Tradução e análise das propriedades psicométricas do “Illness perception questionnaire-revised for dental” para uso em pais/responsáveis de crianças com cárie dentária no Brasil

Abstract

This quantitative cross-sectional study aimed to translate, to perform the cultural adaptation and to test the psychometric properties of the Brazilian Portuguese version of the Illness Perception Questionnaire - Revised for Dental (IPQ-RD), applied to parents/guardians of six- to fourteen-year-old children, from the cities of Governador Valadares and Teófilo Otoni, Minas Gerais (MG). For this purpose, two studies (named articles) were conducted: the first one with the translation and cultural adaptation stages of the IPQ-RD into Brazilian Portuguese with 30 parents/guardians of children patients from a clinic in Governador Valadares, MG; and the second one with the analysis of psychometric properties of the Brazilian version of the IPQ-RD in 63 parents/guardians of children from public schools of Teófilo Otoni, MG. The IPQ-RD consists of 34 items that assess the cognitive and emotional perception/representation of dental caries in childhood, with response options ranging from "strongly agree" (score 1) to "strongly disagree" (score 5). In article 1, the protocol consisted of translation into Brazilian Portuguese, backtranslation into English, expert committee review, and pre-test. Some questions were identical to the translation (T1=T2), others prioritized another translation (T1 or T2) and some were modified (T3). In the first pre-test (n=15), three questions were misunderstood by more than 15% of the sample, and were reviewed by the Expert Committee. In the second pre-test (n=15), all questions were satisfactorily understood. In article 2, the Brazilian Portuguese version of the IPQ-RD was applied by telephone; and the personal data, socioeconomic and quality of life questionnaires ("Parental-Caregiver Perceptions Questionnaire", 16-P-CPQ; "Family Impact Scale", 4-FIS) were self-completed remotely and virtually. Data were analyzed by descriptive statistics, comparison and correlation tests, and psychometric analysis. Almost half of the sample (49%) belonged to the C1/C2 classes (17 to 28 points). Approximately 1/3 rated the child's oral health as "regular"/"poor" (34.9%); while 11.1% reported "very"/"very much" impact on the child's well-being. The most frequently impacted item in the four domains of the 16- P-CPQ were "bad breath (23.8%)", "breathing through the mouth" (20.7%), "feels anxious or afraid" (20.7%), "difficulty paying attention in school" (10%). In the 4-FIS, 11.1% "had less time for self or family". There were higher scores of the domain "disease coherence" for females than males; and lower values of "emotional dimensions" for parents/caregivers with incomplete middle school level compared to those with elementary I, II and incomplete higher education. The IPQ-RD "identity" and "parent/caregiver control" domains were negatively associated with 16-P-CPQ "emotional well-being" and "oral symptoms," respectively. The mean IPQ-RD score was 126.4 (±15.1); and domain scores correlated positively. The internal consistency for the IPQ-RD was "almost perfect" (α=0.85), ranging from "moderate" (α=0.43) to "almost perfect" (α=0.89) for the "control-child" and "consequenceschild" domains, respectively. The intraclass correlation coefficient ranged from 0.04 to 0.68 indicating temporal stability from "poor" to "substantial". The Brazilian Portuguese version of the IPQ-RD was considered socioculturally adapted, valid, and reliable to assess the cognitive and emotional perception of parents/guardians about dental caries in Brazilian children.