Development and Validation of the Latvian Version of the Orofacial Esthetic Scale in Dental Patients with Aesthetic, Functional and No Treatment Needs

The aim was to adapt the Orofacial Esthetic Scale (OES) and to test psychometric properties of the Albanian language version in the cultural environment of the Republic of Kosovo.MethodsThe OES questionnaire was translated from the original English version according to the accepted techniques. The reliability (internal consistency), and validity (construct, convergent and discriminative) were tested in 169 subjects, test-retest in 61 dental students (DS), and responsiveness in 51 prosthodontic patients with treatment needs (PPTN).ResultsThe corrected item correlation coefficients of OES-ALB ranged from 0.686 to 0.909. The inter-item correlation coefficient ranged between 0.572 and 0.919. The Cronbach’s alpha was 0.961 and IIC 0.758. Test- retest was confirmed by good ICCs and by no significant differences of the OES scores through the period of 14 days without any orofacial changes (p > 0.05). Construct validity was proved by the presence of one-factor composition that assumed 79.079 % of the variance. Convergent validity showed significant correlation between one general question about satisfaction with orofacial esthetics and the OES summary score, as well as between the sum of the 3 OHIP-ALB49 questions related to orofacial aesthetics and the OES summary score. Discriminative validity was confirmed with statistically significant differences between DS, prosthodontic patients without treatment need and PPTN (p < 0.01). Responsiveness was confirmed by a significant increase of OES scores after PPTN patients received new fixed partial or removable dentures (P < 0.001).ConclusionThe results proved excellent psychometric properties of the OES-ALB questionnaire in the Republic of Kosovo.

This study examined the extent and correlates of perceived unmet need for treatment among individuals with depression in the U.S. general population. Analyses were based on a representative sample of 6,510 adult participants in the 2005 and 2006 National Surveys on Drug Use and Health who reported a major depressive episode in the past 12 months. A total of 3,568 (62.4%) participants had sought mental health treatment in the past 12 months, and 2,942 (37.6%) had not; 34.9% and 26.8% of these groups, respectively, reported unmet need for treatment. In both groups, older age was associated with a lower likelihood of reporting unmet need for treatment, whereas greater distress and impairment and higher education were associated with a greater likelihood of reporting unmet need. Among treatment seekers, treatment from general medical providers was associated with greater likelihood of unmet need, and more outpatient visits and insurance coverage for the full year were associated with a lower likelihood of unmet need. The most common reason for not seeking needed treatment was a concern about costs (cited as a reason by 46.0% of the total sample). Even though rates of treatment seeking have increased, many persons with major depression continue to experience unmet need for treatment, which in this study was mainly attributable to concerns about treatment costs.

Multicenter validation study. The aim of this study was to translate and adapt the AOSpine PROST (Patient Reported Outcome Spine Trauma) into English, and test its psychometric properties among North-American spine trauma patients. In the absence of an outcome instrument specifically designed and validated for traumatic spinal column injury patients, it is difficult to measure the effect size of various treatment options. The AOSpine Knowledge Forum Trauma initiated a project and developed the AOSpine PROST consisting of 19 items. Patients were recruited from two level-1 North-American trauma centers. For concurrent validity, next to AOSpine PROST also 36-item Short-Form Health Survey (SF-36) was filled out by patients. Patient characteristics were analyzed using descriptive statistics. Floor and ceiling effects as well as the number of inapplicable and missing questions were analyzed for content validity. Cronbach α and item-total correlation coefficients (ITCCs) were calculated for internal consistency. Spearman correlation tests were performed within AOSpine PROST items and in correlation to SF-36. Test-retest reliability was assessed using intraclass correlation coefficients (ICCs). Factor analysis was performed to explore any dimensions within AOSpine PROST. The AOSpine PROST was translated adapted into English using established guidelines. Of 196 enrolled patients, 162 (82.7%) met the inclusion criteria and provided sufficient data. Content validity showed good results, and no floor and ceiling effects were seen. The internal consistency was excellent (Cronbach α = 0.97; ITCC 0.50-0.90) as well as test-retest reliability (ICC = 0.97). Spearman correlations were good (0.29-0.85). The strongest correlations of AOSpine PROST with SF-36 were seen with the physical components (0.69-0.82; P < 0.001). Factor analysis revealed two possible dimensions (Eigen values >1), explaining 75.7% of variance. The English version of AOSpine PROST showed very good validity and reliability. It is considered as a valuable tool, and has the potential to contribute to the reduction of ongoing controversies in spine trauma care. 2.

