Research Article
BibTex RIS Cite

Yatakbaşı Ağız Değerlendirme Aracı’nın Türkçe Versiyonunun Güvenirliği ve Geçerliliği: Metodolojik Çalışma

Year 2025, Volume: 10 Issue: 3, 459 - 463, 30.09.2025
https://doi.org/10.61399/ikcusbfd.1673441

Abstract

Amaç: Bu çalışma, Yatakbaşı Ağız Değerlendirme aracının Türkçe versiyonunun geçerliliğini ve güvenilirliğini değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntem: Bu metodolojik çalışma, Türkiye, İzmir'deki bir üniversite hastanesinin Anestezi ve Reanimasyon yoğun bakım ünitesinde yürütüldü. Çalışmaya dahil edilen 90 hastanın ağız sağlığı ikisi ağız sağlığı konusunda uzman akademisyen ve biri yoğun bakım hemşiresi olmak üzere üç bağımsız gözlemci tarafından değerlendirildi. İçerik geçerliliğini değerlendirmek için uzman görüşleri toplandı ve İçerik Geçerlilik İndeksi hesaplandı. Gözlemciler arası uyum, Gwet'in AC1 katsayısı kullanılarak ölçülürken, iç tutarlılık Cronbach Alpha kullanılarak analiz edilmiştir. Gözlemciler arası güvenilirlik, sınıf içi korelasyon katsayıları aracılığıyla belirlendi.
Bulgular: Her değerlendirme ortalama üç dakikada tamamlandı. Yatakbaşı Ağız Değerlendirme aracının alt ölçekleri için İçerik Geçerlilik İndeksi 0,897 ile 1,000 arasında değişmektedir. Yatakbaşı Ağız Değerlendirme alt ölçekleri için Kappa uyum katsayısı 0,937 ile 1,000 arasında değişmekte olup gözlemciler arasında "mükemmel uyum" olduğunu göstermektedir. Yatakbaşı Ağız Değerlendirme aracı için genel Cronbach's Alpha değeri 0,998 olup çok yüksek iç tutarlılık göstermektedir (ICC = 0,999).
Sonuç: Yatakbaşı Ağız Değerlendirme aracının ve alt ölçeklerinin neredeyse mükemmel gözlemciler arası güvenilirliğe sahip olduğunu göstermektedir ve bu da onu yoğun bakım hastalarında ağız sağlığını değerlendirmek için geçerli ve güvenilir bir araç haline getirmektedir.
Anahtar Kelimeler: Yoğun bakım, hemşirelik, ağız bakımı, güvenilirlik, ölçek, geçerlilik.

