Validation of a measuring instrument for the perception of oral health in women

The aim of this study was to estimate the reliability, validity and factorial invariance of the Portuguese version of the Geriatric/General Oral Health Assessment Index (GOHAI) as applied to Brazilian women. A total 701 women over 18 years of age participated in this study. Telephone interviews were conducted. We evaluated the construct-related validity through factorial, convergent and discriminant validity. We carried out a confirmatory factor analysis using the χ2/df, CFI, GFI and RMSEA indexes. The invariance of the model in a second independent sample was estimated by multi-group analysis and internal consistency using Cronbach’s alpha coefficient. Items 5 and 9 presented factor weights below the adequate value and were removed. The three-dimensional and unifactorial model presented an adequate fit. We observed strong factorial invariance of the models in two independent samples (three-factor: ρλ = 0.62; pCov = 0.89, one-factor: ρλ = 0.81; pCov = 0.68) and weak factorial invariance between users and nonusers of dental prosthetics (three-factor: ρλ = 0.55; pCov = 0.01, one-factor: ρλ = 0.51; pCov = 0.02). The convergent validity was suboptimal. Internal consistency was adequate. The GOHAI applied to the study sample showed adequate reliability, factorial validity and stability in independent samples and between users and nonusers of dental prosthetics in both the three-dimensional and the unifactorial structures.

本研究旨在评估葡萄牙语版老年/口腔整体健康评估指数（Geriatric/General Oral Health Assessment Index, GOHAI）应用于巴西女性人群时的信度、效度及因素不变性。本研究共纳入701名18岁以上女性受试者，采用电话访谈方式开展调研。研究通过因素效度、聚合效度与区分效度评估其结构相关效度；采用χ²/df、CFI、GFI及RMSEA指标开展验证性因素分析。通过多群组分析检验模型在第二独立样本中的不变性，并采用克朗巴赫α系数评估内部一致性。第5、9项的因素载荷未达到合格阈值，予以剔除。三维结构与单因素结构模型均显示出良好的拟合效果。在两个独立样本中，两种结构模型均表现出较强的因素不变性（三维结构：ρλ=0.62；pCov=0.89；单因素结构：ρλ=0.81；pCov=0.68）；而在义齿佩戴者与非佩戴者之间，模型仅表现出弱因素不变性（三维结构：ρλ=0.55；pCov=0.01；单因素结构：ρλ=0.51；pCov=0.02）。聚合效度表现欠佳，内部一致性则符合要求。本研究中应用于受试人群的GOHAI，在三维与单因素结构下，于独立样本间以及义齿佩戴者与非佩戴者之间均展现出良好的信度、因素效度与稳定性。