A validated instrument to assess dentists’ knowledge about diabetes

the dental-diabetes questionnaire





Diabetes mellitus, Dentists, Knowledge, Validation studies as topic


Aim: To elaborate and validate an instrument for Brazilian Portuguese speakers, to assess dentists’ knowledge about care of patients with diabetes mellitus (Dental-Diabetes). Methods: Methodological study comprising four stages: a) Elaboration of instrument; b) Content validation (computing Content Validity Index - CVI) based on Expert Committee assessment; c) Pre-test with 30 dentists, followed by assessment of suggestions by Expert Committee; d) Psychometric validation through instrument application in a sample of 127 dentists by means of the web tool e-Surv. Cronbach’s alpha and intraclass correlation coefficients were used to evaluate, respectively, internal consistency and reproducibility. Results: The final version of the instrument consists of 22 questions (7 on sociodemographic data and 15 querying dentists’ knowledge) and those submitted for validation attained a CVI of 0.95 [95% CI 0.916-0,981], showing satisfactory internal consistency, with 0.794 Cronbach’s alpha [95% CI 0.741-0.842] and an intraclass correlation coefficient of 0.799 [95% CI: 0.746-0.846] between the test and retest scores. Conclusions: Dental-Diabetes is a comprehensive instrument, culturally adequate and validated to assess dentists’ knowledge about care of patients with diabetes.


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Author Biographies

Margarete Aparecida Gonçalves Melo Guimarães, Santa Casa of Belo Horizonte College

Santa Casa of Belo Horizonte College, Belo Horizonte, MG, Brazil.

Amanda Augusto de Oliveira Prates, Santa Casa of Belo Horizonte College

Santa Casa of Belo Horizonte College, Belo Horizonte, MG, Brazil.

Vladimir Reimar Augusto de Souza Noronha, Newton Paiva University Center

Newton Paiva University Center, Belo Horizonte, MG, Brazil.

Adriana Pagano, Federal University of Minas Gerais

Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Aleida Nazareth Soares, Santa Casa of Belo Horizonte College

Santa Casa of Belo Horizonte College, Belo Horizonte, MG, Brazil.

Janice Sepúlveda Reis, Federal University of Minas Gerais

Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.


Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019 Nov;157:107843. doi: 10.1016/j.diabres.2019.107843. DOI: https://doi.org/10.1016/j.diabres.2019.107843

Brazilian Diabetes Society. [Guidelines of the Brazilian Diabetes Society 2019-2020]. São Paulo: Clannad; 2019 [cited 2021 Feb 22]. 289 p. Available from: https://www.diabetes.org.br/profissionais/images/DIRETRIZES-COMPLETA-2019-2020.pdf. Portuguese.

Indurkar MS, Maurya AS, Indurkar S. Oral manifestations of diabetes. Clin Diabetes. 2016 Jan;34(1):54-7. doi: 10.2337/diaclin.34.1.54. DOI: https://doi.org/10.2337/diaclin.34.1.54

Kudiyirickal MG, Pappachan JM. Diabetes mellitus and oral health. Endocrine. 2015 May;49(1):27-34. doi: 10.1007/s12020-014-0496-3. DOI: https://doi.org/10.1007/s12020-014-0496-3

Brazil, Ministry of Health of Brazil, Notebooks for Basic Care. [Strategies for care of the person with chronic disease: diabetes mellitus]. Brasília: Ministry of Health; 2014. p.138-41. Portuguese.

Mauri-Obradors E, Estrugo-Devesa A, Jané-Salas E, Viñas M, López-López J. Oral manifestations of Diabetes Mellitus. A systematic review. Med Oral Patol Oral Cir Bucal. 2017 Sep;22(5):e586-e594. doi: 10.4317/medoral.21655. DOI: https://doi.org/10.4317/medoral.21655

Nazir MA, AlGhamdi L, AlKadi M, AlBeajan N, AlRashoudi L, AlHussan M. The burden of diabetes, its oral complications and their prevention and management. Open Access Maced J Med Sci. 2018 Aug;6(8):1545-53. doi: 10.3889/oamjms.2018.294. DOI: https://doi.org/10.3889/oamjms.2018.294

Brazil, Ministry of Health of Brazil. [Oral health]. (Series A. Standards and Technical Manuals - Basic Care Notebooks; 17). Brasília: Ministry of Health; 2008 [cited 2021 Feb 25]. 92p. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/saude_bucal.pdf. Portuguese.

