Brazilian Version of the Dental Environment Stress Questionnaire
Cristina D. Presoto
Department of Social Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, Humaitá Street, 1680, Postcode: 14801-903 Centro, Araraquara, São Paulo State, Brazil.
Ingrid Mertens Silva
Department of Social Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, Humaitá Street, 1680, Postcode: 14801-903 Centro, Araraquara, São Paulo State, Brazil.
Danielle Wajngarten
Department of Social Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, Humaitá Street, 1680, Postcode: 14801-903 Centro, Araraquara, São Paulo State, Brazil.
Filipa Pimenta
ISPA - University Institute, Lisbon, Portugal.
Juliana A. D. B. Campos
Food and Nutrition Department, São Paulo State University (UNESP), School of Pharmaceutical Sciences, Araraquara – SP, Brazil.
Júlia M. Pazos
Department of Social Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, Humaitá Street, 1680, Postcode: 14801-903 Centro, Araraquara, São Paulo State, Brazil.
Patrícia A. S. Domingos
Department of Dentistry, University of Araraquara (UNIARA), School of Dentistry, Araraquara – SP, Brazil.
Patrícia P. N. S. Garcia *
Department of Social Dentistry, São Paulo State University (UNESP), School of Dentistry, Araraquara, Humaitá Street, 1680, Postcode: 14801-903 Centro, Araraquara, São Paulo State, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Aims: To perform cross-cultural adaptation of the Dental Environment Stress Questionnaire (DES) for use in Portuguese-speaking populations, evaluate its psychometric properties, and determine the effects of gender and educational level in the perception of stress sources in dental students.
Methodology: An observational cross-sectional study design was implemented to examine face and content validity. 466 Brazilian students participated in the study in 2015 (UNESP students response rate=79.2%; UNIARA students response rate=82.4%). Construct validity was assessed via the determination of factorial, convergent, and discriminant validity. Reliability was estimated using Cronbach's α, and composite reliability. A model was designed using structural equation modeling, to verify the effects of gender and educational level on the perception of stress sources.
Results: The complete model purposed was not a good fit to the sample (λs=0.358–0.955, ꭙ2/df=3.36, CFI=0.881, TLI=0.870, RMSEA=0.071, r=0.426–0.664, AVE=0.366–0.856). After the removal of item 12 and insertion of a correlation between the errors for items 1 and 2 (LM=399.154) and Items 14 and 16 (LM=146.216) the model fitted the sample (λs=0.411–0.955, ꭙ2/df=2.54, CFI=0.926, TLI=0.919, RMSEA=0.058, AVE=0.363–0.850). Adequate content validity ratios were observed for 23 items. Gender affected all DES factors, and educational level influenced four factors.
Conclusion: Cross-cultural adaptation process provided an instrument that was easy to understand, with adequate idiomatic and cultural equivalence. The Portuguese version of the DES showed good psychometric properties and reliability in the study sample. Gender and educational level exerted significant effects on seven and four factors, respectively.
Keywords: Stress, psychological, students, dental, validation studies