RESUMO
Abstract Introduction: The evaluation of surgical outcomes measured by patient satisfaction or quality of life is very important, especially in plastic surgery. There is increasing interest in self-reporting outcomes evaluation in plastic surgery. Objective: The aim of this study was to perform the translation, cross-cultural adaptation and validation of "The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty" from English to Portuguese. Methods: Retrospective study involving 50 patients undergoing to rhinoplasty comparing the preoperative period with the current postoperative situation (minimum 6 months and maximum 24 months postoperatively). Statistical analysis was performed to assess internal consistency, test-retest reliability, validity and responsiveness. Results: No patients received a negative score on the visual analogue scale comparing preoperative and postoperative appearance. The postoperative improvement on the visual analogue scale revealed a Gaussian curve of normal distribution with a mean improvement of 4.44 points. The test-retest reliability showed a positive correlation between the postoperative response and the same questionnaire repeated ninety-six hours later. The internal consistency was high (Cronbach's alpha value: Preoperative = 0.88; Postoperative = 0.86). The authors observed a significant improvement in response for all individual questions in the postoperative phase as compared with preoperative situation (t-student test - p < 0.05). Conclusion: The Portuguese version of "The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty" is a valid instrument to assess patients' outcomes following rhinoplasty surgery.
Resumo Introdução: A avaliação do resultado cirúrgico medido pela satisfação do paciente ou qualidade de vida é muito importante, especialmente na cirurgia plástica, uma especialidade na qual há um crescente interesse na avaliação de resultados por auto‐relato. Objetivo: O objetivo deste estudo foi realizar a tradução, a adaptação transcultural e a validação do questionário "The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty", do inglês para português. Método: Estudo retrospectivo envolvendo 50 pacientes submetidos a rinoplastia comparando o período pré‐operatório com a situação atual (mínimo de 6 meses e máximo de 24 meses de pós‐operatório). A análise estatística foi realizada para avaliar a consistência interna, confiabilidade teste‐reteste, validade e capacidade de resposta. Resultados: Nenhum paciente recebeu pontuação negativa na escala visual analógica ao comparar a aparência pré‐ e pós‐operatória. A melhora pós‐operatória na escala visual analógica revelou uma curva gaussiana de distribuição normal, com melhora média de 4,44 pontos. A confiabilidade teste‐reteste mostrou uma correlação positiva entre a resposta pós‐operatória e o mesmo questionário repetido noventa e seis horas depois. A consistência interna foi alta (valor do alfa de Cronbach: pré‐operatório = 0,88; pós‐operatório = 0,86). Os autores observaram uma melhora significante nas respostas para todas as questões individuais na fase pós‐operatória em comparação com a situação pré‐operatória (teste t de Student - p < 0,05). Conclusão: A versão em português do "The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty" é um instrumento válido para avaliar os resultados do paciente após a cirurgia de rinoplastia.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Rinoplastia/psicologia , Traduções , Autorrelato/normas , Portugal , Período Pós-Operatório , Qualidade de Vida/psicologia , Comparação Transcultural , Reprodutibilidade dos Testes , Estudos Retrospectivos , Satisfação do Paciente , Período Pré-Operatório , Escala Visual AnalógicaRESUMO
Abstract Introduction: Following nasal hump removal during septorhinoplasty, the middle vault should be reconstructed to avoid functional and esthetic problems. Middle vault reconstruction, however, may result in widening of the middle vault and may need a camouflage graft to cover dorsal irregularities. Objective: To present the results of reconstructing the middle vault with a technique that covers the nasal dorsum with upper lateral cartilage, from the viewpoint of patient satisfaction. Methods: Retrospective study of patients who underwent septorhinoplasty that included nasal dorsum closure with upper lateral cartilage from December 1, 2014 to January 31, 2016. Those with postoperative follow-up of less than 3 months were excluded. The final study group included 39 patients. The same surgeon performed all septorhinoplasties. The dorsum was closed using an "upper lateral closing" technique that approximated upper lateral cartilages to each other over the septum. Postoperative patient satisfaction was determined using a visual analog scale and the rhinoplasty outcomes evaluation questionnaire. The questionnaire evaluates patient esthetic and functional satisfaction with the operated nose. High scores indicate improved esthetic results. Results: No dorsal irregularities were seen at postoperative follow-up evaluation of the patients. For esthetic nasal appearance, the median visual analogue scale scores was 86%, and the mean for the questionnaire was 77.03%. Conclusion: The natural dome-shaped anatomy of the nasal dorsum was achieved by approximating the upper lateral cartilages to each other. Closing the dorsum with this technique also covers any dorsal irregularities and results in a smooth dorsum. Patients expressed satisfaction with the esthetic and functional aspects of the smooth, attractive nasal dorsum.
