重庆医科大学口腔医学专业教育环境的测量与分析

目的 调查重庆医科大学口腔医学专业学生对教学环境的满意度。方法 采用英国Dundee大学开发的DREEM量表,对重庆医科大学口腔医学专业学生进行问卷调查。采用SPSS24.0软件包对数据进行统计学分析。结果 共回收有效问卷260份,量表总的Cronbach α系数为0.915,量表总得分为 (164.99±19.53)分。结论 DREEM量表在口腔医学专业学生中应用,具有较高的信度。重庆医科大学口腔医学专业教育环境总体处于很好的水平。     

儿童口腔健康相关生存质量量表信度与效度的验证研究

目的 通过对8～15岁儿童口腔健康相关生存质量量表(COHIP)中文版信度与效度的验证研究,探讨其在中国适龄儿童中应用的可行性.方法 按照国际生存质量评价项目的标准程序,对英文原版COHIP系列问卷中的儿童问卷、父母问卷分别进行翻译、回译、文化调适和改造,建立中文版COHIP,形成适应儿童口腔健康和治疗需求的自我评估问卷、内容效度指数(CvI)合格的评估量表.使用该系列量表对8～15岁的儿童及其家长进行儿童口腔健康相关生存质量调查,考评量表的信度和效度.结果 1 189对儿童及家长接受问卷调查,收回有效问卷1 143份,量表完成率为96.1％.COHIP儿童表内部一致性Cronbach's α[系数为0.903,条目-量表相关系数为0.134～0.611,Guttman分半信度系数为0.798,组内相关系数(ICC)为0.926.COHIP家长表内部一致性Cronbach'sα系数为0.796,条目-量表相关系数为0.121～0.614,Guttman分半信度系数为0.796,ICC为0.931.因子分析显示中文版量表所包含的条目存在预想的逻辑关系.结论 中文版COHIP具有良好的信度和效度,其良好的心理测量学性质为其在中国适龄儿童中的应用提供了理论依据.     

口腔黏膜病问卷中文版的信度和效度评价

目的 评价口腔黏膜病问卷（COMDQ）中文版的信度和效度。方法对COMDQ进行初译、回译、质量评价、文化调适和预评估,形成COMDQ中文版。该量表包括26个条目,涉及4个维度：疼痛和功能限制、药物治疗相关、社交及情感功能、对患者的支持。进而将其应用于口腔黏膜病患者,最终对调查结果进行统计学分析,考评量表的信度和效度。结果共回收有效问卷130份。量表总的克朗巴赫α系数为0.914,Guttman分半信度系数为0.809,表格之间相关性r为0.697。经过验证性因子分析,提取4个因子,累积贡献率达67.62%,显示量表存在预想的连带关系和逻辑关系。结论COMDQ中文版通过严格的性能测试,具有良好的信度和效度,可在国内口腔黏膜病患者中推广应用。     

多系统评价评估问卷量表在口腔医学领域中文系统评价应用中的信度和效度评价

目的 评价多系统评价评估问卷（AMSTAR）量表应用于口腔医学领域中文系统评价中的一致性、信度和效度。方法 计算机检索中国生物医学文献数据库、维普中文科技期刊数据库和中国期刊全文数据库,截止日期为 2011年3月1日。手工检索19种中文口腔医学杂志,检索已发表的口腔医学类系统评价。2名评价者分别用总体质量 评估问卷（OQAQ）量表和AMSTAR量表对系统评价进行评价,计算观察者间使用AMSTAR量表的Kappa值,AMSTAR 量表重测信度的级内相关系数（ICC）以及AMSTAR和OQAQ量表得分的最大得分百分比的级内相关系数（结构效度）。 结果 纳入52篇系统评价文献。评价者使用AMSTAR量表的Kappa值为0.81[95%C（I 0.73,0.89）],使用OQAQ量表的 Kappa 值为0.74 [95% CI（0.66,0.83）] 。 重测信度的ICC 为 0.98 [95% CI（0.97,0.99）,P =0.000]。 内部一致性信度Cronbach’α为0.69[95%CI（0.56,0.80）,P=0.000]。AMSTAR和OQAQ量表最大得分百分比的ICC为0.94[95%CI（0.90, 0.97）,P=0.000]。结论 AMSTAR量表在应用于口腔医学领域系统评价时有很好的一致性、信度和效度。AMSTAR 量表可很好的推广至口腔医学领域进行系统评价的方法学质量评价,为医务工作者进行系统评价方法学质量评价时带来了较大的便利。     

