Translation and preliminary validation of a French version of an ageism scale for dental students

Validation of the Polish version of an Ageism Scale for Dental Students (ASDS-PL)

BACKGROUND

Ageism is one of the common forms of discrimination and prejudice. It has also been shown to be present in health professionals, including doctors, nurses, and medical students.

AIMS

The aim of this study was to translate the Ageism Scale For Dental Students (ASDS) into Polish, perform a culture adaptation, and conduct a preliminary validation analysis.

METHODS

The survey was administered to 202 third-, fourth-, and fifth-year students at the Jagiellonian University (No. 1072.6120.283.2020). Data were analyzed using principal components analysis (PCA) with an oblique, Promax rotation, and confirmatory factor analysis (CFA). Cronbach's alpha (α) was calculated to check the internal consistency reliability. Discriminant validity was analyzed using the Mann-Whitney and Kruskal-Wallis test.

RESULTS

PCA produced a 10-item scale distributed into three factors, which explains 59.52% of the total variance. Factor 1 ("preconceived notions about dental treatment") contained four items (α = 0.703), Factor 2 ("cost-benefit of providing care for older patients")-four items (α = 0.660) and Factor 3 ("dentist-older patient interaction")-two items (α = 0.662). CFA confirmed that the model is a good fit (RMSE = 0.058, 90% CI from 0.014 to 0.092, CFI = 0.950, and TLI = 0.926). The discriminant validity showed statistically significant differences in factors or individual items related to the year of the study, gender, and having a history of living with an older person(s) or an older patient(s) treated.

CONCLUSION

The validation of the ASDS conducted in Poland identified 10 items with sufficient validity and reliability.

Translation and psychometric properties of the Arabic version of the ageism scale for dental students (ASDS-Ar): A multi-institutional validation

BACKGROUND AND OBJECTIVE

Ageism represents an important barrier to high-quality healthcare for older adults. The present study sought to translate and validate the Arabic version of the Ageism Scale for Dental Students (ASDS-Arabic).

MATERIALS AND METHODS

The 27-item ASDS tool was translated from English into Arabic following recommended cross-sectional forward and backward translation guidelines. The translated version was subjected to the content validity ratio (CVR) and sent to dental students in 21 institutes from 10 different Arab countries. Principal components analysis (PCA) was used to assess the dimensionality of the scale, and Cronbach's alpha was used to determine internal consistency reliability. The discriminant validity of the scale was assessed using the independent t-test. Confirmatory factor analysis (CFA) was also undertaken.

RESULTS

Based on CVR, three items were removed. The 24-item Arabic version was completed by 3284 dental students. PCA and CFA retained 17 items in six components, explaining 50.3% of the total variance, with acceptable reliability, validity and discrimination. The first component "Adherence of older patients with dental treatment and instructions," included four items with a Cronbach α of 0.64 and scored 4.3 ± 0.8. The second component "Feasibility of the treatment plan," included three items with a Cronbach α of 0.66 and scored from 2.6 ± 1.2 to 2.9 ± 1.1. The third component "Cost of and responsibility for the dental treatment" included four items with a Cronbach α of 0.47 and scored 4.4 ± 0.8 to 4.5 ± 0.8. The fourth component "Medical history of older patients" included two items with a Cronbach α of 0.70 and scored 4.0 ± 1.0 to 4.1 ± 1.0. The fifth Component "Feeling towards older patients" included two items with a Cronbach α of 0.672 and scored 2.6 ± 1.2 to 2.0 ± 1.4. The sixth Component "Confidence and experience in treating older patients" included two items with a Cronbach α of 0.33 and scored 4.4 ± 1 to 4.6 ± 1.

CONCLUSION

This preliminary validation of the ASDS-Ar resulted in a new 17-item scale with six components with acceptable validity, reliability and discrimination.

Ageism scale for dental students (ASDS): A focus group review of content validity

PURPOSE/AIM

Improve content validity of the Ageism Scale for Dental Students (ASDS) and identify barriers to using the scale.

METHODS

Thematic analysis of transcripts of three purposively sampled focus groups of 1) geriatric dentistry specialists, 2) older adult dental patients, and 3) dental students.

RESULTS

Twenty-five participants engaged in focus groups. No new concepts to define ageism were identified. Experts found the scale acceptable and appropriate, yet they raised specific potential revisions to scale questions. Commonly reported themes already addressed by ASDS included the importance of tailoring decision-making to patient preference and not making assumptions about older adults' capacity or preferences for dental care. Barriers to identifying ageism or using the scale included experiential differences in interpreting scale items, cultural differences in attitudes towards older adults, and potential overlap with social determinants of health. Secondary findings include recommendations for older-adult focused training for dental students to provide positive, concrete guidance on caring for older adults.

