Psychometric Properties of the Family Adaptability and Cohesion Evaluation Scale III in Latin American University Dental Students.

OBJECTIVE: The Family Adaptability and Cohesion Evaluation Scale III (FACES III) is a self-report instrument that enables the assessment of the dimensions of adaptability and cohesion within a family, establishing whether or not that family is functional and classifying it according to categories within those dimensions. The objective of this research was to determine the psychometric properties of this instrument using a sample of dental students from 5 Latin American countries. MATERIALS AND METHODS: The FACES III was administered to a sample of 2888 university dental students from Colombia (35.3%), Chile (34.6%), the Dominican Republic (19%), Argentina (6%), and El Salvador (5.1%). Confirmatory factor analysis was used to examine the factorial structure of the scale, comparing 3 models proposed in the Latin American literature, establishing a multigroup analysis to examine invariance among countries. RESULTS: The results revealed a structure composed of 2 dimensions: cohesion and adaptability. These dimensions showed adequate structure and internal consistency. The invariance of the measurement model in the participating countries was confirmed. CONCLUSION: In general, this study offers evidence of the adequacy of the psychometric properties of FACES III in Colombian, Chilean, Dominican, Argentine, and Salvadoran dental students.

Empatía con el paciente en médicos especialistas que trabajan en un Hospital de Cuenca (Ecuador) / Empathy with the Patient in Medical Specialists Working in a Hospital in Cuenca ­ Ecuador / Empatia com o paciente em médicos especialistas que trabalham em um hospital em Cuenca, Equador

ntroducción: la empatía es uno de los componentes de la estructura de la humanización en la atención de los pacientes. Los médicos especialistas deben tener mucha empatía. El objetivo del artículo es des-cribir los índices de empatía en médicos que trabajan en un hospital de alta complejidad y explorar si existen diferencias entre las especialidades estudiadas. Métodos: se accedió a una muestra por conve-niencia de 237 médicos que representa el 53.55 % del total poblacional (n = 443). La empatía se midió con la Escala de Empatía para Profesionales de la Salud (hp), junto con análisis factorial confirmatorio y análisis multigrupo (para examinar la invarianza del modelo entre los sexos) y análisis de confia-bilidad (α de Cronbach, coeficiente de correlación intraclase y ω de McDonald). Resultados: la espe-cialidad de pediatría tuvo los mayores índices de empatía general y en las dimensiones "cuidado con compasión" y "caminando en los zapatos del paciente", no así en la dimensión "toma de perspectiva", donde es semejante a las especialidades de anestesiología, medicina crítica y terapia intensiva, y gine-cología. Conclusión: los valores de la empatía y los valores en las subescalas "cuidado con compasión" y "caminando en los zapatos del paciente" fueron (en valores absolutos, pero no estadísticos) mayores en la especialidad de pediatría. En la subescala "toma de perspectiva", las especialidades de pediatría, anestesiología, cirugía y clínica se observaron puntuaciones prácticamente iguales. Se requieren otros estudios que permita arribar a una explicación que permita entender por qué algunas especialidades tienen valores de empatía mayores que otras

Introduction: Empathy is one of the components of the structure of humanization in patient care. Medical specialists must have high levels of empathy. Objective: The aim of this paper is to describe the levels of empathy in doctors working in a highly complex hospital and to explore whether there are differ-ences between the specialties studied. Methods: A convenience sample of 237 physicians representing 53.55% of the total population (n = 443) was accessed. Empathy was measured using the Empathy Scale for Health Professionals (hp). Confirmatory factor analysis and multigroup analysis were performed to examine the invariance of the model between the sexes and reliability analyzes (Cronbach's α, intraclass correlation coefficient and McDonald's ω). Results: The specialty of pediatrics had the highest levels in general empathy and in the Compassionate Care and Walking in Patient Shoes subscales, but not in the Perspective Taking subescale where it presents levels similar to the specialties of anesthesiology, critical medicine and intensive care. and gynecology. Conclusions: The empathy values and the values in the compassionate care and "Walking in the patient's shoes" subscales were (in absolute values, but not sta-tistically) higher in the Pediatrics specialty. In the subscale Perspective Taking, Pediatrics, Anesthesiology, Surgery, and Clinic, practically the same scores were observed. Other studies are required to arrive at an explanation that allows us to understand why some specialties have higher empathy values than others.

Introdução: a empatia é um dos componentes da estrutura de humanização no atendimento ao paciente. Os médicos especialistas devem ter altos níveis de empatia. Objetivo: o objetivo deste artigo é descre-ver os níveis de empatia em médicos que trabalham em um hospital de alta complexidade e explorar se há diferenças entre as especialidades estudadas. Materiais e métodos: foi acessada uma amostra de conveniência de 237 médicos, representando 53,55% da população total (n = 443). A empatia foi medida usando a Escala de Empatia para Profissionais de Saúde. A análise fatorial confirmatória e a análise mul-tigrupo foram realizadas (para examinar a invariância do modelo entre os sexos) e a análise de confia-bilidade (α de Cronbach, coeficiente de correlação intraclasse e ω de McDonald). Resultados: a pediatria apresentou os níveis mais altos de empatia geral e nas dimensões "cuidado compassivo" e "estar no lugar do paciente", mas não na dimensão "tomada de perspectiva", em que os níveis foram semelhantes aos da anestesiologia, da medicina crítica e da terapia intensiva, e da ginecologia. Conclusões: os valores de empatia e os valores das subescalas "cuidado compassivo" e "estar no lugar do paciente" foram (em valo-res absolutos, mas não estatisticamente) mais altos na especialidade de pediatria. Na subescala "tomada de perspectiva", as especialidades de pediatria, anestesiologia, cirurgia e clínica tiveram pontuações quase iguais. São necessários mais estudos para explicar por que algumas especialidades têm valores de empatia mais altos do que outras

Family functioning in students of health sciences in four Latin American countries: a study of the structure and factorial invariance of the FACES III scale. A cross-sectional study.