Resumo Introdução: Após a remoção da giba nasal durante a rinosseptoplastia, a abóbada deve ser reconstruída para evitar problemas funcionais e estéticos. A reconstrução da abóboda entretanto, pode resultar em alargamento dorsal e pode necessitar de um enxerto para camuflar irregularidades dorsais. Objetivo: Avaliar a satisfação dos pacientes com os resultados da reconstrução da abóboda com uma técnica que utiliza a cartilagem lateral superior para recobrir o dorso nasal. Método: Estudo retrospectivo de pacientes submetidos a rinosseptoplastia, que incluiu fechamento do dorso nasal com cartilagem lateral superior, realizado de 1º de dezembro de 2014 a 31 de janeiro de 2016. Foram excluídos aqueles com acompanhamento pós-operatório de menos de 3 meses. O grupo final do estudo incluiu 39 pacientes. O mesmo cirurgião realizou todas as rinosseptoplastias. O dorso foi fechado com uma técnica de "fechamento lateral superior" que aproxima as cartilagens laterais superiores de cada lado sobre o septo. A satisfação pós-operatória dos pacientes foi determinada através de uma escala visual analógica e o questionário Rhinoplasty Outcomes Evaluation. O questionário avalia a satisfação estética e funcional do paciente com o nariz. Escores altos indicam percepção de melhoria estética. Resultados: Não foram observadas irregularidades dorsais na avaliação pós-operatória de seguimento dos pacientes. Em relação à aparência nasal estética, o escore médio da escala visual analógica foi 86% e o escore médio do questionário foi 77,03%. Conclusões: A anatomia natural em forma de domo do dorso nasal foi conseguida através da aproximação das cartilagens laterais superiores entre si. O fechamento do dorso com essa técnica também abrange todas as irregularidades dorsais e resulta em um dorso liso. Os pacientes expressaram satisfação com os aspectos estéticos e funcionais do dorso nasal liso e atraente.
Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Rinoplastia/métodos , Satisfação do Paciente , Estética , Cartilagens Nasais/cirurgia , Septo Nasal/cirurgia , Período Pós-Operatório , Rinoplastia/psicologia , Inquéritos e Questionários , Reprodutibilidade dos Testes , Estudos Retrospectivos , Técnicas de Sutura , Resultado do Tratamento , Estatísticas não Paramétricas , Escala Visual AnalógicaRESUMO
BACKGROUND: Rhinoplasty is one of the most sought-after procedures in plastic surgery by individuals with body dysmorphic disorder (BDD). The identification of BDD symptoms is a challenge for plastic surgeons. The purpose of this study was to use a specific instrument for detection of BDD symptoms as a screening tool in rhinoplasty candidates and estimate the prevalence and severity of BDD symptoms in this population. METHODS: Eighty patients of both sexes seeking rhinoplasty were consecutively recruited at a plastic surgery outpatient clinic of a university hospital from February 2014 to March 2015. In a clinical interview, 50 of them showed an excessive preoccupation with physical appearance associated with clinically significant subjective distress and were, therefore, selected to participate in the study. All participants were assessed using the Brazilian-Portuguese versions of the Yale-Brown Obsessive Compulsive Scale modified for BDD (BDD-YBOCS) and the Body Dysmorphic Symptoms Scale (BDSS), which can be applied by plastic surgeons, who are laypersons in psychology/psychiatry. RESULTS: Twenty-four (48%, 24/50) candidates had BDD symptoms, and 27 (54%, 27/50) showed moderate to severe appearance-related obsessive-compulsive symptoms. A strong correlation was found between the BDSS and BDD-YBOCS scores (r = 0.841, P < 0.001), and a strong agreement was observed between the BDSS cutoff point and body dysmorphic disorder symptom status (kappa = 0.822). CONCLUSIONS: A high prevalence of BDD and moderate to severe appearance-related obsessive-compulsive symptoms was found among aesthetic rhinoplasty candidates. The BDSS may be used as a screening tool for BDD symptoms in plastic surgery patients. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Assuntos
Transtornos Dismórficos Corporais/epidemiologia , Imagem Corporal/psicologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Psicometria/métodos , Rinoplastia/métodos , Adulto , Distribuição por Idade , Transtornos Dismórficos Corporais/diagnóstico , Brasil/epidemiologia , Estudos de Coortes , Comorbidade , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/diagnóstico , Seleção de Pacientes , Prevalência , Estudos Retrospectivos , Rinoplastia/psicologia , Rinoplastia/estatística & dados numéricos , Distribuição por SexoRESUMO
