《口腔健康影响程度量表（OHIP—14中文版）》与《老年口腔健康评价指数（GOHAI中文版）》的比较研究

目的：了解《口腔健康影响程度量表（OHIP～14中文版）》与《老年口腔健康评价指数（GOHAI中文版）》各自特点及应用范围,指导口腔健康相关生存质量临床研究开展。方法：使用两种量表选取60岁以上、无认知障碍及视力疾患的老年人进行调查及口腔检查。通过对老年人口腔健康相关生存质量的测评,比较两份量表的维度、条目内部一致性及区分效度。结果：共250位老年人参与此次研究,收回有效量表221份,无效量表29份,数据缺失量表12份。比较两种量表平均得分GOHAI中文版比OHIP-14中文版高（P〈0．01）。两份量表都可由缺失牙数区分有牙颌人群的生存质量,同时能够区分出戴用活动义齿的人群与不戴用活动义齿的人群的生存质量,以及能通过自我评价口腔状况和满意程度方面来区分不同人群的生存质量。通过比较可认为这两份量表都具有一定的区分效度。结论：《老年口腔健康评价指数（GOHAI中文版）》和《口腔健康影响程度量表（OHIP-14中文版）》在信度、效度方面存在的差异并不明显,维度的分布方面则各有所侧重。     

老年口腔健康评价指数(GOHAI)中文版的研制

目的：老年口腔健康评价指数GOHAI中文版的研制及其心理测量学性质的考评。方法：按照国际生存质量评价(IQOLA)项目的标准程序，对GOHAI进行翻译、回译和文化调适，建立GOHAI中文版；使用GOHAI中文版和一般项目表，对随机抽取的60岁及以上老年人进行口腔健康生存质量调查，调查结果经统计分析，考评量表的信度、效度和反应度。结果：共有343位老年人接受调查。有效问卷312份，其中数据缺火问卷28份。GOHAI中文版内部一致性Cronbach’s a系数为O．8l，分半信度系数O．80，条目一量表相关系数往O．30～O．7l之间；各条目与所属方面间相关性强，与其他方面相关性较弱；量表得分与自我评价的口腔健康、治疗需要及牙齿数目间，呈显著正相关，相关系数分别为O．505、O．23l和0．653(P＜O．01)；不同口腔健康状况组的量表分数差异明显，口腔健康组得分显著高于口腔不健康组(P＜0．01)。结论：GOHAI中文版具有良好的信度、效度和反应度。其良好的心理测量学性质为其在我国的应用提供了理论依据，为我国老年人口腔健康生存质量的研究，提供了有效的测评工具。     

上海市老年人牙缺失、义齿修复与口腔健康相关生命质量的现状研究

目的：以Eichner分类法代表牙缺失状况,研究上海市老年人牙缺失、修复情况及口腔健康相关生命质量的现状,同时探讨生命质量与牙缺失、义齿修复与否的相关性。方法：以65~74岁年龄组为研究对象,采用多阶段分层抽样方法抽取747名受试者纳入研究。使用第四次全国口腔流行病学调查的检查方法及问卷,收集受试者的缺牙状况、生命质量等数据。采用SPSS 19.0软件包进行非参数检验、二元logistic回归分析等。结果：79.1%的受试者存在牙缺失,35%的受试者未曾接受义齿修复。Eichner分组后,仅A1、A2和C3组受试者的老年口腔健康评价指数（general oral health assessment index,GOHAI）得分高于平均分,B组得分最低。GOHAI得分与受试者修复与否,全身健康状况及Eichner分组有显著相关性（P<0.05）。Eichner分组中,除C2组因样本量原因出现偏差外,其余Eichner组中,未修复受试者的GOHAI得分均低于已修复受试者。而在有缺牙未修复的人群中,81.2%的受试者认为自己牙没有问题或牙病不重。结论：上海市65~74岁老年人中牙缺失问题严重,但进行义齿修复的老人少。老年人的口腔健康相关生命质量与牙缺失状况、义齿修复与否及全身健康相关。应加强对缺牙老年人的口腔健康宣教,及时修复缺失牙,提高老年人的生命质量。     