References

  • 1. Jang CS, Shin YS. Effects of combination oral care on oral health, dry mouth, and salivary pH of intubated patients: A randomized controlled trial. Int J Nurs Pract. 2016;22(5):503–11.
  • 2. Choi MI, Han SY, Jeon HS, Choi ES, Won SE, Lee YJ, et al. The Effect of Professional Oral Care on the Oral Health Status of Critical Trauma Patients Using Ventilators. Int J Environ Res Public Health. 2022;19(10).
  • 3. Celik GG, Eser I. Examination of intensive care unit patients’ oral health. Int J Nurs Pract. 2017;23(6):1–9.
  • 4. Javanmard R, Mozaffari N, Iranpour S, Shamshiri M. Application of the Modified Barrow Oral Care Protocol in Patients Receiving Mechanical Ventilation. J Crit Intensive Care. 2021;(10):85–90.
  • 5. Choi MI, Han SY, Jeon HS, Choi ES, Won SE, Lee YJ, et al. The influence of professional oral hygiene care on reducing ventilator-associated pneumonia in trauma intensive care unit patients. Br Dent J. 2022;232(4):253–9.
  • 6. Prendergast V. Safety and Efficacy of Oral Care for Intubated Neuroscience Intensive Care Unit Patients [Internet]. Lund University; 2012. Available from: http://lup.lub.lu.se/search/ws/files/3951419/2337196.pdf
  • 7. Abdelhafez AI, Tolba AA. Nurses’ practices and obstacles to oral care quality in intensive care units in Upper Egypt. Nurs Crit Care. 2023;28(3):411–8.
  • 8. Quintanilha R, Pereira M, Penoni D, Oliveira, SP, Salgado D, Agostini M, et al. Oral clinical findings and intensive care unit prognostic scores. BMJ Support Palliat Care. 2023;14:1995-2002.
  • 9. Kothari SF, Nascimento GG, De Caxias FP, Jakobsen MB, Nielsen JF, Kothari M. Internal structure and validity of the bedside oral examination tool in patients with brain injury at neurorehabilitation setting. J Oral Rehabil. 2022;49(3):344–52.
  • 10. Oztas M, Oztas B. Effect of Spray Use on Mouth Dryness and Thirst of Patients Undergoing Major Abdominal Surgery: A Randomized Controlled Study. J Perianesthesia Nurs. 2022 Apr 1;37(2):214–20.
  • 11. Prendergast V, Kleiman C, King M. The Bedside oral exam and the barrow oral care protocol: Translating evidence-based oral care into practice. Intensive Crit Care Nurs. 2013;29(5):282–90.
  • 12. Eilers J, Berger AM, Petersen MC. Development, Testing, and Application of the Oral Assessment Guide. Oncol Nurs Form. 1988;15(3):325–30.
  • 13. Dickinson H, Watkins C, Leathley M. The Development of the THROAT : The Holistic and Reliable Oral Assessment Tool Keywords : Assessment , Oral Hygiene. Clin Eff Nurs. 2001;5:104–10.
  • 14. Prendergast V, Hallberg IR, Jakobsson U, Renvert S. Comparison of Oropharyngeal and Respiratory Nosocomial Bacteria between Two Methods of Oral Care : A Randomized Control Trial. Oral Health. 2012;10–8.
  • 15. Prendergast V, Jakobsson U, Renvert S, Hallberg IR. Effects of a standard versus comprehensive oral care protocol among intubated neuroscience ICU patients: Results of a randomized controlled trial. J Neurosci Nurs. 2012;44(2):134–46.
  • 16. Özden D, Türk G, Düger C, Güler EK, Tok F, Gülsoy Z. Effects of oral care solutions on mucous membrane integrity and bacterial colonization. Nurs Crit Care. 2014;19(2):78–86.
  • 17. Walter SD, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. Stat Med. 1998;17(1):101–10.
  • 18. Burns N, Grove S. The Practice of Nursing Research: Appraisal, Synthesis and Generation of Evidence. 6th ed. St. Louis: Missouri: Saunders Elsevier; 2009.
  • 19. Tavşancıl E. Tutumların Ölçülmesi ve SPSS ile Veri Analizi. Ankara: Nobel Yayınev; 2022.
  • 20. Curcio F, Vaquero Abellán M, Dioni E, de Lima MM, Ez zinabi O, Romero Saldaña M. Validity and reliability of the italian-Neonatal skin risk assessment scale (i-NSRAS). Intensive Crit Care Nurs. 2024;80(September 2023).
  • 21. Kothari SF, Nascimento GG, Jakobsen MB, Nielsen JF, Kothari M. Oral health: something to worry about in individuals with acquired brain injury? Brain Inj [Internet]. 2020;34(9):1264–9. Available from: https://doi.org/10.1080/02699052.2020.1795720
  • 22. Kılıç Akça N, Efe Arslan D, İn H. Examination of factors affecting oral health in patients receiving haemodialysis. J Ren Care. 2022;48(4):262–71.
  • 23. Gwet KL. Handbook of inter-rater reliability - the definitive guide to measuring the extent of agreement among raters. 4th ed. Gaithersburg: United States of America: Advanced Analytics, LLC; 2014. 20886–2696 p.
  • 24. Kottner J, Audigé L, Brorson S, Donner A, Gajewski BJ, Hróbjartsson A, et al. Guidelines for reporting reliability and agreement studies (GRRAS) were proposed. J Clin Epidemiol. 2011;64(1):96–106.
  • 25. Conger AJ. Integration and generalization of Kappas for multiple raters. Psychol Bull. 1980;88:322 –8.
  • 26. Viladrich C, Angulo-Brunet A, Doval E. A journey around alpha and omega to estimate internal consistency reliability. An Psicol. 2017;33(3):755–82.
  • 27. Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016;15(2):155–63.
  • 28. Hambleton R, Bollwark J. Adapting Tests for Use in Different Cultures: Technical Issues and Methods. 1991; Available from: https://eric.ed.gov/?id=ED337481
  • 29. Kothari M, Spin-Neto R, Nielsen JF. Comprehensive oral-health assessment of individuals with acquired brain-injury in neuro-rehabilitation setting. Brain Inj [Internet]. 2016;30(9):1103–8. Available from: http://dx.doi.org/10.3109/02699052.2016.1167244
  • 30. Khasanah IH, Sae-Sia W, Damkliang J. The Effectiveness of Oral Care Guideline Implementation on Oral Health Status in Critically Ill Patients. SAGE Open Nurs. 2019;5:1–9.
  • 31. Winning L, Lundy FT, Blackwood B, McAuley DF, El Karim I. Oral health care for the critically ill: a narrative review. Crit Care. 2021;25(1):1–8.
  • 32. Crestani AH, de Moraes AB, de Souza APR. Content validation: Clarity/relevance, reliability and internal consistency of enunciative signs of language acquisition. Codas. 2017;29(4):1–6.
  • 33. Sigerson L, Cheng C. Scales for measuring user engagement with social network sites: A systematic review of psychometric properties. Comput Human Behav [Internet]. 2018;83:87–105. Available from: https://doi.org/10.1016/j.chb.2018.01.023
  • 34. Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011;2:53–5