Background The Vertigo Symptom Scale – short form (VSS–SF) is commonly used to measure dizziness and vertigo over the past month. This study aimed to (1) adapt the VSS–SF for the Swedish population and assess its psychometric properties, and (2) develop a modified version for measuring symptoms in the acute phase of acute vestibular syndrome (AVS). Methods The VSS–SF was translated into Swedish and adapted cross-culturally. Its psychometric properties were evaluated in 86 AVS patients, both in the acute stage (1–7 days from symptom onset) with a modified acute version, and after six weeks of vestibular rehabilitation using the standard VSS–SF. Factor structure, convergent and discriminant validity, and internal consistency were analyzed. Test-retest reliability was assessed at six weeks. Participants were also evaluated with the Dizziness Handicap Inventory (DHI) and balance tests. Controls included 54 healthy participants. Results Exploratory factor analysis revealed a two-factor structure for both versions, corresponding to vertigo-balance (VSS–V) and autonomic-anxiety (VSS–A) subscales. Both versions demonstrated strong factor structures with adequate loadings. Internal consistency was high for the standard version (Cronbach’s alpha 0.76 to 0.87) and for the total and VSS–V subscale of the acute version (0.82 and 0.85, respectively), but poor for the acute VSS–A subscale (0.50). Convergent validity was supported by Spearman’s rank correlations. The discriminative ability was excellent for the acute VSS–SF and VSS–V (AUC 0.98 and 0.99), and acceptable for VSS–A (AUC 0.77). After six weeks, discriminative ability decreased but remained above 0.5. Test-retest reliability at six weeks was excellent for all scales (ICC 0.94, 0.93, and 0.93 for VSS–SF, VSS–V, and VSS–A). Conclusions The VSS–SF was successfully adapted for the Swedish population, including an acute version for early dizziness assessment. Both versions confirmed a robust two-factor structure, with the acute version showing excellent early discriminative ability, particularly for the vertigo-balance dimension. However, the autonomic-anxiety subscale showed weaker psychometric properties, suggesting limited suitability for AVS patients. The adapted scales show promise for clinical use in diagnosing and evaluating dizziness and vertigo in the Swedish population. Trial registration Clinicaltrials.gov Identifier NCT05056324, September 24, 2021. https://clinicaltrials.gov/ct2/show/NCT05056324

Background: Dental patient-centred outcomes are essential in clinical practice and research. To enhance feasibility, Oral Health-Related Quality of Life (OHRQoL) instruments often need to reduce administration time. In Serbia, longer OHIP versions exist (OHIP-14, OHIP-EDENT), but the ultrashort OHIP-5 has not yet been available. Aim: This cross-sectional study aimed to translate, culturally adapt, and evaluate the psychometric properties of the five-item Serbian version of the Oral Health Impact Profile (OHIP5-Srb). Materials and Methods: The OHIP5-Srb was translated using a standard forward–backward procedure. Participants were recruited between June and September 2025 using a convenience sampling approach. Psychometric testing—including internal consistency, exploratory (EFA), confirmatory factor analysis (CFA), and convergent and known-groups validity—was conducted on 236 participants (mean age 47.4 years). Test–retest reliability was evaluated in 35 dental students, and responsiveness in 45 patients undergoing dental treatment. Results: Cronbach’s alpha was 0.784, indicating adequate internal consistency. Test–retest reliability was excellent (mean ICC = 0.96; all inter-item correlations > 0.20). Convergent validity was supported by a strong negative correlation between OHIP5-Srb summary scores and a single-item measure of overall oral/dental health (Spearman’s rho = −0.861, p < 0.01). Known-group validity was confirmed by significant differences between removable denture wearers and individuals with natural teeth (and/or fixed partial dentures), after adjusting for age, and between participants perceiving a need for dental treatment and those who did not. EFA indicated a one-factor structure explaining 55.1% of variance. The one-factor model was confirmed by CFA and showed good fit (χ2 = 15.08, df = 5; CFI = 0.97; TLI = 0.94; RMSEA = 0.092; SRMR = 0.04). Responsiveness analysis demonstrated significant decreases in OHIP5-Srb scores following various dental treatments. Conclusions: The OHIP5-Srb is unidimensional, reliable, valid, and responsive. Its brevity and robust psychometric properties make it suitable for assessing self-perceived oral health-related quality of life in the Serbian urban population, particularly when minimizing respondent burden is critical.

