Semantic equivalence of the Brazilian version of the Patient Satisfaction Questionnaire (B-PSQ).

The Patient Satisfaction Questionnaire (PSQ) is a self-administered instrument to assess adolescent patients' satisfaction with orthodontic treatment. A pre-existing North American instrument was further explored in the Netherlands. Semantic equivalence is part of cross-cultural adaptation and is necessary to achieve a valid and reliable instrument for a specific culture. The present study aimed to evaluate the semantic equivalence of the items, subscales, and overall PSQ between the original English version and the Brazilian Portuguese language version (B-PSQ). The PSQ has 58 items, distributed across 6 subscales: doctor-patient relationship, situational aspects of the clinic, dentofacial improvement, psychosocial improvement, dental function, and a residual category. Semantic equivalence was evaluated according to the following methods: (1) independent translations to Portuguese by two translators, both native in Brazilian Portuguese and fluent in English; (2) an expert committee drafted the first summarized version in Portuguese; (3) two independent back-translations into English by two native English-speaking translators fluent in Portuguese; (4) committee review; (5) committee drafted a summarized version of the back-translations; (6) expert committee drafted the second summarized version in Portuguese; (7) pre-test of the instrument using individual semi-structured interviews with 10 adolescents; (8) review and final version of the B-PSQ. Semantic equivalence between the original and the Brazilian versions of the questionnaire was achieved through diligent and rigorous methods, with effective translation and expert evaluations, incorporating the opinions of the target population.

Satisfaction with orthodontic treatment: cross-cultural adaptation and validation of an instrument for the Brazilian Portuguese language.

OBJECTIVE: To cross-culturally adapt into the Brazilian Portuguese and evaluate the psychometric properties of an instrument for assessing the satisfaction of parents/guardians regarding their sons'/daughters' orthodontic treatment. METHODS: Translations of the instrument from English, pre-test and evaluation of validity and reliability of the Brazilian Portuguese version were performed. The questionnaire has 25 items distributed across 3 subscales (process, psychosocial effect and outcome). Eighty-three parents/guardians of children/adolescents who had completed orthodontic treatment participated. Descriptive statistics and floor and ceiling effects were calculated. Internal consistency, stability (interval of three weeks), convergent construct validity and discriminant construct validity were determined. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed dimensionality. RESULTS: Among the 83 parents/guardians, 58 (69.9%) were mothers and 25 (30.1%) were fathers of children/adolescents. In the questionnaire's total score and the three subscales scores, an acceptable percentage (≤15%) of participants achieved the maximum score (ceiling effect). In the total questionnaire score and in the three subscales scores, no participant achieved the minimum score (floor effect). Cronbach's α coefficient for the total score was 0.72 (internal consistency). Intra-class correlation coefficient for the total score was 0.71 (stability). The questionnaire's total score presented large Pearson correlation coefficient (>0.50) with the three subscales too (construct validity). Female parents/guardians had significantly higher scores in the psychosocial effect (p=0.013) and in the treatment outcome (p=0.037) subscales, compared to male parents/guardians (discriminant validity). EFA and CFA confirmed dimensionality in a three-factor solution. CONCLUSIONS: The final obtained version is valid and reliable to be used in Brazilian populations.

Semantic equivalence of the Brazilian version of the Patient Satisfaction Questionnaire (B-PSQ)

Abstract The Patient Satisfaction Questionnaire (PSQ) is a self-administered instrument to assess adolescent patients' satisfaction with orthodontic treatment. A pre-existing North American instrument was further explored in the Netherlands. Semantic equivalence is part of cross-cultural adaptation and is necessary to achieve a valid and reliable instrument for a specific culture. The present study aimed to evaluate the semantic equivalence of the items, subscales, and overall PSQ between the original English version and the Brazilian Portuguese language version (B-PSQ). The PSQ has 58 items, distributed across 6 subscales: doctor-patient relationship, situational aspects of the clinic, dentofacial improvement, psychosocial improvement, dental function, and a residual category. Semantic equivalence was evaluated according to the following methods: (1) independent translations to Portuguese by two translators, both native in Brazilian Portuguese and fluent in English; (2) an expert committee drafted the first summarized version in Portuguese; (3) two independent back-translations into English by two native English-speaking translators fluent in Portuguese; (4) committee review; (5) committee drafted a summarized version of the back-translations; (6) expert committee drafted the second summarized version in Portuguese; (7) pre-test of the instrument using individual semi-structured interviews with 10 adolescents; (8) review and final version of the B-PSQ. Semantic equivalence between the original and the Brazilian versions of the questionnaire was achieved through diligent and rigorous methods, with effective translation and expert evaluations, incorporating the opinions of the target population.

