Development of an instrument to assess oral hygiene ability in older adults: The oral hygiene ability instrument

Abstract

Objectives To describe the development process of an instrument to assess the ability to manage daily oral hygiene and the cause of impaired oral hygiene. The instrument is initially aimed for use by the dental team in the ageing population. Background Oral hygiene is an important component of oral health. Inability to manage oral hygiene combined with other risk factors often results in poor oral health and impaired quality of life. Methods A guideline for instrument development was used during the construction of the instrument. The method included three phases: I. planning: the purpose and target group of the instrument were determined, and a literature review and qualitative focus‐group study were conducted; II. construction: objectives were formulated, and a pool of items was built; and III. evaluation and validation, which included two pilot studies, interviews, item analyses and revision of the instrument. Results The planning and construction phases resulted in an instrument with 47 items comprising three parts: (a) interview, (b) clinical examination and (c) observation of activities of daily living (oral hygiene). After two pilot studies, the instrument was found to have good content validity. Analyses of qualitative and quantitative data resulted in a reduction in the number of items to 33. Conclusion OHAI can be a valuable tool as a preventive method to identify older adults at risk of impaired oral health. However, the instrument needs further evaluation before wider use.

Decisional needs for older adults, home health care nurses and dental hygienists during team-based oral health assessments in ordinary home settings – a qualitative study

“…In previous research it was concluded that it was crucial to integrate the older adults' preferences and values regarding their oral health in oral assessments (34). Inspired by OHAI (53) to assess ability during the oral hygiene task in home settings, new opportunities for learning were opened. For example, the results show that older adults were recommended to use a chair in the bathroom when balance was poor.…”

Evaluation of the Oral Hygiene Ability Instrument (OHAI): Test of reliability

“…For the intra‐ and inter‐rater reliability of parts II (clinical examination) and III (observation of ADL‐oral hygiene), four dental professionals (one dental hygienist, one dentist, two dental nurses working with dental prophylaxis) participated. The raters were the same as those who conducted all examinations during the development and first evaluation of the OHAI 13 . The group of dental professionals all had extensive experience working in dentistry (30–40 years) and working with older patients (≥20 years).…”

“…A new instrument, the Oral Hygiene Ability Instrument (OHAI), was developed mainly based on the factors described in the qualitative study 12,13 . The OHAI is intended to be used in prophylactic work to assess the cause of any inability for older adults to manage oral hygiene self‐care.…”

Outcomes of inter-organizational health planning between public dental care and municipal care organizations for older people: A study protocol for a randomized controlled study in Sweden

“…-OHAI (48), for measuring ability to perform oral hygiene tasks. The OHAI should be used when indicated, when ROAG (47) shows 2 or 3 at the variables 'teeth', 'gum', 'saliva' and 'oral mucosa' or if the older adult expresses concerns about difficulties with maintaining oral hygiene.…”

“…It was also included to provide a common language. When ROAG indicated difficulties regarding oral hygiene (= score 2 or 3 on 'teeth' or 'gum' within ROAG), the ability to perform oral hygiene tasks could be explored inspired by the Oral Hygiene Ability Instrument (OHAI) (48).…”