Nursing Dental Coping Belief Scale among Portuguese healthcare professionals (NDCBS-PT): validation and associated factors.

چکیده اصلی

BACKGROUND: Oral health is a critical yet frequently overlooked component of global public health, with significant implications for overall health and healthcare costs. In countries like Portugal, where public dental coverage is limited, non-dental healthcare professionals are primarily responsible for monitoring oral health. This study aimed to adapt and validate the Nursing Dental Coping Belief Scale for Portuguese healthcare professionals (NDCBS-PT) and identify factors associated with their beliefs to develop effective interventions and ensure equitable care for dependent populations. METHODS: This cross-sectional psychometric study followed a five-stage international protocol. Structural validity was tested via confirmatory factor analysis (CFA) using the weighted least squares mean and variance (WLSMV) estimator. Internal consistency and temporal stability were evaluated using ordinal alpha, McDonald's omega total (ωt), and intraclass correlation coefficients (ICC). Multivariable associations were examined using robust linear models to identify factors independently associated with NDCBS-PT scores. RESULTS: A total of 304 healthcare professionals were included (82.6% female; mean age 44.5 years). The correlated four-factor model - internal locus of control (IL), external locus of control (EL), self-efficacy (SE) and oral healthcare beliefs (OHCB) - showed the best relative fit, although fit was marginal (CFI = 0.858). Despite pronounced floor effects, total-score reliability was acceptable to good (ordinal α and ωt = 0.81). The institutional sector was the most consistent independent determinant of global scores (p = 0.004). Some non-public sectors showed more favorable global scores than the public sector. The EL domain was the most sensitive to caregiver profiles showing exploratory associations with gender (p = 0.009), area of training (p = 0.043), and age-experience interaction (p = 0.007). Although men had more favorable beliefs, this requires caution as gender invariance was not established. Regarding SE, specific oral health training was the only significant predictor (p = 0.034). Item-level diagnostics identified items 3, 4, and 24 as weak. CONCLUSION: The NDCBS-PT demonstrated sufficient reliability and preliminary structural support for the four-factor model among Portuguese healthcare professionals, though requiring further refinement. Caregivers' beliefs appear to be influenced by organizational settings and professional backgrounds. Oral-health training was linked to better self-efficacy and merits prospective testing.

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