A Persian version of Geriatric Oral Health Assessment Index

Psychometric properties of the Urdu version of the Geriatric Oral Health Assessment Index (GOHAI) and oral health-related quality of life in the elder Pakistani population

OBJECTIVE

The study aimed to translate the English version of the Geriatric Oral Health Assessment Index, assess its reliability and validity, and demonstrate its psychometric properties with regard to OHRQoL in the elder Pakistani population.

MATERIAL AND METHODS

In this cross-sectional study, 408 elder people were randomly recruited from three day-care centres. In the translation process, the translated Urdu version was reviewed by a committee of experts, followed by back-translation into English and re-reviewed by the same committee of experts. The questionnaire sought information about socio-demographic characteristics information and self-perception of oral, general health and treatment needs. OHRQoL was examined using GOHAI-U, and intraoral examination recorded the decayed, missing, and filled teeth. Reliability, internal consistency, convergent and discriminant validity of GOHAI-U were examined.

RESULTS

The mean GOHAI-U score was 40.2 (SD = 5.7, range = 20-55). The Cronbach's alpha for GOHAI score was 0.71, item-scale correlation coefficients ranged from 0.63 to 0.76, and test-retest correlation ranged from 0.59 to 0.74. Three factors supported the theoretical construction in the component factor analysis of the index. For convergent validity, there was a significant relationship between the GOHAI score and self-perceived oral, general health and treatment needs (P < .05). For discriminant validity, a significant correlation was found between the GOHAI score and clinical measures of dental health status except with the carious teeth.

CONCLUSION

The GOHAI-U has sufficient reliability and constructs validity to be used as an efficient measure of oral health-related quality of life in the Pakistani elder population.

Oral Health-Related Quality of Life in Chronic Liver Failure Patients Measured by OHIP-14 and GOHAI

Background

Oro-dental diseases are prevalent in chronic liver failure (CLF) patients. The aim of this study was to evaluate the quality of life associated with oral health in candidates for liver transplant surgery.

Materials and Methods

The demographic information of 105 end-stage liver cirrhotic patients was collected. All patients were ordered a panoramic view for pretransplant dental evaluation. The DMFT (decayed-missing-filled tooth) index was calculated for dental examination. The model for end-stage liver disease (MELD) was used for the severity of liver disease. The OHIP-14 (Oral Health Impact Profile) questionnaire and GOHAI (Geriatric Oral Health Assessment Index) questionnaire were applied to evaluate the impact of oral disease on the quality of life.

Results

A total of 79 patients thoroughly completed the questionnaires; 79.7% were male, 32.9% were over 50, and 25.3% were less than 30 years old. Further, 12.7% smoked, 2.5% were illiterate, 64.6% had not finished school, and 10.1% had university degrees. Almost half of the cirrhotic patients were suffering from the disease for more than 3 years. Most complaints reported by the patients as “very often” were becoming self-conscious (13.9%) and being uncomfortable when eating any foods (13.9%) followed by feeling tense (12.8%). There was no significant difference between gender, smoking, age, and MELD score based on quality of life (OHIP and GOHAI) (P > 0.05). The level of education (P = 0.020), duration of disease (P = 0.017), and DMFT index (P = 0.039) had a significant impact on oral health-related quality of life in CLF patients. An inverse relationship was seen between the DMFT index and the quality of life.

Conclusion

Oral health has a high impact on the quality of life of cirrhotic patients. The psychological dimension of oral health is the most debilitating factor affecting the quality of life. This shows the importance of professional oral care, oral health, and self-care education in this group of patients.

Evaluation of Oral Health Status Using the Geriatric Oral Health Assessment Index Among the Geriatric Population in India: A Pilot Study

Introduction and aim Clinical indicators alone are insufficient for evaluating oral health. In addition to health and disease, oral health includes socio-dental indicators of physical, psychological, and social aspects of well-being. The adaptive capacity of an individual influences the perception of oral health-related quality of life (OHRQoL). Indices such as the Oral Health Impact Profile, Oral Impacts on Daily Performances, and the Geriatric Oral Health Assessment Index (GOHAI) have been used to measure OHRQoL. This study was designed to assess OHRQoL in older individuals using the GOHAI. Methods Subjects aged older than 65 years who visited our institution from January to March 2016 were included. Subjects with cognitive behavior disorders were excluded. Subjects were assigned into three groups based on age: 65-69 years, 70-74 years, and 75 years or older. The participants were asked 12 questions, and their responses were assessed by age group. Our Institutional Ethics Committee approved the study protocol. Results The 219 subjects recruited included 126 (57.5%) patients aged 65-69 years, 57 (26.0%) patients aged 70-74 years, and 36 (16.4%) patients aged 75 years or older. Several physical, physiological, and psychological aspects of the GOHAI differed significantly among these three groups, with overall OHRQoL decreasing with age. Conclusion Although oral healthcare problems were widespread in the geriatric population, they were not a primary concern. Attitudes toward dentistry require improvement. However, further studies in larger populations are required to assess geriatric oral health.