Resumo O Patient Satisfaction Questionnaire (PSQ) é um instrumento autorrelatado específico para avaliar a satisfação de pacientes adolescentes com o tratamento ortodôntico. Um instrumento norte-americano pré-existente foi mais explorado na Holanda. A equivalência semântica faz parte da adaptação transcultural e é necessária para se obter um instrumento válido e confiável para uma cultura específica. O presente estudo teve como objetivo avaliar a equivalência semântica dos itens, subescalas e escore geral do PSQ entre a versão original em inglês e a versão em português do Brasil (B-PSQ). O PSQ possui 58 itens, distribuídos em 6 subescalas; relação médico-paciente, aspectos situacionais da clínica, melhora dentofacial, melhora psicossocial, função dentária e uma categoria residual. A equivalência semântica foi avaliada de acordo com o seguinte método: 1) traduções independentes para o português por dois tradutores, ambos nativos em português brasileiro e fluentes em inglês; 2) um comitê de experts elaborou a primeira versão síntese em português; 3) duas retro-traduções independentes para o inglês por dois tradutores nativos de língua inglesa fluentes em português; 4) revisão do comitê; 5) o comitê elaborou uma versão síntese das retro-traduções; 6) comitê de experts redigiu a segunda versão síntese em português; 7) pré-teste do instrumento por meio de entrevistas individuais semiestruturadas com 10 adolescentes; 8) revisão e versão final do B-PSQ. A equivalência semântica entre as versões original e brasileira do questionário foi alcançada por meio de métodos cuidadosos e rigorosos, com tradução eficaz e avaliações de experts, incorporando as opiniões da população-alvo.

Sense of coherence and dental fear/dental anxiety: A systematic review and meta-analysis.

AIM: The aim of this systematic review and meta-analysis was to evaluate the association between sense of coherence (SOC) and dental fear/dental anxiety. METHODS: Computerized searches were performed in six databases. Gray literature and manual searches were also conducted. Study selection, risk of bias assessment, and meta-analyses were performed. The results of meta-analyses were reported in odds ratio (OR), mean difference (MD), and confidence interval (CI). RESULTS: After removing duplicates, 131 references were retrieved and the full texts of 12 were evaluated. Nine references met the eligibility criteria and were included. The results of meta-analyses demonstrated that individuals with a weaker SOC had a score in the dental anxiety/dental fear scale 6.04 times higher than individuals with a stronger SOC (OR = 6.04, CI = 2.62-13.91). Individuals with no dental anxiety/dental fear had a mean score of the SOC scale higher than individuals with dental anxiety/dental fear (MD = 5.39, CI = 2.21-8.56). Sensitivity analysis demonstrated that the result of a higher mean score of the SOC scale among individuals with no dental anxiety/dental fear remained (MD = 7.38, CI = 3.79-10.98). Risk of bias ranged from low to high. The certainty of evidence was very low. CONCLUSION: Individuals with stronger SOC have lower levels of dental fear/dental anxiety.

Satisfaction with orthodontic treatment: cross-cultural adaptation and validation of an instrument for the Brazilian Portuguese language

ABSTRACT Objective: To cross-culturally adapt into the Brazilian Portuguese and evaluate the psychometric properties of an instrument for assessing the satisfaction of parents/guardians regarding their sons'/daughters' orthodontic treatment. Methods: Translations of the instrument from English, pre-test and evaluation of validity and reliability of the Brazilian Portuguese version were performed. The questionnaire has 25 items distributed across 3 subscales (process, psychosocial effect and outcome). Eighty-three parents/guardians of children/adolescents who had completed orthodontic treatment participated. Descriptive statistics and floor and ceiling effects were calculated. Internal consistency, stability (interval of three weeks), convergent construct validity and discriminant construct validity were determined. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed dimensionality. Results: Among the 83 parents/guardians, 58 (69.9%) were mothers and 25 (30.1%) were fathers of children/adolescents. In the questionnaire's total score and the three subscales scores, an acceptable percentage (≤15%) of participants achieved the maximum score (ceiling effect). In the total questionnaire score and in the three subscales scores, no participant achieved the minimum score (floor effect). Cronbach's α coefficient for the total score was 0.72 (internal consistency). Intra-class correlation coefficient for the total score was 0.71 (stability). The questionnaire's total score presented large Pearson correlation coefficient (>0.50) with the three subscales too (construct validity). Female parents/guardians had significantly higher scores in the psychosocial effect (p=0.013) and in the treatment outcome (p=0.037) subscales, compared to male parents/guardians (discriminant validity). EFA and CFA confirmed dimensionality in a three-factor solution. Conclusions: The final obtained version is valid and reliable to be used in Brazilian populations.

