Critical review of the validity of patient satisfaction questionnaires pertaining to oral health care

Objectives: Review the validation process reported for oral healthcare satisfaction scales that intended to measure general oral health care that is not restricted to specific subspecialties or interventions. Methods: After preliminary searches, PUBMED and EMBASE were searched using a broad search strategy, followed by a snowball strategy using the references of the publications included from database searches. Title and abstract were screened for assessing inclusion, followed by a full-text screening of these publications. English language publications on multi-item questionnaires that report on a scale measuring patient satisfaction for oral health care were included. Publications were excluded when they did not report on any psychometric validation, or the scales were addressing specific treatments or subspecialities in oral health care. Results: Fourteen instruments were identified from as many publications that report on their initial validation, while five more publications reported on further testing of the validity of these instruments. Number of items (range: 8-42) and dimension reported (range: 2-13) were often dissimilar between the assessed measurement instruments. There was also a lack of methodologies to incorporate patient's subjective perspective. Along with a limited reporting of psychometric properties of instruments, cross-cultural adaptations were limited to translation processes. Conclusions: The extent of validity and reliability of the included instruments was largely unassessed, and appropriate instruments for populations outside of those belonging to general adult populations were not present.