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The Development and Evaluation of the Slovenian Version of the Early Childhood Oral Health Impact Scale (ECOHIS-SVN)

Lenka LIKAR OSTRC
Lenka LIKAR OSTRC
, 
Sabina FRANKOVIČ
Sabina FRANKOVIČ
 and 
Alenka PAVLIČ
Alenka PAVLIČ
   | Oct 04, 2023
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Article Category: Original scientific article
Published Online: Oct 04, 2023
Page range: 173 - 181
Received: Mar 10, 2023
Accepted: Aug 10, 2023
DOI: https://doi.org/10.2478/sjph-2023-0025
Keywords
© 2023 Lenka LIKAR OSTRC et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1.

ECOHIS-SVN questionnaire.
ECOHIS-SVN questionnaire.

Figure 2.

Participants’ flowchart.
Participants’ flowchart.

Distribution of responses to individual questions of the ECOHIS-SVN questionnaire.

Never Hardly ever Occasionally Often Very often
(n) (%) (n) (%) (n) (%) (n) (%) (n) (%)
Child impact
   Oral/dental pain 180 70.6 49 19.2 21 8.2 5 2.0 0 0.0
   Difficulty drinking 229 89.8 20 7.8 4 1.6 1 0.4 1 0.4
   Difficulty eating 220 86.3 26 10.2 6 2.4 2 0.8 1 0.4
   Difficulty pronouncing words 230 90.2 14 5.5 4 1.6 5 2.0 2 0.8
   Missed kindergarten, day care, school 233 91.4 17 6.7 5 2.0 0 0.0 0 0.0
   Trouble sleeping 239 93.7 10 3.9 6 2.4 0 0.0 0 0.0
   Irritable, frustrated 220 86.3 30 11.8 4 1.6 1 0.4 0 0.0
   Avoided smiling, laughing 246 96.5 8 3.1 1 0.4 0 0.0 0 0.0
   Avoided talking 251 98.4 3 1.2 1 0.4 0 0.0 0 0.0
Family impact
   Been upset 181 71.0 49 19.2 16 6.3 6 2.4 3 1.2
   Felt guilty 196 76.9 33 12.9 20 7.8 5 2.0 1 0.4
   Time off from work 225 88.2 29 11.4 0 0.0 1 0.4 0 0.0
   Financial impact 244 95.7 6 2.4 1 0.4 1 0.4 3 1.2

Ranges and floor effect of ECOHIS-SVN items (child, family and total).

Domain Number of items Possible range Range Floor effect (% of minimum score)
Child impact 9 9-45 9-31 58.0
Family impact 4 4-20 4-16 63.5
Total score 13 13-65 13-40 50.2

In the subgroup of children with dmft=0, associations between ECOHIS-SVN (child, family and total) and the parent’s age, level of oral health status education, self-reported and OHIP-SVN14 score.

B SE 95 % CI Std. B p-value
ECOHIS-SVN child score
Parent’s age 0.03 0.02 -0.005-0.066 0.132 0.097
Parent’s education
Primary Ref.
Secondary 0.119 0.73 -0.416-0.635 0.119 0.684
University 0.199 0.723 -0.195-0.579 0.199 0.332
Self-reported oral health -0.203 0.111 -0.432-0.045 -0.165 0.112
OHIP-SVN14 0.047 0.017 0.003-0.089 0.234 0.038
R2=0.040, F=2.168 (p=0.061)
ECOHIS-SVN family score
Parent’s age 0.023 0.025 -0.018-0.063 0.079 0.275
Parent’s education
Primary Ref.
Secondary -0.296 0.9 -1.427-0.867 -0.235 0.633
University -0.215 0.891 -1.308-0.927 -0.171 0.739
Self-reported oral health -0.205 0.137 -0.486-0.082 -0.132 0.163
OHIP-SVN14 0.086 0.021 0.008-0.167 0.343 0.032
R2=0.082, F=3.494 (p=0.005)
ECOHIS-SVN total score
Parent’s age 0.052 0.039 -0.009-0.115 0.116 0.093
Parent’s education
Primary Ref.
Secondary -0.177 1.421 -1.533-1.150 -0.089 0.780
University -0.017 1.408 -1.328-1.315 -0.008 0.993
Self-reported oral health -0.408 0.217 -0.870-0.075 -0.166 0.099
OHIP-SVN14 0.132 0.034 0.014-0.250 0.334 0.028
R2=0.086, F=3.629 (p=0.004)

ECOHIS-SVN score validity: correlations with parental-reported oral and general health as well as caries and plaque accumulation.

