Adaptação transcultural da Raghavendra, Madhuri Sujata Pictorial Scale (RMS-PS)para avaliação da ansiedade odontológica em crianças e adolescentes brasileiros

Abstract

The Raghavendra, Madhuri, Sujata Pictorial Scale (RMS-PS) is a scale that was created to measure dental anxiety in Indian children and adolescents. This scale is composed of photographs of real children. It considers different expressions that represent feelings ranging from no/low to high dental anxiety. For its confection, photographs of real children of both sexes in different expressions were considered. Therefore, the original RMS-PS has a scale for females with five expressions and one for males with five expressions. In the literature, the measurement of dental anxiety in children and adolescents can be performed by applying numerous scales, whether they consist of simple drawings, more elaborate drawings with colors, and whether they are accompanied or not by a sequence of questions. It is important to consider that talking about feelings is not something commonly taught to children and adolescents, and many in adulthood may still have difficulties verbalizing their emotions. Thus, launching strategies to facilitate this verbalization of dental anxiety is of great importance. Knowing the degree of dental anxiety before a treatment may bring more confidence to the clinician, since the strategies in the management, development of treatment plan, and guidelines to those responsible will be applied in a personalized and assertive way, because the particularities presented by each child or adolescent will be considered. This consists of a cross-cultural adaptation of the RMS-PS to be applicable to the Brazilian population. In its cross-cultural adaptation process, all items of the original scale were kept, and it was decided to include also the skin color variations. In the cross-cultural adaptation process, we initially made the Brazilian versions of the RMS-PS, with photographs of Brazilian children: black girl, white girl, black boy, white boy. Versions with five expressions (scale five), and shorter ones, with three expressions (scale three) were developed. Next, the Committee of Experts met to evaluate the photographs. The proposed changes were made and the new photographs were applied in the pre-test with 25 children and adolescents from Carmópolis de Minas, Brazil, stratified by age group: 10 to 14 years, 7 to 9 years, and 4 to 6 years. The participants were selected by convenience in private dental clinics. The pre-test was performed virtually or face-to-face, using the five-sided scale and the three-sided scale versions. Participants were asked which scale they preferred, and which expression represented their anxiety during a dental appointment. The Expert Committee was reconvened after the pre-test. Results: The neutral expression was the most frequent (44.0%) for scale three, and the happy expression (36.0%), for scale five. Most adolescents preferred scale five (66.6%), and 75% of children preferred scale three. As a conclusion, the present study provides the Brazilian version of the RMS-PS scale, counting on four variations considering sex and skin color. The preference for a scale of three or five expressions varied according to age