Avaliação da saúde bucal de idosos por enfermeiros: validade e confiabilidade do instrumentO ASBTO

Structural validity and reliability of the "Oral Health Assessment Tool" applied by speech-language therapists in a population of older Chilean people

BACKGROUND

A good state of oral health allows people to communicate and eat. This topic is relevant in older people given its close relationship with their general health. At present, health challenges are directed at detecting and preventing oral disorders and are seen to exclusively by dentists, because the existing instruments can only be applied by them. However, speech-language therapists undergo similar training, which would allow them to collaborate in these processes. In this context, the Oral Health Assessment Tool (OHAT) is a detection instrument with good psychometric properties that is currently available for non-dental use. The objective of this study is the translation into Chilean Spanish of the OHAT and a structural validation of that version for application by these professionals.

MATERIALS AND METHODS

A mixed qualitative-quantitative study was carried out. The OHAT instrument was adapted to Chilean Spanish and subsequently subject to structural validity and evaluation of internal consistency reliability, as well as a valuation of its reproducibility in 286 older people (166 female, 120 male) from different health contexts.

RESULTS

The cultural adaptation of the instrument proved to be semantically consistent with the original instrument. Its application was considered to be speedy and simple in the pre-test. The confirmatory factor analysis evidenced the unidimensionality of the OHAT. In addition, the instrument shows good internal consistency and test-retest reliability.

CONCLUSIONS

The OHAT instrument was considered to possess adequate structural validity and test-retest reliability properties. Its usefulness in the context of oral health disorders of this population in Chile is discussed.

A systematic review of measurement instruments for oral health assessment of older adults in long-term care facilities by nondental professionals

BACKGROUND

Regular oral health assessment of older adults living in Long-term Care Facilities (LTCF) can improve their oral health.

AIMS

This study aimed to systematically review studies describing the development of instruments employed by nondental professionals to assess the oral health of older adults in LTCF and to evaluate their measurement properties.

MATERIAL & METHODS

Electronic searches were conducted in the MEDLINE (PubMed), Embase, Web of Science, Scopus, and LILACS databases. Measurement properties of the identified instruments were evaluated using the Consensus-based Standards to select health Measurement Instruments (COSMIN) checklist. Studies assessing at least one measurement property (validity, reliability, or responsiveness) of instruments used to assess oral health of older adults living in LTCF by nondental professionals were considered. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) checklist was used to evaluate the quality of evidence.

RESULTS

Fifteen studies reporting measurement properties of seven instruments were selected. The ohr-interRAI and the OHAT were considered to have sufficient content validity, with high and moderate evidence quality, respectively. OHAT, BOHSE, and DHI showed acceptable results on reliability but with very low quality of evidence. DHI and OHSTNP also showed acceptable results for criterion validity, but, with low quality of evidence, insufficient or unclear results were observed for the remaining measurement properties. Studies evaluating the validity criteria of BOHSE and hypotheses testing of ohr-MDS were considered to have high evidence quality.

DISCUSSION AND CONCLUSION

The ohr-interRAI can be provisionally recommended for use until further evidence is provided. Further methodologically rigorous studies are needed to assess the measurement properties of the existing instruments.

Intra- and interobserver reliability of nurses and dentists in the assessment and screening of oral conditions of institutionalized older adults

Abstract Introduction older persons in Long-Term Care (LTC) facilities have functional impairments and a higher disease prevalence. Nurses’ comprehensive assessment of older persons’ health is highlighted, including using tools for screening dental treatment needs. Objective to report the intra- and inter-observer reliability of older adults’ oral health assessment in LTC facilities by video. Material and method descriptive study, in three LTC facilities, in the Florianópolis region, Southern Brazil. Data were collected according to Oral Health Assessment Tool (OHAT), which presents 8 categories (“lips, tongue, gums/tissues, saliva, natural teeth, dentures, dental hygiene, and toothache”), and the scores 0=healthy, 1=presence of changes (could be a need for care), 2=unhealthy (need for dental service); final score from 0 to 16. In each LTC facility, a Nurse assessed oral conditions and made a video of each older adult using a smartphone. The dentist performed the oral health assessment through the videos. Estimated Kappa test, p<0.05. Result the sample was 34 older adults, 71% were female. Interobserver reliability between Nurses 1 and 2 and Dentist for “lips” and “natural teeth” was classified as poor and excellent/very good for toothache and denture conditions. The nurse’s intraobserver reliability was classified as weak for the “natural teeth” assessment. Conclusion the OHAT showed reliability for assessing denture conditions and pain. However, nurses’ training for recognizing oral conditions that require dental care is suggested, as well as the management of this action by the dentist and LTC facilities.

Inter-examiner agreement in the application of an oral health assessment instrument in hospitalized elderly

OBJECTIVES

to analyze the correspondence between nurse and dental surgeon assessments in the application of an Oral Health Assessment in dental screening of elderly hospitalized patients.

METHODS

cross-sectional study with elderly patients (n = 54) admitted to University Hospital from the Federal University of São Paulo. Data were collected through the assessment of oral cavity. Descriptive statistical techniques were used to analyze them, using tables and graphs.

RESULTS

there was correlation and agreement between nurse and dental surgeon assessments referring to application of an Oral Health Assessment in dental screening of hospitalized elderly.

CONCLUSIONS

oral Health Assessment in dental screening for hospitalized elderly by nurses demonstrated excellent reproducibility and may be a resource to identify buccal alteration, helping the planning and execution of nurse care associated to oral health.

[Systematic retrospective study of oral cancer-related quality of life scale]

OBJECTIVE

The quality of life (QOL) related to oral cancer has recently become a focus of clinical studies. This study aims to systematically review the current research situation of QOL of local and foreign oral cancer patients and explore the existing related problems and future research directions to provide references and solutions.

METHODS

Through relevant key words, PubMed, Wiley InterScience, Science Direct, CNKI, and Wanfang databases were first searched. The related target literature from 2000 to 2017 were screened. Finally, the frequency of oral cancer related to QOL scale used in literature was calculated, and the related scales were briefly introduced.

RESULTS

From the target literature, 218 English target literature, 55 Chinese target literature, 24 English scales, and 12 Chinese scales were selected. The most widely used scales for assessing the QOL of patients with oral cancer were as follows: University of Washington Quality of Life Questionnaire (UW-QOL), European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Head and Neck 35 (EORTC QLQ-C30/H&N35), 36-Item Short-Form Health Survey (SF-36), Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N), and Oral Health Impact Profile (OHIP).

CONCLUSIONS

The QOL related to oral cancer was well underway, and the study of geographical distribution was widespread. However, the work on self-developed scale remains inadequate. UW-QOL, EORTC QLQ-C30/H&N35, and FACT-H&N can be utilized as the preferred scales for evaluating the QOL of oral cancer patients. A specific disease-related function scale can also be selected according to specific research objectives.