The development and validation of a psychological questionnaire for patients undergoing orthognathic treatment

Structured Objectives To develop a questionnaire to assess the psychosocial aspects which orthognathic patients considered important regarding their dento‐facial deformity. Setting and sample population A multicentre, prospective, questionnaire development and validation study based in the UK. Material and methods Questionnaire development involved item (question) selection through literature review, consultation and feedback from a questionnaire development group and semi‐structured interviews. A ‘final’ questionnaire was tested on a cross‐sectional sample of 110 pre‐operative and 74 post‐operative orthognathic patients and a longitudinal sample of 23 orthognathic patients. Validity was tested using Rasch analysis. Results Reliability for the Hospital Anxiety and Depression Scale (HADS) section was unsatisfactory (ICC = 0.232–0.829, Cronbach alpha = 0.625–0.670), but for the well‐ being (ICC = 0.857, Cronbach alpha = 0.827–0.895) and expectations (ICC = 0.861, Cronbach alpha = 0.804–0.882) sections were satisfactory. The well‐being section was the only section found to be valid for the pre‐and post‐operative samples. Responsiveness was satisfactory for the well‐being scale (p = 0.001). Conclusions A new condition‐specific orthognathic questionnaire has been developed which has been shown to be reliable, valid and responsive for the well‐being scale. The HADS, as tested by Rasch analysis, was found not to be valid for this orthognathic population.