Abstract
BackgroundThe Early Childhood Oral Health Impact Scale (ECOHIS) measures the impact of dental diseases on Oral Health-Related Quality of Life both in children and their families. The aim of this study was to develop a Chilean Spanish version of the ECOHIS that is conceptually equivalent to the original and to assess its acceptability, reliability and validity in the preschool population of Chile.MethodsThe Chilean version of the ECOHIS was obtained through a process including forward and back-translation, expert panel, and cognitive debriefing interviews. To assess metric properties, a cross-sectional study was carried out in Carahue, Southern Chile (April–October 2016). Children younger than six years old without systemic diseases, disabilities or chronic medication from eleven public preschools were included. Parents were invited to complete the Chilean version of the ECOHIS, PedsQL™4.0 Generic Core and PedsQL Oral Health scales, and to answer global questions about their children’s general and oral health. A subsample was administrated ECOHIS a second time 14–21 days after. A clinical examination was performed to assess dental caries, malocclusion, and traumatic dental injuries. Reliability was evaluated using measures of internal consistency (Cronbach’s alpha) and reproducibility (Intraclass correlation coefficient - ICC). Construct validity was assessed by testing hypotheses based on available evidence about known groups and relationships between different instruments.ResultsThe content comparison of the back-translation with the original ECOHIS showed that all items except one were conceptually and linguistically equivalent. The cognitive debriefing showed a suitable understanding of the Chilean version by the parents. In the total sample (n = 302), the ECOHIS total score median was 1 (IQR 6), floor effect was 41.6%, and ceiling effect 0%. Cronbach’s alpha was 0.89 and the ICC was 0.84. The correlation between ECOHIS and PedsQL™4.0 Generic Core was weak (r = 0.21), while it was strong-moderate (r = 0.64) with the PedsQL Oral Health scale. In the known groups comparison, the ECOHIS total score was statistically higher in children with poor than excellent/very good oral health (median 11.6 vs 0, p < 0.01), and in the high severity than in the caries-free group (median 8 vs 0.5, p < 0.01). No differences were found according to malocclusion and traumatic dental injuries groups.ConclusionsThese results supported the feasibility, reliability and validity of the Chilean version of ECOHIS questionnaire for preschool children through proxy.
Highlights
The Early Childhood Oral Health Impact Scale (ECOHIS) measures the impact of dental diseases on Oral Health-Related Quality of Life both in children and their families
Oral diseases are highly prevalent in children worldwide despite the improvement in oral health indices initiated in the last decades [1,2,3]
The knowledge of the Oral Health-Related Quality of Life (OHRQoL) might help to improve the development of effective oral health programs and services because it permits the assessment of young children’s perceived needs, and treatment strategy effectiveness [13]
Summary
The Early Childhood Oral Health Impact Scale (ECOHIS) measures the impact of dental diseases on Oral Health-Related Quality of Life both in children and their families. The knowledge of the OHRQoL might help to improve the development of effective oral health programs and services because it permits the assessment of young children’s perceived needs, and treatment strategy effectiveness [13]. This can contribute to the identification of groups with a higher level of need, to prioritize public health programs for care of children and adolescents, and to improve access to care [14]. The use of OHRQoL as an outcome measure is consistent with patient-centered care, being crucial in understanding the effectiveness of treatment from the patients’ perspective [12]
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