Beagley J, Guariguata L, Weil C, Motala AA. Global estimates of undiagnosed diabetes in adults. Diabetes Res Clin Pract. 2014 Feb;103(2):150-60. doi: 10.1016/j.diabres.2013.11.001. DOI: https://doi.org/10.1016/j.diabres.2013.11.001

Pilatti LA, Pedroso B, Gutierrez GL. [Psychometric Properties of Assessment Instruments: A Necessary Debate]. RBECT. 2010;3(1):81-91. Portuguese. doi: 10.3895/S1982-873X2010000100005. DOI: https://doi.org/10.3895/S1982-873X2010000100005

Pasquali L. [Psychometrics]. Rev Esc Enferm USP. 2009;43(spe):992–9. Portuguese. DOI: https://doi.org/10.1590/S0080-62342009000500002

Leite SS, Áfio ACE, Carvalho LV, Silva JM, Almeida PC, Pagliuca LMF. [Construction and validation of an Educational Content Validation Instrument in Health]. Reben. 2018;71(suppl 4):1635–41. Portuguese. doi: 10.1590/0034-7167-2017-0648. DOI: https://doi.org/10.1590/0034-7167-2017-0648

Fernandes BSM, Reis IA, Pagano AS, Cecilio SG, Torres HC. [Development, validation and cultural adaptation of the COMPASSO protocol: Adherence to self-care in diabetes]. Acta Paul Enferm. 2016;29(4):421–9. Portuguese. doi: 10.1590/1982-0194201600058. DOI: https://doi.org/10.1590/1982-0194201600058

Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health. 2007 Aug;30(4):459-67. doi: 10.1002/nur.20199. DOI: https://doi.org/10.1002/nur.20199

Borsa JC, Damásio BF, Bandeira DR. [Cross-cultural adaptation and validation of psychological instruments: some considerations]. Paidéia (Ribeirão Preto). 2012 Dec;22(53):423–32. Portuguese. doi: 10.1590/S0103-863X2012000300014. DOI: https://doi.org/10.1590/S0103-863X2012000300014

Coluci MZO, Alexandre NMC, Milani D. [Construction of measurement instruments in the area of health]. Cien Saude Colet. 2015 Mar;20(3):925-36. Portuguese. doi: 10.1590/1413-81232015203.04332013. DOI: https://doi.org/10.1590/1413-81232015203.04332013

Souza AC, Alexandre NMC, Guirardello EB. Psychometric properties in instruments evaluation of reliability and validity. Epidemiol Serv Saude. 2017 Jul-Sep;26(3):649-659. doi: 10.5123/S1679-49742017000300022. DOI: https://doi.org/10.5123/S1679-49742017000300022

Alexandre NM, Coluci MZ. Validade de conteúdo nos processos de construção e adaptação de instrumentos de medidas [Content validity in the development and adaptation processes of measurement instruments]. Cien Saude Colet. 2011 Jul;16(7):3061-8. Portuguese. doi: 10.1590/s1413-81232011000800006. DOI: https://doi.org/10.1590/S1413-81232011000800006

Terra BG, Goulart RR, Bavaresco CS. [Dental care for patients with type 1 and 2 diabetes mellitus in primary health care]. Rev APS. 2011;14(2):149–61. Portuguese.

Tavares GR, Lima AL, Tavares SSS, Castro RD, Padilha WW. [Multiprofessional boarding to the carrying patient of diabetes in dentistry attendance]. Rev Flum Odontol. 2010; 16(33):52-59. Portuguese.

Martins GA. [About reliability and validity]. RBGN. 2006;8(20):1-12. Portuguese.

Braga CG, da Cruz DA. Contribuições da psicometria para a avaliação de respostas psicossociais na enfermagem [Psychometric contributions to the assessment of psychosocial responses in nursing]. Rev Esc Enferm USP. 2006 Mar;40(1):98-104. Portuguese. doi: 10.1590/s0080-62342006000100014. DOI: https://doi.org/10.1590/S0080-62342006000100014

Keszei AP, Novak M, Streiner DL. Introduction to health measurement scales. J Psychosom Res. 2010 Apr;68(4):319-23. doi: 10.1016/j.jpsychores.2010.01.006. DOI: https://doi.org/10.1016/j.jpsychores.2010.01.006

Torres H de C, Chaves FF, Silva DDR da, Bosco AA, Gabriel BD, Reis IA, et al. [Translation, adaptation and validation the contents of the Diabetes Medical Management Plan for the Brazilian context]. Rev Latino-Am Enfermagem. 2016; 24:e2740. DOI: 10.1590/1518-8345.1138.2740. Portuguese. DOI: https://doi.org/10.1590/1518-8345.1138.2740

