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Trismus in head and neck cancer: translation and validation of the Chinese version of the Gothenburg Trismus Questionnaire-2 (C-GTQ-2)

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Abstract

Objectives

Trismus, marked by restricted mouth opening, significantly affects patients with temporomandibular disorder (TMD) and head and neck cancer (HNC). Despite its prevalence, specialized questionnaires for trismus assessment are scarce. This study aims to fill this gap by translating and validating the Gothenburg Trismus Questionnaire version 2 (GTQ-2) into Chinese (C-GTQ-2), enhancing the evaluation of trismus in HNC and TMD patients.

Materials and Methods

The study involved 78 HNC patients, 75 TMD patients, and a control group of 150 individuals without trismus symptoms. Participants were asked to complete the C-GTQ-2 and other health-related quality of life (HRQL) instruments. A subset of 30 individuals retook the questionnaire within two weeks to assess test-retest reliability.

Results

The C-GTQ-2 demonstrated remarkable reliability, with Cronbach’s alpha values exceeding 0.70 in three of the four domains, indicating high internal consistency. The instrument also showcased high intra-class correlations in the test-retest, affirming its reliability. Furthermore, it exhibited strong convergent validity, aligning well with other HRQL instruments, and effectively discriminated between patients with and without trismus, establishing its discriminant validity.

Conclusions

The C-GTQ-2 emerges as a valid and reliable tool for assessing trismus in HNC and TMD patients, promising to significantly enhance both clinical and research approaches to managing trismus-related complications in the Chinese-speaking demographic.

Clinical relevance

C-GTQ-2 proves effective for trismus assessment in head and neck cancer and temporomandibular disorder patients, offering enhanced clinical and research utility.

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Data availability

The datasets during and/or analysed during the current study available from the corresponding author on reasonable request.

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Funding

This work was supported by grants from the Tri-Service General Hospital (TSGH-D-110181).

Author information

Authors and Affiliations

  1. School of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan

    Chia-Hui Shao, Rou-Han Chen, Chia-Jung Chan, Ya-Jen Chen, Chia-Hsin Lee, Shu-Chun Tsai & Tsai-Wei Huang

  2. Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan

    Chia-Hui Shao

  3. Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Lisa Tuomi

  4. Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra GötalandSahlgrenska University Hospital, Gothenburg, Sweden

    Lisa Tuomi & Caterina Finizia

  5. Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Caterina Finizia

  6. Division of Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan

    Chia-Yu Wu

  7. School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan

    Chia-Yu Wu

  8. Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan

    Chia-Jung Chan & Chia-Hsin Lee

  9. Department of Dentistry, Tri-Service General Hospital, Taipei, Taiwan

    Wei-Chin Chang

  10. Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Shu-Chun Tsai & Tsai-Wei Huang

  11. Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Tsai-Wei Huang

  12. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan

    Tsai-Wei Huang

Authors
  1. Chia-Hui Shao
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  2. Lisa Tuomi
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Contributions

Conceptualization: CHS and TWH

Methodology: CHS, LT, CF and TWH

Software: CHS and TWH

Validation: CHS, LT, CF and TWH

Formal analysis: CHS, LT, CF, CYW and TWH

Investigation: CHS, RHC, CJC, YJC, CHL, SCT and WCC

Writing—original draft preparation: CHS, LT, CF and TWH

Writing—review and editing: CHS, LT, CF and TWH

Visualization: CHS

Supervision, LT, CF, and TWH

All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Tsai-Wei Huang.

Ethics declarations

Ethics approval and consent to participate statement

The study received approval from the Institutional Review Boards of Tri-Service General Hospital (approval number: A202105048, March 8, 2021) and Taipei Medical University, Taiwan (approval numbers: A202105048 and A202205085). The researcher provided a verbal explanation of the consent form to participants, who then provided their written consent.

Institutional review board statement

The study approval from the Institutional Review Board of Tri-Service General Hospital (approved number: A202105048 on March 8, 2021) and Taipei Medical University, Taiwan (approved number: A202105048 and A202205085) involving humans.

Competing interests

The authors declare no competing interests.

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Shao, CH., Tuomi, L., Finizia, C. et al. Trismus in head and neck cancer: translation and validation of the Chinese version of the Gothenburg Trismus Questionnaire-2 (C-GTQ-2). Clin Oral Invest 28, 146 (2024). https://doi.org/10.1007/s00784-024-05537-1

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