Journal of Oral & Facial Pain and Headache 323
Aims: To develop the Malay DC/TMD through a formal cross-cultural adaptation
(CCA) process for use in non–English speaking populations and to determine the
reliability and validity of the Malay Graded Chronic Pain Scale (M-GCPS) and Malay
Jaw Functional Limitation Scale (M-JFLS). Methods: The English DC/TMD
was translated into the Malay language using the forward-backward translation
procedures specified in the INfORM guideline. The initial Malay instrument
was pre-tested, and any discrepancies were identified and reconciled before
producing the final Malay DC/TMD. Psychometric properties of the M-GCPS
and M-JFLS were evaluated using a convenience sample of 252 subjects and
were assessed using internal consistency and test-retest reliability, as well as
face, content, concurrent, and construct validity testing. Internal consistency was
assessed using Cronbach’s alpha, while test-retest reliability was examined using
intraclass correlation coefficient (ICC). Concurrent and construct validity of both
domains were performed using Spearman ρ correlation test. In addition, construct
and discriminant validity were appraised using Kruskal-Wallis and Mann-Whitney
U tests, respectively. Results: Cronbach’s alpha values for the M-GCPS and
M-JFLS were 0.95 and 0.97, respectively. The ICC was 0.98 for the M-GCPS and
0.99 for M-JFLS. The majority of the tested associations for both domains were
found to be statistically significant, with good positive correlations. Conclusion:
The M-GCPS and M-JFLS were found to be reproducible and valid. The Malay
DC/TMD shows potential for use among Malay-speaking adults. J Oral Facial
Pain Headache 2020;34:323–330. doi: 10.11607/ofph.2624
Keywords: cross-cultural adaptation, DC/TMD, Malay language,
temporomandibular disorders, translation
T
MD refer to a diverse group of conditions affecting the TMJs,
masticatory muscles, and their surrounding structures.
1
They
present a signifcant public health problem and have been found
to negatively impact quality of life.
2
Findings from a large prospective
study established TMD as a “complex disorder with multiple caus-
es consistent with a biopsychosocial model of illness.”
3
Accordingly,
TMD diagnosis entails a dual-axis approach comprising both physical
and psychosocial status. The evidence-based Diagnostic Criteria for
TMD (DC/TMD), which can be used in both research and clinical set-
tings, was presented to the dental community in 2014.
4
These criteria
were developed based on the widely employed Research Diagnostic
Criteria for TMD (RDC/TMD),
5
with the aim of improving the sensi-
tivity and specifcity of diagnostic algorithms. Axis I of the DC/TMD
consists of the TMD pain screener, TMD symptoms questionnaire,
demographic profle, and a clinical examination to evaluate mandibu-
lar range of motion and associated pain/joint sounds, as well as TMJ
and masticatory muscle tenderness on palpation. Specifcations are
offered for carrying out the examination and fndings documentation.
Axis II assesses pain-related disability and psychosocial status with
an assortment of instruments, including the Graded Chronic Pain
Scale (GCPS), Jaw Functional Limitation Scale (JFLS), Patient Health
Questionnaire (PHQ), Generalized Anxiety Disorders (GAD) Scale,
pain drawings, and the Oral Behavior Checklist (OBC).
Mohd Khairul Anwar Mohd Tahir, BDS
Kathreena Kadir, BDS, MClinDent
(OMFS)
Muzaffar Apipi, DDS
Siti Mazlipah Ismail, BDS, FDSRCS
Department of Oral & Maxillofacial
Clinical Sciences
Faculty of Dentistry
University of Malaya
Kuala Lumpur, Malaysia
Zamros Yuzadi Mohd Yusof, BDS,
MSc, PhD
Department of Community Oral Health
and Clinical Prevention
Faculty of Dentistry
University of Malaya
Kuala Lumpur, Malaysia
Adrian Ujin Yap, BDS, MSc, PhD,
Grad Dip Psychotherapy
Department of Restorative Dentistry
Faculty of Dentistry
University of Malaya
Kuala Lumpur, Malaysia;
Department of Dentistry, Ng Teng Fong
General Hospital, National University
Health System, Singapore;
Duke-NUS Medical School and National
Dental Research Institute Singapore
National Dental Centre Singapore
Correspondence to:
Dr Kathreena Kadir
Department of Oral & Maxillofacial
Clinical Sciences
Faculty of Dentistry, University of Malaya
50603 Kuala Lumpur, Malaysia
Fax: +603-79674534
Email: kathreena@um.edu.my
Submitted November 5, 2019; accepted
April 14, 2020.
©2020 by Quintessence Publishing Co Inc.
Translation and Adaptation of the Diagnostic Criteria for
Temporomandibular Disorders into the Malay Language:
Psychometric Evaluation of Contents
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