Orthodontic patient satisfaction: Validation of an Arabic patient satisfaction questionnaire

Abstract

Objectives: Orthodontic patient satisfaction is a primary aim of orthodontic treatment. Satisfaction is a multidimensional concept, requiring multi-item questionnaires for it to be adequately assessed. A 58-item, orthodontic patient satisfaction questionnaire (PSQ) was developed to assess orthodontic patient satisfaction. Appropriately adapted assessment tools are needed to assess orthodontics patient satisfaction in different populations. The validity and reliability of such tools should be demonstrated before their use for each target population. The PSQ was yet to be validated in Arabic. Therefore, the objective of this study was to translate, adapt, and validate an Arabic orthodontic PSQ. Material and Methods: The 58-item English PSQ was translated to Arabic through translation and back-translation. An expert panel examined the relevance of PSQ items. The questionnaire was circulated through social media to recruit responses from Arabic-speaking orthodontic patients who completed orthodontic treatment. Cronbach’s alpha, item-total correlation (I-TC), and kappa reliability coefficient were calculated. The analysis of variance test was used to compare satisfaction scores between genders and different orthodontic treatment appliances. Results: Ten items were removed based on expert ratings. The questionnaire was filled by 327 patients (55.6% females, mean age = 28.5 ± 7.2, 59.8% on metal braces, 35.3% on clear aligners, and 5.2% on tooth-colored braces). Nine questionnaire items were removed because of low I-TC (<0.3). The resulting 39-item questionnaire had a Cronbach alpha of 0.79 and a kappa coefficient of 0.82. The mean total PSQ score of the sample was 167.61 ± 21.45. Items with the top ten highest I-TC correlations had a Cronbach’s alpha of 0.90. Patients on metal braces had a highest mean total PSQ score (P = 0.004). Among these patients, satisfaction with situational aspects was lower but satisfaction with dentofacial, psychosocial, and dental improvements were all higher compared to other orthodontic treatments (P < 0.001). Conclusion: The 39-item Arabic PSQ is valid and reliable. A shorter collection of 10 items with high validity were identified. Patients on metal braces had better outcomes, driving higher satisfaction. Studies collecting satisfaction data using the PSQ from orthodontic clinics are needed.