Development of the Diabetes Oral Health Assessment Tool © for Nurses

Abstract

Although some studies have suggested a bidirectional relationship between diabetes and periodontal disease, there were no appropriate tools for nurses to evaluate oral status and oral health behaviors in patients with diabetes. Therefore, the Diabetes Oral Health Assessment Tool (DiO-HAT©) was developed with items contributed by health care professionals (diabetologists, periodontal specialists, a preventive dentist, a Certified Nurse in Diabetes Nursing, a national registered dietitian, registered nurses, a dental hygienist, and nursing researchers) who were involved in the medical care of patients with diabetes. Subsequently, a survey of 700 Diabetes Nurse Specialists (DNS) was conducted to determine their score of recognition and implementation of the DiOHAT©, however, 304 participants (43.4%) responded. Constructive concept validation and the Cronbach's alpha coefficient for all assessment items was 0.932, indicating high reliability: Factor 1, Patient's oral health status (α = 0.874); Factor 2, Implementation of oral health behaviors (α = 0.890); Factor 3, Information transmission regarding dental visits (α = 0.862); and Factor 4, Perceptions and knowledge of oral health behaviors (α = 0.793). Although the mean score of recognition of DiOHAT© was 3.5 ± 0.4 points, the mean value of the implementation score was 1.5 ± 0.5 Y. Kuwamura et al. 1711 points (obtained using a 4-grade scale). The implementation scores were significantly lower than the recognition scores for all items (p < 0.001). The findings suggested that the DNS were not inclined to implement all items of DiOHAT©, despite recognizing their importance.

Structural Validity and Reliability of the “oral Health Assessment Tool” Applied by Speech-language Therapists in a Population of Older Chilean People

“…In terms of internal consistency reliability, the reported ordinal Cronbach's alpha and Mcdonald's Omega coe cient were good (α = 0.82; ω = 0.87) for the entire one-dimension instrument, similar results than obtained by Kuwamura et al (40) but differing from the values obtained by Mello et al ( 26), who evaluated the internal consistency of the instrument applied by a group of nurses and dentists to 50 older people, obtaining alpha values considered to be low. In this respect, the following should be considered:…”

Structural validity and reliability of the “Oral Health Assessment Tool” applied by speech-language therapists in a population of older Chilean people

“…Consequently, the results obtained in the present research are sufficient to consider that the OHAT has structural validity. In terms of internal consistency reliability, the reported ordinal Cronbach's alpha and Mcdonald's Omega coefficient were good (α = 0.82; ω = 0.87) for the entire onedimension instrument, similar results than obtained by Kuwamura et al [41] but differing from the values obtained by Mello et al [26], who evaluated the internal consistency of the instrument applied by a group of nurses and dentists to 50 older people, obtaining alpha values considered to be low. In this respect, the following should be considered: first of all, it is important to note the definition of this measure, which is frequently considered to refer to the degree in which all elements of a test or instrument measure the same attribute or dimension [42].…”

Assessing the oral health of in-patients with diabetes using a clinical version of the Diabetes Oral Health Assessment Tool© and its association with dental examinations

“…As for oral care, nurses should discuss how they can help patients avoid getting worse and what they can do to improve patients' oral self-management. In a previous study (4,5), several nurses reported that they wished to conduct quick oral assessments because in real clinical settings they have to educate patients about several other aspects of the disease. Not surprisingly, the present study found significant relationships between the items of C-DiOHAT© ("use of supplementary tools") and the dentist's examination ("number of present teeth by sex and age" and "dentist's recommendation of dental examination").…”