukie Nakai
- Department of Behavioral Pediatric Dentistry, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
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Humphris GM, Freeman R, Campbell J, Tuutti H, D'Souza V. Further evidence for the reliability and validity of the Modified Dental Anxiety Scale. Int Dent J 2000; 50:367-70. [PMID: 11197195 DOI: 10.1111/j.1875-595x.2000.tb00570.x] [Citation(s) in RCA: 140] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIM To gain further evidence of the psychometric properties of the Modified Dental Anxiety Scale. SETTING Dental admission clinics. DESIGN Consecutive sampling, cross-sectional survey. PARTICIPANTS Patients (n = 800) in four cities (Belfast, Northern Ireland; Helsinki, Finland; Jyväskylä, Finland and Dubai, UAE). METHODS Questionnaire booklet handed to patients, attending clinics, for completion following an invitation by the researcher to be included in the study. MEASURES Modified Dental Anxiety Scale (MDAS), together with further questions concerning dental attendance and nervousness about dental procedures. RESULTS Overall 9.3 per cent of patients indicated high dental anxiety. MDAS showed high levels of internal consistency, and good construct validity. The relationship of dental anxiety with age was similar to previous reports and showed lowered anxiety levels in older patients. CONCLUSION Data from three countries has supported the psychometric properties of this modified and brief dental anxiety scale.
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Affiliation(s)
- G M Humphris
- Department of Clinical Psychology, Whelan Building, University of Liverpool, L69 3GB, UK.
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