CONCLUSION

There are opportunities to refine the Ageism Scale for Dental Students and to allow tailoring of the scale for specific national or cultural contexts.

Translation and validation of ageism scale for dental students into Malay language

AIMS

Identifying ageism among dental students is essential in gerodontology courses. This study aimed to perform a preliminary validation of a Malay version of the ageism scale for dental students (ASDS-My).

METHODS AND RESULTS

The 27-item ASDS were translated into Malay language and completed by 168 dental students. Exploratory factor analysis (EFA) with Promax rotation, Polychoric Correlation Matrix and Principal Axis Factoring was conducted. Internal consistency reliability and discriminative validity were analysed. Criterion validity was measured by comparing ASDS-My with Fraboni Scale of Ageism (FSA). A Kaiser-Meyer-Olkin of 0.612 and a Bartlett's Test of Sphericity yielding p < .001 confirmed the adequate factorability. EFA revealed a 15-items scale distributed into five-factors explaining 54.5% of overall variance, with acceptable reliability. The two factors involved cost-benefit of dental treatment on older patients and challenges during medical history taking. The third, fourth and fifth factors explained attitude towards older patients, negative views of older patients and exposure of dental students to Gerodontology training and experiences respectively. Most factors were significantly positively related to FSA. Discriminative validity revealed significant differences for gender, place of stay and year of study.

CONCLUSION

Preliminary validation of the ASDS-My produced a five-factors 15-items scale with acceptable validity and reliability.

Survey on the attitudes and perceptions of Swiss dental practitioners and dental students toward treating patients with disabilities and sensory impairments

AIMS

This study evaluated the attitudes and perceptions of private dental practitioners (PPs) and students on treating patients with disabilities and sensory impairments.

METHODS AND RESULTS

A multifaceted questionnaire was used to assess the participants' attitudes on providing care to persons with disabilities and sensory impairments [visual (VI) and hearing (HI)]. The survey evaluated different aspects of the participants' attitudes that included integrity, altruism, perceived barriers, and theory of planned behavior (TPB). One hundred twenty participants [students: n = 73, practitioners (PP): n = 47), with a mean-age of 27.7 ± 5.3 years, completed the survey (response rate: 100%). Fourth-year students scored better than the PP in integrity (p = .019). For altruism, the students scored better than PPs (vs. fourth-year: p = .009, vs. fifth-year: p = .031). There were no differences between the participant groups for the overall assessments of the TPB (p = .213), VI (p = .863), and HI (p = .261).

CONCLUSION

Dental practitioners and students revealed a positive attitude, with few barriers, towards treating individuals with disabilities/sensory impairments and considered the training in the field of special care dentistry as a necessary part of the dental education. Furthermore, a demand for an increase in the hands-on practical experience in treating individuals with disabilities/sensory impairments during the undergraduate study curriculum was identified.

Factors associated with predoctoral and graduate dental students' intention to care for elderly patients: A cross-sectional study

OBJECTIVES

Ageism among pre-doctoral and graduate dental students may reduce their propensity to provide dental treatment to elderly patients leading to substandard healthcare for this population. This study evaluated the impact of perceived ageism constructs and geriatric dentistry education on the intention of pre-doctoral and graduate students to provide dental care for elderly patients.

METHODS

A questionnaire was applied to collect the data for this cross-sectional study from pre-doctoral students in their clinical years and graduate students in their internship year (N = 201). A total of 183 completed responses were received, and the response rate was 91%. Hierarchical regression analysis was performed to determine the incremental effects of perceived ageism constructs and geriatric dentistry education on the intention to provide dental care for elderly patients.

RESULTS

Geriatric dental education (B = 0.328, t = 3.826, p < 0.001) and patients' low compliance (B = 0.503, t = 4.658, p < 0.001) were significantly positive predictors of pre-doctoral and graduate students' intentions to care for elderly patients. Also, negative attitudes toward the lives of elderly people have a substantial adverse effect on the intention of care for this population (B = -0.225, t = -2.206, p = 0.029). Cronbach's alpha for the scale constructs ranged from 0.738 to 0.886.

CONCLUSIONS

Advanced geriatric training may cultivate pre-doctoral and graduate students' deeper understanding and recognition of the intellectual and practical benefits that might arise from offering dental care to elderly people.

Translation and validation of the ageism scale for dental students in Iran (ASDS-Persian)

AIMS

A longer life and the growing population of older adults are the achievements of the 20th century. The World Health Organization considers ageism an important barrier to age-appropriate care for older adults. The aim of this study was to translate and validate the ageism scale for dental students in Iran (ASDS-Persian).

METHODS

The 27-question ASDS was translated from English into Persian (Farsi) and completed by 275 dental students from two universities in Isfahan, Iran. Principal component analysis (PCA), internal consistency reliability, and discriminant validity were estimated. Furthermore, in this study we conducted an analytical cross sectional study among dental students of Isfahan province (two universities) with the aim of proving data regarding their ageism beliefs and attitudes.

