Validation and reliability of the Malaysian English version of the psychosocial impact of dental aesthetics questionnaire for adolescents.
BACKGROUND
The Malay version of the Psychosocial Impact of Dental Aesthetics Questionnaire has been validated for use by Malaysian adolescents. Although Malay is their national language, English is widely used as the lingua franca among Malaysians of different ethnicities. This study aimed to validate an English version of the PIDAQ adapted for use by Malaysian adolescents to optimize data capture from adolescents who prefer English as the medium for communication.


METHODS
The published English version of PIDAQ was pilot tested on 12- to 17-year-old adolescents, resulting in a few modifications to suit the Malaysian variety of English. Psychometric properties were tested on 393 adolescents who attended orthodontic practices and selected schools. Malocclusion was assessed using the Malocclusion Index, an aggregation of Perception of Occlusion Scale and the Aesthetic Component of the Index of Orthodontic Treatment Need, by the subjects (MI-S) and investigators (MI-D). Data were analysed for internal consistency and age-associated invariance, discriminant, construct and criterion validities, reproducibility and floor and ceiling effects using AMOS v.20 and SPSS v.20.


RESULTS
The item Don't like own teeth on video of the Aesthetic Concern (AC) subscale was not relevant to a large proportion of participants (11.7%). Therefore, it was removed and the Malaysian English PIDAQ was analysed based on 22 items instead of 23 items. Confirmatory factor analysis showed good fit statistics (comparative fit index: 0.902, root-mean-square error of approximation: 0.066). Internal consistency was good for the Dental Self-Confidence, Social Impact and Psychological Impact subscales (Cronbach's alpha: 0.70-0.95) but lower (0.52-0.62) though acceptable for the AC subscale as it consisted of only 2 items. The reproducibility test was acceptable (intra-class correlations: 0.53-0.78). For all PIDAQ subscales, the MI-S and MI-D scores of those with severe malocclusion differed significantly from those with no or slight malocclusion. There were significant associations between the PIDAQ subscales with ranking of perceived dental appearance, need for braces and impact of malocclusion on daily activities. There were no floor or ceiling effects.


CONCLUSIONS
The adapted Malaysian English PIDAQ demonstrated adequate psychometric properties that are valid and reliable for assessment of psychological impacts of dental aesthetics among Malaysian adolescents.
Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia. wannurazreena@um.edu.my.
Wan Nurazreena
http://orcid.org/0000-0003-1627-3671
WN
Wan Hassan
Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
Zamros Yuzadi Mohd
ZY
Yusof
Orthodontic Unit, Klinik Pergigian Cahaya Suria, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
Mohd Zambri Mohamed
MZ
Makhbul
Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
Siti Safuraa Zahirah
SS
Shahidan
Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
Siti Farhana
SF
Mohd Ali
Orthodontic Unit, Klinik Pergigian Cahaya Suria, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
Rashidah
R
Burhanudin
Orthodontic Unit, Klinik Pergigian Cahaya Suria, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.
Maria Jirom
MJ
Gere
D000293:Adolescent; D004955:Esthetics, Dental / Q000523:psychology*; D005260:Female; D006801:Humans; D007802:Language; D008296:Malaysia; D008297:Male; D008310:Malocclusion / Q000523:psychology*; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012649:Self Concept; D012647:Self-Assessment; D011795:Surveys and Questionnaires / Q000592:standards*
Adolescent; Cross-cultural adaptation; Impact-related need; Malocclusion; Oral health-related quality of life; Patient-reported outcome measure