INTRODUCTION: The evaluation of surgical outcomes measured by patient satisfaction or quality of life is very important, especially in plastic surgery. There is increasing interest in self-reporting outcomes evaluation in plastic surgery. OBJECTIVE: The aim of this study was to perform the translation, cross-cultural adaptation and validation of "The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty" from English to Portuguese. METHODS: Retrospective study involving 50 patients undergoing to rhinoplasty comparing the preoperative period with the current postoperative situation (minimum 6 months and maximum 24 months postoperatively). Statistical analysis was performed to assess internal consistency, test-retest reliability, validity and responsiveness. RESULTS: No patients received a negative score on the visual analogue scale comparing preoperative and postoperative appearance. The postoperative improvement on the visual analogue scale revealed a Gaussian curve of normal distribution with a mean improvement of 4.44 points. The test-retest reliability showed a positive correlation between the postoperative response and the same questionnaire repeated ninety-six hours later. The internal consistency was high (Cronbach's alpha value: Preoperative=0.88; Postoperative=0.86). The authors observed a significant improvement in response for all individual questions in the postoperative phase as compared with preoperative situation (t-student test - p<0.05). CONCLUSION: The Portuguese version of "The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty" is a valid instrument to assess patients' outcomes following rhinoplasty surgery.
Assuntos
Rinoplastia/psicologia , Autorrelato/normas , Traduções , Adulto , Comparação Transcultural , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Portugal , Período Pós-Operatório , Período Pré-Operatório , Qualidade de Vida/psicologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Escala Visual Analógica , Adulto JovemRESUMO
INTRODUCTION: Following nasal hump removal during septorhinoplasty, the middle vault should be reconstructed to avoid functional and esthetic problems. Middle vault reconstruction, however, may result in widening of the middle vault and may need a camouflage graft to cover dorsal irregularities. OBJECTIVE: To present the results of reconstructing the middle vault with a technique that covers the nasal dorsum with upper lateral cartilage, from the viewpoint of patient satisfaction. METHODS: Retrospective study of patients who underwent septorhinoplasty that included nasal dorsum closure with upper lateral cartilage from December 1, 2014 to January 31, 2016. Those with postoperative follow-up of less than 3 months were excluded. The final study group included 39 patients. The same surgeon performed all septorhinoplasties. The dorsum was closed using an "upper lateral closing" technique that approximated upper lateral cartilages to each other over the septum. Postoperative patient satisfaction was determined using a visual analog scale and the rhinoplasty outcomes evaluation questionnaire. The questionnaire evaluates patient esthetic and functional satisfaction with the operated nose. High scores indicate improved esthetic results. RESULTS: No dorsal irregularities were seen at postoperative follow-up evaluation of the patients. For esthetic nasal appearance, the median visual analogue scale scores was 86%, and the mean for the questionnaire was 77.03%. CONCLUSION: The natural dome-shaped anatomy of the nasal dorsum was achieved by approximating the upper lateral cartilages to each other. Closing the dorsum with this technique also covers any dorsal irregularities and results in a smooth dorsum. Patients expressed satisfaction with the esthetic and functional aspects of the smooth, attractive nasal dorsum.
Assuntos
Estética , Cartilagens Nasais/cirurgia , Septo Nasal/cirurgia , Satisfação do Paciente , Rinoplastia/métodos , Adulto , Feminino , Humanos , Masculino , Período Pós-Operatório , Reprodutibilidade dos Testes , Estudos Retrospectivos , Rinoplastia/psicologia , Estatísticas não Paramétricas , Inquéritos e Questionários , Técnicas de Sutura , Resultado do Tratamento , Escala Visual Analógica , Adulto JovemRESUMO
Abstract Introduction: Approximately 5-15% of patients submitted to rhinoplasty operations undergo revision surgery. Those patients have varied functional and aesthetic complaints that should receive a detailed assessment that includes all the expectations the patient had before the previous procedure. Objective: To draw the profile of the main aesthetic-functional complaints reported by patients to be submitted to revision rhinoplasty and to correlate them with the internal and external objective nasal evaluation performed by the surgeon. Methods: A prospective study was conducted with 43 patients to be submitted to revision rhinoplasty and their respective surgeons, by applying a questionnaire about the patients' epidemiological questions and subjective aesthetic-functional complaints as well as the respective functional deformities observed by the surgeons. Subsequently, these data were correlated with the purpose of observing the frequency of congruent reports between physicians and patients. Results: The presence of drooping tip and residual bridge hump were the patients' main complaints, confirmed by the surgeons. The correlation between subjective obstructive symptoms and the intranasal evaluation performed by surgeons was shown to be present in 87.5% of the cases. Among the patients with respiratory symptoms, the main deformity identified was residual septal deviation in 56.25% of the cases. Conclusion: The drooping tip followed by residual hump were the main complaints reported by the patients and confirmed by the objective examination by the physicians. The presence of nasal obstructive complaints in 37.2% of the patients shows that greater attention needs to be paid to functional deformities during the first surgical procedure. The differences observed between patients' complaints and surgeons' evaluations confirm the need for detailed assessment and clarification to the patients regarding their expectations and actual surgical possibilities.
