Validação de um instrumento para avaliar a qualidade da Atenção em Saúde Bucal de Crianças de 0 a 5 anos na Atenção Primária à Saúde na visão do Cirurgião-Dentista

Abstract

The incorporation of the dentist into the Family Health Strategy was recognized as an integral part of the general health and quality of life of the population, increasing interest in monitoring and evaluating the results of oral health care in Primary Health Care (PHC). No instrument was found to assess oral health care in PHC for children 0 to 5 years old from the perspective of the dental surgeon. Thus the purpose of thisstudy is to validate an instrument to fill this gap. As a theoretical-methodological stage, the test-retest was carried out with 107 CDs of the PHC of the municipalities of Belo Horizonte, Diamantina and Montes Claros, by e-mail, using the SurveyMonkey platform. For the validation of the construct we used the Exploratory Factorial Analysis (EFA) with the Principal Factor method from the Polycoric Correlation andOblimim Rotation using the software Stata version 14.0. Crombach's alfa was calculated for internal consistency. For the hypothesis test, the estimated scores of each factor were compared between the groups defined by the dentists' selfassessment of the quality of services (Kruskal Wallis test). RESULTS: The instrument sent for the test-retest consisted of 46 items divided into two parts: 1st part with 13 items for professional characterization and the 2nd part with 33 items to evaluate the quality of oral health care of children from 0 to 5 years old. 41 professionals responded. We excluded 9 items with Coeficiente Kappa lower than0.60. The instrument started to have 24 in the second part and was sent to 402 dentists of the three municipalities. The instrument was answered by 185 dentists. The descriptive analysis of the 24 items of the 2nd part was done and 2 items were excluded because they presented more than 98% tendency to the "always" response. The EFA excluded 5 itens. The final version of the instrument was composed by 13 professional characterization items and 17 to assess the quality of oral health care of children aged 0 to 5 years in the PHC. He presented two factors that grouped items related to Factor 1 "integral attention to oral health in PHC" and to Factor 2 "Longitudinality". For all 17 items the factor loads were greater than 0.40. Its internal consistency was calculated by the Cronbach's alfa ( 0.70) was 0.87 for the set of items and for Factor 1, 0.88 and, for Factor 2, 0.72. The hypothesis test pointed out that the dentist who evaluated the care positively presented a lower quality score. CONCLUSIONS: The instrument was considered reliable and valid and could be a tool for the planning and management of the health system in the evaluation of its potentialities and needs, qualifying the professional attention in oralhealth of children from 0 to 5 years in the PHC.