Propriedades de medida do índice anamnésico de fonseca

• Ano de defesa: 2011
• Autor(a) principal: Pedrosa, Alexsandra de Souza
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Cidade de São Paulo; Brasil; Pós-Graduação; Programa de Pós-Graduação Mestrado em Fisioterapia; UNICID
• Palavras-chave em Português: Síndrome da disfunção da articulação temporomandibular; Questionários; Triagem; Confiabilidade e validade; Brasil; FISIOTERAPIA E TERAPIA OCUPACIONAL
• Link de acesso: https://repositorio.cruzeirodosul.edu.br/handle/123456789/1153

This master thesis aims to discuss the use of some instruments related to the evaluation and diagnosis of temporomandibular joint disorders. Temporomandibular joint disorder is a multidimensional condition. As it is not clear what would be its specific cause, it is crucial to use instruments to evaluate patients signs and symptoms that are associated with this condition. In Brazil and around the world, the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) is commonly used to obtain a specific diagnosis of temporomadibular joint disorder. However this questionnaire is very long and time consuming. On the other hand, the Fonseca’s Anamnestic Index is a screening questionnaire that requires less professional diagnostic ability with a shorter application time compared with the RDC/TMD. Therefore, Chapter 2 aimed to evaluate the measurement properties of the Fonseca's Anamnestic Index in a sample of participants with and without temporomandibular joint disorder, by using this index. We evaluated 330 undergraduate students and the study was conducted in three stages. In the stage 1, the Fonseca's Anamnestic Index was used to classify the participants in relation to the severity of signs and symptoms of temporomandibular joint disorders and to test the internal consistency of this instrument. In the second stage, the participants completed the questionnaire after 48 hours in a test-retest design to evaluate its reproducibility. Finally, in the stage 3 the RDC/TMD questionnaire was used in order to categorize the participants according to their diagnoses classification and also to performed an exploratory correlation analysis to test the correlation among the Fonseca’s Anamnestic Index and eight questions of the Axis II of the RDC/TMD. The stage 3 was performed with a maximum five days interval after the first application of the Fonseca’s Anamnestic Index. The Fonseca’s anamnestic index showed adequate internal consistency with a Cronbach's alpha index of 0.80 (Cronbach’s alpha if item deleted range= 0.75–0.80). Excellent reliability (Intraclass Correlation Coefficient: 0.93; 95% Confidence Interval: 0.97 to 0.94) and good agreement estimates (Standard Error of Measurement = 6.08 points) were found. The exploratory correlation analysis showed weak and moderate statistically significant correlation (r=0.27 and 0.45) among the Fonseca’s anamnestic index and questions 11 and 19 measured by the Axis II of the RDC/TMD, respectively. For the other questions, a correlation was not found. Concluding, it is important to have an instrument in Brazilian-Portuguese language with adequate measurement properties to be used in high quality studies in the field of tempomandibular joint disorders. The Fonseca’s anamnestic proved to be an easy instrument to use and can be useful for screening patients with temporomandibular joint disorders as it presented appropriated measurement properties. This index can be used for screening patients with temporomandibular joint dysfunction, as it presented appropriate measurement properties, especially considering the internal consistency and reproducibility. However, the assessment of the construct validity was hampered by the lack of similar instruments in Brazilian Portuguese language. We suggest that further studies should be carry out to test the diagnostic accuracy of the Fonseca’s Anamnestic Index in order to perform large epidemiological studies for a better understanding of the epidemiology of the temporomadibular joint disorders in Brazil.