The PedsQL™ Oral Health Scale: feasibility, reliability and validity of the Brazilian Portuguese version

Background: Oral and orofacial problems may cause a profound impact on children's oral health-related quality of life (OHRQoL) because of symptoms associated with these conditions that may influence the physical, psychological and social aspects of their daily life. The OHRQoL questionnaires found in the literature are very specific and are not able to measure the impact of oral health on general health domains. Consequently, the objective of this study was to evaluate the psychometric properties of the Portuguese version for Brazilian translation of the Pediatric Quality of Life Inventory (TM) (PedsQL (TM)) Oral Health Scale in combination with the PedsQL (TM) 4.0 Generic Core Scales. Methods: The PedsQL (TM) Oral Health Scale was forward-backward translated and cross-culturally adapted for the Brazilian Portuguese language. In order to assess the feasibility, reliability and validity of the Brazilian version of the instrument, a study was carried out in Belo Horizonte with 208 children and adolescents between 2 and 18 years-of-age and their parents. Clinical evaluation of dental caries, socioeconomic information and the Brazilian versions of the PedsQL (TM) Oral Health Scale, PedsQL (TM) 4.0 Generic Core Scales, Child Perceptions Questionnaire (CPQ(11-14) and CPQ(8-10)) and Parental-Caregiver Perception Questionnaire (P-CPQ) were administered. Statistical analysis included feasibility (missing values), confirmatory factor analysis (CFA), internal consistency reliability, and test-retest intraclass correlation coefficients (ICC) of the PedsQL (TM) Oral Health Scale. Results: There were no missing data for both child self-report and parent proxy-report on the Brazilian version of the PedsQL (TM) Oral Health Scale. The CFA showed that the five items of child self-report and parent proxy-report loaded on a single construct. The Cronbach's alpha coefficients for child/adolescent and parent oral health instruments were 0.65 and 0.59, respectively. The test-retest reliability (ICC) for child self-report and parent proxy-report were 0.90 [95% confidence interval (CI) = 0.86-0.93] and 0.86 (95% CI = 0.81-0.90), respectively. The PedsQL (TM) Oral Health Scale demonstrated acceptable construct validity, convergent validity and discriminant validity. Conclusions: These results supported the feasibility, reliability and validity of the Brazilian version of the PedsQL (TM) Oral Health Scale for child self-report for ages 5-18 years-old and parent proxy-report for ages 2-18 years-old children.