BackgroundThe importance of mental health services that support a recovery-oriented approach is increasingly recognized, and measures that evaluate this practice and promote change over time are needed. The INSPIRE measure is a 27-item questionnaire designed to assess service users’ perceptions of the support received from health professionals in their personal recovery. This study aimed to validate the Portuguese version of INSPIRE and assess its psychometric properties as a measure of staff support for personal recovery.MethodsThe questionnaire survey was conducted from October 2023 to February 2024. Service users completed the Portuguese version of INSPIRE, the Client Satisfaction Questionnaire (CSQ-8), and a demographic and clinical questionnaire. Internal consistency was assessed using Cronbach’s alpha and McDonald’s model-based Omega. Test-retest reliability was assessed through the intraclass correlation coefficient (ICC) and weighted kappa. Convergent validity was examined by assessing correlation with CSQ-8. Factor validity was evaluated using exploratory factor analysis (EFA), with confirmatory factor analysis (CFA) performed to test the fit of factor structures derived from the EFA.ResultsThe study included 165 participants from seven psychosocial rehabilitation units which primarily target persons with a severe mental illness. For test–retest evaluation, 52 participants completed the questionnaire a second time. Internal consistency was satisfactory across all subscales and dimensions of the Support subscale, except for the Identity domain, which had marginally acceptable values. INSPIRE demonstrated significant positive correlations with CSQ-8 scores, supporting its convergent validity. EFA identified five factors for the Support scale and one factor for the Relationship scale, explaining 62% and 59% of the cumulative variance, respectively. CFA confirmed a good model fit for the Relationship scale and all Support subscales, except for the Identity and Empowerment subscales.ConclusionsThe Portuguese version of INSPIRE showed strong internal consistency, as well as convergent and factor validity. This validated instrument can be applied in research and clinical settings to assess staff support for personal recovery and promote recovery-oriented mental health practices.Clinical trial numberNot applicable.

Questionnaire for measuring organisational attributes in dental-care practices: psychometric properties and test–retest reliability

This study aimed to develop the German version of the Orofacial Esthetic Scale (OES-G) and to assess its psychometric properties. The OES is an eight-item instrument with seven items directly addressing esthetic impacts of the orofacial region and an eighth item for a global assessment. It applies an 11-point ordinal rating scale, with summary scores ranging from 0 (worst) to 70 (best). The original OES items were translated into German using a forward-backward method. A de novo development of German items (n = 21 patients) and a cross-cultural adaptation after pilot testing (n = 15 patients) established content validity. Internal consistency and construct validity (structural, convergent, known-groups) of the OES-G were assessed in a sample of 165 prosthodontic patients. The OES was applied in 42 patients on two occasions, with a temporal distance of 2-4 weeks apart to determine test-retest reliability. Internal consistency of the OES-G was considered as satisfactory (Cronbach's alpha 0.94; average inter-item correlation 0.64). Intraclass correlation coefficient of 0.95 (95 % confidence interval 0.92-0.98) indicated excellent test-retest reliability. Correlation matrix and exploratory factor analysis provided support for unidimensionality of the measured construct. The OES-G summary score was correlated with the patients' global assessment of their esthetics (r = 0.87) and external ratings of the expert group (r = 0.55) and discriminated patients with treatment need (39.4 points) from patients without (58.4 points; p < 0.001) and with a large effect size. The OES-G has good psychometric properties and is a valuable instrument for the assessment of self-perceived orofacial esthetics.

A new comprehensive diabetes health literacy scale: Development and psychometric evaluation

BackgroundThe Quality of Life (QOL) in Life-threatening Illness-Family Carer Version (QOLLTI-F) has been proven to be a brief, reliable, and valid instrument for measuring the caregivers’ QOL in western cultures. However, whether it is suitable to be used in Chinese culture is unclear. This study aimed to test the reliability and validity of the Chinese version of (QOLLTI-F-CV).Materials and methodsA total of 202 family caregivers (FCs) of advanced cancer patients from Fujian Provincial hospice care center were investigated using the Chinese version of QOLLTI-F-CV from September 2019 to August 2020. The questionnaire was evaluated using an exploratory structural equation model. Its psychometric properties were examined in terms of factor structure, convergent validity, discriminant validity, internal consistency, and test–retest reliability.ResultsDifferently from the seven-domain original QOLLTI-F, its Chinese version had only three domains including caregiver’s self-feelings, caregiver’s stress, and caregiver’s outlooks. The total variance explanation rate for the domains was 55.4%. The Chinese version fitted well with the structure model (χ2 = 153.932, df = 75, P < 0.001); its comparative fit index (CFI) was 0.971; Tucker–Lewis index was 0.954; and the root mean square error of approximation (RMSEA) was 0.072. The success rate of its convergent and discriminant validity calibration test was 100%. Its Cronbach’s alpha coefficient of the whole questionnaire and three domains was from 0.650 to 0.874, and test–retest reliability was 0.836.ConclusionThe 3-domain QOLLTI-F-CV is a valid and reliable instrument for identifying QOL concerns of FCs of advanced cancer patients in China. The refactoring structure optimally matches Chinese culture and value system well.