BACKGROUND: Psychometric studies of the FACES III scale in Spanish-speaking countries show a lack of agreement on the factorial structure of the scale. In addition, most of the studies have only performed exploratory analyses of its factorial structure. OBJECTIVE: The objective of the present study was to confirm the structure and factorial invariance of the FACES III scale in nursing and obstetric students from Chile, Colombia, Peru, and Mexico. METHODS: A total of 3303 students from the four countries participated in this study (Colombia = 1559, Chile = 1224, Peru = 215, Mexico = 305). RESULTS: The results of the study showed that the Bi-factor model presents the best-fit indexes to the data from Colombia, Chile, and Mexico, but not from Peru. In addition, it was found that this model showed evidence of being strictly invariant among the three countries in the sequence of the invariance models proposed: metric invariance (ΔRMSEA = .000), scalar (ΔRMSEA = .008), and strict (ΔRMSEA = .008). The bi-factor model also showed adequate reliability indexes in the three countries. CONCLUSION: It is concluded that the FACES III scale shows adequate psychometric performance under a bi-factor model in nursing and obstetric students from Colombia, Chile, and Mexico. The lack of fit of the model in Peru could be associated with the small sample size.

Evaluation of the psychometric properties of the family adaptability and cohesion scale (FACES III) through item response theory models in students from Chile and Colombia.

BACKGROUND: A psychometric study of the Family Adaptability and Cohesion Scale (FACES III) has been conducted in Spanish-speaking countries from the perspective of the classical test theory. However, this approach has limitations that affect the psychometric understanding of this scale. OBJECTIVE: Accordingly, this study used the item response theory to investigate the psychometric performance of the items. Furthermore, it evaluated the differential performance of the items for Colombia and Chile. METHOD: For this purpose, 518 health science students from both countries participated. Confirmatory Factor Analysis was used. RESULTS: The study results revealed that the cohesion and adaptability items presented adequate discrimination and difficulty indices. In addition, items 5, 8, 13, 17, and 19 of cohesion indicated differential functioning between students from both countries, with Chilean students exhibiting a greater discriminatory power. Further, the Colombian group exhibited a greater discriminatory power for item 18 of adaptability. CONCLUSIONS: The study concluded that the items of FACES III indicated adequate psychometric performance in terms of their discriminative capacity and difficulty in Chile and Colombia.

Family functioning in students of health sciences in four Latin American countries: a study of the structure and factorial invariance of the FACES III scale. A cross-sectional study

Abstract Background Psychometric studies of the FACES III scale in Spanish-speaking countries show a lack of agreement on the factorial structure of the scale. In addition, most of the studies have only performed exploratory analyses of its factorial structure. Objective The objective of the present study was to confirm the structure and factorial invariance of the FACES III scale in nursing and obstetric students from Chile, Colombia, Peru, and Mexico. Methods A total of 3303 students from the four countries participated in this study (Colombia = 1559, Chile = 1224, Peru = 215, Mexico = 305). Results The results of the study showed that the Bi-factor model presents the best-fit indexes to the data from Colombia, Chile, and Mexico, but not from Peru. In addition, it was found that this model showed evidence of being strictly invariant among the three countries in the sequence of the invariance models proposed: metric invariance (ΔRMSEA = .000), scalar (ΔRMSEA = .008), and strict (ΔRMSEA = .008). The bi-factor model also showed adequate reliability indexes in the three countries. Conclusion It is concluded that the FACES III scale shows adequate psychometric performance under a bi-factor model in nursing and obstetric students from Colombia, Chile, and Mexico. The lack of fit of the model in Peru could be associated with the small sample size.

La empatía de los enfermeros con los pacientes en los hospitales públicos / Working nurses' empathy with patients in public hospitals / A empatia dos enfermeiros com os pacientes em hospitais públicos

Objetivo: determinar los niveles de empatía en profesionales de enfermería de un hospital de alta complejidad, relacionar la edad con la empatía (y cada una de sus dimensiones), y establecer si existen diferencias entre estos niveles según el tipo de jornada laboral. Método: diseño comparativo, correlacional y transversal. La muestra utilizada (n=271) constituyó el 40,9% del total de profesionales de enfermería. Se estudiaron las propiedades psicométricas de la Escala de Empatía de Jefferson para Profesionales de la Salud. Se calcularon estadísticos descriptivos: media y desviación estándar. La asociación entre empatía y edad se estimó mediante ecuaciones de regresión y significancia estadística de los coeficientes de regresión, luego de evaluar el tipo de curva mediante análisis de varianza. Resultados: se identificó el modelo subyacente de las tres dimensiones de la empatía. Los valores de los estadísticos descriptivos observados fueron relativamente bajos en empatía y sus dimensiones. Los niveles de empatía no se asociaron con el rango de edad. No se encontraron diferencias en la empatía entre los tipos de horarios de trabajo. Se encontró variabilidad en las dimensiones: "cuidado compasivo" y "ponerse en los zapatos del paciente". Conclusión: estos resultados muestran que los niveles de empatía observados pueden implicar un desempeño deficiente en el cuidado empático de los pacientes.

