Cross-Cultural Adaptation and Preliminary Psychometric Evaluation of the Malay Orthodontic Patient Satisfaction Questionnaire and Patient Satisfaction Following Fixed Orthodontic Treatment in Malaysia.

Background: Orthodontic treatment is a long-term intervention in which patient satisfaction is an important outcome alongside clinical measures. This study aimed to translate and culturally adapt the Orthodontic Patient Satisfaction Questionnaire (OPSQ) into Malay (M-OPSQ), evaluate its content validity, face validity, internal consistency and structural validity, and assess satisfaction following fixed appliance treatment. Methods: Content validity was evaluated by eight orthodontists using the Content Validity Index and Content Validity Ratio. Translation involved forward translation, cognitive debriefing, back translation and review by the original questionnaire developer. Face validity was assessed among 34 participants. Preliminary psychometric evaluation involved 159 adults recruited using convenience and snowball sampling. Internal consistency was assessed using Cronbach's alpha, while structural validity was evaluated using exploratory and confirmatory factor analyses. Exploratory group comparisons were analysed using non-parametric tests. Results: Content and face validity assessments resulted in a final 31-item M-OPSQ. Participants had a mean age of 27.11 ± 8.02 years, and 72.3% were female. The mean total score was 159.18 ± 20.33, with excellent internal consistency (α = 0.954; 95% confidence interval (CI) 0.942-0.963). Exploratory factor analysis supported a three-factor structure. The three-factor confirmatory model showed better relative fit than the unidimensional model, although most fit indices remained outside acceptable thresholds. Exploratory analyses identified differences across treatment provider and setting groups. Conclusions: The M-OPSQ demonstrated acceptable content and face validity and excellent internal consistency among Malaysian adults who had completed fixed appliance orthodontic treatment. Independent confirmation of the proposed factor structure, together with further assessment of construct validity and test-retest reliability, is required.