RESULTS

PCA revealed an 18-question, four-component scale with acceptable validity and reliability. The four components are 'barriers/concerns on dental treatment in older adults', 'opinions about older adults', 'practitioner's perspective,' and 'older adults' perspective'.

CONCLUSION

This preliminary validation of ASDS-Persian produced a new 18-question scale with four components with acceptable validity and reliability. This instrument could be further tested in larger samples in Farsi speaking countries.

Psychometric properties of the Arabic version of the perceived prosthodontic treatment need scale: Exploratory and confirmatory factor analyses

BACKGROUND

It is crucial to take into account the concerns of dental patients about their prosthodontic needs when planning the course of treatment. However, there is a dearth of research that examines these needs among adult dental patients.

OBJECTIVES

This study aims to translate and validate the perceived prosthodontic treatment need scale (PPTN) in Arabic.

METHODS

The 17-item PPTN scale was translated from English into Arabic and completed by 206 patients seeking prosthodontic treatment in a dental hospital in Saudi Arabia. Data collection was carried out in September and October 2023. Exploratory factor analysis (EFA) was used to ascertain the underlying factor structure; a unidimensional scale was hypothesised and tested using confirmatory factor analysis (CFA), including several multiple model fit indices. The assessment of reliability was conducted using Cronbach's alpha. The convergent and discriminant validity of the final scale were examined.

RESULTS

EFA produced an 11-item scale distributed into three factors that explain 65.43% of the total variance with eigenvalues > 1. All items showed acceptable reliability, ranging from 0.65 to 0.84. The first factor pertained to social issues, while the second item was concerning dental appearance. Lastly, the third factor included functional difficulties associated with tooth loss or dental problems. The results of the CFA demonstrate a satisfactory level of model fit, with the standardised factor loadings ranging from 0.51 to 0.89. Convergent and discriminant validity of the model factors were established.

CONCLUSION

The translated questionnaire was deemed legitimate and would be useful in comprehending patients' perceived treatment requirements, hence contributing to the advancement of prosthodontic research and practical implementation.

Correlation between attitude towards dental care for older adults and ageism in dental students and clinical trainees: Cross-sectional study

INTRODUCTION

Since the needs for dental care among older adults in Japan are expected to increase in the future, this study aimed to examine the influence of ageism among dental students and clinical trainees on the attitude towards the older adults in dental care.

MATERIALS AND METHODS

In 2022, we conducted a questionnaire survey of 9th-, 11th-semester dental students and first-year clinical trainees enrolled at Kyushu Dental University, using the Japanese version of Ageism Scale for Dental Students (ASDS-J), Japanese version of Fraboni Scale of Ageism (FSA-J). Questions on intention to provide dental care to the older adults, relationships with the older adults and living with the older adults were also surveyed.

RESULTS

There were 162 participants (84 males and 78 females), and the response rate was 71.7%. The participants were divided into the positive group for dental care to older adults (68 respondents) and the negative group (94 respondents). The ASDS-J score of the negative group was significantly higher than that of the positive group [49 (36-66) vs. 52 (34-88), p < .001]. The binomial logistic regression analysis revealed that the odds ratio of being negative attitude was 1.1 per one point of ASDS-J (95% confidence interval: 1.0-1.2) in the model adjusted for student grade, interaction with the older adults, gender, experience living with the older adults and FSA-J.

CONCLUSION

These findings suggest that ageism specific to dental students and clinical trainees (as assessed using the ASDS-J) was independently correlated with negative attitudes towards dental care for older adults.

Validation of ageism scale for dental students in India: (Ageism Scale for Dental Students- India) - a cross sectional study

Background: Ageism persists in many different societies as it is innate and subconscious in nature. Negative effects such as loneliness, mistreatment, and occupational discrimination are frequently present due to ageism. The dental students in our study were wary of the possible benefits of expensive dental care because ageism is rife in their field. There is no validated and reliable ageism scale to assess how dental students perceive ageism in India. The current study was carried out to validate the ageism scale for dental students in the Indian context.

METHODS

This was a cross sectional analytical study carried out among both males and females in Manipal College of Dental Sciences, Mangalore in which the instrument was 27-item Ageism scale for dental students. Content validity was done by six subject experts. The final version was administered to 213 students/Residents of dental school. The factorability of data was confirmed with KMO = 0.61 and Bartlett's Test of Sphericity resulting in p < 0.001.