Objective: to determine the levels of empathy in professional nurses of a high-complexity hospital, to relate age to empathy (and each one of its dimensions), and to establish if there are differences between these levels according to the type of working schedules. Method: comparative, correlational and cross-sectional design. The sample used (n=271) constituted 40.9% of the total number of nursing professionals. Psychometric properties of the Jefferson Scale of Empathy for Health Professionals were studied. Descriptive statistics were calculated: mean and standard deviation. The association between empathy and age was estimated using regression equations and statistical significance of the regression coefficients, after evaluating the type of curve using variance analysis. Results: the underlying model of three dimensions of empathy was identified. The values of the descriptive statistics observed were relatively low in empathy and its dimensions. Empathy levels were not associated with the age range. No differences in empathy were found between the types of work schedules. Variability was found in the dimensions: "compassionate care" and "Walking on the patient's shoes". Conclusion: these results show that the levels of empathy observed may imply a deficient performance in empathetic care for patients.

Objetivo: determinar os níveis de empatia em enfermeiros profissionais de um hospital de alta complexidade, relacionar a idade com a empatia (e cada uma das suas dimensões) e verificar se existem diferenças entre esses níveis, de acordo com o tipo de horário de trabalho. Método: delineamento comparativo, correlacional e transversal. A amostra utilizada (n=271) constituiu 40,9% do total de profissionais de enfermagem. Foram estudadas as propriedades psicométricas da Escala de Empatia de Jefferson para Profissionais da Saúde. Foram calculadas estatísticas descritivas: média e desvio padrão. A associação entre empatia e idade foi estimada por meio de equações de regressão e significância estatística dos coeficientes de regressão, após avaliação do tipo de curva por meio de análise de variância. Resultados: o modelo subjacente de três dimensões de empatia foi identificado. Os valores das estatísticas descritivas observados foram relativamente baixos em empatia e suas dimensões. Níveis de empatia não foram associados com a faixa etária. Não foram encontradas diferenças de empatia entre os tipos de horários de trabalho. Foi encontrada variabilidade nas dimensões: "cuidado compassivo" e "colocar-se no lugar do paciente". Conclusão: esses resultados mostram que os níveis de empatia observados podem implicar em um desempenho deficiente no atendimento empático aos pacientes.

Working nurses' empathy with patients in public hospitals. / La empatía de los enfermeros con los pacientes en los hospitales públicos.

OBJECTIVE: to determine the levels of empathy in professional nurses of a high-complexity hospital, to relate age to empathy (and each one of its dimensions), and to establish if there are differences between these levels according to the type of working schedules. METHOD: comparative, correlational and cross-sectional design. The sample used (n=271) constituted 40.9% of the total number of nursing professionals. Psychometric properties of the Jefferson Scale of Empathy for Health Professionals were studied. Descriptive statistics were calculated: mean and standard deviation. The association between empathy and age was estimated using regression equations and statistical significance of the regression coefficients, after evaluating the type of curve using variance analysis. RESULTS: the underlying model of three dimensions of empathy was identified. The values of the descriptive statistics observed were relatively low in empathy and its dimensions. Empathy levels were not associated with the age range. No differences in empathy were found between the types of work schedules. Variability was found in the dimensions: "compassionate care" and "Walking on the patient's shoes". CONCLUSION: these results show that the levels of empathy observed may imply a deficient performance in empathetic care for patients. (1) The levels of empathy are low in the nursing professionals studied. (2) These levels are not associated with age and type of work performed. (3) Low levels of empathy could imply a negative alteration of humanized attention.

Family Functioning as an Explanatory Factor of Empathic Behavior in Argentine Medical Students.

Empathy is a relevant competence in the study and practice of medicine whose development could depend on the functioning style of each family. This study aims to compare the distribution of empathy levels, about functionality or dysfunction, and the three styles, which can be derived from family functioning in the families of Argentine medical students. Previously providing evidence of the validity of the family functioning measure. As well as provide evidence of the validity of the measure of family functioning. METHODS: Ex post facto design: 306 Argentine medical students who had already taken the Jefferson Scale of Empathy-Spanish Edition (JSE-S) and the abbreviated Spanish Family Adaptability and Cohesion Evaluation Scale (FACES-20). A gender-weighted linear regression analysis was made, establishing an ANOVA and multiple comparisons via DMS to determine the effect of functional and dysfunctional families' balanced, intermediate and extreme functioning styles concerning empathy. RESULTS: Students who presented dysfunction in familial cohesion and adaptability showed measures of empathy greater than those classified as functional. Differences of cohesion were statistically significant in compassionate care, perspective taking and general empathy. These components were significantly higher in students from families classified as extreme than balanced ones. Students classified within families with either extreme or dysfunctional styles showed greater levels of empathy than more adaptive and functional ones, except in the 'walking in patient's shoes' component where differences were not observed. CONCLUSIONS: Individual resilience as an intervening variable in the presence of empathy is discussed. IMPLICATIONS: The study of empathy, its associated variables, and the conditions of its development remains a central theme in relation to students and professionals of the health sciences. To achieve an effective professional practice, it is necessary to develop human capacities such as empathy and personal resilience.

