Abstract
Aims and objectivesOral health deteriorates following hospitalisation in critical care units (CCU) but there are no validated measures to assess effects on oral health-related quality of life (OHQoL). The objectives of this study were (i) to develop a tool (CCU-OHQoL) to assess OHQoL amongst patients admitted to CCU, (ii) to collect data to analyse the validity, reliability and acceptability of the CCU-OHQoL tool and (iii) to investigate patient-reported outcome measures of OHQoL in patients hospitalised in a CCU.MethodsThe project included three phases: (1) the development of an initial questionnaire informed by a literature review and expert panel, (2) testing of the tool in CCU (n = 18) followed by semi-structured interviews to assess acceptability, face and content validity and (3) final tool modification and testing of CCU-OHQoL questionnaire to assess validity and reliability.ResultsThe CCU-OHQoL showed good face and content validity and was quick to administer. Cronbach’s alpha was 0.72 suggesting good internal consistency. For construct validity, the CCU-OHQoL was strongly and significantly correlated (correlation coefficients 0.71, 0.62 and 0.77, p < 0.01) with global OHQoL items. In the validation study, 37.8% of the participants reported a deterioration in self-reported oral health after CCU admission. Finally, 26.9% and 31% of the participants reported considerable negative impacts of oral health in their life overall and quality of life, respectively.ConclusionsThe new CCU-OHQoL tool may be of use in the assessment of oral health-related quality of life in CCU patients. Deterioration of OHQoL seems to be common in CCU patients.
Highlights
During the last 30 years, much emphasis has been placed on the importance of patient-reported outcome measures (PROM) in research investigating patients hospitalised in Electronic supplementary material The online version of this article contains supplementary material, which is available to authorised users.critical care [1]
Quality of Life Research (2020) 29:559–568 importance: this population is more vulnerable to oral disease, this deterioration may potentially affect their quality of life and poor oral health may result in a greater risk of Ventilator Associated Pneumonia (VAP) as it is reported that VAP-associated pathogens may translocate from the oral cavity into the lungs
A systematic review that included 11 trials and 3242 patients concluded that “Oral decontamination of mechanically ventilated adults using antiseptics is associated with a lower risk of ventilator associated pneumonia” indicating that fourteen patients would need to receive this intervention to prevent one case of VAP [11]
Summary
Used generic OHQoL questionnaires include a large number of questions which are irrelevant for the critically ill given their life circumstances, limiting their applicability in this setting. These questionnaires take a long time to complete and are not feasible if the patients are frail and severely compromised, as it is the case in a CCU, because of the burden placed on patients and/or healthcare givers. The aim of this study was to develop and validate a suitable tool to assess the impact of critical care on oral health-related quality of life (OHQoL) and to investigate patient-reported outcome measures of OHQoL in patients hospitalised in a CCU
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