Purpose To develop and cross-culturally adapt a Brazilian-Portuguese version of the Falls Behavioral Scale (FaB-Brazil) and to verify its psychometric properties. Material and Methods The translation and cross-cultural adaptation process of the scale followed standard guidelines. The FaB-Brazil scale was applied to 93 community-dwelling older people. Cronbach’s alpha was calculated to evaluate internal consistency and the intraclass correlation coefficient (ICC) to evaluate interrater and test–retest reliability. The standard error of measurement (SEM), minimal detectable change (MDC), ceiling and floor effects, convergent and discriminative validity were evaluated. A significance level of .05 was set for statistical analyses. Results Internal consistency was moderate (α = 0.73). An excellent inter-rater (ICC = 0.93; p < 0.001) and a good test–retest (ICC = 0.79; p < 0.001) reliability were found. The SEM was 0.27 and MDC was 0.53. Neither ceiling nor floor effects were found. Convergent validity was established by the positive correlations between the FaB-Brazil scale, age, and functional mobility, and by the negative correlations between the FaB-Brazil scale and balance confidence, community mobility and EuroQol-5D (p < 0.05). No significant differences were found between males and females and between non-fallers and fallers. Conclusions Our results offer evidence for the reliability and validity of the FaB-Brazil scale for community-dwelling older people. Implications for Rehabilitation Fall-related behaviors should be part of the fall risk assessment of community-dwelling older people. The Brazilian-Portuguese version of the Falls Behavioral Scale (FaB-Brazil) is reliable and valid for assessing fall-related behaviors in community-dwelling older people. The FaB-Brazil scale may be used to raise awareness about potential fall hazards and to guide fall prevention programs.

Persistent Postural-Perceptual Dizziness (PPPD) is a frequent chronic functional disorder that manifests with dizziness, unsteadiness, or non-spinning vertigo present for at least 3 months. Characteristic provocation factors are moving or complex visual stimuli and exclusion of organic diseases. To assess the severity and impact of PPPD, Japanese researchers developed the Niigata PPPD Questionnaire (NPQ). The study's aim was to evaluate the concurrent construct validity and reliability [including test-retest reliability, internal consistency, standard error of measurement (SEM), and minimal detectable change (MDC)] of the German version of the NPQ (12 items) and its revised version, NPQ-R, which contains 19 items addressing additional symptoms and symptom behavior. The Swiss Reha Rheinfelden and the German Center for Vertigo and Balance Disorders included 265 PPPD patients (mean age 50.2 ± 16.8 years, disease duration 46.3 ± 76.6 months). Patients completed the NPQ and the NPQ-R (twice), the DHI and potentially related constructs: anxiety (ABC-Scale, VSS), depression (HADS), and general health (SF-36) once. To assess the questionnaires' reliability and validity, several statistical measures were calculated, including Spearman's rank correlation coefficients, Intraclass Correlation Coefficients (ICC2, 1), Cronbach's alpha, SEM, and MDC. On average, patients scored 29.9 ± 13.2 for NPQ and 52.3 ± 19.6 for NPQ-R. Correlations between NPQ/NPQ-R and (1) disease-specific questionnaires were rs= 0.712 and rs= 0.752 (DHI), rs=0.426 and rs= 0.0.462 (VSS-V), rs= -0.500 and rs= -0.545 (ABC-Scale), (2) anxiety-specific subscales rs = 0.394 and rs = 0.430 (VSS-A) and rs= 0.354 and rs= 0.430 (HADS-A), (3) depression-related subscales rs=0.438 and rs= 0.487 (HADS-D), and (4) general health rs ranged between rs= -0.216 and -0.578 (all SF-36 subscales). Internal consistency, test-retest reliability, SEM and MDC calculated for NPQ/NPQ-R were α = 0.88/α = 0.91, ICC=0.83 (CI 0.77 to 0.0.87), SEM 5.55/8.37, and MDC 15/23 points. The German versions of NPQ and NPQ-R are valid and reliable patient-reported outcome measures for assessing PPPD, demonstrating satisfactory psychometric measurement properties including convergent construct validity and reliability parameters: internal consistency, test-retest reliability, SEM, and MDC as an evaluative measure. The NPQ-R, with its additional subscales addressing associated symptoms and symptom behavior, represents both the patient and clinician perspective on PPPD-specific problems. Therefore, we recommend utilizing the NPQ-R for a comprehensive assessment of PPPD.

