Cross-cultural adaptation, psychometric properties and application of the Brazilian version of the SOHO-5, childrens oral health-related quality of life instrument for 5-year-old children

Author(s)

Jenny Haydeé Abanto Alvarez

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Odontologia (FO/SDO)
• Defense date: 2013-02-28

Examining board members

Marcelo Jose Strazzeri Bonecker; Rosa Ana Melgar Hermoza; Saul Martins de Paiva; Paulo Frazão São Pedro; Aronita Rosenblatt

• Advisor: Marcelo Jose Strazzeri Bonecker; Saul Martins de Paiva

Abstract

The aims were: 1) translate and cross-cultural adapt the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) to the Brazilian Portuguese language; 2) to assess the psychometric properties (reliability, validity and responsiveness) of self- and parental proxy-reports of the SOHO-5; 3) to assess the impact of dental caries and trauma dental injuries (TDI) on childrens oral health-related quality of life (OHRQoL) according to both self- and parental reports; 4) to assess the agreement among parents and children regarding the childs OHRQoL. We tested the cross-cultural adaptation in two pilots with 40 children aged 5- 6-years and their parents. Validity and reliability were tested on 193 children and parents. Of the 193, 154 completed the SOHO-5 7-14 days after the childs dental treatment to assess responsiveness. For this purpose, they also answered global transition judgments on subjects perceptions of change in their oral health following treatment. Measures of responsiveness included standardized effect sizes (ES) and standardized response mean (SRM). To assess the impact, 335 pairs of parents and children completed the SOHO-5 and three calibrated examiners performed the childrens oral examinations. Agreement among reports was assessed in 298 mother-child and 37 father-child pairs. The internal consistency by Cronbach\'s alpha coefficient was 0.90 and 0.77 for the children self- and for parental proxy- reports, respectively. For test-retest reliability, Intraclass Correlation Coefficient (ICC) for total score was 0.92 of of the child version and 0.98 of the parental version. The SOHO-5 showed satisfactory construct and discriminant validity. For responsiveness, there was an improvement of childrens oral health after treatment (p<0.001). There were significant differences in the pre- and post-treatment scores of those who reported improving a little and those who reported improving a lot (p<0.05). For both versions, the ES and SRM based on change scores mean for total scores and for categories of global transitions judgments were moderate to large. The multivariate model showed an association between dental caries and a worse childs OHRQoL, according to children and parents perceptions, (RR (Rate Ratio) (CI95%) = 6.37 (4.71; 8.62) e 10.81 (7.65; 15.27)), respectively. The mean directional difference of the total scores of -1.35 (CI95% -2.330; -0.372) was only significant for the father-child pairs. The ICC for total scores was 0.84 (CI 95% 0.798; 0.867) and 0.67 (CI 95% 0.445; 0.814) among mother-child and father-child pairs, respectively. The Brazilian version of the SOHO-5 is reliable, valid and responsive for 5-6 years-old children in Brazil. Dental caries, but not TDI, is associated with worse OHRQoL in children aged 5-6-years. Mothers do rate their young childrens OHRQoL similarly to childrens self-reports, while fathers tend to underreport. (AU)

• FAPESP's process: 09/17040-0 - Cross-cultural adaptation, validity and responsiveness of a new instrument to measure oral health-related quality of life in brazilian preschool children
• Grantee: Jenny Haydee Abanto Alvarez
• Support Opportunities: Scholarships in Brazil - Doctorate