Document Type : Original Article
Authors
- . Patrícia Petromilli Nordi Sasso Garcia
- . Danielle Wajngarten
- . Juliana Alvares Duarte Bonini Campos
Abstract
CONTEXT: The ergonomic posture protocol is extremely important for the maintenance of
occupational health in dentistry. The lack of compliance with this protocol results in a high risk of
developing musculoskeletal disorders.
AIMS: This study developed a direct observation method for the evaluation of dental student
compliance with ergonomic posture protocol.
SUBJECTS AND METHODS: The method is named compliance assessment of dental ergonomic
posture requirements (CADEP). During the development of the method, 14 items were elaborated
considering the theory of dental ergonomics. Each item should be classified as appropriate, partially
appropriate, or inappropriate. After evaluation, all item values should be added, and the final score
expressed as the percent of compliance with correct postures, with a score range of 0%–100%.
STATISTICAL ANALYSIS USED: The reliability of CADEP was assessed through intra‑ and
interobserver reproducibility. For the CADEP application, 73 senior year students from the
undergraduate course in dentistry were evaluated. The intra‑ and interexaminer concordance
was estimated using the intraclass correlation coefficient (ρ). A descriptive statistical analysis was
performed.
RESULTS: The reproducibility of evaluator 1 (ρ =0.90; confidence interval [CI] 95%: 0.83–0.94),
evaluator 2 (ρ = 0.83; CI 95%: 0.70–0.90), the interexaminer in the first evaluation (ρ = 0.81; CI
95%:0.67–0.89), and in the second one (ρ = 0.76; CI 95%: 0.59–0.87) was classified as good. In the
analysis of the compliance, it was verified that moderate compliance was the most prevalent among
the evaluated students (65.6%, CI 95%: 60.3%–70.7%).
CONCLUSIONS: CADEP was valid and reliable for the assessment of dentistry students’ compliance
regarding ergonomic posture requirements.
Keywords
- Efstathiou G, Papastavrou E, Raftopoulos V, Merkouris A. Factors
influencing nurses’ compliance with standard precautions in
order to avoid occupational exposure to microorganisms: A focus
group study. BMC Nurs 2011;10:1.
2. McKay CD, Verhagen E. ‘Compliance’ versus ‘adherence’ in
sport injury prevention: Why definition matters. Br J Sports Med
2016;50:382‑3.
3. Arai A, Tanabe M, Nakamura A, Yamasaki D, Muraki Y,
Kaneko T, et al. Utility of electronic hand hygiene counting
devices for measuring physicians’ hand hygiene adherence
applied to outpatient settings. Am J Infect Control
2016;44:1481‑5.
4. Garcia PP, Gottardello AC, Presoto CD, Campos JA. Ergonomic
work posture in undergraduate dentistry students: Correlation
between theory and practice. J Educ Eth Dent 2015;5:47‑50.
5. Offner D, Strub M, Rebert C, Musset AM. Evaluation of an ethical
method aimed at improving hygiene rules compliance in dental
practice. Am J Infect Control 2016;44:666‑70.
6. Anders PL, Townsend NE, Davis EL, McCall WD Jr. Observed
infection control compliance in a dental school: A natural
experiment. Am J Infect Control 2016;44:e153‑6.
7. Garcia PP, Gottardello AC, Wajngarten D, Presoto CD,
Campos JA. Ergonomics in dentistry: Experiences of the practice
by dental students. Eur J Dent Educ 2017;21:175‑9.
8. Garcia PP, Campos JA, Pinelli C, Derceli JR. Musculoskeletal
disorders in upper limbs of undergraduate dental students. Braz
J Oral Sci 2012;11:148‑53.
9. Corrocher PA, Presoto CD, Campos JA, Garcia PP. The association
between restorative pre‑clinical activities and musculoskeletal
disorders. Eur J Dent Educ 2014;18:142‑6.
10. Biswas R, Sachdev V, Jindal V, Ralhan S. Musculoskeletal
disorders and ergonomic risk factors in dental practice. Indian J
Dent Sci 2012;4:70‑4.
11. Presoto CD, Garcia PP. Risk factors for the development of
musculoskeletal disorders in dental work. Br J Educ Soc Behav
Sci 2016;15:1‑6.
12. Kirshner B, Guyatt G. A methodological framework for assessing
health indices. J Chronic Dis 1985;38:27‑36.
13. Porto FA. The Dental Office. São Carlos: Scritti; 1994.
14. Lawshe CH. A quantitative approach to content validity. Pers
Psychol 1975;28:563‑75.
15. Wilson FR, Pan W, Schumsky DA. Recalculation of the critical
values for lawshe’s content validity ratio. Meas Eval Couns Dev
2012;16:1‑14.
16. Gandavadi A, Ramsay JR, Burke FJ. Assessment of dental student
posture in two seating conditions using RULA methodology – A
pilot study. Br Dent J 2007;203:601‑5.
17. Fermanian J. Measure de I’accord entre deux juges: Cas
quantitative. Rev Epidemiol Sante Publique 1984;32:408‑13.
18. Cherniack MG, DussetschlegerJ, Bjor B. Musculoskeletal disease
and disability in dentists. Work 2010;35:411‑8.
19. Rising DW, Bennett BC, Hursh K, Plesh O. Reports of body pain
in a dental student population. J Am Dent Assoc 2005;136:81‑6.
20. Diaz‑Caballero AJ, Gómez‑Palencia IP, Díaz‑Cárdenas S.
Ergonomic factors that cause the presence of pain muscle
in students of dentistry. Med Oral Patol Oral Cir Bucal
2010;15:e906‑11.
21. Valachi B, Valachi K. Preventing musculoskeletal disorders
in clinical dentistry: Strategies to address the mechanisms
leading to musculoskeletal disorders. J Am Dent Assoc
2003;134:1604‑12. - 22. Valachi B, Valachi K. Mechanisms leading to musculoskeletal
disorders in dentistry. J Am Dent Assoc 2003;134:1344‑50.
23. Kimberlin CL, Winterstein AG. Validity and reliability
of measurement instruments used in research. Am J
Health Syst Pharm 2008;65:2276‑84.
24. Garbin AJ, Garbin CA, Diniz DG, Yarid SD. Dental students’
knowledge of ergonomic postural requirements and their
application during clinical care. Eur J Dent Educ 2011;15:31‑5.
)