Background and objectives The Multidimensional Scale of Perceived Social Support (MSPSS) is a measure of perceived adequacy of social support. Whilst this is an important area of research for family caregivers of people with dementia, it is not clear whether the MSPSS retains its psychometric properties when used with this population. The aim was to conduct an in-depth psychometric analysis of the MSPSS to ensure that it remains a psychometrically robust measure for this population. Research design and methods Participants completed measures online using a self-complete procedure. A subsample completed the MSPSS twice, within a 4-week period. Properties assessed were internal consistency, floor and ceiling effects, test-retest reliability, convergent validity and factor structure. Results 270 participants completed the study and 58 comprised the test-retest sample. Internal consistency was excellent for the total score (α = 0.92) and three subscales (α = 0.92–0.94). Significant correlations were observed in the expected directions with depression (r = −.48, p < .001) and mental (r = 0.32, p<.001) and physical (r = 0.17, p=.003) health-related quality of life. Test re-test reliability was excellent for the total score (ICC = 0.90 95%CI = 0.84, 0.94) and subscale scores (ICC = 0.84-0.89). Confirmatory factor analysis indicated acceptable fit indices for the three-factor solution. Discussion and implications The MSPSS has robust psychometric properties when used with caregivers of people with dementia and may be recommended for use with this population. Further research is required to establish responsiveness and determine cross-cultural validity.

Measuring patients' orofacial appearance: Validity and reliability of the English-language Orofacial Esthetic Scale

To develop a new unidimensional questionnaire for patients' self-assessment of their chewing function (chewing function questionnaire: CFQ) and to test its psychometric properties. A focus group of 7 dentists and 15 prosthodontic patients generated a pool of 30 relevant items. A 5-point Likert scale (0-4) was used. A focus group reduced some redundant items, and 21 items remained for pilot testing after which additional four items were eliminated. Then, the 17-item questionnaire was tested on a larger sample (200 participants). Factor analysis was obtained to investigate the dimensionality of the questionnaire. Finally the 10 items remained, and the CFQ was unidimensional. To test the psychometric properties, the CFQ was administrated to 224 individuals: 100 patients were already removable denture wearers (RDWs), 24 patients needed a removable prosthodontic treatment, and 100 individuals had natural teeth (NT group). Discriminative validity was tested between the RDWs and the NT groups. Convergent validity and internal consistency were tested on 200 subjects. The internal consistency was assessed by calculating the Cronbach's alpha coefficient and the average interitem correlation. The test-retest reliability was tested on 60 subjects. Responsiveness was tested on 24 patients who received new removable prosthodontic treatment. The initial factor analysis revealed that the items had been grouped in three different dimensions. By eliminating items with complexities greater than one, additional six questions were eliminated. One more item with the lowest correlation was further eliminated. The final questionnaire included 10 items. Discriminative validity showed significant differences between the NT group and the RDWs, as predicted (P < 0.001). Convergent validity was confirmed by the Spearman's rank correlation. A significant positive association (P < 0.001) was found between the CFQ and one general question about chewing difficulties, as well as between the CFQ and five items from the OHIP49 related to chewing. The test-retest reliability showed high intraclass correlation and no significant differences between the two administrations of the CFQ (P > 0.05). The internal consistency showed satisfactory Cronbach's alpha values (0.916 for all subjects, 0.742 for the NT group, and 0.852 for the RDWs). Responsiveness was confirmed by a significant difference between the baseline and the follow-up score (P < 0.001) and a high effect size (0.95). The developed CFQ provides an assessment instrument of the hypothetical construct invoked to explain the chewing function. Psychometric properties are satisfactory demonstrating that the instrument is suitable for the assessment of a self-perceived chewing function.