Cross-cultural adaptation and psychometric properties of a Mutual Understanding Scale (MUS) – Indonesia version

Introduction
Transactional communication between a doctor/dentist and a patient is important. Doctors and patients should equate clinical realities or explanatory models in health consultations and communicate in accordance with mutual understanding.

Objectives
The aims of this study were to cross-culturally adapt the Mutual Understanding Scale (MUS) to Indonesian language and to test its reliability and validity.

Material and methods
MUS is a questionnaire for measuring mutual understanding; however, the oral health services version and Indonesian version of the scale is not yet available. In this study, we assessed the validity and reliability of an Indonesian version of MUS for assessment of mutual understanding between dentist and patients in oral health service at Jakarta. A sample of patients was recruited from among 100 Papuan with oral health complaints. After translating the instrument, we conducted psychometric testing.

Results
The reliability coefficients (Cronbach’s α) for Indonesian version of MUS dentist and MUS patient questionnaires were 0.928 and 0.925, respectively. The test-retest reliability test of MUS Indonesian version was rated as excellent interclass correlation coefficient for MUS dentist and MUS patient as 0.845 and 0.825, respectively. With respect to validity, the scores of MUS Indonesian version showed significant correlation coefficient r = 0.70-0.80, with global ratings on a five-point Likert scale. The perception with global rating dichotomies questions was defined as significant in Mann-Whitney test, with p < 0.05.

Conclusions
The questionnaire showed excellent discriminant validity for measurement of mutual understanding of dentists and patients in dentist-patient communications. This study provides strong evidence of the reliability and validity of the Indonesian MUS for assessment of mutual understanding during dentist-patient communication in oral health services.