Cuestionario de bruxismo autoinformado. Estudio piloto en el noreste de México / Self-reported bruxism questionnaire. A pilot study in northeastern Mexico

RESUMEN

Resumen El diagnóstico adecuado del bruxismo incluye el análisis y la correlación de signos y síntomas con diferentes métodos de diagnóstico, siendo esencial la interpretación y evaluación de los síntomas que reporta el paciente. El presente es un trabajo inicial sobre las propiedades psicométricas del cuestionario de bruxismo autoinformado (CBA). Participaron 100 personas (34 hombres y 66 mujeres) del noreste de México, la muestra se dividió en dos grupos, uno con diagnóstico clínico y autoinforme de bruxismo (N = 50) y otro sin bruxismo. Se evaluó la confiablidad por consistencia interna, la estructura factorial y la validez convergente entre la escala de estrés percibido PSS-14 y el CBA. Los resultados muestran consistencia interna entre los 11 ítems (α = .88). El análisis factorial confirmatorio para un solo factor presentó índices estadísticos de bondad de ajuste adecuados (χ2/gl = 1.461; GFI = .916; AGFI = .857, CFI = .967, RMSEA = .068). La correlación entre las escalas PSS-14 y CBA fue positiva (r = .27; p = .001), y entre la escala de estrés percibido y las subescalas bruxismo de sueño r = .20 (p = .039) y bruxismo de vigilia r = .29 (p = .002), La correlación entre las subescalas BS y BV fue r = .71 (p = .001), Los resultados del CBA muestran alta confiabilidad, consistencia interna y correlación inter-ítems apropiada, y respaldan la validez convergente del cuestionario. Asimismo, contribuyen a mejorar los estándares de calidad al evaluar los datos subjetivos aportados por personas con bruxismo y se considera de interés continuar con el análisis del CBA, evaluando su comportamiento en otras poblaciones.

ABSTRACT

Abstract Bruxism is defined as a repetitive jaw-muscle activity, characterized by grinding or clenching the teeth, and /or by bracing or thrusting of the mandible, which has different circadian manifestations, either during sleep (sleep bruxism) or when wakefulness (awake bruxism). For an appropriate clinical diagnosis of bruxism different techniques have been proposed; the most common technique is the usage of a self-reported questionnaire combined with a professional evaluation. While the first is a questionnaire in which the patient expresses their symptoms, the second depends on the presence of observed signs associated according to an evaluator, including tooth wear as well as identify symptoms associated to this jaw-muscle activity, to confirm a clinical diagnosis, there must be a correlation between the self-report questionnaire and clinical diagnosis. Therefore, there is no quantifiable measure that may help to evaluate, from a patient's perspective, the signs and symptoms that belongs to his/her muscle and mandibular activity while assessing both its proportion and measure. To strengthen the self-report technique as a reliable procedure for assessing the information expressed by patient with bruxism, this initial study reports the reliability and validity proprieties of the self-report bruxism questionnaire (CBA). The present study was conducted in Mexico and includes one hundred participants. Fifty percent of them presented a clinical diagnosis of bruxism (n = 50), the other half (control group) do not. In both groups the perceived stress scale (PSS) and the self-reported bruxism questionnaires (CBA) were equally completed on a self-administered way. Both a high internal consistency (α = .884) was found on the eleven items and a corrected item-total correlation ranged from .43 to .78, reflects an adequate reliability. The exploratory factor analysis was used to group the CBA variables; the extraction was made using a main component with Varimax rotation method. The sample adequacy coefficients, the Kaiser Meyer-Olkin (KMO = .826) and Bartlett's Sphericity test (χ2 = 579.866, p = .000) were assessed and expressed an appropriate intercorrelation between items. The factor analysis showed a bifactorial the latent variables explained one factor of 47.8 % (eigenvalue = 5.26) variance and another of 11.5 % (eigenvalue = 1.27), thus its cumulative variance of this model was 59.36 %. Due to amount of explained variance and the difference between the eigenvalues of this initial solution we considered to prove a unidimensional model. A one solution factor scale was feasible, with factor weights greater than .52 on all items. This single-factor structure was verified in a confirmatory factor analysis, which presented significant values and suitable goodness of fit indexes (χ2/df = 1.461; GFI = .916; AGFI = .857, CFI = .967, RMSEA = .068). Also, a convergent analysis was performed proving a positive (r = .27; p = .001) correlation between the PSS-14 and CBA scales, the correlation with the subscales of self-reported awake bruxism, SAB was positive (r = .299, p = .002). Regarding self-reported sleep bruxism, SAB the correlation was also positive (r = .207, p = .039). The correlation between the subscales was both positive and strong (r = .713, p = .001). Based on the results obtained, we can conclude that, there are a positive, significant, and adequate correlation between PSS-14 scale and the scale of self-reported bruxism, as though as in the sub-scales SAB and SSB. These results suggested that the one factor solution of the CBA has high reliability, internal consistency, and an appropriate inter-item correlation; also, it supports the convergent validity of the questionnaire. Due to the possible contributions of the CBA to the improvement of the quality standards of the evaluation of subjective data provided by people with bruxism, it is suggested to continue with the analysis of the scale in future studies with other populations.