RESULTS

Final PCA model resulted in 15 items and six components that together accounted for 70.37% of overall variance. The six components had reliability ranging from marginal 0.51 (Component 6) to a high of 0.81 (Component 3). As per the gender differences by component females showed less ageism than men in "non-compliance" (-0.9(-1.66-0.14), p<0.05) and "practitioner perspective" (1.43 (0.84, 2.03), p<0.01). Statistical significance was seen in Barriers/concerns in dental treatment of elderly where residents showed reversed (1.4 (0.41, 2.38), p<0.01). Urban group showed more ageism for component 'time restraint' (-0.79 (-1.57, -0.02), p<0.05.

CONCLUSION

Preliminary validation resulted in 15 item scale with six components with acceptable validity of the ageism scale and could be further tested in large samples. This scale will help recognize ageism in Indian context and provide necessary information to make changes in the curriculum as required.

Specific form of ageism in dental care: Convergent validity of the Ageism Scale for Dental Students and its implications for education

INTRODUCTION

The World Health Organisation considers ageism as an important barrier to age-appropriate care for older adults. An Ageism Scale for Dental Students (ASDS) has been validated in the United States, Brazil, Greece, Romania and in France. At present, the convergent validity of ASDS has never been evaluated. Moreover, a specialised and disciplinary tool as the ASDS may not overlap with more general ageism assessment which may highlight the need for specific courses during the education of the future health professionals.

MATERIALS AND METHODS

The survey was administered from December 2020 to January 2021. All the undergraduate students of the last 3 years of study at the dental school of Clermont-Ferrand were invited to complete both scales. Two hundred sixteen students were randomly divided into two equal groups. The first group answered first Aging Semantic Differential- ASD then ASDS, the second in reverse order. The convergent validity between ASDS and ASD was assessed by computing a Pearson correlation coefficient and discriminant analysis between each component of the two scales.

RESULTS

The response rate was of 53.7%. The correlation analysis conducted on the total scores of the ASDS and of the ASD shows a significant, yet weak relationship. The discriminant analysis indicates that only the first component of the ASDS is significantly associated with each dimension of the ASD, whereas the second component is totally independent from the ASD and the third component almost independent from the ASD, except for the integrity dimension.

CONCLUSIONS

This specialised questionnaire may assess a form of ageism that is not captured at all in more general scales. Such a scale may help to identify the different dimensions of ageism among dental students which is required to reduce ageism in medical care. This reduction should pass by adapted courses in gerodontology.

Greek dental students' perceptions of treating older patients

BACKGROUND AND AIM

The oral problems of the older population are largely undertreated because of various barriers, including negative perceptions and ageist stereotypes, among care providers. The aim of this study was to record the perceptions of Greek dental students of treating older patients.

MATERIALS AND METHODS

An anonymous written questionnaire including two open-ended questions about the positive and negative issues when treating older patients was administered to clinical dental students. A content analysis was conducted to identify the main themes.

RESULTS

A total of 135 students responded to the questionnaire (response rate 88.23%). Five key themes were identified for the facilitating factors and six for the barriers/challenging factors. The facilitating factors of treating older people were the promotion of the patients' health and quality of life, the good interaction and communication with older patients, the dentist's intrinsic reward treating older people, the positive feedback from the patients and the improvement of professional dental competences when treating complex cases. The barriers included communication and cooperation problems, treatment challenges related to disease and disability, patients' negative beliefs about oral health, barriers to accessing dental care, complex and time-consuming treatment plans, and communication and cooperation problems with the patients' carers.

CONCLUSION

A range of facilitating and challenging factors influence dental students' perceptions of treating older patients. More research is necessary on the methods that will enhance their geriatric knowledge and skills, help them overcome the challenges they detected and improve their attitudes and behaviours towards treating older patients.

Translation and preliminary validation of the Serbian version of an ageism scale for dental students (ASDS-Serb)

AIMS

The ageist attitudes among dental clinicians may result in inadequate treatment planning and reduce quality of life for older adults. This study aimed at performing a preliminary validation of an ageism scale for dental students (ASDS) in Serbia (ASDS-Serb).

METHODS AND RESULTS

The 27-item ASDS was translated from English into Serbian and completed by 129 dental students. Principal component analysis (PCA), Confirmatory factor analysis (CFA), internal consistency reliability and discriminant validity were estimated. PCA produced a 17-item scale distributed into five factors that explain 64.24% of the total variance. All items showed high to moderate reliability (0.50-0.83). CFA indicates an acceptable model fit with significant standardized factor loadings ranging from 0.14-0.99. The first factor dealt with negative views of older adults' life and dental treatment, the second factor related to ethical values about older people, the third factor compared younger and older adults in dental care and the fourth factor related to difficulties in medical history taking. The fifth factor related to perceptions of oral health and treatment of older adults. Discriminant validity revealed significant differences related to the semester of studies, gender and having older people in the family.

CONCLUSION

The preliminary validation of the ASDS-Serb resulted in a 17-item scale distributed into the five factors with acceptable validity and reliability.