Building a new scale to measure worries about oral hygiene self-management in vulnerable older adults

This paper describes a new scale to measure worries about self-management of oral hygiene in low-income older adults.

Oral hygiene that prevents oral diseases and worsening of chronic conditions improves with instruction, but other cognitive/emotional factors impede oral hygiene practice especially among older adults. Many scales measure dental anxiety, but none measures oral hygiene self-management worries.

Formative research with diverse older adults 55-95 in low-income housing identified scale items. A 23-item scale was tested in a pilot intervention study (n = 84) and formalised with a new sample (N = 331).

In both studies, PCA/factor analysis produced two subscales: (a) worries about cleaning teeth and (b) consequences of cleaning. Chronbach's alpha coefficient evaluated internal consistency, and Pearson's r and Kendall tau/Spearman's rho evaluated scale predictability, convergent and divergent validity. The scale and subscales showed good internal consistency in both studies (over 0.90) and stability T0 0.90; T1: 0.90). In the larger sample, statistically significant correlations between the scale, subscales; plaque score, and similar scales (perceived risk of oral health problems, and fears of oral diseases) demonstrated convergent validity. For divergent validity, the worries scale, not the GOHAI, a similar scale measuring oral health life quality, was associated with Plaque Score. Each scale was associated with different mediators suggesting different constructs.

The overall scale has good internal consistency, test-retest reliability, predictability and convergent and divergent validity. It captures a psycho-emotional construct useful in oral health research and hygiene education with older adults.