Validation of a Persian Version of the Oral Health Impact Profile (OHIP-14)
Navabi, N., Nakhaee, N., Mirzadeh, A., Iranian Journal of Public Health
Background: The oral health-related quality of life indicators are increasingly used to measure the impact of the oral conditions on quality of life. One of the most used indicators is the Oral Health Impact Profile (OHIP-14), but it has never been applied in Iran. The aim of this study was to validate the usage of OHIP-14 among Iranians.
Methods: A cross-sectional study was performed in Kerman (Iran). A consecutive sample (n= 400) of the Kerman Dental School Clinics attending patients participated in this study. All participants self-completed the translated OHIP-14. Reliability analyses, validity tests, and responsiveness were carried out to evaluate the psychometric properties of the OHIP-14.
Results: The reliability coefficient (Cronbach's alpha) of the OHIP-14 was above the recommended 0.7 threshold and considered excellent (alpha: 0.85). The coefficient of the test-retest reliability measured by ICC was 0.88 (CI 95%: 0.80-0.93). Poorer oral condition was strongly associated with OHIP scores of the patients, supporting construct validity. Moreover, for evaluation of responsiveness, the ES was measured to be 0.43 and the SRM was 0.67.
Conclusions: The Persian version of OHIP-14 is a precise, valid and reliable instrument for assessing oral health-related quality of life among Persian population.
Keywords: Oral health, Quality of life, Validity, Iran
A patient-based assessment of health status is essential to the measurement of health. Oral diseases are highly common and they do not only have physical but also socioeconomic and psychological consequences on the affected patients. Quality of life is impaired in a large number of these patients and various aspects of their life such as mastication of food and speech can be affected (1). Oral Health-related Quality of Life (OHRQL) is defined as an individual assessment of how the functional, psychological and social factors affect the well-being, discomfort and pain, that the patient experiences in relation to or ofacial concerns (1, 2). The need to develop an individual measure when assessing oral health outcomes on an individual level was first suggested by Locker (1988) (2). The most widely used method to assess OHRQL are multiple-item questionnaires (3). Researchers have developed quality of life instruments specific to oral health to comply with the demand of oral specific measures (4).
The Oral health Impact Profile (OHIP) was developed by Slade and Spencer (1994) and is a technically sophisticated OHRQL instrument that is widely used internationally (4, 5). Original OHIP consists of 49 items. As it is long and timeconsuming, Slade (1997) developed a short-form of it with 14 questions; named OHIP-14.OHIP- 14 has a good reliability, validity, and precision (6). Fourteen items of OHIP is subdivided into seven domains: functional limitation, physical discomfort, psychological discomfort, physical disability, psychological disability, social disability, and handicapness (2, 4, 6).
An example of an OHIP statement is mentioned in one of the questions in this statement (Have you had to interrupt meals because of problems with your teeth, mouth, or dentures?) (4). Patients are asked how frequently they had experienced each impact in the last month. Responses to the items are recorded in a 5-point Likert scale: 0=never; 1=hardly ever; 2=occasionally; 3=fairly often; 4= very often (7). The OHIP-14 score is calculated by summing the scores of the responses to 14 items and the total OHIP scores ranged from 0 to 56 (5). Total OHIP-14 score represents the overall burden of oral problems. The OHIP-14 was originally developed in English for Englishspeaking population Therefore, when used in a non-English-speaking country that is culturally different it should be translated and validated to ensure its proper use (8).
Several language versions of OHIP-14 already exist, for example in German, Swedish, Hebrew, Chinese, and Scottish. …