(n) Child impact (9 items) Family impact (4 items) Total score (13 items)
Mean (SD) r (95% CI) Mean (SD) r (95% CI) Mean (SD) r (95% CI)
General health rating
Excellent 108 9.3 (1.3) 0.56 4.1 (0.6) 0.52 13.5 (1.9) 0.60
Very good 116 10.6 (2.4) (0.46-0.64)* 5.5 (2.3) (0.41-0.61)* 16.1 (4.0) (0.50-0.68)*
Good 25 13.2 (4.9) 6.4 (2.2) 19.6 (6.4)
Fair 5 10.0 (1.2) 5.0 (1.0) 15.0 (2.1)
Poor 1 15.0 (/) 7.0 (/) 22.0 (/)
Dental health rating
Excellent 93 9.1 (0.3) 0.69 4.1 (0.3) 0.65 13.2 (0.5) 0.75
Very good 89 9.6 (1.0) (0.61-0.76)* 4.7 (1.3) (0.56-0.72)* 14.3 (1.8) (0.68-0.80)*
Good 43 11.6 (2.0) 5.7 (2.1) 17.3 (3.2)
Fair 22 14.1 (5.6) 7.8 (3.0) 22.0 (7.2)
Poor 8 15.0 (4.1) 8.4 (2.3) 23.4 (4.7)
Mean (SD) Median (IQR) Mean (SD) Median (IQR) Mean (SD) Median (IQR)
Dmft
dmft=0 140 9.5 (1.0) 9 (9-9) 4.6 (1.3) 4 (4-4) 14.0 (2.0) 13 (13-14)
dmft>0 115 11.4 (3.5) 10 (9-12)* 5.6 (2.4) 5 (4-6)* 17.0 (5.2) 15 (13-19)*
Dental plaque
no 131 9.7 (1.5) 9 (9-10) 4.8 (1.9) 4 (4-5) 14.6 (3.0) 13 (13-15)
yes 124 11.0 (3.4) 10 (9-11)* 5.2 (1.9) 4 (4-6) 16.2 (4.8) 14 (13-17)*

Associations between ECOHIS-SVN (total, child and family) and the parent’s age, education level, self-reported oral health status and OHIP-SVN14 score.

B SE 95 % CI Std. B p-value
ECOHIS-SVN child score
Parent’s age -0.068 0.036 -0.140-0.005 -0.118 0.068
Parent’s education
Primary Ref.
Secondary 0.278 1.003 -2.592-3.182 0.105 0.842
University -0.578 0.993 -3.337-2.210 -0.218 0.691
Self-reported oral health 0.330 0.197 -0.149-0.812 0.109 0.177
OHIP-SVN14 0.076 0.034 -0.013-0.168 0.146 0.096
R2=0.072, F=4.916 (p<0.001)
ECOHIS-SVN family score
Parent’s age -0.043 0.026 -0.088-0.001 -0.103 0.044
Parent’s education
Primary Ref.
Secondary -0.341 0.748 -2.497-1.934 -0.177 0.804
University -0.374 0.740 -2.536-1.912 -0.194 0.784
Self-reported oral health 0.02 0.147 -0.244-0.308 0.009 0.822
OHIP-SVN14 0.065 0.025 -0.004-0.133 0.171 0.065
R2=0.022, F=2.156 (p=0.059)
ECOHIS-SVN total score
Parent’s age -0.111 0.055 -0.213-0.015 -0.126 0.025
Parent’s education
Primary Ref.
Secondary -0.063 1.540 -5.267-4.878 -0.016 0.941
University -0.952 1.524 -6.091-3.927 -0.236 0.673
Self-reported oral health 0.350 0.303 -0.298-1.034 0.076 0.279
OHIP-SVN14 0.141 0.052 -0.002-0.279 0.177 0.054
R2=0.06, F=4.259 (p<0.001)

ECOHIS-SVN score reliability of the study sample.

Number of items Internal consistency (n=255) Test-retest reliability (n=71)
Cronbach’s alpha (lower limit of 95% CI) Average inter-item correlation ICC (95% CI) Mean ECOHIS score difference examination time 1-time 2 (95% CI)
Child impact 9 0.81 (0.77) 0.38 0.85 (0.76-0.91) 0.13 (-0.28-0.54)
Family impact 4 0.76 (0.71) 0.46 0.79 (0.65-0.87) 0.25 (0.06-0.44)
Total score 13 0.85 (0.82) 0.34 0.85 (0.76-0.91) 0.38 (-0.14-0.90)
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Medicine, Clinical Medicine, Hygiene and Environmental Medicine
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