Translation, cross-cultural adaptation, and psychometric properties of the Finnish version of the Malocclusion Impact Questionnaire (MIQ)

Authors

  • Lucas Arrais Campos Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Ear and Oral Diseases, Tampere University Hospital, Tampere, Finland; Faculty of Health Sciences, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland; School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
  • Terhi Kaikkonen Research Unit of Population Health, University of Oulu, Oulu, Finland; Wellbeing Services County of Kainuu, Kainuu, Finland
  • Kaisa Ylitervo The Wellbeing Service County of North Ostrobothnia, Pohde, Finland
  • Leena Ylikontiola Research Unit of Population Health, University of Oulu, Oulu, Finland; The Wellbeing Service County of North Ostrobothnia, Pohde, Finland
  • Anna-Sofia Silvola Research Unit of Population Health, University of Oulu, Oulu, Finland; The Wellbeing Service County of North Ostrobothnia, Pohde, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland

DOI:

https://doi.org/10.2340/aos.v84.42833

Keywords:

Psychometrics, validation studies, malocclusion, questionnaire, oral health-related quality of life

Abstract

Objectives: This study aimed to translate and adapt the Malocclusion Impact Questionnaire (MIQ) into Finnish; to estimate its psychometric properties when applied to Finnish adolescents; and to estimate the effect of demographic characteristics on the perceived impact of malocclusion.

Methods: The Finnish version of MIQ (MIQ-Fi) was established through translation, back-translation, and a pilot study. Psychometric properties were estimated using factorial validity (confirmatory factor analysis [CFA]), convergent validity (Average Variance Extracted [AVE]), and reliability (αordinal and ω). Structural Equation Model estimated the effect of demographic characteristics on malocclusion impact.

Results: A total of 268 Finnish adolescents participated in the study (mean age = 13.4 [standard deviation, SD = 1.5] years, 48.5% girls). MIQ-Fi factor model presented an adequate fit to the data after refinements (CFA: comparative fit index [CFI] = 0.96, Tucker-Lewis index [TLI] = 0.95, standardized root mean square residual [SRMR] = 0.08, exclusion of 4 items and 1 correlation between items error). Convergent validity (AVE = 0.61) and reliability (αordinal and ω ≥ 0.90) were adequate. Gender and self-reported need for orthodontic treatment had moderate effects on malocclusion impact (βstandardized = 0.36 and 0.30, respectively, p < 0.01), while other demographic characteristics had weak effects (βstandardized < |0.18|, p < 0.04).

Conclusion: MIQ-Fi demonstrated adequate psychometric properties and can measure malocclusion impact in Finnish adolescents. Demographic characteristics had weak to moderate effect on the malocclusion impact.

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References

Sorensen C, Lemberger M, Larsson P, Pegelow M. Comparing oral health-related quality of life, oral function and orofacial aesthetics among a group of adolescents with and without malocclusions. Acta Odontol Scand. 2022;80(2):99–104. https://doi.org/10.1080/00016357.2021.1943518 DOI: https://doi.org/10.1080/00016357.2021.1943518

Khela S, Newton JT, Jeremiah HG. The effect of malocclusion on dating prospects. J Orthod. 2020;47(1):30–7. https://doi.org/​10.1177/1465312519888926 DOI: https://doi.org/10.1177/1465312519888926

Gasparello GG, Junior SLM, Hartmann GC, Meira TM, Camargo ES, Pithon MM, et al. The influence of malocclusion on social aspects in adults: study via eye tracking technology and questionnaire. Prog Orthod. 2022;23(1):4. https://doi.org/10.1186/s40510-022-00399-3 DOI: https://doi.org/10.1186/s40510-022-00399-3

Bondemark L. How to succeed with high quality randomised clinical trials in clinical orthodontic research. J Orthod. 2019;46(1 suppl):​13–6. https://doi.org/10.1177/1465312519842886 DOI: https://doi.org/10.1177/1465312519842886

Cunningham SJ. The Sheldon Friel Memorial Lecture 2020 it’s not just about the teeth: patient-centred orthodontics. Eur J Orthod. 2020;42(5):472–7. https://doi.org/10.1093/ejo/cjaa049 DOI: https://doi.org/10.1093/ejo/cjaa049

Qin D, Hua F, John MT. Glossary for dental patient-centered outcomes. J Evid Based Dent Pract. 2024;24(1S):101951. https://doi.org/10.1016/j.jebdp.2023.101951 DOI: https://doi.org/10.1016/j.jebdp.2023.101951

Reissmann DR. Methodological considerations when measuring oral health-related quality of life. J Oral Rehabil. 2021;48(3):233–45. https://doi.org/10.1111/joor.12983 DOI: https://doi.org/10.1111/joor.12983

Kline RB. Principles and practice of structural equation modeling. 5th ed. New York: The Guilford Press; 2023. 494 p.

