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The development and validation of a psychological questionnaire for patients undergoing orthognathic treatment
A T Shelton1, N Y Houghton, D O Morris
1Department of Orthodontics, Montagu Hospital, Mexborough, UK; Department of Orthodontics, Leeds Dental Institute, Leeds, UK.
Objectives:
To develop a questionnaire to assess the psychosocial aspects which orthognathic patients considered important regarding their dento-facial deformity.
Setting And Sample Population:
A multicentre, prospective, questionnaire development and validation study based in the UK.
Material And Methods:
Questionnaire development involved item (question) selection through literature review, consultation and feedback from a questionnaire development group and semi-structured interviews. A 'final' questionnaire was tested on a cross-sectional sample of 110 pre-operative and 74 post-operative orthognathic patients and a longitudinal sample of 23 orthognathic patients. Validity was tested using Rasch analysis.
Results:
Reliability for the Hospital Anxiety and Depression Scale (HADS) section was unsatisfactory (ICC = 0.232-0.829, Cronbach alpha = 0.625-0.670), but for the well- being (ICC = 0.857, Cronbach alpha = 0.827-0.895) and expectations (ICC = 0.861, Cronbach alpha = 0.804-0.882) sections were satisfactory. The well-being section was the only section found to be valid for the pre-and post-operative samples. Responsiveness was satisfactory for the well-being scale (p = 0.001).
Conclusions:
A new condition-specific orthognathic questionnaire has been developed which has been shown to be reliable, valid and responsive for the well-being scale. The HADS, as tested by Rasch analysis, was found not to be valid for this orthognathic population.