学龄前儿童口腔健康影响程度量表中文版的信度和效度评价

目的:评价学龄前儿童口腔健康影响程度量表(The Early Childhood Oral Health Impact Scale,ECOHIS)中文版的信度和效度。方法:对ECOHIS进行初译、回译、质量评价、文化调适和预评估,形成ECOHIS中文版,进而将其应用于成都市两部分人群,一部分为随机选择的成都市2所幼儿园的200名学龄前儿童;另一部分是在四川大学华西口腔医院儿童牙病科就诊的100例3～5岁患儿。通过这些儿童的监护人完成问卷调查,最终对调查结果进行统计学分析,考评量表的信度和效度。结果:①共回收有效问卷292份,有效问卷的回收率为97.3%;②信度—量表总的克朗巴赫α系数为0.899,Guttman分半信度系数为0.799,表格之间相关性r=0.666;③结构效度—经过验证性因子分析,提取3个因子,累积贡献率达63.87%,显示量表存在预想的连带关系和逻辑关系;判别效度—所有条目均能区分幼儿园普通儿童和患儿的生命质量差异(P值均<0.01)。结论:ECOHIS中文版通过严格的性能测试,具有良好的信度和效度,可在我国学龄前儿童中推广应用。     

5条目口腔健康影响程度量表中文版的信度和效度研究

目的 对5条目口腔健康影响程度量表（OHIP-5）进行信度和效度评价。方法 按照国际生活质量量表准则,形成OHIP-5中文版,该量表包括5个条目。将OHIP-5中文版应用于就诊的患者,最终对调查结果进行统计学分析。采用内部一致性信度、重测信度对量表的信度进行考评;采用结构效度和收敛效度对量表的效度进行评价。结果 共回收有效问卷556份。量表总的克朗巴赫α系数为0.868,重测信度系数为0.831。经过验证性因子分析,修正模型的主要指标中,卡方/自由度=2.419,拟合指数=0.995,调整拟合指数=0.960,标准拟合指数=0.996,增量拟合指数=0.997,塔克-刘易斯指数=0.985,比较拟合指数=0.997,误差平方根近似值=0.070,均达到模型拟合标准。量表总分的Spearman’s等级相关系数为0.674。结论 OHIP-5中文版通过严格的性能测试,信度和效度良好,可在临床研究及流行病学调查中进一步推广应用。     

儿童口腔健康相关生存质量量表的验证研究

目的通过对11～14岁儿童口腔健康相关生存质量量表(COHRQoL11-14)中文版的验证研究,探讨其在中国适龄人群中应用的可行性。方法按照国际生存质量评价项目的标准程序,对原版COHRQoL11-14系列问卷11～14岁儿童感知问卷(CPQ11-14)、父母感知问卷(PPQ)和家庭影响问卷(FIS)进行翻译、回译、文化调适和改造,建立COHRQoL11-14中文版。使用该系列量表对11～14岁的儿童及其家长进行儿童口腔健康相关生存质量调查,考评量表的信度和效度。结果 67对儿童及家长接受问卷调查,收回有效问卷CPQ11-1462份,PPQ和FIS各65份,量表的完成率在89%以上。CPQ11-14内部一致性Cronbach′sα系数为0.92,条目-量表相关系数为0.49～0.70,ICCs为0.90,分半信度系数为0.85。PPQ和FIS的Cronbach′sα系数分别为0.91和0.89,分半信度系数分别为0.84和0.83。因子分析显示中文版量表所包含的条目存在预想的逻辑关系。结论 COHRQoL11-14具有可接受的信度和效度,其良好的心理测量学性质为其在中国适龄儿童中的应用提供了理论依据。     