Resumo: Introdução: As rinoplastias possuem índice de revisão em torno de 5% a 15% dos pacientes operados. Tais pacientes possuem queixas funcionais e estéticas variadas e a avaliação detalhada é de extrema importância, tendo em vista todas as expectativas em torno de um procedimento já anteriormente realizado. Objetivo: Traçar o perfil das principais queixas estético-funcionais referidas pelo paciente a ser submetido à rinoplastia revisional e correlacioná-las a avaliação nasal objetiva interna e externa realizada pelo cirurgião. Método: Foi realizado um estudo prospectivo com 43 pacientes a serem submetidos à rinoplastia revisional e com seus respectivos cirurgiões, através da aplicação de questionário acerca de questões epidemiológicas e queixas estético-funcionais subjetivas dos pacientes e as respectivas deformidades funcionais observadas pelos cirurgiões. Após, esses dados foram correlacionados com a finalidade de observar a frequência de relatos concomitantes entre os médicos e pacientes. Resultados: A presença de ponta caída e giba óssea residual foram as principais queixas dos pacientes confirmadas pelos cirurgiões. Já a correlação entre sintomas subjetivos obstrutivos e a avaliação intranasal realizada pelos cirurgiões demonstrou estar presente em 87,5% dos casos. Dentre os pacientes com sintomas respiratórios, a principal deformidade encontrada foi o desvio septal residual em 56,25% dos casos. Conclusão: A ponta caída seguida de giba óssea residual foram as principais queixas relatadas pelos pacientes e confirmadas ao exame objetivo pelos médicos. A presença de 37,2% dos pacientes com queixas obstrutivas nasais demonstra que maior atenção deve ser dada a deformidades funcionais já durante o primeiro procedimento cirúrgico. As diferenças observadas entre as queixas dos pacientes e avaliações dos cirurgiões comprovam a necessidade da avaliação pormenorizada e esclarecimento ao paciente com relação as suas expectativas e reais possibilidades cirúrgicas.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Reoperação/psicologia , Rinoplastia/psicologia , Inquéritos e Questionários , Relações Médico-Paciente , Complicações Pós-Operatórias/cirurgia , Complicações Pós-Operatórias/psicologia , Obstrução Nasal/cirurgia , Obstrução Nasal/psicologia , Estudos Prospectivos , Satisfação do Paciente , Estética/psicologiaRESUMO
INTRODUCTION: Approximately 5-15% of patients submitted to rhinoplasty operations undergo revision surgery. Those patients have varied functional and aesthetic complaints that should receive a detailed assessment that includes all the expectations the patient had before the previous procedure. OBJECTIVE: To draw the profile of the main aesthetic-functional complaints reported by patients to be submitted to revision rhinoplasty and to correlate them with the internal and external objective nasal evaluation performed by the surgeon. METHODS: A prospective study was conducted with 43 patients to be submitted to revision rhinoplasty and their respective surgeons, by applying a questionnaire about the patients' epidemiological questions and subjective aesthetic-functional complaints as well as the respective functional deformities observed by the surgeons. Subsequently, these data were correlated with the purpose of observing the frequency of congruent reports between physicians and patients. RESULTS: The presence of drooping tip and residual bridge hump were the patients' main complaints, confirmed by the surgeons. The correlation between subjective obstructive symptoms and the intranasal evaluation performed by surgeons was shown to be present in 87.5% of the cases. Among the patients with respiratory symptoms, the main deformity identified was residual septal deviation in 56.25% of the cases. CONCLUSION: The drooping tip followed by residual hump were the main complaints reported by the patients and confirmed by the objective examination by the physicians. The presence of nasal obstructive complaints in 37.2% of the patients shows that greater attention needs to be paid to functional deformities during the first surgical procedure. The differences observed between patients' complaints and surgeons' evaluations confirm the need for detailed assessment and clarification to the patients regarding their expectations and actual surgical possibilities.
