Abstract
(1) Background: The present study aimed to examine the psychometric properties of the Persian adaptation of the Modified Dental Anxiety Scale (MDAS) in Iranian adolescents. (2) Methods: Adolescents with a mean age of 15.10 (n = 3197; 47.1% males) were recruited from Qazvin city of Iran using a stratified cluster random sampling technique. All children completed the five-item Persian MDAS and information related to background characteristics. Psychometric testing was conducted using classical test theory (CTT) and Rasch models. For CTT, an item-total correlation of >0.4 was considered satisfactory while for Rasch analysis, infit and outfit mean squares (Mnsq) ranging from 0.5–1.5 were considered satisfactory. Confirmatory Factor Analysis (CFA) was conducted to confirm the unidimensional structure of MDAS using various fit indices. Differential item functioning (DIF) was evaluated based on gender and time since last dental visit. Moreover, latent class analysis (LCA) was used to classify the participants into different levels of dental fear based on their pattern of responses. Both item level reliability using Cronbachs alpha (α) and test-reliability using intraclass correlation coefficients were evaluated. (3) Results: Item-total correlations ranged from 0.69–0.78, infit MnSq ranged from 0.80 to 1.11 and the range of outfit MnSq was 0.84–1.10. The data confirmed a one-factor structure of MDAS with satisfactory fit indices. DIF analysis indicated that the scale was interpreted similarly across the genders and time since dental visit groups. LCA analysis identified three levels, low, moderate and high levels of dental anxiety. The groups with moderate and high levels of dental anxiety had more females (44.6% and 36.7%) than the group with low level of dental anxiety (18.8%; p < 0.001). α of the total scale was 0.89 and item test-retest reliability ranged from 0.72–0.86. (4) Conclusions: The Persian MDAS was unidimensional with satisfactory psychometric properties evaluated using both CTT and Rasch analysis among Iranian adolescents. The scale was stable across the genders and individuals with different dental visiting patterns. The Persian MDAS also demonstrated excellent reliability.
Highlights
The novel coronavirus disease 2019 (COVID-19) hugely impacts individuals’ psychological health and overall wellbeing worldwide [1,2,3,4,5,6]
Given the context and the literature gap, the present study aimed to examine the psychometric properties of the Persian Modified Dental Anxiety Scale (MDAS), using two types of psychometric theories [classical test theory (CTT) and modern test theory using Rasch models], among Iranian adolescents during the COVID-19 pandemic period
The present study showed that the Persian MDAS had promising psychometric properties among adolescent Iranians, even in the current COVID-19 pandemic situation
Summary
The novel coronavirus disease 2019 (COVID-19) hugely impacts individuals’ psychological health and overall wellbeing worldwide [1,2,3,4,5,6]. Social distancing and other public health measures prohibiting social interactions (e.g., city lockdown and school closure) are being implemented by several governments to mitigate the spread of the infection [7,8,9]. Under such circumstances, accessing health care and seeking treatment could be associated with significant psychological distress due to several reasons. Oral diseases and their treatment could cause significant stress and anxiety during the COVID-19 pandemic This is because of the high risk of transmission of COVID-19 in dental practices due to the nature of dental treatment procedures and closer proximity of patient with the provider [10]. This is more so among individuals with dental anxiety who are already more likely to avoid care
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