压力知觉量表在复发性阿弗他溃疡中的信度与效度

目的:评估压力知觉量表(PSS-10中文量表)应用于复发性阿弗他溃疡的效度和信度。方法:采用方便抽样的方法,选取155例复发性阿弗他溃疡进行现场问卷调查。采用内部一致性信度、复测信度检验其信度;采用探索性因子分析和验证性因子分析的方法检验PSS-10中文量表的结构效度,选用HADS作为效度检验效标效度。结果:探索性因素分析获得无助感和自我效能感2个因子,累计解释量表总方差变异的70.42%;验证性因素分析验证了双因素模型(χ²/df=1.98,CFI=0.96,NNFI=0.93,RMSEA=0.08,RMSR=0.09)。量表的内部一致性系数为0.72,其中无助感的内部一致性系数为0.90,自我效能感的内部一致性系数为0.89。PSS-10中文量表与HADS相关显著(P<0.01),显示较好的效标关联效度。相关性分析显示女性在无助感和自我效能感上均高于男性;不同类型的RAU患者在无助感和自我效能感上具有明显差异,其差异性具有统计学意义。结论:压力知觉量表具有良好的效度和信度,可将其作为自评工具用于评估复发性阿弗他溃疡的压力程度。     

应用UW-QOL评价口腔鳞癌患者的生存质量

目的:应用UW-QOL第4版评价口腔鳞癌患者的生存质量(quality of life,QOL).方法:采用直接翻译并经过适当修改的UW-QOL第4版,对97例确诊为口腔鳞癌的连续患者的术前QOL进行测量,术后3个月对其中55例患者的QOL作重复测量.采用SPSS12.0软件包分析量表的信度、效度和反应度.结果:量表总的克朗巴赫系数和分半信度分别为0.725和0.701;12个条目可提取4个因子,累计方差贡献率为65.4%;以SF-36中文版和FACT-H&N的头颈特异性子量表FACT-HN为效标,其效标效度分别为0.543和0.738;量表能敏感地区分已知的2组口腔癌患者术前QOL的差异及口腔癌患者QOL随时间的变化.结论:UW-QOL第4版具有良好的信度和反应度,其测定结构呈多维性,可用于中国人口腔癌患者生存质量的测量.     

FACT-H&N用于口腔鳞癌患者生存质量测量的效果评价

目的:分析FACT-H&N第4 版用于口腔鳞癌患者生存质量(quality of life, QOL)测量的效果.方法:采用FACT-H&N对97 例确诊为口腔鳞癌的连续患者进行QOL的测量,分析量表的信度、效度和反映度.结果:量表5 个领域的内部一致性系数为0.51～0.81,分半信度为0.83;36 个条目可提取9 个因子,累计方差贡献率为60.5%;量表能敏感的区分已知的2 组口腔癌患者术前QOL的差异及口腔癌患者QOL随时间的变化.结论:FACT-H&N用于国人口腔癌患者生存质量的测量具有较好的信度、效度和反应度,其构建结构合理,值得在临床上推广使用.     

Appraisal of the Dundee Ready Educational Environment Measure in the New Zealand dental educational environment

Aims: To examine the reliability and validity of the Dundee Ready Educational Environment Measure (DREEM) amongst New Zealand students in the first professional year of the Bachelor of Dental Surgery (BDS) and Bachelor of Oral Health (BOH) programmes. Method: In 2009 and 2010, students’ perceptions of the educational environment were evaluated using a modified version of the 50‐item DREEM, completed on the first and last day of their first professional year. Individual DREEM items’ strengths and weaknesses were identified. The difference or dissonance between students’ expectations and actual experience was determined by subtracting the Actual DREEM score (for each item or subscale) from the Expected DREEM score. Effect‐size statistics were calculated, and internal consistency was tested using Cronbach’s alpha. Results: Overall, 82% of 2009 and 2010 BDS and BOH students in their first professional year completed the Expected and Actual DREEM (N = 176). Both groups identified the ‘overemphasis of factual learning’ as an Expected and Actual aspect and ‘memorising all I need to know’ as an Actual aspect of the educational environment. Internal consistency was high for the overall DREEM and the BDS and BOH Expected DREEM (0.89 and 0.88, respectively) and excellent for both the BDS and BOH Actual DREEM (0.92 and 0.90, respectively). Conclusion: Overall, students entering the courses anticipated a number of strengths and weaknesses and those expectations were relatively similar in the different programmes (BDS and BOH). The DREEM showed excellent internal consistency for the overall scores, and that for the subscale scores was generally acceptable. The study confirms the DREEM’s utility for the NZ dental education environment.     

