Validação e análise de confiabilidade de um instrumento de qualidade de higiene bucal do paciente crítico

Abstract

In the Intensive Care Center (ICU) setting, pneumonia is one of the main infections in patients. This may be associated with the bacterial composition of the dental biofilm, which accumulates in the oral cavity due to neglected oral hygiene, favoring or aggravating the occurrence of pneumonia during hospitalization. Therefore, it is relevant that in the hospital routine there are indices that ascertain the quality of oral hygiene of patients and are able to cover all patients efficiently at the time of hospitalization. The aim of this study was to validate an instrument and indicators for evaluating the Critical Patient Oral Hygiene Index (IHO-PC). The indicators present in the index both determine and determine the quality of oral hygiene, considering the presence of retention factors that hinder the performance and proper maintenance of oral hygiene. Following the standards of the content validation strategy, this research comprised the judgment of the IHO-PC Operational Indicators Manual and the index by experts, assessment of the instrument's indicator structure and measurement of each item contained in the index separately. Subsequently, a pilot study was performed, followed by the application of the instrument in an Adult Intensive Care Center in patients under mechanical ventilation. The data obtained after the analytical statistical analysis showed both the validity and reliability of the indicators, with reformulation of these and the IHO-PC, which now has five items. The content and reliability validation strategy legitimized the five indicators as well as the IHO-PC after changes, indicating that these same indicators: presence of plaque / biofilm, gingivitis, siding, presence of secretion / crust, presence of food remains have consistency for the measurement of a given domain / concept. Regarding the reliability analysis of the instrument (internal consistency), Cronbach's alpha obtained in all evaluations (α = 0.70) was considered good, showing that the present indicators are directed to measure the quality of oral hygiene. Based on the results obtained in this study, both validation and reliability analysis, we believe in the improvement and proposition of new possibilities in hospital dentistry care, because the results from the application of a valid and reliable instrument are important quality markers, subsidizing better adjustments, promoting the quality of care.