ABSTRACT
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
BACKGROUND: Mucous membrane pemphigoid is a rare autoimmune bullous disorder. Numerous treatment regimens have been proposed in the literature. OBJECTIVE: To assess the efficacy and tolerance of treatment regimens proposed in mucous membrane pemphigoid (MMP), from a systematic review of the literature. METHODS: Randomized control trials have been identified using the PubMed and Embase databases up to April 2009. Uncontrolled prospective and retrospective studies have also been analyzed. RESULTS: Literature analysis confirms that clinical and therapeutic trials are very uncommon in MMP; only retrospective series or case reports are available and have been analyzed. Therefore, the level of evidence is usually weak. Twenty-four series have been analyzed in this review. Dapsone remains the first line treatment in non-ocular forms of MMP. Sulfasalazine or cyclins can be used when dapsone is not tolerated or effective. Corticosteroids can be used to control inflammatory flares of the disease. Immunosuppressants are not used as the first line of treatment and can be added to anti-inflammatory drugs for a better control of MMP. Cyclophophamide or mycophenolate mofetil can be used, especially in the elderly. In ocular forms of the disease, the severity and chronicity of ocular involvement is the main therapeutical target. Non-scarring conjunctivitis can be treated by dapsone monotherapy. Ocular flares of the disease can be treated with systemic corticosteroids or cyclophosphamide. Many immunomodulating drugs are under evaluation. Intravenous immunoglobulins, etanercept or rituximab can be proposed when cyclophosphamide is not able to control the disease. CONCLUSION: Data from the literature did not allow identifying the best therapeutic regimen, mainly because of the lack of prospective comparative studies. Dapsone remains the first line treatment in MMP. Immunosuppressive or immunomodulating drugs should be discussed patient by patient.
Subject(s)
Pemphigoid, Benign Mucous Membrane , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Antibodies, Monoclonal/therapeutic use , Combined Modality Therapy , Dapsone/administration & dosage , Dapsone/therapeutic use , Drug Therapy, Combination , Evidence-Based Medicine , Humans , Immunoglobulins, Intravenous/therapeutic use , Immunosuppressive Agents/administration & dosage , Immunosuppressive Agents/therapeutic use , Immunotherapy , Multicenter Studies as Topic/statistics & numerical data , Pemphigoid, Benign Mucous Membrane/drug therapy , Pemphigoid, Benign Mucous Membrane/epidemiology , Pemphigoid, Benign Mucous Membrane/pathology , Pemphigoid, Benign Mucous Membrane/physiopathology , Pemphigoid, Benign Mucous Membrane/psychology , Pemphigoid, Benign Mucous Membrane/therapy , Prospective Studies , Randomized Controlled Trials as Topic/statistics & numerical data , Retrospective StudiesABSTRACT
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.