Marôco J. Análise de equações estruturais. 3ª ed. Lisboa: ReportNumber; 2021. 410 p.

Hair JF, Black WC, Babin B, Anderson RE. Multivariate data analysis. 8th ed. Hampshire: Cengage Learning; 2019. 832 p.

Mittal H, John MT, Sekulić S, Theis-Mahon N, Rener-Sitar K. Patient-reported outcome measures for adult dental patients: a systematic review. J Evid Based Dent Pract. 2019;19(1):53–70. https://doi.org/10.1016/j.jebdp.2018.10.005 DOI: https://doi.org/10.1016/j.jebdp.2018.10.005

Patel N, Hodges SJ, Hall M, Benson PE, Marshman Z, Cunningham SJ. Development of the Malocclusion Impact Questionnaire (MIQ) to measure the oral health-related quality of life of young people with malocclusion: part 1 – qualitative inquiry. J Orthod. 2016;43(1):7–13. https://doi.org/10.1080/14653125.2015.1114712 DOI: https://doi.org/10.1080/14653125.2015.1114712

Cunningham SJ, Garratt AM, Hunt NP. Development of a condition-specific quality of life measure for patients with dentofacial deformity: II. Validity and responsiveness testing. Community Dent Oral Epidemiol. 2002;30(2):81–90. https://doi.org/10.1034/​j.1600-0528.2002.300201.x DOI: https://doi.org/10.1034/j.1600-0528.2002.300201.x

Cunningham SJ, Garratt AM, Hunt NP. Development of a condition-specific quality of life measure for patients with dentofacial deformity: I. Reliability of the instrument. Community Dent Oral Epidemiol. 2000;28(3):195–201. https://doi.org/10.1034/​j.1600-0528.2000.280305.x DOI: https://doi.org/10.1034/j.1600-0528.2000.280305.x

Klages U, Claus N, Wehrbein H, Zentner A. Development of a questionnaire for assessment of the psychosocial impact of dental aesthetics in young adults. Eur J Orthod. 2006;28(2):103–11. https://doi.org/10.1093/ejo/cji083 DOI: https://doi.org/10.1093/ejo/cji083

Benson PE, Cunningham SJ, Shah N, Gilchrist F, Baker SR, Hodges SJ, et al. Development of the Malocclusion Impact Questionnaire (MIQ) to measure the oral health-related quality of life of young people with malocclusion: part 2 – cross-sectional validation. J Orthod. 2016;43(1):14–23. https://doi.org/10.1080/14653125.2015.1114223 DOI: https://doi.org/10.1080/14653125.2015.1114223

Benson PE, Gilchrist F, Farella M. The Malocclusion Impact Questionnaire (MIQ): cross-sectional validation in a group of young people seeking orthodontic treatment in New Zealand. Dent J (Basel). 2019;7(1):24. https://doi.org/10.3390/dj7010024 DOI: https://doi.org/10.3390/dj7010024

Kolawole KA, Ayodele-Oja MM. Oral health-related quality of life of adolescents assessed with the malocclusion impact and child perceptions questionnaires. Am J Orthod Dentofacial Orthop. 2021;159(2):e149–56. https://doi.org/10.1016/j.ajodo.2020.09.017 DOI: https://doi.org/10.1016/j.ajodo.2020.09.017

Tsichlaki A, Adcock R, Fleming PS. A cross-sectional evaluation of the impact of class II division 1 malocclusion in treated and untreated adolescents on oral health-related quality of life. Am J Orthod Dentofacial Orthop. 2021;160(1):58–65. https://doi.org/10.1016/j.ajodo.2020.03.030 DOI: https://doi.org/10.1016/j.ajodo.2020.03.030

Peter E, Monisha J, Edward Benson P, Ani George S. Does orthodontic treatment improve the oral health-related quality of life when assessed using the Malocclusion Impact Questionnaire-a 3-year prospective longitudinal cohort study. Eur J Orthod. 2023;45(6):​773–80. https://doi.org/10.1093/ejo/cjad040 DOI: https://doi.org/10.1093/ejo/cjad040

Li MY, He SL, Wang JH. Validation of the Chinese version of the Malocclusion Impact Questionnaire (MIQ). Clin Oral Investig. 2021;25(4):2419–27. https://doi.org/10.1007/s00784-020-03565-1 DOI: https://doi.org/10.1007/s00784-020-03565-1

Hope B, Zaror C, Sandoval P, Garay M, Streiner DL. Cross-cultural adaptation and validation in spanish of the Malocclusion Impact Questionnaire (MIQ). Health Qual Life Outcomes. 2020;18(1):146. https://doi.org/10.1186/s12955-020-01385-1 DOI: https://doi.org/10.1186/s12955-020-01385-1