可摘局部义齿佩戴与口腔健康相关生活质量的关系

目的研究可摘局部义齿治疗前后老年修复患者的口腔健康相关生活质量,为可摘局部义齿治疗计划的制定提供参考。方法收集可摘局部义齿修复的老年牙列缺损患者154例,平均年龄为64.35岁,采用老年口腔健康评价指数(geriatric oral health assessment index,GOHAI)量表中文版进行问卷调查,对可摘局部义齿修复治疗前后的GOHAI得分进行统计学分析。结果可摘局部义齿修复后,患者GOHAI量表中生理功能(Z=-7.989)、心理功能维度(Z=-8.128)和总体得分(Z=-7.932)较治疗前明显升高,差异具有统计学意义(P<0.01)。结论可摘局部义齿修复通过改善患者的口腔生理功能和心理社会功能,可显著提高老年牙列缺损患者的口腔健康相关生活质量。     

老年口腔健康评价指数(GOHAI)中文版的信度考评

目的:考评老年口腔健康评价指数GOHAI中文版的信度。方法:按照国际生存质量评价(IQOLA)项目的标准程序,对GOHAI进行翻译、回译和文化调适,建立GOHAI中文版;使用GOHAI中文版和一般项目表对随机抽取的60岁及以上老年人进行口腔健康生存质量调查,调查结果经统计分析,考评量表的内部一致性信度和重测信度。结果:共有343位老年人接受调查。有效问卷312份,数据缺失问卷28份。GO-HAI中文版内部一致性Cronbach′sα系数为0.81,分半信度系数0.80,条目-量表相关系数在0.25~0.71之间;重测相关系数为0.866(P<0.01)。结论:GOHAI中文版具有良好的信度。     

老年无牙颌患者首次配戴全口义齿前后口腔健康评价指数的变化

目的:应用老年口腔健康评价指数(Geriatric Oralhealth Assessment Index,GOHAI)中文版量表测量初次配戴全口义齿的老年无牙颌患者治疗前后口腔健康相关生活质量(Oral Health-related Quality of Life,OHRQoL)的变化。方法:80例老年无牙颌患者分别于配戴义齿前和配戴义齿后1个月填写GOHAI中文版量表,进行相关统计分析。结果:配戴义齿1月后量表的12个条目中有7个得分明显比配戴义齿前得分升高,差异具有统计学意义(P<0.05);量表总得分和3个维度中的2个得分明显升高,差异具有统计学意义(P<0.05)。结论:全口义齿的配戴不仅改善了老年无牙颌患者的生理功能,更为重要的是满足了患者的心理和社会交往的需求。     

赫尔老年人口腔健康评价指数与口腔健康影响程度量表评价中国西南地区农村中老年人口腔生存质量的对比研究

目的 使用赫尔老年人口腔健康评价指数(GOHAI)和口腔健康影响程度(OHIP-14)量表评价中国西南地区农村中老年人的口腔健康生存质量,检验两量表信度,选出更适合评价中老年人口腔健康生存质量的量表.方法 随机抽取四川青川县和贵州习水县45岁以上中老年人,进行入户面对面的GOHAI和OHIP-14量表问卷调查,采用配对样本t检验,比较两量表在各个维度中老年人的得分,并分别计算两量表的克朗巴哈值进行信度比较.结果 GOHAI和OHIP-14量表对同一对象的口腔健康生存质量评价上一致性较高.中年人和老年人在这2个量表中各维度的得分中,除了GOHAI量表的心理维度得分无差异之外,其他维度得分在两表中均存在差异.信度分析发现OHIP-14量表内在稳定性和可靠性更高.结论 OHIP-14量表更适用于评价中老人的口腔健康生存质量.     