Validation of a modified version of the Spanish Geriatric Oral Health Assessment Index (GOHAI-SP) for adults and elder people

Background

The Geriatric Oral Health Assessment Index (GOHAI) was developed and validated in 1990 and translated into Spanish in 1999. Since then, the original version has been used in numerous studies, but it has not been re-evaluated in terms of language in the new generations of older adults. The purpose of this study is to confirm the validity of the Spanish version of the Geriatric Oral Health Assessment Index (GOHAI-SP) after three decades to be used as part of an ongoing field trial.

Methods

The GOHAI-SP was pilot tested in a focus group to confirm linguistic comprehension. A version with minor language changes was administered to individuals with metabolic syndrome aged 55–75 years from one health care district in southern Spain as part of an ongoing field trial (PREDIMED-Plus). Clinical evaluation included assessment of dental and periodontal status. The psychometric properties of the GOHAI-SP were evaluated through stability and internal consistency measures, and concurrent and discriminant validity were assessed.

Results

The new version of the GOHAI-SP was administered to 100 individuals. The application time was reduced by 7 min. The alpha value for reliability was 0.87. The item-scale correlation coefficients ranged from 0.54 to 0.75, and the test–re-test correlation for the total score was 0.75. There were inverse correlations between GOHAI-SP scores and the number of lost teeth and the decayed-missing-filled teeth index (p < 0.001).

Conclusions

The GOHAI-SP questionnaire remains a valid and useful tool to assess oral health-related quality of life in primary health care settings. A linguistic update of the questionnaire brought improvements to the instrument application.

Trial registration

The PREDIMED-Plus trial is registered in the ISRCTN registry with reference number ISRCTN89898870. Registration date: 4th July 2014.

Objective and perceived oral health status of elderly nursing home residents: a local survey in southern France

Objective

The aim of this study was to compare the perceived oral health of elderly persons and the clinical reality of their oral status.

Background

Persons aged over 60 have considerable need for oral health care; a need that increases over time. However, this population appears to be unaware of their state of oral health, and this may be a further obstacle to professional management. We thought it useful to examine the objective and the perceived oral health of these patients. Understanding what may influence their perception can help us to improve their management.

Methods

The data analyzed in this work are the findings of a field survey carried out in elderly nursing home residents. Their objective oral health was evaluated by using two variables: oral profile, determined by clinical examination, and the oral health index determined using the Oral Health Assessment Tool (OHAT). Perceived oral health was evaluated using the various categories and fields of the General Oral Health Assessment Index (GOHAI).

Results

Our clinical study showed a discrepancy between perceived oral health and the clinical reality: although a significant association can be demonstrated between the OHAT and the GOHAI, there are considerable variations. It also appeared that the number of teeth and total edentation considerably influence perceived oral health and that findings vary according to different situations.

Conclusion

Numerous factors influence elderly persons' perception of their true oral health. In order to improve our elders' quality of life, the necessary measures must be taken for the follow-up and regular monitoring of their oral health. At the same time, all possible means should be used and awareness should be raised to improve the health behavior and perception of patients and their entourage.

Cultural adaptation and validation of the Geriatric Oral Health Assessment Index - GOHAI - Colombian version

Objective

This study aims to carry out the cultural adaptation and the validation of the GOHAI scale for the Colombian population.

Methods

Translation process, cultural adaptation, and content and face validity were carried out with a sample of 63 participants as a pretest. The validation counted with a sample of 7,200 subjects, divided into two groups: a work sample (WS) with 3,628 subjects and a confirmatory sample (CS) with 3,572 subjects. Construct, criterion validity and internal consistency were performed for both samples. Test-retest reliability was assessed with a sub-sample of 75 participants.

Results

The GOHAI showed an appropriate face and content validity, the pre-test revealed an understandable questionnaire, the scale showed a unidimensional factorial structure and a Cronbach's Alpha of 0.8. Convergent validity with a self-perception on general health scale pointed to a significant correlation (p= 0.0001), while discriminant validity showed significant differences regarding groups according to age group, skin color, educational level, socio-economic level, healthcare affiliation and self-perception about need of dental prostheses. Gender groups did not show significant differences among groups within either sample. The CS showed similar results, differences existed among factorial structures of 2 and 3 factors, and for discriminant validity, the CS showed statistically significant differences for the Area variable not in the WS. Kendall's test-retest analysis's correlation is 0.85 (p= 0.0000).

Conclusions

The GOHAI scale is valid and reliable enough to be used as a measure of Oral-Health-Related Quality of Life in the Colombian elderly population, also could be applied for other Latin-American populations.

Oral Health-Related Quality of Life among Elderly People with Edentulous Jaws in Hafar Al-Batin Region, Saudi Arabia

Aims and Objectives:

The aims of this study were to determine oral health-related quality of life (OHRQoL) among elderly people aged 65 and above years from Hafar Al-Batin area, Saudi Arabia, by utilizing Arabic version of Geriatric Oral Health Assessment Index (GOHAI-Ar).

