Pleno acesso à justiça e a atividade da ortodontia: questionário para mensuração da vulnerabilidade dos profissionais no exercício da ortodontia diante dos riscos de demandas judiciais indenizatórias

Abstract

Dentists, particularly orthodontists, are potential targets for compensation lawsuits and frequently find themselves unprepared, facing unnecessary risks of legal actions concerning their treatment. Because of the increasing number of dissatisfied orthodontic patients and because of lack of a useful tool capable of measuring the exposure risks of such professionals to lawsuits in the literature, creating and validating an instrument for that purpose was needed. In the initial phase, a comprehensive study was performed on the responsibility of orthodontists towards criminal, ethical and civil aspects of their activities. This study included a literature review, study of doctrine and jurisprudence with emphasis on civil responsibility. Subsequently, semi-structured interviews with law professionals, orthodontists, and orthodontic patients were performed. After the transcription and analysis of the interviews, fundamental domains (aspects) concerning the vulnerability of the orthodontists, who produce evitable risks in lawsuits, were identified. Those seven domains were organized in order to be used in the first version of the 53-question questionnaire, using the Likert scale. Such questionnaire was first evaluated by a specialist committee that proposed some corrections and fine adjustments, excluding some questions and rewriting others. Five different possible alternatives, which varied from 1 to 5, were determined, indicating that the higher the score, the lesser the exposure risk to lawsuits, and the lesser the score, the higher the vulnerability of the orthodontist. A data bank with the names of orthodontists was established. Initially, ten orthodontists were drawn to initiate the test and retest phases of the instrument, aiming to evaluate its temporal stability through the application of the instrument in two different periods of time, with a 12- or 15-day interval, using the same group of participants. Once stability was determined, the experts suggested rewriting one of the questions. For the application of the final version of the questionnaire by the researcher 184 respondents were used. Another questionnaire was elaborated with the same content and format using the Google Form plataform. It was sent by email to the data bank provided by postgraduate orthodontics schools to require participation in the study. The sample consisted of 63 respondents. The internal consistency and stability analyses demonstrated a value of 0.946 for the Cronbach alpha coefficient. The value of the Kaiser-Meyer-Olkin method was 0.909 and the Bartlett’s test of Spherecity was p < 0.01 with sample adequacy for the factorial analysis. Scores from the orthodontists’ answers were also determined identifying groups with different levels of vulnerability: little risk, moderate risk, and high risk. After conclusion and validation of the questionnaire, it is expected to be able to measure the real risk of exposure of orthodontists to lawsuits when the lack of caution, knowledge and care during orthodontic treatment prevails. Judicial actions are often opportunist and stimulate the prevention of risks in the relationship between professional and patient, characterizing a more defensive professional activity.