Bourzgui F, Diouny S, Mkhantar H, Serhier Z, Bennani Othmani M. Cross-cultural adaptation and validation of ‘Malocclusion Impact Questionnaire’ into Moroccan Arabic. Int J Dent. 2020;2020(1):8854922. https://doi.org/10.1155/2020/8854922 DOI: https://doi.org/10.1155/2020/8854922

Vučić L, Juloski J, Stefanović N, Pajević T, Glišić B. Validation of the translated and cross-culturally adapted malocclusion impact questionnaire in young people seeking orthodontic treatment in Serbia. Srp Arh Celok Lek. 2021;149(9–10):544–50. https://doi.org/10.2298/SARH200707063V DOI: https://doi.org/10.2298/SARH200707063V

Agou S, Al-Sakkaf G, Barboud L, Elhussein M. Cross-cultural adaptation and validation of the malocclusion impact questionnaire for patients seeking orthodontic treatment. J Orthod Sci. 2022;11(1):37. https://doi.org/10.4103/jos.jos_203_21 DOI: https://doi.org/10.4103/jos.jos_203_21

Campos LA, Kämäräinen M, Silvola AS, Marôco J, Peltomäki T, Campos JADB. Orofacial esthetic scale and psychosocial impact of dental aesthetics questionnaire: development and psychometric properties of the Finnish version. Acta Odontol Scand. 2021;79(5):335–43. https://doi.org/10.1080/00016357.2020.1857435 DOI: https://doi.org/10.1080/00016357.2020.1857435

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report ­measures. Spine. 2000;25(24):3186–91. https://doi.org/10.1097/​00007632-200012150-00014 DOI: https://doi.org/10.1097/00007632-200012150-00014

Campos LA, da Silva JA, Santos-Pinto A, Marôco J, Campos JADB. Multidimensional Pain Inventory (MPI): adaptation to orthodontic patients and its psychometric properties. Pain Stud Treat. 2019;7(1):1–20. https://doi.org/10.4236/pst.2019.71001 DOI: https://doi.org/10.4236/pst.2019.71001

American Educational Research Association, American Psychological Association, National Council on Measurement in Education. Standards for educational and psychological testing [Internet]. American Educational Research Association; 2014. Available from: https://www.apa.org/science/programs/testing/standards [cited 15 December 2024]

Linacre JM. A user’s guide to WINSTEPS® MINISTEP. Rasch-Model Computer Programs. Program Manual 5.8.5. 2025. Available from: https://www.winsteps.com/winman/copyright.htm. [cited 11 January 2025]

Bond T, Yan Z, Heene M. Applying the Rasch model: fundamental measurement in the human sciences. 4th ed. New York: Routledge; 2020. DOI: https://doi.org/10.4324/9780429030499

Wright B, Linacre JM. Reasonable mean-square fit values. Rasch Measurement Transactions [Internet]. 1994. Available from: www.rasch.org/rmt/rmt83b.htm [cited 15 December 2024]

Glas CAW, Verhelst ND. Testing the Rasch model. In: Fischerm GH, Molenaar IW, editors. Rasch models: foundations, recent developments, and applications. New York: Springer; 1995. p. 69–95. DOI: https://doi.org/10.1007/978-1-4612-4230-7_5

Mair P, Hatzinger R, Maier MJ, Rusch T, Mair MP. Package ‘eRm’. Vienna: R Foundation; 2021.

Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling. 1999;6(1):1–55. https://doi.org/10.1080/​​10705519909540118 DOI: https://doi.org/10.1080/10705519909540118

Fornell C, Larcker DF. Evaluating structural equation models with unobservable variables and measurement error. J Mark Res. 1981;18(1):39–50. https://doi.org/10.1177/002224378101800104 DOI: https://doi.org/10.1177/002224378101800104

Ferrando PJ, Lorenzo-Seva U. Assessing the quality and appropriateness of factor solutions and factor score estimates in exploratory item factor analysis. Educ Psychol Meas. 2018;78(5):762–80. https://doi.org/10.1177/0013164417719308 DOI: https://doi.org/10.1177/0013164417719308

Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155–63. https://doi.org/10.1016/j.jcm.2016.02.012 DOI: https://doi.org/10.1016/j.jcm.2016.02.012

Nolte S, Elsworth GR. Factorial invariance. In: Michalos AC, editor. Encyclopedia of quality of life and well-being research. Vol. 10. Dordrecht: Springer Netherlands; 2014. p. 2146–8. DOI: https://doi.org/10.1007/978-94-007-0753-5_983

Rosseel Y. lavaan: an R package for structural equation modeling and more. Version 0.5–12 (BETA). J Stat Softw. 2012;48(2):1–36. https://doi.org/10.18637/jss.v048.i02 DOI: https://doi.org/10.18637/jss.v048.i02