种植覆盖义齿修复牙列缺失的生活质量研究

目的研究下颌牙列缺失患者采用全口义齿（CD）和种植覆盖义齿（IOD）修复后的患者满意度以及口腔健康相关生活质量（OHRQoL）,探讨种植覆盖全口义齿修复对老年下颌牙缺失患者的心理及社会行为是否存在积极的影响。 方法收集2016至2018年在中山大学附属口腔医院门诊就诊,50 ~ 80岁下颌牙列缺失,曾采用传统全口义齿修复且因义齿稳定性差而自愿行种植覆盖全口义齿修复的受试者19例,其中男8例,平均69.25岁;女11例,平均72.45岁。通过自身对照研究,每位受试者均先后佩戴在相同标准下制作的新传统全口义齿（CD）以及种植覆盖义齿（IOD）,并于戴用义齿3个月后完成口腔健康影响程度量表（OHIP-20）、老年口腔健康评价指数量表（GOHAI）和日常生活牙科影响量表（DIDL）调查,分析传统全口义齿和种植覆盖全口义齿修复对患者心理状态和生活质量的影响。数据采用Wilcoxon符号秩检验进行统计分析,P<0.05为差异有统计学意义,并计算CD组和IOD组OHRQoL得分的效应量（ES值）以评价其影响程度。 结果OHIP-20、GOHAI、DIDL量表均显示,IOD组在量表的功能限制、疼痛、心理不适、生理能力受限、心理能力受限、社交能力丧失、身心缺陷、美观、口腔舒适的各领域得分及总体得分上均明显优于CD组,差异具有统计学意义（P<0.05）。此外,根据DIDL量表评价标准得知,IOD修复可有效提提升患者满意度,并减少不满意人数的比例。3个量表在各领域及总得分的ES值均大于0.8,代表每个领域均受到高度影响,并以咀嚼能力（ES = 3.74）、生理能力受限（ES = 3.12）和功能限制（ES = 2.94）等生理功能改善最为显著。说明,IOD组比CD组对患者的生活质量改善较好,且对各方面的改善程度较高。 结论OHIP-20、GOHAI、DIDL量表调查结果反映种植覆盖全口义齿修复对老年下颌牙缺失患者的心理及社会行为有积极的影响。     

正常(牙合)青少年替牙期至恒牙初期切牙和磨牙转矩度的纵向观察

目的：研究正常胎青少年从替牙期到恒牙初期切牙和第一恒磨牙转矩度的生长变化，为正畸诊断、治疗方案设计提供依据。方法：对北京大学口腔医学院·口腔医院颅面生长发育中心收集的20名正常胎青少年样本（男性6名，女性14名）替牙期和恒牙初期的牙颌模型进行分析：替牙期：第一恒磨牙及4颗恒切牙萌出至胎平面，研究对象平均（9.5±0.9）岁；恒牙初期：除第三磨牙外其他恒牙均萌出至眙平面，研究对象平均（13．7±1．3）岁。使用BiagginiRayset系统测量切牙和第一恒磨牙的转矩度，分析替牙过程中牙冠倾斜度的变化。结果：替牙期与恒牙初期相比，男、女切牙和磨牙的转矩度差异均无统计学意义（P〉0．05）。替牙期至恒牙初期，上颌中切牙转矩度由14。减小为10.9°（P〈0．001）；下颌中切牙转矩度由1．8°增加为5.2°（P〈0.01）；上颌侧切牙转距度的变化无统计学意义（P〉0．05）；下颌侧切牙转矩度由1．2°增加为3．0°（P〈0．05）。上颌第一恒磨牙转矩度由-6．6°减小为-10．3°（P〈0．001）。下颌第一恒磨牙转矩度由一38．6°增加为-33.2°（P〈0，001）。结论：从替牙期到恒牙初期，上颌第一恒磨牙逐渐舌向直立，下颌第一恒磨牙逐渐颊向直立。     