Frecuencia de perforaciones radiculares en tratamientos endodónticos realizados por estudiantes de postgrados chilenos

Introducción: Este estudio evaluó la frecuencia de perforaciones radiculares provocadas por estudiantes de primer y segundo año de la especialidad de Endodoncia de la Facultad de Odontología de la Universidad Andrés Bello (UNAB), Santiago (Chile), entre 2019 y marzo de 2021. Materiales y Métodos: Se realizó un estudio observacional descriptivo a través de datos recopilados retrospectivamente en fichas clínicas de pacientes atendidos en el área de postgrado en Endodoncia de la universidad, durante 2019, 2020 y hasta marzo de 2021. Resultados: Un total de 569 pacientes fueron atendidos en el período, 118 fueron atendidos por estudiantes de primer año y 451 por los de segundo año. La frecuencia de perforaciones del primer año fue de un 0% y la del segundo año del 2 % (n = 9). Considerando el total general de pacientes, la frecuencia relativa de perforaciones fue de apenas 1,6 %. Con respecto a ubicación, 3 perforaciones fueron en el tercio cervical de la raíz, 3 en el tercio medio, 2 en el tercio apical y 1 en el piso cameral. Ninguna perforación resultó en la indicación inmediata de extracción y todas fueron selladas con materiales a base de silicato de calcio. Conclusiones: La frecuencia de perforaciones radiculares por los estudiantes de postgrado fue muy baja, lo que podría evidenciar la seguridad de los protocolos institucionales de tratamiento y enseñanza. La mayor ocurrencia de perforaciones fue con los estudiantes de segundo año, lo cual puede ser atribuido a que tratan casos de mayor complejidad.

Introduction: The present study evaluated the frequency of root perforations caused by first- and second-year students of the Endodontics specialty of the Faculty of Dentistry of the UNAB University in Santiago (Chile), between January 2019 and March 2021. Materials and Methods: A descriptive observational study was carried out through data collected retrospectively in clinical records of patients treated in the Postgraduate Endodontics Clinic of the Andrés Bello University (UNAB) during 2019, 2020 and until March 2021. Results: A total of 569 patients were treated during the period, 118 patients were seen by first-year students and 451 by second-year students. The frequency of perforations in the first year was 0% and in the second year it was 2% (n=9). Considering the overall total number of patients, the relative frequency of perforations was only 1.6%. Regarding location, 3 perforations were in the cervical third of the root, 3 in the middle third, 2 in the apical third and 1 in the pulp chamber floor. No perforation resulted in the immediate indication of extraction and all were sealed with calcium silicate-based materials. Conclusions: Te frequency of root perforations by postgraduate students was very low, which could evidence the safety of institutional treatment and teaching protocols. The greatest occurrence of perforations was with second-year students, which can be attributed to the fact that they treat cases of greater complexity.

An Artificial Placenta Experimental System in Sheep: Critical Issues for Successful Transition and Survival up to One Week.

OBJECTIVE: To describe the development of an artificial placenta (AP) system in sheep with learning curve and main bottlenecks to allow survival up to one week. METHODS: A total of 28 fetal sheep were transferred to an AP system at 110-115 days of gestation. The survival goal in the AP system was increased progressively in three consecutive study groups: 1-3 h (n = 8), 4-24 h (n = 10) and 48-168 h (n = 10). Duration of cannulation procedure, technical complications, pH, lactate, extracorporeal circulation (EC) circuit flows, fetal heart rate, and outcomes across experiments were compared. RESULTS: There was a progressive reduction in cannulation complications (75%, 50% and 0%, p = 0.004), improvement in initial pH (7.20 ± 0.06, 7.31 ± 0.04 and 7.33 ± 0.02, p = 0.161), and increment in the rate of experiments reaching survival goal (25%, 70% and 80%, p = 0.045). In the first two groups, cannulation accidents, air bubbles in the extracorporeal circuit, and thrombotic complications were the most common cause of AP system failure. CONCLUSIONS: Achieving a reproducible experimental setting for an AP system is extremely challenging, time- and effort-consuming, and requires a highly multidisciplinary team. As a result of the learning curve, we achieved reproducible transition and survival up to 7 days. Extended survival requires improving instrumentation with custom-designed devices.

Empathy, psychometrics, cut-off points in nursing students from Latin America.

BACKGROUND: Currently, there are no cut-off points for levels of empathy, making it difficult to assess the change experienced in its development or as a result of its intervention. It is an unsolved problem. INTRODUCTION: Empathy is a cognitive-affective attribute that enables nursing staff to maintain a professional relationship that entails various benefits for the patient. Its strengthening and development during university education is desirable. Empathy studies in Latin American nursing students are based on the direct scores obtained on an empathy test, based on which the variable is described and groups are compared. Statistical comparisons are not enough to discriminate substantive changes since two statistical values can show differences without implying that the post-intervention levels may correspond to a higher category in relation to those of pre-intervention or that two compared groups are qualitatively different. The above applies to empathic behaviour and is valid for students and professionals of health. This study aimed to establish cut-off points that allow defining ordinal categories in empathy. METHODS: In this multicenter and cross-sectional study, 3712 students from 11 Latin American nursing schools participated. The Jefferson Empathy Scale (JES) was applied; the psychometric properties were confirmed by Factor Analysis Confirmatory and Invariance. RESULTS: The JSE empathy scale is a measure with adequate reliability and construct validity. Examined cut-offs determined a structure of five empathy intervals that allowed them to be classified as empathy values in very high, high, medium, low and very low. DISCUSSION: The sequence of statistical tests carried out allowed us to determine ranges of categorical values in the empathy levels of groups of students. However, the determined categories may constitute a specific characteristic of them. It is not possible to extrapolate these results to regions other than those of Latin America. CONCLUSION: The estimated rankings allow comparing levels of empathy between groups of nursing students and the real effect of empathic interventions. IMPLICATIONS FOR NURSING: To contribute with strategies to evaluate changes in the empathic skills of nursing students, resulting in a well-valued skill in health services. IMPLICATIONS FOR NURSING POLICY: The cut-off points define evaluative categories (very low, low, medium, high and very high) that allow objective classification of levels of empathy achieved after (for example) an empathic intervention. This allows assessment of substantive changes experienced by nursing students (and professionals).

