Study of the Unidimensionality of the Subjective Measurement Scale of Schizophrenia Coping Oral Health Profile and Index: SCOOHPI.

BACKGROUND: The Schizophrenia Coping Oral Health Profile and Index (SCOOHPI) scale studies the coping strategies of schizophrenic patients with regard to oral health. The structural validity of this scale is studied has been studied using factor analyses. In this article, we study the unidimensionality of the SCOOHPI scale to use it as an index. METHODS: We studied the internal consistency of the items of the SCOOHPI scale. Then, we studied the construct validity. The unidimensionality of the SCOOHPI scale was studied by the partial credit model. RESULTS: The data used in this study come from five hospitals, and the total number of individuals participating in this study is 96, of which 72% are men and 59% are smokers. The SCOOHPI scale has good internal consistency (α = 0.84). The validity of divergence was checked by the absence of correlation between the SCOOHPI scale and the GOHAI (General Oral Health Assessment Index) scale. The unidimensionality of the SCOOHPI scale with data smoothing was demonstrated by the partial credit model. CONCLUSION: In this study, we completed the study of the psychometric validation of the SCOOHPI. The SCOOHPI scale can then contribute to improving evaluation of the coping strategies of schizophrenic patients with regard to oral health.

Dimensional Structure and Preliminary Results of the External Constructs of the Schizophrenia Coping Oral Health Profile and Index (SCOOHPI).

The Schizophrenia Coping Oral Health Profile and Index (SCOOHPI) was developed to assess oral health coping strategies in people with schizophrenia. We show that the difficulty and discrimination indices of 18 items, selected for the final version, are acceptable according to the Rasch model, as are the inter-item (0.25) and inter-score (α = 0.85) correlations. This scale can be considered as an index, giving a global score between 0 and 72, with a Likert scale with five response modalities. This is also a profile with the following three dimensions of coping-related oral health, emerging independently of each other: (1) physical well-being strategies (α = 0.72); (2) moral well-being strategies (α = 0.60); (3) access strategies for oral well-being (α = 0.79). The sub-scores, ranging from 0 to 24, specify populations focused on the themes of coping strategies that may be most affected, depending on the subject's characteristics and their clinical oral health status. The validation study of this scale is still in progress, to evaluate the reproducibility of the results, sensitivity to change, and reliability for other populations of people with schizophrenia.

Psychometric Properties of the Schizophrenia Oral Health Profile: Preliminary Results.

The Schizophrenia Oral Health Profile questionnaire was developed to assess the oral health-related quality of life among individuals with schizophrenia based on their perceptions rather than from caregivers. A 5-point Likert scale was used to self-report on 42 items. In the present study, different analyses were conducted to determine the dimensional structure of the final scale: (1) inter-item correlation analysis and Cronbach's α coefficient, (2) Rasch model analysis, (3) exploratory factor analysis and (4) confirmatory factor analysis. The final version of the Schizophrenia Oral Health Profile questionnaire consisted of 20 items and an internal structure composed of three dimensions: (1) emotions related to oral health, (2) oral pain and discomfort and (3) self-image, others' views and the need for care. We showed that the difficulty and discrimination indices of each of the 20 selected items were acceptable according to the Rasch model, as well as their inter-item and inter-score correlations (α = 0.875). The psychometric study of the Schizophrenia Oral Health Profile questionnaire is still in progress to investigate reproducibility, sensitivity to change and external structure.

A qualitative study on experiences of persons with schizophrenia in oral-health-related quality of life.

Our study aimed to explore the views and experiences in oral health and oral-health-related quality of life (OHRQoL) of persons with schizophrenia (PWS) in order to expand the understanding of the factors that either limit or facilitate their healthcare pathway, which can ultimately optimize their oral health and/or OHRQoL. A qualitative study was conducted in France in the Côte d'Or department (530 000 in habitants) centered on PWS's perceived meanings regarding oral health or OHRQoL, and semi-structured individual interviews were used. A conventional content analysis approach was chosen in order to highlight unrevealed themes. A sample of 20 PWS (12 males; 8 females) with a median age was 45.8 (± 9.5) were recruited to assess views and experiences regarding OHRQoL, which were focused on three dimensions: an individual dimension related to experience of "oral symptoms", a second dimension related to experience of "stress and its management", and a third related to "Autonomy dimension in oral health". We showed that PWS clearly expressed their mental representations of oral health and OHRQoL. This study supports that PWS were able to define their needs and had the ability to discuss their oral health and OHRQoL. These finding could be used to support specific interventions for this population to better manage the negative impact of antipsychotics and help them to consult dentists on a regular basis.

A qualitative study on experiences of persons with schizophrenia in oral-health-related quality of life

Abstract Our study aimed to explore the views and experiences in oral health and oral-health-related quality of life (OHRQoL) of persons with schizophrenia (PWS) in order to expand the understanding of the factors that either limit or facilitate their healthcare pathway, which can ultimately optimize their oral health and/or OHRQoL. A qualitative study was conducted in France in the Côte d'Or department (530 000 in habitants) centered on PWS's perceived meanings regarding oral health or OHRQoL, and semi-structured individual interviews were used. A conventional content analysis approach was chosen in order to highlight unrevealed themes. A sample of 20 PWS (12 males; 8 females) with a median age was 45.8 (± 9.5) were recruited to assess views and experiences regarding OHRQoL, which were focused on three dimensions: an individual dimension related to experience of "oral symptoms", a second dimension related to experience of "stress and its management", and a third related to "Autonomy dimension in oral health". We showed that PWS clearly expressed their mental representations of oral health and OHRQoL. This study supports that PWS were able to define their needs and had the ability to discuss their oral health and OHRQoL. These finding could be used to support specific interventions for this population to better manage the negative impact of antipsychotics and help them to consult dentists on a regular basis.

