Page 54 - FINAL COMPENDIUM 2020-2021 27.2.2022

ACCESSIBILITY TO ORAL HEALTHCARE SERVICES AMONG CHILDREN WITH CEREBRAL
PALSY
NMRR-19-1622-49187

Datu MAA, Normastura AR, Munirah MA, Muhamad SBY

Introduction: Oral healthcare is still out of reach for marginalised group around the world
including children with cerebral palsy (CP). Therefore, information on barriers to access
oral healthcare services for children with CP should be investigated. The available
questionnaires on accessibility to oral healthcare services do not cater for children with
CP. Objective: To develop and validate the “accessibility of children with cerebral palsy to
oral healthcare services” (CP2OHS) questionnaire. Materials and methods: The
development and validation of the CP2OHS questionnaire involved items development,
content validation, response process validation, and internal structure determination.
Items development involved merging the results of the literature exploration and in-depth
interviews followed by aligning them with the access to oral healthcare services
framework. Content validation was carried out by seven expert panels and they were
requested to review each item for its relevance in representing the domain, and the
calculation of the content validity index (CVI) was performed. Thirty caregivers of children
with CP registered with the Department of Social Welfare Malaysia participated in
response process validation and they were asked to assess the clarity and
comprehensibility of the items with the face validity index (FVI). A total of 129 caregivers
of children with CP registered with the Department of Social Welfare Malaysia were
invited to participate in the study and exploratory factor analysis and reliability analysis
were utilized to determine meaningful underlying constructs of the CP2OHS
questionnaire. Results: There were 42 items, and a total of 38 items have reached the
satisfactory level of the Item-level CVI value within the range of 0.71 – 1.00. In response
process validation, 33 items were retained and had the Item level – FVI ranging from 0.83
to 1.00. The final model of the CP2OHS questionnaire in the Exploratory Factor Analysis
has 28 items with factor loading > 0.4 and the Cronbach’s Alpha values in the range 0.597
– 0.834. The items were loaded across five domains which are Abilities to Perceive, Ability
to Seek, Ability to Reach, Ability to Pay, and Ability to Engage. Conclusions: The CP2OHS
questionnaire has 28 items, the CVI and FVI were rated as good and it is a reliable and
valid scale. Therefore, the validation process showed that the CP2OHS questionnaire has
good psychometric properties and enables the assessment of barriers to access oral
healthcare services by children with CP.

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