Validade da Escala de Imagens Faciais (FIS) para uso com crianças brasileiras na clínica odontopediátrica

Abstract

This study aimed to evaluate the validity of the Facial Image Scale (FIS) in pediatric dental patients in Rio de Janeiro, Brazil, based on: 1) the criterion validity, which was measured with the Venham Picture Test - Brazilian version; 2) the construct validity, using the correlation of FIS with the following variables: age, sex, DA perceived by parents/caregivers, socioeconomic classification (income), first visit the dentist, type of treatment performed, use of local anesthesia, previous and current experience of toothache, dental caries index and behavior during the dental appointment; and 3) a qualitative assessment with 30 children to evaluate if the instrument was capturing the child's feeling regarding DA. The form of application of the FIS was adapted to the Brazilian context by a group of four Brazilian pediatric dentists and a British psychologist (author of the FIS). The work was approved by the research ethics committee of the Pedro Ernesto University Hospital – HUPE/UERJ. Children aged 3 to 12 years old and their guardians who attended a dental appointment in the pediatric dentistry clinics of the Faculty of Dentistry of the Rio de Janeiro State University, the dental service of the Policlínica Piquet Carneiro Polyclinic and Penha’s Naval Ambulatory of the Brazilian Navy were included. Children with special needs and who did not want to participate in the study were excluded. A pilot study was carried out to assess the understanding of FIS and test the procedures that would be used in the main study, in a non-probabilistic sample of 15 children/guardians. The results suggested that age could influence the measurement of FIS validity and it was decided to carry out a sampling process by quotas, adaptations of the FIS and VPT application instructions for a more accessible language and decision to carry out the qualitative study. The sample selected by quotas of the validation study comprised 150 children, divided into groups of 31 children aged 3-4 years, 5-6 years, 7-8 years, 9-10 years, and 26 children aged 11-12 years; 65 (43%) were female; 20 (13.3%) had their first dental appointment; 47 invasive procedures were performed on the day of the interview (restorative treatment, procedures under rubber dam, extraction and/or endodontic treatment); 55 (36.7%) had no experience of caries in the primary dentition (dmft=0) and 111 (74%) in the permanent dentition (DMFT=0). Spearman's correlation coefficient (rs) with the Venham Picture Test was moderate (rs=0.50; p<0.01); statistically significant associations (p<0.05) was found with female gender, anxiety perceived by caregivers, use of rubber dam, current toothache, and caries experience. The qualitative study found discrepancies between the choice of FIS and the child's feelings towards DA in all age groups. The results suggest that FIS does not seem to be able to measure DA in Brazilian children.