Ferrando PJ, Lorenzo-Seva U. Program FACTOR at 10: origins, development and future directions. Psicothema. 2017;29(2):236–40. https://doi.org/10.7334/psicothema2016.304 DOI: https://doi.org/10.7334/psicothema2016.304

Jorgensen TD, Pornprasertmanit S, Schoemann AM, Rosseel Y. semTools: useful tools for structural equation modeling [Internet]. 2022. Available from: https://cran.r-project.org/web/packages/semTools/index.html [cited 15 December 2024]

Anttila T, Selander K, Oinas T. Disconnected lives: trends in time spent alone in Finland. Social Indic Res. 2020;150:711–30. https://doi.org/10.1007/s11205-020-02304-z DOI: https://doi.org/10.1007/s11205-020-02304-z

Rönkä AR, Taanila A, Rautio A, Sunnari V. Multidimensional and fluctuating experiences of loneliness from childhood to young adulthood in Northern Finland. Adv Life Course Res. 2018;35:87–102. https://doi.org/10.1016/j.alcr.2018.01.003 DOI: https://doi.org/10.1016/j.alcr.2018.01.003

Campos LA, Campos JADB, Kämäräinen M, Silvola AS, Marôco J, Peltomäki T. Self-perception of orofacial appearance: Brazil-Finland cross-national study. Acta Odontol Scand. 2022;80(8):626–34. https://doi.org/10.1080/00016357.2022.2077432 DOI: https://doi.org/10.1080/00016357.2022.2077432

Hoehl S, Keupp S, Schleihauf H, McGuigan N, Buttelmann D, Whiten A. ‘Over-imitation’: a review and appraisal of a decade of research. Dev Rev. 2019;51:90–108. https://doi.org/10.1016/j.dr.2018.12.002 DOI: https://doi.org/10.1016/j.dr.2018.12.002

van Schaik JE, Hunnius S. Little chameleons: the development of social mimicry during early childhood. J Exp Child Psychol. 2016;147:71–81. https://doi.org/10.1016/j.jecp.2016.03.003 DOI: https://doi.org/10.1016/j.jecp.2016.03.003

Campos LA, Peltomäki T, Marôco J, Campos JADB. Use of Oral Health Impact Profile-14 (OHIP-14) in different contexts. What is being measured? Int J Environ Res Public Health. 2021;18(24):13412. https://doi.org/10.3390/ijerph182413412 DOI: https://doi.org/10.3390/ijerph182413412

Cheng H, Furnham A. Personality, peer relations, and self‐confidence as predictors of happiness and loneliness. J Adolesc. 2002;25(3):​327–39. https://doi.org/10.1006/jado.2002.0475 DOI: https://doi.org/10.1006/jado.2002.0475

Mertoğlu M. Factors affecting happiness of school children. J Educ Train Stud. 2020;8(3):10–20. https://doi.org/10.11114/jets.v8i3.4674 DOI: https://doi.org/10.11114/jets.v8i3.4674

Cella D, Hahn EA, Jensen SE, Butt Z, Nowinski CJ, Rothrock N, et al. Patient-reported outcomes in performance measurement. Research Triangle Park, NC : RTI Press; 2015. DOI: https://doi.org/10.3768/rtipress.2015.bk.0014.1509

Campos JADB, Zucoloto ML, Bonafe FSS, Maroco J. General oral health assessment index: a new evaluation proposal. Gerodontology. 2017;34(3):334–42. https://doi.org/10.1111/ger.12270 DOI: https://doi.org/10.1111/ger.12270

Gattario KH, Frisen A. From negative to positive body image: men’s and women’s journeys from early adolescence to emerging adulthood. Body Image. 2019;28:53–65. https://doi.org/10.1016/j.bodyim.2018.12.002 DOI: https://doi.org/10.1016/j.bodyim.2018.12.002

Anderman EM, Allsop Y, Ching K, Ha SY. Key developments during adolescence: implications for learning and achievement. In: Tierney RJ, Rizvi F, Ercikan K, editors. International encyclopedia of education. 4th ed. Vol. 6. Amsterdam: Elsevier; 2023. p. 486–96. DOI: https://doi.org/10.1016/B978-0-12-818630-5.14057-6

[55] Fredrickson BL, Roberts TA. Objectification theory: toward understanding women’s lived experiences and mental health risks. Psychol Women Q. 1997;21(2):173–206. https://doi.org/10.1111/j.1471-6402.​1997.tb00108.x DOI: https://doi.org/10.1111/j.1471-6402.1997.tb00108.x

Daniels EA, Zurbriggen EL, Monique Ward L. Becoming an object: a review of self-objectification in girls. Body Image. 2020;33:278–99. https://doi.org/10.1016/j.bodyim.2020.02.016 DOI: https://doi.org/10.1016/j.bodyim.2020.02.016

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2025-01-30