儿童口腔健康影响程度量表的研制

目的评价儿童口腔健康影响程度量表（CPQ11- 14）中文版的信度和效度,探讨其在中国儿童中应用的可行性。方法对CPQ11- 14进行翻译、回译、文化调适和改造,建立儿童口腔健康影响程度量表中文版。使用该量表和口腔健康自我评价表对南宁市218名11～14岁中、小学生进行口腔健康检查和口腔健康相关生存质量调查,考评量表的信度和效度。结果口腔健康影响程度量表的重测信度系数为0.82（P<0.001）,内部一致性Cronbach′s α系数为0.79。通过因子分析提取的5个因子显示,口腔健康影响程度量表存在预想的连带关系和逻辑关系。量表得分与自我评价的口腔健康状态、自我感觉口腔健康对生活质量的影响间有明显相关性,其相关系数分别为- 0.33和0.50（P<0.000 5）。量表得分与龋失补牙指数呈明显正相关（P<0.001）,与中学组错畸形情况（美牙指数）也呈正相关（P<0.05）。结论本量表具有良好的信度和效度,为在中国进一步推广应用提供了理论依据。     

Impact of masticatory performance on oral health-related quality of life for elderly Japanese

PURPOSE: This study aimed to investigate the association of masticatory performance with oral health-related quality of life in independently living elderly Japanese subjects. MATERIALS AND METHODS: The study sample consisted of 1028 independently living people over the age of 60 years. Masticatory performance was determined by the concentration of dissolved glucose obtained from test gummy jellies, which are the standardized food developed for measuring masticatory performance. The short-form Oral Health Impact Profile (OHIP-14) and Geriatric Oral Health Assessment Index (GOHAI) were used to measure the impact of oral conditions on oral health-related quality of life. RESULTS: Subjects with lower masticatory performance had significantly higher total OHIP-14 and GOHAI scores (15.0 +/- 9.0 and 14.5 +/- 9.2, respectively) than their counterparts (10.0 +/- 7.5 and 11.3 +/- 7.1, respectively) (P < .01). Logistic regression analyses showed that after controlling for age, gender, self-perceived general health, satisfaction with financial status, and number of teeth, a higher GOHAI score was significantly related to lower masticatory performance (P = .001; odds ratio: 0.56; 95% CI: 0.40 to 0.79). A higher OHIP-14 score was associated with lower masticatory performance but at a level below statistical significance (P = .096; odds ratio: 0.75; 95% CI: 0.53 to 1.05). CONCLUSION: It is suggested that masticatory performance is an important factor influencing the quality of life in independently living, relatively healthy elderly Japanese subjects.     

Oral health-related quality of life and nutritional status

OBJECTIVES: This study examines whether oral health-related quality of life (OHRQoL) is associated with malnutrition risk in the elderly. METHODS: A cross-sectional study was designed using a representative sample of Spaniards over 65 years old. Data on sociodemographics and oral health status were gathered by interview and examination. Oral health-related quality of life was evaluated using the Geriatric Oral Health Assessment Index (GOHAI), and malnutrition risk using the Mini Nutritional Assessment (MNA). RESULTS: The final sample included 2,860 elderly, 41.7 percent males and 58.3 percent females, with a mean age of 73.7 +/- 6.8 years. Mean GOHAI score was 52.1 +/- 7.2, with 70.7 percent of the sample needing oral health care according to this index. The mean MNA score was 24.0 +/- 3.31; 3.5 percent of the elderly were malnourished, 31.5 percent were at risk of malnutrition, and 65.0 percent were considered adequately nourished. A strong association was found between mean GOHAI and MNA scores.     

