口腔健康評估量表—非牙醫專業人員中文版發展與信效度檢定

Validation of the Chinese Version in Oral Health Assessment Tool (OHAT) for Clinical Non-Dentist Professionals

背景：影響口腔健康的原因雖然已有相關文獻，但多以癌症病人為主，較少針對長期照護機構住民的口腔健康需求做評估。另外，國內口腔健康相關的評估量表，大多數都是針對牙醫師臨床使用所設計，並沒有針對非牙醫專業人員所設計的口腔健康評估量表。目的：本研究目的是針對非牙醫專業人員（包括：護理人員）所設計「口腔健康評估量表(Oral Health Assessment Tool, OHAT)」，進行量表中文版之信效度檢定。方法：本量表為Chalmers 與Schilling (2004) 發展之口腔健康篩檢工具，適用於失智住民。本文採用「翻譯—反轉翻譯方式」進行中英文的翻譯，以立意取樣方式施測於台灣南部護理之家的116 位失智症住民，以建立該中文版量表之內在一致性、測試者間的一致信度，建構效度與同時效標效度。結果：研究結果為 OHAT 信度部分: 一、Cronbach’s α 為.598(N=116)，顯示該量表具有相當的內在一致性；二、測試者間的一致性的Intraclass Correlation Coefficients 值為.868(p< .00)。效度部分：一、建構效度；OHAT 總分與OHAT 各類別以Spearman 相關法分析，大部分均顯著相關，除了假牙狀態外；二、同時效度，Kappa 值在3.162-4.337 之間，均顯著相關，顯示OHATB 與Brief Oral Health Status Examination(BOHSE) 各項間都具有高度相關(p<0.01- p<0.001)。結論/ 實務運用：「口腔健康評估量表—非牙醫專業人員」中文版具有相當的內在一致性，以及良好的信效度。由於本量表篩檢項目少，易評估，故適用於機構式長期照護單位，包括失智住民，是值得推廣的口腔健康篩檢工具。

Background: Despite the abundance of related literatures on factors related to oral health, most of them target on cancer patients. Assessments focusing on oral health of long-term institution residents remain rare. In addition, oral health assessment scales are mostly designed for dentists in clinical trials and have not been designed for non-dental professional. Purpose: The purpose of this study was to validate the Chinese version of the Oral Health Assessment Tool (OHAT), specifically designed for non-dental professionals (including nurses ). Methods: Chalmers and Schilling (2004) developed the OHAT as a screening tool of oral health assessment for demented residents. The Chinese OHAT was developed through translation and back translation and tested by a purpose sampling of 116 nursing home demented residents in southern Taiwan. We examined its reliability and construct validity by concurrent validity and hypothesis testing. Results: The results on reliability: Firstly, the OHAT yielded acceptable internal consistency (Cronbach’s α= .598). Secondly, the inter-rater reliability was examined by Item Characteristic Curve (ICC) and was significant (ICC = .868). The results on validity: Firstly, the Spearmen correlation coefficients were significant, except for the denture condition. Secondly, Kappa values ranged from 3.161 to 4.337, indicating that OHAT and BOHSE were highly correlated (p < .05). Conclusion: The Chinese OHAT demonstrates clinically easy to use, acceptable reliability and good validity. In addition, it consists of few items. It, therefore, appears to be a practical and valid oral health screening instrument for nursing home residents, including those with cognitive impairment.