Development of a questionnaire measuring treatment concerns in regular dental patients

The aim of this study was to develop an instrument measuring core concerns about dental treatment guided by Reiss' expectancy theory of fear. This would include the content domains of injury, somatic reaction and interpersonal concerns, to study the underlying factorial structure, and to determine the test quality of the resulting subscales.

A total of 555 regular dental patients answered the item pool. Subsamples filled in the Dental Anxiety Scale (DAS) (n = 346) and the Anxiety-Present Scale of the state-form of the State-Trait Anxiety Inventory (STAI-S) (n = 187). A second sample (n = 89) was used to determine test-retest reliability and bias for social desirability [Self Disclosure Scale of the Freiburg Personality Inventory (FPI)].

Exploratory and confirmatory factor analyses identified a stable three-dimensional structure underlying the items convergent to the content domains of interpersonal, injury and somatic reaction concerns. Internal consistencies of the resulting subscales were between alpha = 0.84 and alpha = 0.87, test-retest reliabilities were from r(tt) = 0.72-0.78. No evidence for a social desirability response bias was found. All subscales discriminated between patients with low and high dental trait anxiety at a level of P < 0.00001. Dental treatment concerns predicted 36% of variations in actual anxiety during treatment.

The results suggest that the proposed instrument, namely the Dental Treatment Concerns Inventory, shows good test qualities according to construct, discriminant and predictive validity, and may be a promising tool for research and clinical applications.