Oral Health-Related Quality of Life in institutionalized elderly in Barcelona (Spain)

Objective: The objective of this study is to describe the oral health status and the factors associated with oral health-related quality of life (OHRQoL) in people aged 65 and older institutionalized in Barcelona in 2009. Study Design: Cross sectional study in 194 elderly. The dependent variable was poor OHRQoL, according to the Geriatric Oral Health Assessment Index (GOHAI). The independent variables were socio-demographic data, last dental visit, subjective and objective oral health status. Robust Poisson regression analysis was used to determine the factors associated with OHRQoL as well as the strengths of association (Prevalence Ratios with respective confidence intervals at 95%). Results: According to GOHAI, 94 women (68.1%) and 36 men (64.3%) had poor OHRQoL. The average DMFT index (number of decayed, missing and filled teeth) was 22.8, with mean 10.2 remaining teeth. According to the Community Periodontal Index only 1.9% were healthy. 33.8% of the sample (35.5% of women and 30.4% of men) presented edentulism, 54.2% needed upper dental prostheses (51.1% of women and 60.7% of men) and 64.7% needed lower ones (61.6% of women and 71.4% of men). Only 7.2% had visited a dentist in the past year (8.8% of women and 3.6% of men). After fitting several multivariate adjusted robust Poisson regression models, poor OHRQoL was found to be associated to self-reporting problems with teeth or gums, self-reporting poor opinion about teeth/gums/denture and also associated to functional edentulism, needing upper denture, but not to socio-demographic factors or time since last dental visit. Conclusions: The study population has poor objective oral health. A high percentage has poor OHRQoL associated to subjective and objective oral health conditions. Dental care is required and these services should be included in the Spanish National Health System. Key words:Oral health, homes for the aged, elderly, self-assessment, quality of life, geriatric oral health assessment index (GOHAI).     

Validation of the Geriatric Oral Health Assessment Index (GOHAI) in the Malay language

OBJECTIVE: To translate and validate the Geriatric Oral Health Assessment Index (GOHAI into the Malay language for use in Malaysia. METHODOLOGY: The 6-Likert scale GOHAI was translated into the Malay language and self-administered on 189 subjects aged 60+. All subjects underwent oral status assessment. The measure was assessed for construct and discriminant validity, for test-retest reliability and principal component factor. FINDINGS: Mean GOHAI score was 46.2 (SD 9.7, range 17-60). The Cronbach's alpha was 0.79. Mean GOHAI scores increased with more positive self-rated oral health and general health. The elderly with no perceived dental treatment need had higher mean GOHAI scores than those with perceived needs. There were slightly stronger inverse correlations between GOHAI scores and caries experience, number of teeth present, and number of pathologically mobile teeth. The measure demonstrated strong test-retest reliability. Eight of the 12 items had Spearman's r3 0.7. Only one principal factor was found at eigenvalue > 1. Using ANCOVA, self-rated perception of oral health and perceived need for dental treatment had the most significant impact on the GOHAI score. CONCLUSION: AND RECOMMENDATIONS: The Malay language version of the GOHAI demonstrated acceptable validity and reliability and will be an important instrument to measure oral health-related quality of life among Malay-speaking Malaysians. Use of the Malay language version GOHAI should also be pursued among diverse adult age groups.     

Dental status, xerostomia and the oral health-related quality of life of an elderly institutionalized population

The author examined the relative effects of tooth loss and xerostomia on the oral health-related quality of life of an elderly, medically compromised population, living in a long-term care setting. Data were collected from 225 subjects (mean age: 83 years) via a questionnaire and review of dental charts. Oral health-related quality of life was assessed using self-ratings, satisfaction ratings, an index of chewing capacity, the GOHAI, and OH1P-14. Almost all participants had one or more chronic medical conditions and were taking prescribed medications. Two-thirds of the study group was dentulous with a mean number of 16 remaining teeth. One-third of the participants had scores on a xerostomia index indicating marked oral dryness. In bivariate and multivariate analyses, xerostomia index scores were significantly associated with all oral health-related quality of life outcomes. Dental status was associated with chewing capacity only. The results suggest that xerostomia has an important influence on the well-being and quality of life of this population.     