DREEM on,dentists! Students’ perceptions of the educational environment in a German dental school as measured by the Dundee Ready Education Environment Measure

Objectives: The educational climate in which future doctors are trained is an important aspect of medical education. In contrast to human medicine, it has been rather neglected in dental educational research. The aim of the study was to supplement this lack by applying and validating the Dundee Ready Education Environment Measure (DREEM) for the first time in a German‐speaking sample of dental students. Methods: All dental students at the Medical Faculty of Heinrich‐Heine‐University Düsseldorf were asked to complete a German adaptation of the DREEM and the Düsseldorf Mission Statement Questionnaire (DMSQ) in a paper‐pencil survey. Data from 205 participants were analysed. Psychometric validation included analysis of item homogeneity and discrimination, test reliability, criterion and construct validity (convergent, factorial). Results: DREEM item parameters were satisfactory, reliability (α = 0.87) and convergent validity (r = 0.66 with DMSQ) were also high. Factor analyses, however, yielded dimensions which did not fully correspond to the original DREEM subscales. Overall perception of the educational environment was positive (DREEM total score = 122.95 ± 15.52). Students in the clinical part of course rated the atmosphere more negatively, but their academic self‐perception more positively than preclinical students. Conclusions: Showing satisfactory psychometric properties, DREEM proved suitable for assessing educational environments among dental students. Given the right circumstances, e.g., small and early clinically oriented classes, traditional curricula can generate positive environments.     

The dental school learning milieu: students' perceptions at five academic dental institutions in Pakistan

The significance of the educational environment in health professions academic institutions, increasingly recognized on a global scale, is fundamental to effective student learning. This study was carried out to evaluate students' perceptions of the educational environment in five undergraduate dental institutions in Pakistan. This non-interventional study used a postal questionnaire based on the Dundee Ready Educational Environment Measure (DREEM). The subjects were dental students taking the final professional B.D.S. examination at five dental institutions affiliated with the University of Health Sciences, Lahore, Pakistan. A total of 197 students participated in the study (response rate of 83.82 percent). The overall DREEM score was 115.06 (Cronbach's alpha 0.87). Nine items recorded scores <2 and were flagged for remediation. Significant differences were observed between students' perceptions of learning and of teachers (p<0.05). Many issues challenge the quality and delivery of dental education in Pakistan, and dental institutions need to develop robust mechanisms to incorporate contemporary international trends in dental education in order to improve the educational environment.     

Students’ perceptions of the educational environment in a Greek Dental School,as measured by DREEM

Aim: The aim of this study was to estimate the dental students’ perceptions of their educational environment and to identify any differences related both to their gender and semester of studies. Materials and methods: The translated and validated in Greek Dundee Ready Education Environment Measure (DREEM) questionnaire was distributed to all 2nd‐ to 5th‐year students of the Athens Dental School. The questionnaire consisted of 50 statements organised in five subscales (perceptions of learning, teachers, atmosphere, academic self‐perceptions and social self‐perceptions). Internal validity was checked with Cronbach alpha. Confirmatory factor analysis (CFA) was performed under the same conditions as the original inventory. Mean statement, subscale and overall scores were calculated and given as percentages. Results: The response rate was 64%. Overall Cronbach alpha was 0.93 (excellent). CFA produced five meaningful subscales, not matching the original ones. The overall DREEM mean score was 56%. Gender did not influence the findings. The students’ perceptions of the educational environment with the exception of the academic self‐perceptions were more positive in the pre‐clinical years. Statistically significant differences were revealed only for the ‘learning’ subscale between the 3rd‐ and the 4th‐year students. Seventy‐eight percent of the statements were in the positive side. The lowest scores were related to students’ stress, tiredness and lack of appropriate feedback from the teachers, and the highest were related to accommodation, school friends and perceptions that they feel socially comfortable in class. Conclusions: Students’ perceptions of the educational environment were reasonably positive, with no gender difference. However, some weaknesses were identified, particularly in the clinical years. Further research is needed to clarify appropriate interventions.     