Reliability and Validity of Bedside Oral Exam Tool’s Turkish Version: Methodological Study

Year 2025, Volume: 10 Issue: 3, 459 - 463, 30.09.2025
https://doi.org/10.61399/ikcusbfd.1673441

Abstract

Objective: This study aims to assess the validity and reliability of the Turkish version of the Bedside Oral Exam Tool.
Material and Methods: This methodological study was conducted in the Anesthesia and Reanimation intensive care unit of a university hospital in Izmir, Turkey. Ninety patients were evaluated by three independent nurse-observers: two academic specialists in oral care and one specialist intensive care unit nurse. To assess content validity, expert opinions were collected, and the Content Validity Index was calculated. Interobserver agreement was measured using Gwet’s AC1 coefficient, while internal consistency was analyzed using Cronbach’s Alpha. Interobserver reliability was determined through intraclass correlation coefficients.
Results: Each assessment was completed in ≤3 minutes. The Content Validity Index for the Bedside Oral Exam subscales ranged between 0.897 and 1.000. The Kappa agreement coefficient for the Bedside Oral Exam subscales ranged from 0.937 to 1.000, indicating “perfect agreement” among observers. The overall Cronbach’s Alpha value for the Bedside Oral Exam was 0.998, demonstrating very high internal consistency (ICC = 0.999).
Conclusion: The Bedside Oral Exam tool and its subscales show almost perfect inter-observer reliability, making it a valid and reliable tool for assessing oral health in intensive care patients.
Keywords: Intensive care, nursing, oral care, reliability, scale, validity.

