ABSTRACT
BACKGROUND: Orofacial granulomatosis (OFG) is a term used to describe a persistent, painless swelling of lips and orofacial region. It can be associated with ulceration, gingival hypertrophy and cobble stone appearance of the buccal mucosa. OFG is commonly associated with Crohn's disease and can precede the intestinal manifestation of the disease. Exclusive enteral nutrition (EEN) is a recognized treatment for induction of remission for Crohn's disease. The aim of this study was to review the use of EEN in the management of OFG in children. METHODS: Retrospective review of medical records of all children diagnosed with OFG between 2007 and 2012 was conducted. Presence of comorbidities, progression to inflammatory bowel disease (IBD) and response to EEN was evaluated. RESULTS: Twenty-nine children were included, mean age at diagnosis was 9 years (standard deviation 3.9) years. Ten children had isolated OFG and 19 had OFG and IBD, of which 12 presented with OFG and IBD and 7 developed IBD later. Median time to progression to IBD was 33 months (inter quartile range: 9.8-85.5). Twenty-two children completed 6 weeks of EEN, and 19 showed clinical improvement in the OFG appearance. CONCLUSION: EEN appears to be an effective treatment option for children with isolated OFG or OFG and IBD.
Subject(s)
Crohn Disease/therapy , Enteral Nutrition/methods , Granulomatosis, Orofacial/diagnosis , Granulomatosis, Orofacial/therapy , Quality of Life , Child , China , Chronic Disease , Cohort Studies , Crohn Disease/complications , Crohn Disease/physiopathology , Databases, Factual , Female , Follow-Up Studies , Granulomatosis, Orofacial/complications , Granulomatosis, Orofacial/psychology , Humans , Male , Retrospective Studies , Role , Severity of Illness Index , Tertiary Care Centers , Treatment OutcomeABSTRACT
INTRODUCTION: The aim of this study was to evaluate the reliability and validity of the Chinese version of the Chronic Oral Mucosal Diseases Questionnaire (COMDQ). METHODS: A consecutive sample of 200 patients with chronic oral mucosal diseases was enrolled to complete the questionnaire after its translation and cross-cultural adaptation. The reliability of the Chinese version of COMDQ was determined through internal consistency and test-retest methods. The construct validity of COMDQ was analysed by exploratory factor analysis (EFA). RESULTS: Cronbach's alpha value for the total COMDQ score was 0.894, and the test-retest intraclass correlation coefficient value for the total COMDQ score was 0.83. The EFA extracted four factors, which accounted for 67.89% of the variance. All items showed adequate factor loadings, ranging from 0.487 to 0.947. CONCLUSION: The results suggest that the Chinese version of the COMDQ has satisfactory psychometric properties and is applicable to patients with chronic oral mucosal diseases in China.
Subject(s)
Mouth Diseases/psychology , Quality of Life , Surveys and Questionnaires/standards , Activities of Daily Living , Attitude to Health , China , Chronic Disease , Cross-Cultural Comparison , Emotions , Factor Analysis, Statistical , Female , Granulomatosis, Orofacial/drug therapy , Granulomatosis, Orofacial/psychology , Humans , Language , Lichen Planus, Oral/drug therapy , Lichen Planus, Oral/psychology , Male , Middle Aged , Mouth Diseases/drug therapy , Pain/psychology , Pemphigoid, Benign Mucous Membrane/drug therapy , Pemphigoid, Benign Mucous Membrane/psychology , Pemphigus/drug therapy , Pemphigus/psychology , Psychometrics/standards , Social Support , Stomatitis, Aphthous/drug therapy , Stomatitis, Aphthous/psychology , TranslatingABSTRACT
OBJECTIVE: To test the reliability and responsiveness of the Chronic Oral Mucosal Diseases Questionnaire (COMDQ), in measuring the quality of life (QofL) in patients with chronic oral mucosal conditions. METHODS: A random sample of 160 patients with the following chronic oral mucosal conditions, recurrent aphthous stomatitis, oral lichen planus, the more common vesiculobullous conditions (mucous membrane pemphigoid and pemphigus vulgaris) and orofacial granulomatosis received a copy of the COMDQ. A subset of 100 patients received the questionnaire on two further occasions, 2 weeks and 3 months later. Statistical tests were carried out to evaluate the test-retest reliability and responsiveness of this instrument. RESULTS: This study has demonstrated that the COMDQ has good test-retest reliability with an intraclass correlation coefficient of 0.81 and is responsive to changes in the patients' overall conditions. CONCLUSION: In conclusion, this study has further demonstrated the reliability and responsiveness of the COMDQ in assessing QofL in patients with chronic oral mucosal diseases.