口腔健康影响程度量表的验证研究

目的通过对口腔健康影响程度量表（OHIP-14中文版）的验证研究及其性质的考评，对该量表的信度、效度作出评价，探讨其在中国人群中进一步应用的可行性。方法按照国际生存质量评价（IQOLA）项目的标准程序，对OHIP-14进行翻译、回译、文化调适和改造，建立口腔健康影响程度量表。使用该量表和《口腔健康自我评价表》，对广东省部分地区年龄在18～65岁之间的居民应用多阶段简单随机抽样法，共抽取592个个体进行口腔健康相关生存质量调查，对调查结果进行统计学分析，考评量表的信度和效度。结果共有592位个体接受调查。回收有效问卷550份，其中数据缺失问卷38份。口腔健康影响程度量表内部一致性Cronbach’s α系数为0．93，条目与量表间的相关系数在0．53～0．71之间。因子分析提取的4个维度显示，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、自我感觉的治疗需要间呈显著正相关，相关系数分别为0．54、0．49（P〈0．0001）。结论口腔健康影响程度量表具有良好的信度、效度，其良好的心理测量学性质，为该量表在中国人群中的进一步推广应用提供了理论依据。     

Development and validation of Hong Kong Rapid Estimate of Adult Literacy in Dentistry

Aim: To develop and validate an instrument, the Hong Kong Rapid Estimate of Adult Literacy in Dentistry (HKREALD‐30). Methods: The Rapid Estimate of Adult Literacy in Dentistry (REALD‐99) was translated into Chinese and modified in the pretest. A total of 200 parents of pediatric dental patients were interviewed using this modified scale and administered additional three sets of self‐reported questionnaires. The 99 items of the scale were reduced to 30 (HKREALD‐30). Concurrent validity was tested by comparing the HKREALD‐30 scores with the participants’ educational level, pattern of dental visits and reading habits. Convergent validity was tested by examining the association between HKREALD‐30 and the Test of Functional Health Literacy in Dentistry (TOFHLiD). The test–retest reliability and internal consistency of HKREALD‐30 were also evaluated. Results: A significant correlation (P < 0.01) was found between HKREALD‐30 and participants’ reading habits. HKREALD‐30 was also highly correlated with TOFHLiD (Spearman’s rho = 0.693, P < 0.01). In the regression model, HKREALD‐30 was positively associated with TOFHLiD (P < 0.05) after controlling for participants’ characteristics. The intra‐class correlation coefficient of HKREALD‐30 was 0.78 and the Cronbach’s alpha was 0.84. Conclusion: Initial testing of HKREALD‐30 suggested that it is a valid and reliable instrument for the basic screening of oral health literacy among Chinese people in Hong Kong.     

Development and evaluation of a questionnaire to evaluate clinical dental teachers (ECDT)

OBJECTIVES: To develop and test the psychometric properties (validity and reliability) of a questionnaire to evaluate clinical dental teachers. METHODS: An item (question) pool was generated with the use of a literature review, feedback from faculty staff, and from focus group discussions with dental students. Following factor analysis the validity and reliability of a revised questionnaire was assessed. This involved 148 dental students and 453 assessments of 29 clinical dental teachers. RESULTS: Effective clinical dental teaching (ECDT) scores were associated with 'global ratings' of the effectiveness of clinical dental teaching (P<0.01), indicating strong criterion validity. In comparison analysis there was strong agreement between students regarding ratings of individual clinical dental teachers, indicating good construct validity. Reliability was assessed by examining internal consistency of sub-scales and overall ECDT scale, and found to be good (Cronbach alpha's > 0.80). CONCLUSION: A valid and reliable measure to evaluate clinical dental teachers has been developed for use in a clinical academia setting, and has potential use as a quality assurance measure.