References

  • 1. Jang CS, Shin YS. Effects of combination oral care on oral health, dry mouth, and salivary pH of intubated patients: A randomized controlled trial. Int J Nurs Pract. 2016;22(5):503–11.
  • 2. Choi MI, Han SY, Jeon HS, Choi ES, Won SE, Lee YJ, et al. The Effect of Professional Oral Care on the Oral Health Status of Critical Trauma Patients Using Ventilators. Int J Environ Res Public Health. 2022;19(10).
  • 3. Celik GG, Eser I. Examination of intensive care unit patients’ oral health. Int J Nurs Pract. 2017;23(6):1–9.
  • 4. Javanmard R, Mozaffari N, Iranpour S, Shamshiri M. Application of the Modified Barrow Oral Care Protocol in Patients Receiving Mechanical Ventilation. J Crit Intensive Care. 2021;(10):85–90.
  • 5. Choi MI, Han SY, Jeon HS, Choi ES, Won SE, Lee YJ, et al. The influence of professional oral hygiene care on reducing ventilator-associated pneumonia in trauma intensive care unit patients. Br Dent J. 2022;232(4):253–9.
  • 6. Prendergast V. Safety and Efficacy of Oral Care for Intubated Neuroscience Intensive Care Unit Patients [Internet]. Lund University; 2012. Available from: http://lup.lub.lu.se/search/ws/files/3951419/2337196.pdf
  • 7. Abdelhafez AI, Tolba AA. Nurses’ practices and obstacles to oral care quality in intensive care units in Upper Egypt. Nurs Crit Care. 2023;28(3):411–8.
  • 8. Quintanilha R, Pereira M, Penoni D, Oliveira, SP, Salgado D, Agostini M, et al. Oral clinical findings and intensive care unit prognostic scores. BMJ Support Palliat Care. 2023;14:1995-2002.
  • 9. Kothari SF, Nascimento GG, De Caxias FP, Jakobsen MB, Nielsen JF, Kothari M. Internal structure and validity of the bedside oral examination tool in patients with brain injury at neurorehabilitation setting. J Oral Rehabil. 2022;49(3):344–52.
  • 10. Oztas M, Oztas B. Effect of Spray Use on Mouth Dryness and Thirst of Patients Undergoing Major Abdominal Surgery: A Randomized Controlled Study. J Perianesthesia Nurs. 2022 Apr 1;37(2):214–20.
  • 11. Prendergast V, Kleiman C, King M. The Bedside oral exam and the barrow oral care protocol: Translating evidence-based oral care into practice. Intensive Crit Care Nurs. 2013;29(5):282–90.
  • 12. Eilers J, Berger AM, Petersen MC. Development, Testing, and Application of the Oral Assessment Guide. Oncol Nurs Form. 1988;15(3):325–30.
  • 13. Dickinson H, Watkins C, Leathley M. The Development of the THROAT : The Holistic and Reliable Oral Assessment Tool Keywords : Assessment , Oral Hygiene. Clin Eff Nurs. 2001;5:104–10.
  • 14. Prendergast V, Hallberg IR, Jakobsson U, Renvert S. Comparison of Oropharyngeal and Respiratory Nosocomial Bacteria between Two Methods of Oral Care : A Randomized Control Trial. Oral Health. 2012;10–8.
  • 15. Prendergast V, Jakobsson U, Renvert S, Hallberg IR. Effects of a standard versus comprehensive oral care protocol among intubated neuroscience ICU patients: Results of a randomized controlled trial. J Neurosci Nurs. 2012;44(2):134–46.
  • 16. Özden D, Türk G, Düger C, Güler EK, Tok F, Gülsoy Z. Effects of oral care solutions on mucous membrane integrity and bacterial colonization. Nurs Crit Care. 2014;19(2):78–86.
  • 17. Walter SD, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. Stat Med. 1998;17(1):101–10.
  • 18. Burns N, Grove S. The Practice of Nursing Research: Appraisal, Synthesis and Generation of Evidence. 6th ed. St. Louis: Missouri: Saunders Elsevier; 2009.
  • 19. Tavşancıl E. Tutumların Ölçülmesi ve SPSS ile Veri Analizi. Ankara: Nobel Yayınev; 2022.
  • 20. Curcio F, Vaquero Abellán M, Dioni E, de Lima MM, Ez zinabi O, Romero Saldaña M. Validity and reliability of the italian-Neonatal skin risk assessment scale (i-NSRAS). Intensive Crit Care Nurs. 2024;80(September 2023).
  • 21. Kothari SF, Nascimento GG, Jakobsen MB, Nielsen JF, Kothari M. Oral health: something to worry about in individuals with acquired brain injury? Brain Inj [Internet]. 2020;34(9):1264–9. Available from: https://doi.org/10.1080/02699052.2020.1795720
  • 22. Kılıç Akça N, Efe Arslan D, İn H. Examination of factors affecting oral health in patients receiving haemodialysis. J Ren Care. 2022;48(4):262–71.
  • 23. Gwet KL. Handbook of inter-rater reliability - the definitive guide to measuring the extent of agreement among raters. 4th ed. Gaithersburg: United States of America: Advanced Analytics, LLC; 2014. 20886–2696 p.
  • 24. Kottner J, Audigé L, Brorson S, Donner A, Gajewski BJ, Hróbjartsson A, et al. Guidelines for reporting reliability and agreement studies (GRRAS) were proposed. J Clin Epidemiol. 2011;64(1):96–106.
  • 25. Conger AJ. Integration and generalization of Kappas for multiple raters. Psychol Bull. 1980;88:322 –8.
  • 26. Viladrich C, Angulo-Brunet A, Doval E. A journey around alpha and omega to estimate internal consistency reliability. An Psicol. 2017;33(3):755–82.
  • 27. Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016;15(2):155–63.
  • 28. Hambleton R, Bollwark J. Adapting Tests for Use in Different Cultures: Technical Issues and Methods. 1991; Available from: https://eric.ed.gov/?id=ED337481
  • 29. Kothari M, Spin-Neto R, Nielsen JF. Comprehensive oral-health assessment of individuals with acquired brain-injury in neuro-rehabilitation setting. Brain Inj [Internet]. 2016;30(9):1103–8. Available from: http://dx.doi.org/10.3109/02699052.2016.1167244
  • 30. Khasanah IH, Sae-Sia W, Damkliang J. The Effectiveness of Oral Care Guideline Implementation on Oral Health Status in Critically Ill Patients. SAGE Open Nurs. 2019;5:1–9.
  • 31. Winning L, Lundy FT, Blackwood B, McAuley DF, El Karim I. Oral health care for the critically ill: a narrative review. Crit Care. 2021;25(1):1–8.
  • 32. Crestani AH, de Moraes AB, de Souza APR. Content validation: Clarity/relevance, reliability and internal consistency of enunciative signs of language acquisition. Codas. 2017;29(4):1–6.
  • 33. Sigerson L, Cheng C. Scales for measuring user engagement with social network sites: A systematic review of psychometric properties. Comput Human Behav [Internet]. 2018;83:87–105. Available from: https://doi.org/10.1016/j.chb.2018.01.023
  • 34. Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011;2:53–5
There are 34 citations in total.