Subject(s)
Mouth Diseases/psychology , Quality of Life , Surveys and Questionnaires , Depression/psychology , Drinking , Eating/psychology , Facial Pain/psychology , Granulomatosis, Orofacial/psychology , Humans , Interpersonal Relations , Lichen Planus, Oral/psychology , Mouth Mucosa , Pemphigoid, Benign Mucous Membrane/psychology , Pemphigus/psychology , Pharmaceutical Preparations, Dental , Reproducibility of Results , Stomatitis, Aphthous/psychologyABSTRACT
OBJECTIVE: The objective of this study was to develop a self-completion questionnaire measuring quality of life in patients with chronic oral mucosal diseases. STUDY DESIGN: The stages of development involved the use of both clinical expert input, via a modified Delphi technique, and patient input, via qualitative interviews, in the generation of items. Item reduction was carried out using a judgment method. RESULTS: Expert input was derived from 5 professors or consultants in oral medicine. Qualitative interviews were conducted with 24 patients during the item-generation phase of development. An initial item pool of 28 items was generated from the clinician and patient input. Importance ratings ranged from 4.0 to 0.44. Items with importance ratings below 1 were reviewed and considered for exclusion. Three items were subsequently excluded and 1 item added resulting in a final 26-item instrument. CONCLUSIONS: This is the first discipline-specific quality-of-life measure developed in the field of oral medicine.
Subject(s)
Mouth Diseases/psychology , Quality of Life , Sickness Impact Profile , Surveys and Questionnaires , Adult , Aged , Chronic Disease , Delphi Technique , Female , Focus Groups , Granulomatosis, Orofacial/psychology , Humans , Interviews as Topic , Lichen Planus, Oral/psychology , Male , Middle Aged , Mouth Mucosa/pathology , Patient-Centered Care , Pemphigoid, Benign Mucous Membrane/psychology , Pemphigus/psychology , Qualitative Research , Stomatitis, Aphthous/psychologyABSTRACT
OBJECTIVE: To explore the experience of daily life of persons with chronic oral mucosal conditions. METHODS: Purposive sampling was used to recruit patients from the Oral Medicine Unit of Cork University Dental School and Hospital. An experienced independent facilitator convened the focus groups and conducted individual interviews in a non clinical setting. Focus groups were mixed with regard to gender, age, chronic oral mucosal condition, time since diagnosis and severity. A total of 24 patients took part, including patients with oral lichen planus, mucous membrane pemphigoid, pemphigus vulgaris, recurrent aphthous stomatitis and orofacial granulomatosis. RESULTS: Analysis of the interviews revealed that patient views could be divided into the following themes - biopsychosocial issues, treatment limitations and side effects, unpredictability of the conditions and the potential for malignant transformation and issues for the healthcare professionals. CONCLUSION: Chronic oral mucosal conditions impact upon the experience of daily life of patients in a variety of areas from physical health and functioning, to concerns about their future. The role of the oral medicine practitioner in treating patients with chronic oral mucosal diseases extends beyond active management and symptomatic relief to the management of all aspects of these conditions that impact upon their daily lives.
