Cross-cultural adaptation and psychometric properties of the Brazilian version of the scale of oral health outcomes for 5-year-old children (SOHO-5)

Abstract

BackgroundMost of the instruments available to measure the oral health-related quality of life (OHRQoL) in paediatric populations focus on older children, whereas parental reports are used for very young children. The scale of oral health outcomes for 5-year-old children (SOHO-5) assesses the OHRQoL of very young children through self-reports and parental proxy reports. We aimed to cross-culturally adapt the SOHO-5 to the Brazilian Portuguese language and to assess its reliability and validity.FindingsWe tested the quality of the cross-cultural adaptation in 2 pilot studies with 40 children aged 5–6 years and their parents. The measurement was tested for reliability and validity on 193 children that attended the paediatric dental screening program at the University of São Paulo. The children were also clinically examined for dental caries. The internal consistency was demonstrated by a Cronbach's alpha coefficient of 0.90 for the children’s self-reports and 0.77 for the parental proxy reports. The test-retest reliability results, which were based on repeated administrations on 159 children, were excellent; the intraclass correlation coefficient was 0.98 for parental and 0.92 for child reports. In general, the construct validity was satisfactory and demonstrated consistent and strong associations between the SOHO-5 and different subjective global ratings of oral health, perceived dental treatment need and overall well-being in both the parental and children’s versions (p < 0.001). The SOHO-5 was also able to clearly discriminate between children with and without a history of dental caries (mean scores: 5.8 and 1.1, respectively; p < 0.001).ConclusionThe present study demonstrated that the SOHO-5 exhibits satisfactory psychometric properties and is applicable to 5- to 6-year-old children in Brazil.

Parental influence on children’s answers to an oral-health-related quality of life questionnaire

“…7,9 Moreover, children have demonstrated the ability to understand the questionnaire appropriately. 4 The present results show that the answers of children on the SOHO-5 were not influenced by the presence of their parents/guardians.…”

“…The child and one of the guardians (preferably the one who spent the most time with the child) completed the Brazilian SOHO-5 in face-to-face interviews. 7 The interviews were conducted by two trained interviewers blinded to the clinical findings. The child and the guardian answered the respective child and parental versions of the SOHO-5 in the presence of each other.…”

“…Two measures have been validated and adapted for Brazilian Portuguese: the Early Childhood Oral Health Impact Scale (ECOHIS) and the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5). 6,7 However, the ECOHIS is based only on parental proxy reports. 5,6 Although such proxy measures are commonly employed, parents/guardians do not always perceive the OHRQoL of their children accurately.…”

“…4,8 Studies involving the SOHO-5 that evaluate the perception of parents/guardians and children have demonstrated that five-year-old children are capable of providing their own perceptions regarding their OHRQoL. 4,7,9,10,11 However, their comprehension is dependent on social, emotional, cognitive and linguistic development. 12 Moreover, children in this age group are influenced by their parents/guardians, who are the main decision makers regarding healthcare issues.…”

“…Previous studies evaluating the perception of children regarding their OHRQoL have not clarified this issue. 4,7,9,10,11 The aim of the present study was to evaluate how the presence of parents/guardians influences the answers to an OHRQoL questionnaire directed at five-year-old preschool children.…”