Oral health treatment habits of people with schizophrenia in France: A retrospective cohort study.

OBJECTIVE: To identify the differences between persons with schizophrenia (PWS) and general population in France in terms of oral health treatment (tooth scaling, dental treatment and tooth extraction) and the factors associated with these differences. METHODS: This retrospective cohort study included PWS identified from a representative sample of 1/97th of the French population (general sample of beneficiaries). PWS were identified from 2014 data by an algorithm that included: F2 diagnostic codes in the register of long-term diseases in 2014 AND {(at least three deliveries of antipsychotics in 2014) OR (F20 diagnostic codes as a main or associated diagnosis in hospital discharge abstracts in 2012 or 2013 (hospital data for medicine, surgery and obstetrics)}. Follow-up dental care was explored for all people over a period of 3 years (2014 to 2017). RESULTS: In 2014, 580,219 persons older than 15 years were identified from the 96 metropolitan departments in France; 2,213 were PWS (0.4%). Fewer PWS were found along a diagonal line from north-east to south-west France, and the highest numbers were located in urban departments. PWS were more often male (58.6% vs 48.7%, p<0.001). They were less likely to have had tooth scaling but more likely to have undergone a dental extraction. In one third of departments, more than 50% of PWS had at least one tooth scaling over a three-year period; the rate of dental extraction in these departments ranged from 6 to 23%. Then, a quarter of the departments in which 40 to 100% of PWS had had at least one dental extraction (2/8) presented a rate of tooth scaling ranging from 0 to 28% over the study period. CONCLUSIONS: Compared with the general population, PWS were less likely to have had tooth scaling and dental treatment but more likely to have undergone dental extraction.

Anticholinergic Drugs and Oral Health-related Quality of Life in Patients with Schizophrenia: A Pilot Study.

OBJECTIVE: The aim of this study was to explore, in a sample population of people with schizophrenia (PWS), the role of the anticholinergic burden on the perception of oral health-related quality of life (OHrQoL) in France. METHODS: A pilot study was performed between March 2014 and January 2016. PWS were recruited from a population in Côte d'Or department in France. Dental status was investigated using the Decayed, Missing, or Filled Teeth (DMFT) index, the Xerostomia Index (XI), and the Global Oral Health Assessment Index (GOHAI) for OHrQoL. The anticholinergic impregnation score was recorded using the anticholinergic impregnation scale (AIS). RESULTS: A sample of 62 people was selected. The DMFT score was 16.5± 8.7, the XI score was 22.9±7.8, the GOHAI score was 43.0±8.8, and the AIS score was 3.1±2.8. In total, 169 drugs were prescribed to the people of our sample, and 114 different anticholinergic drugs were observed. The most frequently used anticholinergic drugs (51.40%), in the study had a low antimuscarinic potency (1 point according to AIS scale). The multiple linear regression model showed that the OHrQoL scores were significantly lower when the DMFT scores, XI score, and anticholinergic scores were high. CONCLUSIONS: This pilot study highlighted the potential role of the anticholinergic burden on the OHrQoL of PWS. A study with a validated specific scale for the OHrQoL and a standard anticholinergic burden scale should be conducted to clarify the role of anticholinergic drugs on the OHrQoL for PWS.

The Schizophrenia Coping Oral Health Profile. Development and Feasibility.

BACKGROUND: The aim of this work was to present the creation of appropriate tools to evaluate the coping strategies in Oral-Health-related Quality of Life (OHrQOL) implemented by persons with schizophrenia (PWS), the Schizophrenia Coping Oral Health Profile (SCOOHP), and the results of a feasibility study. METHODS: A qualitative investigation was conducted between June 2016 and May 2017.The first step included 26 semi-structured individual interviews, 20 with PWS and 6 with health professionals (HPs), and 2 focus groups (PWS and HPs) to explore the experiences of the participants and how they felt about coping strategies in OHrQOL. The second step was a feasibility study involving a statistical analysis to test the acceptability and internal consistency (Cronbach's α) of the SCOOHP. RESULTS: The analysis of these interviews allowed for us to obtain 277 items from 3545 verbatim transcriptions related to various dimensions of OHrQOL. We presented the items selected in coping concepts in this study. After selecting items in several stages, we drew up the SCOOHP scale with 23 items (15 items for positive coping and 8 items for negative coping). The feasibility study showed good acceptability, good understanding of the items and good consistency reliability (α = 0.59). CONCLUSIONS: This is the first study that has enabled us to draw up a specific tool to assess coping strategies in OHrQOL of PWS. A multicentre study involving a larger sample of PWS is underway in order to perform the psychometric validation of the SCOOHP. TRIAL REGISTRATION: Clinical Trials Gov NCT02730832. Date registered: 21 March 2016.