Comparison of the GOHAI and OHIP-14 as measures of the oral health-related quality of life of the elderly

OBJECTIVES: This paper compares the performance of the GOHAI and the OHIP-14 as measures of the oral health-related quality of life of the compromised elderly. METHODS: Data were obtained from a cross-sectional survey of 225 participants, most of whom lived in a large geriatric care centre. RESULTS: The mean age of subjects was 83 years and the majority had one or more chronic medical conditions and physical disabilities. Their main oral problems were high rates of tooth loss and xerostomia. Additive and simple count methods were used to derive GOHAI and OHIP-14 scores. Using the additive method, 8.4% had a GOHAI score of zero and 30.3% an OHIP-14 score of zero. Using the simple count method the percentage with a score of zero was 15.1% and 45.8%. Both measures discriminated between dentate subjects with and without one or more dentures, with and without a chewing problem and with and without dry mouth. Both also showed significant associations with self-rated oral health and satisfaction with oral health status. Associations tended to be stronger between GOHAI scores and these variables. The measures were equally good at predicting overall psychological well-being and life satisfaction. Although the GOHAI identified more oral functional and psychosocial impacts than the OHIP-14, neither was markedly superior to the other when used as discriminatory measures. However, the high prevalence of subjects with zero scores may compromise the ability of the OHIP-14 to detect within-subject change.     

Translation and validation of the Chinese version of GOHAI

OBJECTIVE: To translate and validate the Chinese version of General Oral Health Assessment Index (GOHAI) for elderly in Hong Kong and to investigate factors that possibly may influence the GOHAI scores. METHODS: The English version of GOHAI was translated into Chinese. Persons aged 60-80 years were interviewed by two trained interviewers and clinically examined by a dentist. Information on subjects' demographic background and oral health conditions was collected. RESULTS: Altogether 1,023 elderly were interviewed and clinically examined. The mean GOHAI score was 48.9 (SD = 7.2). Cronbach's alpha of the translated GOHAI was 0.81; item-scale correlation ranged from 0.28-0.61. It was found that the mean GOHAI scores were lower for subjects with poorer perceived oral health (rs = 0.57, P < .001). Elderly who had perceived dental treatment need had a lower mean GOHAI score than those who did not (P < .001). It was also found that elderly who lived in elderly homes, those who received social welfare assistance, those who had recent dental visits, and those with higher DMFT scores had higher mean GOHAI scores. CONCLUSION: The translated Chinese version of GOHAI demonstrated acceptable reliability and validity. It is available for use by researchers in oral health-related quality of life studies on Chinese elderly population.     

Correlates of change in self-perceived oral health among older adults in Brazil: findings from the Health, Well-Being and Aging Study

BackgroundIdentifying changes in the oral health status of older populations, and their predictors and explanations, is necessary for public health planning. The authors assessed patterns of change in oral health–related quality of life in a large cohort of older adults in Brazil during a five-year period and evaluated associations between baseline characteristics and those changes.MethodsThe sample consisted of 747 older people enrolled in a Brazilian cohort study called the Health, Well-Being and Aging (Saúde, Bem-estar e Envelhecimento [SABE]) Study. Trained examiners measured participants' self-perceived oral health by using the General Oral Health Assessment Index (GOHAI). The authors calculated changes in the overall GOHAI score and in the scores for each of the GOHAI's three dimensions individually by subtracting the baseline score from the score at follow-up. A positive difference indicated improvement in oral health, a negative difference indicated a decline and a difference of zero indicated no change.ResultsThe authors found that 48.56 percent of the participants experienced a decline in oral health and 33.48 percent experienced an improvement. Participants with 16 or more missing teeth and eight or more years of education were more likely to have an improvement in total GOHAI score. Deterioration was more likely to occur among those with two or more diseases. Improvement and decline in GOHAI functional scores were related to the number of missing teeth. The authors found no significant model for the change in the psychosocial score, and self-rated general health was the only variable related to both improvement and decline in pain or discomfort scores.ConclusionsThe authors observed a bidirectional change in self-perceived oral health, with deterioration predominating. The strongest predictor of improvement in the total GOHAI score was the number of missing teeth, whereas the number of diseases was the strongest predictor of deterioration.Clinical ImplicationsDental professionals and policymakers need to know the directions of change in older adults' oral health to establish treatment priorities and evaluate the impact of services directed at this population.