The Attitude of Nursing Staff Towards Oral Healthcare for Care‐Dependent Older Adults ( ANOCO ) Questionnaire: Development and Validation

ABSTRACT Aims This study aims to report on the development and validation of the Attitude of Nursing staff towards Oral healthcare for Care‐dependent Older adults (ANOCO) questionnaire. Methods The development of the ANOCO questionnaire was performed in three stages between 2008 and 2019. In a first stage, domains related to oral healthcare attitudes were identified. Next, relevant statements per domain were formulated by a Delphi panel in two rounds, resulting in a questionnaire with 32 statements. In a final phase, this questionnaire was subjected to psychometric analysis, including an evaluation of the construct validity, an internal consistency analysis (Cronbachs alpha) and a principal component analysis. Results The questionnaire could significantly distinguish between known groups (dentists, nurses' aides, nursing students and nurses). Regarding internal consistency, Cronbach's alpha was 0.863 in the first sample ( n  = 361) and 0.843 in the second sample ( n  = 1051). Based on principal component analysis, 22 statements were retained. Four components with an eigenvalue of more than 1 explained 45% of the total variance. Conclusion The ANOCO‐22 questionnaire consists of 22 statements and is a valid tool to assess the changes or differences in the attitude of nursing staff towards oral healthcare for care‐dependent older adults.