Family Functioning as a Possible Factor that Modulates Empathy Levels in Dental Students

Aim: The objective of this paper is to explore whether there are differences in the levels of empathy and its dimensions between family typologies in dental students. Methodology: A quantitative and not experimental study, with a cross-sectional descriptive design, a population of dental students from the Evangelical University of El Salvador, and a convenience sample were applied. The levels of empathy and family functioning were evaluated using the Jefferson Scale of Empathy for Health Professions students and the Brief Scale of Family Functioning. The construct validity of both instruments was estimated using Confirmatory Factor Analysis. The reliability was estimated using McDonald's omega and Cronbach's alpha. Comparisons of empathy and its dimensions between family typologies were made using a two-factor analysis of variance. Results: No statistical differences were observed in empathy and its dimensions based on family typologies. It was found that women are more empathic than men. This result is not in accordance with other studies carried out in Latin America on dental and medical students evaluating empathy and family functioning with the same instruments. Conclusions: The distribution of empathy levels and their dimensions are similar among the family typologies studied. Therefore, it was not found that family functioning can influence empathy in the population studied. It is necessary to continue these studies to obtain more empirical evidence regarding the influence of family functioning on empathy.

Objetivo: El objetivo del presente trabajo es determinar la existencia de diferencias de los niveles de empatía y de sus dimensiones entre las tipologías familiares en estudiantes de odontología. Metodología: Estudio cuantitativo y no experimental, con un diseño descriptivo transversal, una población de estudiantes de odontología de la Universidad Evangélica de El Salvador y una muestra por conveniencia. Fueron evaluados los niveles de empatía y el funcionamiento familiar mediante la Escala de Empatía de Jefferson para estudiantes de profesiones de la salud y la Escala Breve de Funcionamiento Familiar. Se estimó la validez de constructo de ambos instrumentos mediante Análisis Factorial Confirmatorio y la confiabilidad mediante omega de McDonald y alfa de Cronbach. Las comparaciones de la empatía y sus dimensiones entre las tipologías familiares fueron realizadas mediante análisis de varianza bifactorial. Resultados: No se observaron diferencias estadísticas en la empatía y en sus dimensiones en función de las tipologías familiares. Se encontró que las mujeres son más empáticas que los hombres. Este resultado no está en concordancia con otros estudios realizados en América Latina en estudiantes de odontología y medicina, evaluando la empatía y el funcionamiento familiar con los mismos instrumentos. Conclusiones: La distribución de los niveles de empatía y de sus dimensiones son semejantes entre las tipologías familiares estudiadas. Por lo tanto, no se constató que el funcionamiento familiar tenga un efecto sobre la empatía en la población estudiada. Es necesario continuar estos estudios para obtener mayor evidencia empírica respecto de la influencia del funcionamiento familiar en la empatía.

Incidencia del Traumatismo Dentoalveolar en pacientes atendidos por el Sistema de Salud Pública en Chile

Introducción: Los traumas dentoalveolares constituyen un conjunto de lesiones que comprometen los dientes o a sus estructuras periodontales (producto de impactos violentos, directos o indirectos). Constituyen un problema de salud pública a nivel mundial. Objetivo: El objetivo de esta investigación fue: escribir la tendencia de la incidencia del traumatismo dentoalveolar según grupos etarios en pacientes del Fondo Nacional de Salud reportados en Atención Primaria en Salud y Centros de Especialidades en Chile durante el periodo 2008-2018. Métodos: Investigación de tipo descriptivo transversal se calcularon las tasas de incidencia específicas por edad entre 2008 y 2014 de la Atención Primaria de Salud y estas mismas tasas en los Centros de Especialidades entre 2009-2018. Resultados: Los resultados obtenidos nos permiten observar que la tendencia en APS disminuyó de forma progresiva y en Centros de Especialidades aumentó en todos los años, excepto en el rango etario de 20-64 años. En este último caso, el número de años estudiados permitió la estimación de proyecciones de las tasas de incidencia hacia los años 2019-2021, que indican que habría un aumento. Conclusiones: El registro de traumas dentoalveolares en Chile en el Sistema de Salud Pública es deficiente para realizar investigaciones con poblaciones representativas. Lo que dificulta la comprensión de la epidemiología y la determinación de estrategias adecuadas.