Details

Primary Language English
Subjects Fundamentals of Nursing, ICU Nursing
Journal Section Research Articles
Authors

Gül Güneş Aktan 0000-0002-4761-5809

İsmet Eşer 0000-0002-8200-2127

Ebru Baysal 0000-0002-8831-3065

Mehmet Uyar 0000-0001-9292-2616

Ceyda Yamaç 0000-0002-2718-2495

Publication Date September 30, 2025
Submission Date April 10, 2025
Acceptance Date July 14, 2025
Published in Issue Year 2025 Volume: 10 Issue: 3

Cite

APA Aktan, G. G., Eşer, İ., Baysal, E., … Uyar, M. (2025). Reliability and Validity of Bedside Oral Exam Tool’s Turkish Version: Methodological Study. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 10(3), 459-463. https://doi.org/10.61399/ikcusbfd.1673441
AMA Aktan GG, Eşer İ, Baysal E, Uyar M, Yamaç C. Reliability and Validity of Bedside Oral Exam Tool’s Turkish Version: Methodological Study. İKÇÜSBFD. September 2025;10(3):459-463. doi:10.61399/ikcusbfd.1673441
Chicago Aktan, Gül Güneş, İsmet Eşer, Ebru Baysal, Mehmet Uyar, and Ceyda Yamaç. “Reliability and Validity of Bedside Oral Exam Tool’s Turkish Version: Methodological Study”. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi 10, no. 3 (September 2025): 459-63. https://doi.org/10.61399/ikcusbfd.1673441.
EndNote Aktan GG, Eşer İ, Baysal E, Uyar M, Yamaç C (September 1, 2025) Reliability and Validity of Bedside Oral Exam Tool’s Turkish Version: Methodological Study. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi 10 3 459–463.
IEEE G. G. Aktan, İ. Eşer, E. Baysal, M. Uyar, and C. Yamaç, “Reliability and Validity of Bedside Oral Exam Tool’s Turkish Version: Methodological Study”, İKÇÜSBFD, vol. 10, no. 3, pp. 459–463, 2025, doi: 10.61399/ikcusbfd.1673441.
ISNAD Aktan, Gül Güneş et al. “Reliability and Validity of Bedside Oral Exam Tool’s Turkish Version: Methodological Study”. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi 10/3 (September2025), 459-463. https://doi.org/10.61399/ikcusbfd.1673441.
JAMA Aktan GG, Eşer İ, Baysal E, Uyar M, Yamaç C. Reliability and Validity of Bedside Oral Exam Tool’s Turkish Version: Methodological Study. İKÇÜSBFD. 2025;10:459–463.
MLA Aktan, Gül Güneş et al. “Reliability and Validity of Bedside Oral Exam Tool’s Turkish Version: Methodological Study”. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, vol. 10, no. 3, 2025, pp. 459-63, doi:10.61399/ikcusbfd.1673441.
Vancouver Aktan GG, Eşer İ, Baysal E, Uyar M, Yamaç C. Reliability and Validity of Bedside Oral Exam Tool’s Turkish Version: Methodological Study. İKÇÜSBFD. 2025;10(3):459-63.



Licensed under a Creative Commons Attribution 4.0 International License.