CEPPAR, Hospital Israelita Albert Einstein, Av. Albert Einstein 627, São Paulo, SP, Brazil.
Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Av. Limeira, 901 - Areião, Piracicaba, SP, Brazil.
BMC Oral Health. 2021 Aug 28;21(1):421. doi: 10.1186/s12903-021-01742-6.
Access to oral health services remains a challenge in the Brazilian healthcare system, especially in the primary health care setting, where the use of a risk stratification tool that could identify individuals with higher dental vulnerability would be extremely valuable. However, there literature on this theme is scarce, and there is no validated instrument in Brazil that is capable of measuring dental vulnerability. Hence, this psychometric study aimed at the development and evaluation of content and internal structure validity of the Dental Vulnerability Scale for Primary Health Care (PHC).
The items were developed based on a qualitative exploratory analysis. A total of 172 items were prepared and submitted to a panel of specialists, with content validity analyzed with the Content Validity Ratio (CVR), resulting in an the initial version of the instrument composed by 41 items. Internal structure validity was analyzed by Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and by applying 3 reliability indicators (Cronbach's Alpha, McDonald's Omega and Greatest Lower Bound - GBL), with a sample of 1227 individuals.
The final configuration indicated a scale of 15 items divided into 4 dimensions (overall health, oral health, infrastructure, and healthcare services) with explained variance of 72.11%. The factor loads varied from 0.37 to 0.96. The model adjustment indices were set at × 2/df = 3.23, NNFI = 0.95, CFI = 0.98, GFI = 0.96, AGFI = 0.97, RMSEA = 0.04 and RMSR = 0.03.
DVS presented satisfactory evidence of validity, indicating its suitability to be used by healthcare professionals, students and managers to plan oral health actions and services at PHC.
在巴西的医疗保健系统中，获得口腔卫生服务仍然是一个挑战，尤其是在基层医疗保健环境中，使用一种可以识别具有更高牙齿脆弱性的个体的风险分层工具将是非常有价值的。然而，关于这个主题的文献很少，巴西也没有经过验证的能够衡量牙齿脆弱性的工具。因此，这项心理测量学研究旨在开发和评估基层医疗保健（PHC）的牙齿脆弱性量表（DVS）的内容和内部结构效度。
根据定性探索性分析开发项目。共准备了 172 个项目，并提交给专家组进行内容有效性分析，内容有效性比（CVR），得出初始版本的工具组成的 41 个项目。内部结构效度通过探索性因素分析（EFA）、验证性因素分析（CFA）以及应用 3 个可靠性指标（Cronbach 的 Alpha、McDonald 的 Omega 和最大下界 - GBL）进行分析，样本量为 1227 人。
最终配置表明，该量表由 15 个项目组成，分为 4 个维度（整体健康、口腔健康、基础设施和医疗服务），解释方差为 72.11%。因子负荷从 0.37 到 0.96 不等。模型调整指数设置为 ×2/df=3.23，NNFI=0.95，CFI=0.98，GFI=0.96，AGFI=0.97，RMSEA=0.04 和 RMSR=0.03。
DVS 具有令人满意的有效性证据，表明其适合医疗保健专业人员、学生和管理人员用于规划基层医疗保健的口腔卫生行动和服务。