Introducción: Dentoalveolar traumas are defined as a set of injuries that compromise the teeth or their periodontal structures, as a consequence of a direct or indirect violent impact. They constitute a public health problem worldwide. Objective. To describe the trend of the incidence of dentoalveolar trauma according to age groups in patients from the National Health Fund reported in Primary Health Care and Specialty Centers in Chile during the period 2008-2018. Methods: The research carried out in the present work is of a descriptive transversal type. Age-specific incidence rates were calculated between 2008 and 2014 for Primary Health Care and these same rates in Specialty Centers between 2009-2018. Results: The results obtained allow us to observe that the trend in PHC decreased progressively and in Specialty Centers it increased in all years, except in the age range of 20-64 years. In the latter case, the number of years studied allowed the estimation of incidence rate projections towards the years 2019-2021, which indicate that there would be an increase. Conclusions: The registry of dentoalveolar traumas in Chile in the Public Health System is deficient to carry out research with representative populations. This makes it difficult to understand epidemiology and determine appropriate strategies.

Garantías explícitas en salud odontológica de las embarazadas y la salud pública por regiones y años 2010-2019 en Chile

Objetivo: Estimar la tasa de uso de las Garantías Explícitas de Salud (GES) dental de la embarazada entre 2010 a 2019 en todas las regiones de Chile. Pacientes y métodos: Diseño: descriptivo, observacional. Participantes: mujeres embarazadas, atendidas en el sistema público. Se estudió un total de 1 854 621 gestantes, 1 445 903 de gestantes con ingreso al GES y 1 257 775 de gestantes con alta dental integral pertenecientes a cada región y año analizado. Mediciones: estimación de tasas de uso del GES odontológico, análisis de las tasas de eficacia y de la evolución de las tasas de uso del GES mediante series de tiempo. Resultados: Las medias del uso del GES y la eficacia de la atención por GES fue inferior al valor óptimo (100 %). Ambas tasas difieren del valor meta de la autoridad sanitaria. Los valores de las tasas del uso del GES varían por año y región. La forma de las curvas fue predominantemente no lineal. Conclusión: El uso y la eficacia del GES odontológico en embarazadas chilenas no está en correspondencia con los objetivos del Ministerio de Salud Pública. Se requieren nuevos estudios para explicar las causas de estos resultados.

Objective. Estimate the rate of use of the Explicit Dental Health Guarantees (GES) by pregnant women from 2010 to 2019 in the regions of Chile. Patients and methods. Design: Descriptive, observational. Participants: Pregnant women, cared for in the public system. The total of pregnant women (1,854,621), pregnant women admitted to the GES (1,445,903), and pregnant women with full dental discharge (1,257,775) belonging to each of the regions and years analyzed (2010-2019) were studied. Measurements: estimation of dental GES use rates, evolution of rates over time using time series (regressions). Results. The means of the use of the GES and the effectiveness of the care by the GES was less than the optimal value (100%). Both rates differ from the target value of the health authority. The value of usage fees varies by year and region. The shape of the curves was predominantly non-linear. Conclusions. The use and effectiveness of the dental GES in Chilean pregnant women is not in correspondence with the objectives of the Ministry of Public Health. New studies are required to explain the causes of these results.

Empathy levels among dental students and professors from a dental school in the Dominican Republic / Empatía en estudiantes y profesores de una escuela de odontología de República Dominicana

Abstract Introduction: The concept of empathy has been incorporated as one of the key elements for the achievement of the teaching-learning process goals in health science students. Objective: To estimate and compare the levels of empathy among dental students and professors in the undergraduate dental medicine program at the Universidad Central del Este (Dominican Republic). Materials and methods: Cross-sectional study. The study population (n=264) was divided into two groups: the first consisted of students in their first to fifth year of dental school (N=223; n=215), distributed in two areas (basic-preclinical and clinical courses), while the second group comprised professors working in both areas in the dental school of the university (N=53; n=49). The Jefferson Scale of Empathy (S-Version) was used. The descriptive analysis of the data included the estimation of means, standard deviations and percentages, and the reliability of the data was estimated using Cronbach's alpha. In addition, a two-way ANOVA was performed, calculating the effect size and the statistical power of the test; furthermore, when the Fisher's exact test was significant for any factor, Tukey's test was used to estimate differences between means. A significance level of α<0.05 and β<0.20 was established. Results: Overall empathy scores and compassionate care dimension scores among the professor group did not differ significantly from the scores obtained by the students (basic-preclinical and clinical area), but there were differences between students from both areas (p<0.05). There were no significant differences between the three subgroups in the Perspective Taking and Walking in the Patient's Shoes dimensions (p=0.428 and p=0.866). Conclusion: The levels of empathy and compassionate care dimension of professors are similar to those of students in general (regardless of the area).

Resumen Introducción. El concepto de empatía se ha integrado como uno de los elementos centrales para el logro final del proceso de enseñanza-aprendizaje en estudiantes de ciencias de la salud. Objetivo. Estimar y comparar los niveles de empatía entre estudiantes y profesores de pregrado de odontología de la Universidad Central del Este (República Dominicana). Materiales y métodos. Estudio transversal. La población de estudio (n=264) se dividió en dos grupos: el primero, compuesto por estudiantes de primero a quinto año de la carrera de odontología (N=223; n=215) distribuidos en dos áreas (básica-preclínica y clínica), y el segundo, por los docentes de ambas áreas en la escuela de odontología de la universidad (N=53; n=49). Se utilizó la Escala de Empatía Médica de Jefferson (Versión-S). El análisis descriptivo de los datos incluyó la estimación de medias, desviaciones estándar y porcentajes, y la confiabilidad de los datos se estimó mediante CC de Cronbach; además, se realizó un ANOVA bifactorial, calculándose el tamaño del efecto y la potencia de la prueba, y en los casos en que la prueba exacta de Fisher fue significativa para algún factor, se utilizó la prueba de Tukey para estimar las diferencias entre las medias. El nivel de significancia estadística utilizado fue α<0.05 y β<0.20. Resultados. Los valores globales de empatía y de la dimensión Cuidado con compasión en los profesores no difirieron significativamente con los obtenidos por los estudiantes (área básica-preclínica y clínica), pero sí hubo diferencias entre los estudiantes de ambas áreas (p<0.05). En las dimensiones Adopción de perspectiva y Ponerse en los zapatos del otro no existieron diferencias entre los tres subgrupos (p=0.428 y p=0.866). Conclusión. Los niveles de empatía y de la dimensión Cuidado compasivo de los profesores no difieren de los de los estudiantes en general (ambas áreas).

