Linguistic-cultural validation of the oral health assessment tool (OHAT) for the Italian context

Background: The increase in the ageing population and the consequent establishment of a network of adequate structures to respond effectively to the welfare needs of institutionalized elderly people have stimulated the discussion by healthcare professionals on the subject of oral hygiene. Literature data show that the same attention has not been paid to oral health care compared to other health needs. Many studies have demonstrated that oral health has a significant impact on the quality of life, especially for older people. Poor oral health also has a considerable role on the physical condition of the elderly because it affects their ability to eat, feed themselves, forcing them to have unbalanced diets. The consequence of this condition is dehydration, malnutrition and impairment of communication skills. The essential nursing activity for oral care is the assessment of the state of oral health, an activity that should be conducted by means of valid tools. To date there are no tools for assessing the health of the oral cavity validated for the Italian linguistic-cultural context. The aim of this study is to conduct a linguistic-cultural validation for the Italian context, of the original Australian version of the Oral Health Assessment Tool (OHAT) scale. Methods: Study design: Linguistic-cultural validation and adaptation of a tool for the assessment of oral health. The Beaton and Sousa & Rojjanasrirat (2011) models were used to conduct the linguistic-cultural validation and adaptation process. This validation involved 368 inmates/patients aged over 65 years with cognitive deficit. Results: The face validity was confirmed by a score for each item related to clarity equal to or greater than 80%. The content validity was confirmed by an content validity index for items (I-CVI) score equal to or greater than 0.8 for each item and an content validity index for scales (S-CVI) of 0.93 for the entire tool. For the reliability of the internal consistency the Cronbach alpha was calculated, which was found to be 0.82. The test-retest was calculated by means of the Pearson coefficient correlation which turned out to be 0.5. Conclusions: The Italian version of the OHAT is a tool that can help to consider oral health at the same level as other health needs aimed at increasing the quality of nursing care provided. This tool can be used by nurses to assess the health of the oral cavity in elderly subjects also with cognitive deficit.