Assuntos
Reoperação/psicologia , Rinoplastia/psicologia , Inquéritos e Questionários , Adolescente , Adulto , Estética/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/psicologia , Obstrução Nasal/cirurgia , Satisfação do Paciente , Relações Médico-Paciente , Complicações Pós-Operatórias/psicologia , Complicações Pós-Operatórias/cirurgia , Estudos Prospectivos , Adulto JovemRESUMO
Abstract Introduction: Evaluation of surgery outcome measured by patient satisfaction or quality of life is very important, especially in plastic surgery. There is increasing interest in self-reporting outcomes evaluation in plastic surgery. Objective: The aim of our study was to determine patient satisfaction in regard to nose appearance and function with the use of a validated questionnaire, before and after rhinoplasty surgery. Methods: A prospective study was realized at a tertiary centre. All rhinoplasty surgeries performed in adults between February 2013 and August 2014 were included. Many patients underwent additional nasal surgery such as septoplasty or turbinoplasty. The surgical procedures and patients' characteristics were also recorded. Results: Among 113 patients, 107 completed the questionnaires and the follow-up period. Analysis of pre-operative and post-operative Rhinoplasty Evaluation Outcome showed a significant improvement after 3 and 6 months in functional and aesthetic questions (p < 0.01). In the pre-operative, patients anxious and insecure had a worse score (p < 0.05). Difference in improvement of scores was not significant when groups were divided on basis of other nasal procedures, primary or revision surgery and open versus closed approach. Conclusion: We found that patients with lower literacy degree were more satisfied with the procedure. Rhinoplasty surgery significantly improved patient quality of life regarding nose function and appearance.
Resumo Introdução: A avaliação do desfecho de cirurgia medido pela satisfação ou qualidade de vida do paciente é muito importante, especialmente em cirurgia plástica. Existe um interesse crescente na autoavaliação de desfechos nesta especialidade cirúrgica. Objetivo: O objetivo deste estudo foi determinar a satisfação do paciente em relação à aparência e função do nariz com o uso de um questionário validado, antes e depois da cirurgia de rinoplastia. Método: Estudo prospectivo realizado em um centro terciário. Todas as cirurgias de rinoplastia feitas em adultos entre fevereiro de 2013 e agosto de 2014 foram incluídas. Muitos pacientes foram submetidos à cirurgia nasal adicional, como septoplastia ou turbinoplastia. Os procedimentos cirúrgicos e as características dos pacientes também foram registrados. Resultados: Entre 113 pacientes, 107 completaram os questionários e o período de acompanhamento. A análise da avaliação do desfecho de rinoplastia (ADR) no pré-operatório e pós-operatório mostrou uma melhoria significativa após 3 e 6 meses em questões funcionais e estéticas (p < 0,01). No pré-operatório, os pacientes ansiosos e inseguros apresentaram um escore pior (p < 0,05). A diferença na melhoria dos escores não foi significativa quando os grupos foram divididos com base em outros procedimentos nasais, cirurgia primária ou revisão e abordagem aberta versus fechada. Conclusão: Verificou-se que pacientes com menor grau de alfabetização estavam mais satisfeitos com o procedimento. A cirurgia de rinoplastia melhorou significativamente a qualidade de vida do paciente quanto à função e ao aspecto do nariz.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Rinoplastia/métodos , Satisfação do Paciente , Qualidade de Vida , Rinoplastia/psicologia , Obstrução Nasal/cirurgia , Estudos Prospectivos , Inquéritos e Questionários , Resultado do Tratamento , Escolaridade , Estética , Septo Nasal/cirurgiaRESUMO
INTRODUCTION: Evaluation of surgery outcome measured by patient satisfaction or quality of life is very important, especially in plastic surgery. There is increasing interest in self-reporting outcomes evaluation in plastic surgery. OBJECTIVE: The aim of our study was to determine patient satisfaction in regard to nose appearance and function with the use of a validated questionnaire, before and after rhinoplasty surgery. METHODS: A prospective study was realized at a tertiary centre. All rhinoplasty surgeries performed in adults between February 2013 and August 2014 were included. Many patients underwent additional nasal surgery such as septoplasty or turbinoplasty. The surgical procedures and patients' characteristics were also recorded. RESULTS: Among 113 patients, 107 completed the questionnaires and the follow-up period. Analysis of pre-operative and post-operative Rhinoplasty Evaluation Outcome showed a significant improvement after 3 and 6 months in functional and aesthetic questions (p<0.01). In the pre-operative, patients anxious and insecure had a worse score (p<0.05). Difference in improvement of scores was not significant when groups were divided on basis of other nasal procedures, primary or revision surgery and open versus closed approach. CONCLUSION: We found that patients with lower literacy degree were more satisfied with the procedure. Rhinoplasty surgery significantly improved patient quality of life regarding nose function and appearance.