Psychometry and Cut-off Points of the Jefferson Scale of Empathy in Medical Students in Central America and the Caribbean.

OBJECTIVE: The objective of this study was to determine cut-off points that can be used to differentiate measures of empathy, which would then be classified as high, medium, or low. To do so, we used data from students from 7 medical schools in Colombia, El Salvador, and the Dominican Republic, after determining the psychometric properties of the 3-dimensional model of empathy in the Jefferson Scale of Empathy, S-version (for medical students). MATERIALS AND METHODS: This non-experimental descriptive study had a sample that consisted of 6291 students. The structure and factor invariance were analyzed by country and sex. A hierarchical cluster analysis and a bifactorial analysis of variance were applied. RESULTS: The measure of empathy was reliable on the global scale (α = .82; ω = .88). A confirmatory factor analysis showed that the original model was replicable and adjusted to the data (comparative fit index [CFI] = .90; goodness of fit index = .94), while the multigroup analysis allowed to assume an invariant factor structure by country and gender (ΔCFI < .01). Tables were constructed with cut off points for empathy and its dimensions. DISCUSSION AND CONCLUSION: Our study solves the problem of comparing the scores and the levels of empathy observed in the medical students at different schools of medicine, making said comparisons within and between countries and between genders. The instrument used has adequate psychometric properties and the cut-off values obtained allow the classifying of people with lower or higher levels of empathy.

Trends in HIV Infection Incidence in a Mostly Mining Population

Objective: To determine the trends in the incidence of HIV infection in the Atacama region, Chile, according to age and sex, for the 2010-2017 period. Material and Methods: Analysis from the database of confirmed HIV-positive diagnosis cases. HIV incidence rates were made up from confirmed HIV cases adjusted by year, age, and sex, with population denominators from the INE. General and specific trend analysis was performed using regression equations. Results: The groups with the highest incidence of HIV infection were: 20-29 years, 30-39 years, and 40-49 years. The analysis of the curve and its general trend showed that the growth curve of the 20-29 years group is the strongest. Adjusting for sex, it was observed that, in men, the 20-29 years group has the strongest growth and growth forecast of all groups, followed by men aged 50-59 years. In the case of women, the 50-59 and 60-69 age groups are the fastest growing, however, it is a slower growth in relation to the men's group. Conclusions: Chile has one of the fastest growing HIV epidemics in the world. We estimate that the most incidental groups are linked to the mining population, which denotes the importance of the relationship between mining activity and the high incidence of HIV infection. The results suggest the need for prevention and early detection of the sources of HIV infection and the need to adapt strategies in this population. It is necessary to close the gap of HIV-positive people who do not know their health status, in order to stop the spread of HIV among miners and in the communities surrounding the mining industry.

Objetivo: Determinar las tendencias de la incidencia del contagio por VIH en la región de Atacama, Chile, según edad y sexo, para el período 2010-2017. Materiales y Métodos: Análisis desde la base de datos de casos confirmados de diagnóstico de VIH positivos. Las tasas de incidencia de VIH se confeccionaron a partir de los casos confirmados por VIH ajustados por año, edad y sexo, con denominadores poblacionales del INE. Se realizó un análisis de tendencia general y específica mediante ecuaciones de regresión. Resultados: Los grupos con mayor incidencia de infección por VIH fueron: 20-29 años, 3039 años y 40-49 años. El análisis de la curva y su tendencia general mostró que la curva de crecimiento del grupo 20-29 años es la más fuerte. Ajustando por sexo, se observó que en los hombres del grupo 20-29 años el crecimiento y el pronóstico de crecimiento es el más fuerte de todos los grupos, seguido por hombres de 50-59 años. En el caso de las mujeres, los grupos más incidentes fueron 50-59 y 60-69 años. Conclusiones: Chile tiene una de las epidemias de VIH de más rápido crecimiento en el mundo. Estimamos que los grupos más incidentes están vinculados a la población minera, lo que denota la importancia de la relación existente entre la actividad minera y la alta incidencia del contagio por VIH. Los resultados sugieren la necesidad de prevenir y pesquisar tempranamente las fuentes de infección por VIH y adaptar las estrategias en esta población.