Walter OM. [Analysis of free tools for conducting online surveys]. Produto & Produção. 2013;14(2):44-58. Portuguese. doi: 10.22456/1983-8026.22172. DOI: https://doi.org/10.22456/1983-8026.22172

Medeiros RK, Ferreira Júnior M, Pinto D, Vitor A, Santos V, Barichello E. [Pasquali’s model of content validation in the Nursing researches]. Rev Enf Ref. 2015;4(4):123-31. Portuguese. doi: 10.12707/RIV14009. DOI: https://doi.org/10.12707/RIV14009

Diniz KKS, Pagano AS, Fernandes APPC, Reis IA, Pinheiro Júnior LG, Torres HC. Development and validation of an instrument to assess Brazilian healthcare professional providers' knowledge on sickle cell disease. Hematol Transfus Cell Ther. 2019 Apr-Jun;41(2):145-52. doi: 10.1016/j.htct.2018.08.003. DOI: https://doi.org/10.1016/j.htct.2018.08.003

Silva TON, Alves LBO, Balieiro MMFG, Mandetta MA, Tanner A, Shields L. [Cross-cultural adaptation of an instrument to measure the family-centered care]. Acta Paul Enferm. 2015 april;28(2):107–12. Portuguese. DOI: https://doi.org/10.1590/1982-0194201500019

Maroco J, Garcia-Marques T. [How reliable is Cronbach's alpha? Old issues and modern solutions?] Lab Psicol. 2006;4(1):65–90. Portuguese. doi: 10.14417/lp.763. DOI: https://doi.org/10.14417/lp.763

Streiner DL. Being inconsistent about consistency: when coefficient alpha does and doesn't matter. J Pers Assess. 2003 Jun;80(3):217-22. doi: 10.1207/S15327752JPA8003_01. DOI: https://doi.org/10.1207/S15327752JPA8003_01

Leal DL, Werneck MAF, Borges-Oliveira AC. [Validation of the oral health version of the Instrument for Diagnosis of the Developmental Stage of the Healthcare Network]. Rev Pan-Amaz Saude. 2017;8(4):65-75. doi: 10.5123/s2176-62232017000400011. Spanish. DOI: https://doi.org/10.5123/S2176-62232017000400011

Vituri DW, Évora YDM. Reliability of indicators of nursing care quality: testing interexaminer agreement and reliability. Rev Latino-Am Enfermagem. 2014;22(2):234–40. DOI: https://doi.org/10.1590/0104-1169.3262.2407

Frost MH, Reeve BB, Liepa AM, Stauffer JW, Hays RD. What is sufficient evidence for the reliability and validity of patient-reported outcome measures? Value Health. 2007;10 Suppl 2:S94-S105. doi: 10.1111/j.1524-4733.2007.00272.x. DOI: https://doi.org/10.1111/j.1524-4733.2007.00272.x

Fayers P, Machin D. Quality of life: the assessment, analysis and interpretation of patient-reported outcomes. 2 ed. Chichester: John Wiley & Sons; 2007. 544 p.

DeVon HA, Block ME, Moyle-Wright P, Ernst DM, Hayden SJ, Lazzara DJ et al. A psychometric toolbox for testing validity and reliability. J Nurs Scholarsh. 2007;39(2):155-64. doi: 10.1111/j.1547-5069.2007.00161.x. DOI: https://doi.org/10.1111/j.1547-5069.2007.00161.x

Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007 Jan;60(1):34-42. doi: 10.1016/j.jclinepi.2006.03.012. DOI: https://doi.org/10.1016/j.jclinepi.2006.03.012

Valim MD, Marziale MH, Hayashida M, Rocha FL, Santos JL. Validity and reliability of the Questionnaire for Compliance with Standard Precaution. Rev Saude Publica. 2015;49:87. doi: 10.1590/S0034-8910.2015049005975. DOI: https://doi.org/10.1590/S0034-8910.2015049005975




How to Cite

Guimarães MAGM, Prates AA de O, Noronha VRA de S, Pagano A, Soares AN, Reis JS. A validated instrument to assess dentists’ knowledge about diabetes: the dental-diabetes questionnaire . Braz. J. Oral Sci. [Internet]. 2022 Mar. 23 [cited 2022 Aug. 13];21(00):e225337. Available from: https://periodicos.sbu.unicamp.br/ojs/index.php/bjos/article/view/8665337



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