Development of an instrument to assess oral hygiene ability in older adults: The oral hygiene ability instrument.

Objectives: To describe the development process of an instrument to assess the ability to manage daily oral hygiene and the cause of impaired oral hygiene. The instrument is initially aimed for use by the dental team in the ageing population. Background: Oral hygiene is an important component of oral health. Inability to manage oral hygiene combined with other risk factors often results in poor oral health and impaired quality of life. Methods: A guideline for instrument development was used during the construction of the instrument. The method included three phases: I. planning: the purpose and target group of the instrument were determined, and a literature review and qualitative focus-group study were conducted; II. construction: objectives were formulated, and a pool of items was built; and III. evaluation and validation, which included two pilot studies, interviews, item analyses and revision of the instrument. Results: The planning and construction phases resulted in an instrument with 47 items comprising three parts: (a) interview, (b) clinical examination and (c) observation of activities of daily living (oral hygiene). After two pilot studies, the instrument was found to have good content validity. Analyses of qualitative and quantitative data resulted in a reduction in the number of items to 33. Conclusion: OHAI can be a valuable tool as a preventive method to identify older adults at risk of impaired oral health. However, the instrument needs further evaluation before wider use.