Versão única do child perceptions questionnaire para crianças brasileiras com idade entre 5 e 14 anos

Abstract

In Dentistry, measures of oral health-related quality of life (OHRQoL) provide essential information for assessing treatment needs, guiding clinical decision-making, and evaluating interventions, services, and public health programs. Two of the most commonly used instruments to assess OHRQoL in Brazilian children are the Child Perceptions Questionnaire (CPQ) in two age-specific versions: 8–10 years (CPQ8-10) and the short version for 11–14 years (short-form CPQ11-14). A study conducted in New Zealand demonstrated that children as young as five years old are capable of reliably responding to both instruments. Therefore, the aim of the present study was to validate a unified version of the Child Perceptions Questionnaire for Brazilian children aged 5– 14 years (CPQ5–14) and to determine whether the use of a single instrument across this age range is feasible. A cross-sectional study was conducted with a convenience sample of 200 children aged 5 to 14 years, enrolled in public schools in Belo Horizonte, Minas Gerais, Brazil. The sample was stratified by age group: 5–7 years (n = 60), 8– 10 years (n = 60), and 11–14 years (n = 80), including 20 children per individual year of age. Children were clinically examined by a single examiner previously trained and calibrated for dental caries diagnosis using the ICDAS-II system (Kappa > 0.80). The children completed the unified version of the CPQ5-14 through face-to-face interviews. Parents or legal guardians responded to a questionnaire containing sociodemographic and child-related variables. Psychometric evaluation included exploratory and bifactor confirmatory factor analyses, Spearman's correlation, Mann–Whitney test, intraclass correlation coefficient (ICC), and McDonald’s omega. Bartlett’s test of sphericity (2154.8, p < 0.001) and the KMO index (0.08) supported the interpretability of the item correlation matrix. Parallel analysis and exploratory factor analysis parameters (UniCo = 0.963; ECV = 0.873; MIREAL = 0.191) indicated unidimensionality. The bifactor model demonstrated that the unidimensional structure better explained item variance (moderate-to-high factor loadings) compared to a four-factor model. The instrument showed high internal consistency (McDonald's omega = 0.93) and strong reliability (ICC = 0.838). Discriminant validity was supported by statistically significant differences between children with and without dental caries (p = 0.002). The total CPQ5-14 score showed a positive and significant correlation with the global rating items (r = 0.384, p < 0.001; r = 0.557, p < 0.001). In conclusion, the unidimensional structure of the CPQ5–14 demonstrated high reliability and strong internal consistency, indicating that this is a valid instrument for assessing oral health-related quality of life in Brazilian children aged 5 to 14 years.