RESUMO Objetivo: Adaptar transculturalmente para a língua portuguesa do Brasil e avaliar as propriedades psicométricas de um questionário que avalia a satisfação de pais e responsáveis com relação ao tratamento ortodôntico recebido por seus filhos. Métodos: Tradução do questionário em inglês, pré-teste e avaliação da validade e confiabilidade da versão em português obtida. O questionário consistiu de 25 itens distribuídos em três subescalas (processo durante o tratamento, efeito psicossocial e resultado geral do tratamento). Participaram 83 pais/responsáveis de crianças/adolescentes que concluíram o tratamento ortodôntico. Estatística descritiva foi realizada e foi calculado valor máximo e valor mínimo. Foram determinadas a consistência interna, a estabilidade (intervalo de três semanas), a validade de constructo convergente e a validade de constructo discriminante. A análise fatorial exploratória (AFE) e a análise fatorial confirmatória (AFC) avaliaram a dimensionalidade. Resultados: dos 83 pais/responsáveis que participaram do estudo, 58 (69,9%) eram mães e 25 (30,1%) eram pais das crianças/adolescentes. No escore total do questionário e no escore das três subescalas, uma porcentagem aceitável (≤15%) dos participantes atingiu o escore máximo (ceiling effect). No escore total do questionário e no escore das três subescalas, nenhum participante atingiu o escore mínimo (floor effect). O coeficiente α de Cronbach para o escore total foi 0,72 (consistência interna). O coeficiente de correlação intraclasse para o escore total foi 0,71 (estabilidade). O escore total do questionário apresentou um coeficiente de correlação de Person alto (>0,50) com as três subescalas (validade de constructo). Pais/responsáveis do sexo feminino apresentaram escores significativamente maiores nas subescalas efeito psicossocial (p=0,013) e desfecho do tratamento (p=0,037), em comparação aos pais/responsáveis do sexo masculino (validade discriminante). AFE e AFC confirmaram a dimensionalidade em uma solução de três fatores. Conclusões: A versão do questionário obtida no presente estudo mostrou-se válida e confiável para o uso na população brasileira.

Satisfação com o tratamento ortodôntico: tradução, adaptação transcultural e validação de um instrumento para a Língua Portuguesa do Brasil / Satisfaction with orthodontic treatment: translation, cross-cultural adaptation and validation of an instrument for the Brazilian Portuguese language

