Dental Management Survey Brazil (DMS-BR): creation and validation of a management instrument

Abstract Questionnaires for the assessment of knowledge and self-perception can be useful to diagnose what a dentist knows about management and administration. The aim of the present study was to create and validate the Dental Management Survey Brazil (DMS-BR) scale, based on meetings with experts in the field. After having elaborated the first version, 10 audits were performed in dental offices in order to produce the final version, which included nine dimensions: location, patient, finance, marketing, competition, quality, staff, career, and productivity. The accuracy of the instrument was measured by intrarater and interrater reliability. In the validation phase, 247 Brazilian dentists answered a web-based questionnaire. The data were processed using Stata 13.0 and the significance level was set at 95%. The instrument had intrarater and interrater reliability (ICC-0.93 and 0.94). The overall average of respondents for the DMS-BR scale was 3.77 (SD = 0.45). Skewness and kurtosis were below absolute values 3 and 7, respectively. Internal validity measured by Cronbach’s alpha was 0.925 and the correlation of each dimension with the final result of the DMS-BR ranged between 0.606 and 0.810. Correlation with the job satisfaction scale was 0.661. The SEM data ranged between 0.80 and 0.56. The questionnaire presented satisfactory indicators of dentists’ self-perception about management and administration activities.用于评估知识与自我认知的抽象问卷，可用于辅助诊断牙医在管理与行政领域的认知水平。本研究旨在结合该领域专家研讨成果，编制并验证巴西牙科管理调查问卷（Dental Management Survey Brazil, DMS-BR）量表。初稿编制完成后，研究团队在牙科诊所开展了10项稽核工作，最终形成正式版本，该版本包含9个维度：诊疗布局、患者管理、财务管理、市场营销、竞争态势、服务质量、员工队伍、职业发展与运营效率。采用评定者内信度与评定者间信度对该测评工具的准确性进行检验。验证阶段共有247名巴西牙医完成了网络版问卷调研。数据采用Stata 13.0统计软件进行处理，显著性水平设定为95%。该量表的评定者内信度与评定者间信度分别为组内相关系数（Intraclass Correlation Coefficient, ICC）0.93与0.94。巴西牙科管理调查问卷的受访者总体平均得分为3.77（标准差SD=0.45）。偏度与峰度值均分别低于绝对阈值3与7。采用克朗巴哈α系数（Cronbach's Alpha）检验得到的内部效度为0.925，各维度与量表总分的相关系数介于0.606至0.810之间。该量表与工作满意度量表的相关系数为0.661。结构方程模型（Structural Equation Modeling, SEM）的拟合指标介于0.80至0.56之间。本问卷在牙医对自身管理与行政活动的自我认知测评中展现出良好的指标表现。