Validation of child drawing hospital (CD: H) scale and the role of drawing in the evaluation of Dental anxiety

Abstract

Background: Child Drawing: Hospital (CD: H) was developed as a tool to measure the emotional state of hospitalized school-age children. This scale consists of sections A, B and C, which allow understanding of anxiety through children’s drawings. The CD: H Scale, which is widely used in medicine, has only been validated in two different cultures. The adaptation and validation of the scale in the field of dentistry has recently started to take place in the literature. In our study, we aimed to conduct a Turkish validation study of the Child Drawing: Hospital (CD: H) Scale and to evaluate dental anxiety and pain experienced during treatment through drawing. Methods: Pediatric patients between the ages of 5–12 who attended the Pediatric Dentistry Department between 2018 and 2020 were included in the study. Following the translation of the CD: H Scale into Turkish and linguistic-cultural validation, the behaviors of pediatric patients during treatment were evaluated with the Frankl Behavior Rating Scale, the pain they experienced during treatment with the Wong- Baker Face Rating Scale, and their anxiety levels were evaluated with the pictures drawn by the patients at the end of the treatment. The data were analyzed with IBM SPSS v23, and the significance level was taken as p < 0.05. Results: Within the scope of the scale’s reliability-validity study, the Intra-Class Correlation Coefficient (ICC) was evaluated with test-retest consistency. For section A, B,C and total score reliability was found to be positive and strong level correlation. Conclusions: The Turkish version of the CD: H Scale is a reliable and valid scale that can be used to evaluate the dental anxiety of Turkish pediatric patients. Trial registration: ClinicalTrials (NCT05236101/11.02.2022), ‘retrospectively registered’.