Assuntos
Satisfação do Paciente , Rinoplastia/métodos , Adolescente , Adulto , Escolaridade , Estética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/cirurgia , Septo Nasal/cirurgia , Estudos Prospectivos , Qualidade de Vida , Rinoplastia/psicologia , Inquéritos e Questionários , Resultado do Tratamento , Adulto JovemRESUMO
ABSTRACT: CONTEXT AND OBJECTIVE: Rhinoplasty is one of the most sought-after esthetic operations among individuals with body dysmorphic disorder. The aim of this study was to cross-culturally adapt and validate the Body Dysmorphic Symptoms Scale. DESIGN AND SETTING: Cross-cultural validation study conducted in a plastic surgery outpatient clinic of a public university hospital. METHODS: Between February 2014 and March 2015, 80 consecutive patients of both sexes seeking rhinoplasty were selected. Thirty of them participated in the phase of cultural adaptation of the instrument. Reproducibility was tested on 20 patients and construct validity was assessed on 50 patients, with correlation against the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder. RESULTS: The Brazilian version of the instrument showed Cronbach's alpha of 0.805 and excellent inter-rater reproducibility (intraclass correlation coefficient, ICC = 0.873; P < 0.001) and intra-rater reproducibility (ICC = 0.939; P < 0.001). Significant differences in total scores were found between patients with and without symptoms (P < 0.001). A strong correlation (r = 0.841; P < 0.001) was observed between the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder and the Body Dysmorphic Symptoms Scale. The area under the receiver operating characteristic curve was 0.981, thus showing good accuracy for discriminating between presence and absence of symptoms of body dysmorphic disorder. Forty-six percent of the patients had body dysmorphic symptoms and 54% had moderate to severe appearance-related obsessive-compulsive symptoms. CONCLUSIONS: The Brazilian version of the Body Dysmorphic Symptoms Scale is a reproducible instrument that presents face, content and construct validity.
RESUMO CONTEXTO E OBJETIVO: Rinoplastia é uma das operações mais procuradas por indivíduos com o transtorno dismórfico corporal. O objetivo deste estudo foi adaptar culturalmente e validar a Body Dysmorphic Symptoms Scale. DESENHO E LOCAL: Estudo de validação cultural desenvolvido no ambulatório de cirurgia plástica de um hospital universitário público. MÉTODOS: Oitenta pacientes consecutivos de ambos os gêneros que desejavam submeter-se à rinoplastia foram selecionados entre fevereiro de 2014 e março de 2015. Trinta pacientes participaram da fase de adaptação cultural do instrumento. A reprodutibilidade foi testada em 20 pacientes e a validade de construto em 50 pacientes, correlacionando-se a escala com a Yale-Brown Obsessive Compulsive Scale para transtorno dismórfico corporal. RESULTADOS: A versão brasileira do instrumento mostrou alfa de Cronbach de 0,805 e excelente reprodutibilidade interobservador (coeficiente de correlação intraclasse, CCI = 0,873; P < 0,001) e intraobservador (CCI = 0,939; P < 0,001). Houve diferença significante entre os escores totais de pacientes com e sem sintomas (P < 0,001). Observou-se forte correlação (r = 0,841; P < 0,001) entre a Yale-Brown Obsessive Compulsive Scale para transtorno dismórfico corporal e a Body Dysmorphic Symptoms Scale. A área sob a curva característica de operação do receptor (ROC) foi de 0,981, revelando boa acurácia para discriminar a presença de sintomas para transtorno dismórfico corporal; 46% dos pacientes apresentaram sintomas do transtorno dismórfico corporal e 54% dos pacientes apresentaram sintomas obsessivo-compulsivos moderados a graves relacionados com a aparência. CONCLUSÃO: A versão brasileira da Body Dysmorphic Symptoms Scale é um instrumento reprodutível que apresenta validade de face, conteúdo e construto.