Existe uma escassez de instrumentos validados para avaliação de satisfação com serviços que ofertam tratamento ortodôntico. Na língua portuguesa do Brasil não existe qualquer questionário validado que aborde este desfecho. Essa dissertação teve como objetivo traduzir, adaptar transculturalmente e validar um instrumento de avaliação de satisfação em ortodontia para a língua portuguesa do Brasil. O instrumento avalia a satisfação de pais/responsáveis com o tratamento ortodôntico de seus(as) filhos(as) com idade inferior a 18 anos. O Comitê de Ética em Pesquisa com Seres Humanos da Universidade Federal de Minas Gerais aprovou este estudo (06898519.4.0000.5149). As etapas deste estudo seguiram as normas internacionais para estudos de validação de instrumentos para a avaliação de desfechos em saúde que são: tradução do instrumento no idioma inglês para o idioma português do Brasil, revisão das traduções por um comitê multidisciplinar composto por especialistas brasileiros, retrotradução para o inglês, pré-teste e avaliação da validade e confiabilidade da versão em português obtida. O instrumento consiste de 25 questões, distribuídas em 3 subescalas (processo durante o tratamento, efeito psicossocial do tratamento e resultado geral do tratamento). A amostra foi composta por 83 pais/responsáveis de crianças/adolescentes com idade entre 8 e 18 anos que concluíram o tratamento ortodôntico. A análise estatística foi realizada através do programa Statistical Package for the Social Sciences (SPSS). Estatística descritiva foi realizada. A consistência interna e a estabilidade foram calculadas através do Coeficiente Cronbach alfa e do Coeficiente de Correlação Intraclasse (CCI). A validade de constructo convergente foi testada por meio do coeficiente de Pearson através da associação entre as subescalas do questionário. A validade de constructo discriminante foi determinada através da comparação entre pais/cuidadores do sexo masculino e do sexo feminino com relação aos escores das subescalas e do escore total do questionário. Das 83 crianças/adolescentes que participaram do estudo, 41 (49,4%) eram meninos e 42 (50,6%) eram meninas. A média de idade das crianças/adolescentes foi 13,0 anos (±3,07). No escore total do questionário e nas três subescalas, porcentagens aceitáveis (15% ou menos) de participantes atingindo o escore máximo foram encontradas. No escore total do questionário e nas três subescalas, nenhum participante atingiu o escore mínimo. Com relação à consistência interna, o valor do coeficiente α de Cronbach para o escore total do questionário foi 0,72. Para as subescalas, os valores variaram de 0,68 a 0,75. Com relação à confiabilidade teste-reteste, o valor do CCI para o escore total do questionário foi de 0,71, indicando uma correlação boa. Para as subescalas, os valores variaram de 0,68 a 0,72. Para a validade de constructo, o escore total do questionário atingiu um coeficiente de correlação de Pearson grande (>0,50) com as três subescalas. Para a validade discriminante, pais/cuidadores do sexo feminino apresentaram escores significativamente maiores para as subescalas efeito psicossocial do tratamento (p=0,013) e resultado geral do tratamento (p=0,037) em comparação a pais/cuidadores do sexo masculino. A versão obtida nesse estudo mostrou-se válida e confiável para uso na população brasileira.

There is a scarcity of validated instruments for assessing satisfaction with services, where orthodontic treatment is provided. In the Brazilian Portuguese language, there is no validated questionnaire that addresses this outcome. This dissertation aimed to translate into the Brazilian Portuguese language, cross-culturally adapt and validate an instrument for the assessment of satisfaction in Orthodontics. The instrument assesses the satisfaction of parents/guardians of individuals under the age of 18 regarding the orthodontic treatment of their children. The Federal University of Minas Gerais (UFMG) Ethics Research Committee has approved this study (protocol 06898519.4.0000.5149), and the phases of this study followed international guidelines for translation, cross-cultural adaptation and validation of instruments for the assessment of health outcomes, which are: translation of the instrument from English to Brazilian Portuguese, revision of the translations by a multidisciplinary committee composed of Brazilian specialists, back-translation into English, pre-test and evaluation of the validity and reliability of the Portuguese version obtained. The questionnaire consists of 25 questions, distributed across 3 subscales (process, psychosocial effect and outcome). The sample consisted of 83 parents/caregivers of children/adolescents under 18 years of age who completed orthodontic treatment. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software, and descriptive statistics were performed. Internal consistency and stability were calculated using the Cronbach's α coefficient and the intraclass correlation coefficient (ICC), respectively. The convergent construct validity was tested using the Pearson's coefficient through the association between pairs of questionnaire subscales. The discriminant construct validity was determined by means of the comparison between male and female parents/caregivers who answered the questionnaire regarding the subscale scores and the total questionnaire score. From the 83 children/adolescents who participated in the study, 41 (49.4%) were boys and 42 (50.6%) were girls. The mean age of children/adolescents was of 13.0 years (±3.07). In the total score of the questionnaire and in the scores of the three subscales, an acceptable percentage (15% or lower) of participants achieved the maximum score. In the total questionnaire score and in the three subscales, no participant achieved the minimum score. Regarding internal consistency, the value of the Cronbach's α coefficient for the total score of the questionnaire was of 0.72. For the subscales, the values ranged from 0.68 to 0.75. Regarding test-retest reliability, the ICC value for the total score of the questionnaire was 0.71, indicating good correlation. For the subscales, the values ranged from 0.68 to 0.72. For construct validity, the total score of the questionnaire presented large Pearson correlation coefficient (>0.50) with the three subscales. For discriminant validity, female parents/caregivers had significantly higher scores in the psychosocial effect subscale (p=0.013) and in the outcome subscale (p=0.037) compared to male parents/caregivers. The version obtained in this study proved to be valid and reliable for use in the Brazilian population.