Materials and Methods:

This was a cross-sectional study undertaken from October 2017 to December 2017. A convenience sampling methodology was employed to select the elderly patients aged ≥65 years attending dental clinics of primary health-care centers in five different regions of the Hafar Al-Batin, Saudi Arabia. OHRQoL of the participants was measured using the Saudi Arabian version of GOHAI-Ar. The oral examinations performed to record a total number of remaining natural teeth, complete and removable partial dentures, and fixed partial dentures. Descriptive and inferential statistics were performed.

Results:

A total of 200 elderly participants (M = 157 and F = 43) having mean age (± standard error [SE]) was 69.26 (±0.34) years, participated in the study. Mean ± SE of GOHAI-Ar was 27.68 ± 0.54, physical function 9.12 ± 0.26, pain and discomfort (6.87 ± 0.18), and psychological discomfort (11.69 ± 0.25). Remaining natural teeth and prosthodontic status significantly correlated with pain and discomfort. The presence of prosthesis was found to influence the psychological function. Gender and prosthodontic statuses were found to have significant correlation with OHRQoL.

Conclusion:

Poor OHRQoL among elderly from Hafar Al-Batin city was found, and presence dental prosthesis showed a positive impact on OHRQoL.

Validation and comparison of the Arabic versions of GOHAI and OHIP-14 in patients with and without denture experience

BACKGROUND

The assessment of oral heath related quality of life (OHRQoL) for complete denture wearers according to a participant's subjective perception may provide an indication of the adaptive capacity of the individual. The aim of this study was to compare and assess the validation of two quality of life measures, the Oral Health Impact Profile-14 (OHIP-14) and Geriatric Oral Health Assessment Index (GOHAI), in patients with and without previous denture experience.

METHODS

A total of 69 elders (36 male and 34 female; mean age, 63 years) from Dental Clinics of the University of Khartoum and the National University in Sudan, with and without previous denture experience, were included in the study. OHRQoL was assessed using two Arabic-translated questionnaires (OHIP-14 and GOHAI) before and after complete denture therapy. Global self-ratings of oral and general health were obtained, and denture satisfaction was assessed using the Denture Satisfaction questionnaire.

RESULTS

Both tools had significant correlations with self-rating oral health in patients without denture experience (P < 0.05). However, no significant correlations were found in patients with denture experience. There were significant differences between pre-and post-treatment total scores with both the GOHAI and OHIP-14 (P < 0.001). Responsiveness to treatment using GOHAI and OHIP-14 revealed overall mean effect size higher in patients without (1.49) and (0.83) than those with previous denture experience (0.89) and (0.60), respectively. However, neither tool could detect significant differences between patients with and without denture experience (P > 0.05).

CONCLUSION

Greater improvements of OHRQoL after complete denture therapy were observed in participants without than those with previous denture experience. The Arabic-translated versions of GOHAI and OHIP-14 can be regarded as effective measures for assessing treatment outcomes of complete denture therapy.

Validation of a Dutch version of the Geriatric Oral Health Assessment Index (GOHAI-NL) in care-dependent and care-independent older people

BACKGROUND

The GOHAI is a frequently used instrument to measure oral health-related quality of life (OHRQoL) of adults, in particular older people. The aim of this study was to translate the original English version of the GOHAI into a Dutch version (GOHAI-NL), and to test the validity and reliability of the GOHAI-NL in care-independent and care-dependent older people.

METHODS

The GOHAI questionnaire was translated into Dutch, discussed by an expert panel, back-translated to the original, pilot-tested and assessed for cognitive and conceptual equivalence. The resulting GOHAI-NL was tested in a groups of care-independent (Group A, n = 109, mean age 73.1 ± 5.4 years) and care-dependent (Group B, n = 118, mean age 85.6 ± 7.0. years) cognitively alert people of 65 years and over. Psychometric properties including reliability (internal consistency, item-total, item-dimension, dimension-total, inter-item correlation, and test-retest stability), and validity (convergent, discriminant, known-group), and floor and ceiling effects were assessed.

RESULTS

Internal consistency was confirmed by Cronbach's alphas of 0.86 (group A) and 0.80 (group B). Item-total score correlations were between 0.4 and 0.7 except for item 3 in group A (0.34) and B (0.08) and for item 12 in group A (0.20). Item-dimension and dimension-total correlations were between 0.30 and 0.78 and around 0.7 respectively for the dimensions 'physical functioning' and 'psychosocial functioning', but lower for the dimension 'pain and discomfort' with item-dimension correlations between 0.13 and 0.44. Average inter-item correlations were 0.34 ± 0.11 (group A) and 0.33 ± 0.08 (group B). Test-retest correlation of the total score (GOHAI-ADD) was 0.88 in group A (ICCs: 0.62 - 0.88) and 0.93 in group B (ICCs: 0.64 - 0.91). Significant correlations in the expected direction were found between GOHAI and most oral health-related variables except for presence of caries in group A, and perceived general health, prosthodontic status and number of natural teeth in group B. No floor or ceiling effects were detected at GOHAI-ADD level; however ceiling effects did occur at dimension level.

CONCLUSION

The GOHAI-NL has satisfactory reliability and validity and can be used to measure OHRQoL in Dutch care-dependent and care-independent older people.