Variability of empathy among dental students. Implications not yet understood in Latin America / Variabilidad empática en estudiantes de odontología. Consecuencias aún no entendidas en América Latina

Abstract Introduction: Empathy is a quality that allows dentists to build an intersubjective relationship with their patients, which, among other benefits, contributes to the effectiveness of the treatment. Objective: To determine whether there is variability in empathy levels between two populations of dental students and to describe theoretically the general implications of this variability for intervention strategies. Materials and methods: Exploratory cross-sectional study. The study population consisted of 1st-5th year dental students from the Universidad Santiago de Cali, Colombia (n=610; N=647) and the Universidad San Sebastián, Chile (n=535; N=800). In both groups, empathy was measured using the Jefferson Scale of Empathy (S-Version) Scale. Descriptive statistics (mean and standard deviation) were used for data analysis. Internal consistency of data was estimated using Cronbach's alpha and the intraclass correlation coefficient. A factorial analysis of variance was performed, and three factors were studied: University (U), Course (C), and Sex (S). The statistical significance level used was α≤ 0.05 and β ≤0.20. Results: Differences in empathy level and in some of its three dimensions were observed between students from both universities and among courses (lst-5th year). No differences were found between sexes. Conclusions: There is variability in empathy levels among dental students from both universities. Thus, the implementation of specific empathy intervention strategies in each dental medicine program offered in Latin America is required to increase empathy levels in this population.

Resumen Introducción. La empatía es un atributo que permite a los odontólogos establecer una relación intersubjetiva con sus pacientes, lo que contribuye a un tratamiento exitoso, entre otros beneficios. Objetivo. Determinar si hay variabilidad en los niveles de empatía entre dos poblaciones de estudiantes de odontología y describir teóricamente las implicaciones generales de esta variabilidad en estrategias de intervención. Materiales y métodos. Estudio exploratorio transversal. La población de estudio consistió de estudiantes de odontología de 1er a 5to año de la Universidad Santiago de Cali, Colombia (n=610; N=647) y la Universidad San Sebastián, Chile (n=535; N=800). En ambos grupos, la empatía se midió con la Escala de Empatía Médica de Jefferson (Versión S). Para el análisis de los datos se utilizó estadística descriptiva (media y desviación estándar). La consistencia interna de los datos se estimó mediante el coeficiente alfa de Cronbach y el coeficiente de correlación intraclase. Se realizó un análisis de varianza factorial: tres factores estudiados: Universidad (U), Curso (C) y Sexo (S). El nivel de significancia estadística utilizado fue de α≤0.05 y β≤0.20. Resultados. Se observaron diferencias en el nivel de empatía y algunas de sus tres dimensiones entre los estudiantes de ambas universidades y entre los cursos (1er-5to año). No se observaron diferencias entre sexos. Conclusiones. Existe variabilidad en los niveles de empatía entre los estudiantes de ambas universidades. Para aumentar los niveles de empatía en esta población en Latinoamérica se requiere implementar estrategias específicas de intervención empática en cada programa de odontología ofrecido en la región.

Empathy in Professors and Students of a School of Dentistry in the Caribbean

Abstract Objective: To estimate and compare the levels of empathy between undergraduate dentistry students and professors at a university in the Dominican Republic. Material and Methods: Cross-sectional and descriptive study. The studied population consisted of two groups. The first: students of the Dentistry Career (N=520; n=335: 64.42% of total students) were distributed in two areas, basic-preclinical and clinical, while the second group corresponded of teachers who work in both areas (N=92; n=56; 60.87% of all teachers). The total sample was n = 391. The Jefferson Scale of Physician Empathy (S-Version) was used. Reliability was estimated using Cronbach's α and intraclass correlation coefficient, descriptive statistics, two-way analysis of variance, Tukey's test, effect size, and power of the test. Significance level: α≤0.05 and β≤0.20. Results: The empathy and dimension values were, in general, higher in the professors of the clinical area in relation to the other areas studied, with the exception of the compassionate care dimension. Conclusion: The finding that clinical teachers have a greater value of empathy is potentially an advantage for training students, especially in the clinical area (AU).

Concordancia entre pruebas de estabilidad unipodal estática para riesgo de caída en adultos mayores chilenos / Concordance between Static Unipodal Stability Tests concerning Risk of Falling in Chilean Aged Adults

Introducción: El equilibrio postural conforma parte de la evaluación funcional para riesgo de caída en adultos mayores. El Ministerio de Salud Chileno aplica el Test Estación Unipodal para valora la estabilidad unipodal estática como herramienta de prevención en salud. Objetivo: Determinar la concordancia o equivalencia diagnóstica entre el Test Estación Unipodal y el Test unipodal para estabilidad corporal estática, en modalidad ojos abiertos. Métodos: Estudio de concordancia diagnóstica, de tipo transversal; aplicado en 60 adultos mayores autovalentes pertenecientes a talleres deportivos del Gimnasio Olímpico de San Miguel, Región Metropolitana, Chile, quienes voluntariamente ejecutaron dos pruebas de estabilidad unipodal estática y respondieron un instrumento de consulta al final de la evaluación referida al Test unipodal para estabilidad corporal estática. Resultados: Entre las dos pruebas de estabilidad unipodal, en modalidad ojos abiertos, se presentó una concordancia significativa al evaluar buena o deficiente estabilidad (p = 0,0005). Los adultos mayores evaluados percibieron el Test unipodal para estabilidad corporal estática como prueba de fácil aplicación, bajo nivel de riesgo físico y cansancio, declarando intención de volver a realizarla si se requiere valorar nuevamente su estabilidad. Conclusión: Ambos métodos, Test Estación Unipodal y Test unipodal para estabilidad corporal estática, en modalidad ojos abiertos, fueron capaces de clasificar correctamente buena estabilidad o estabilidad deficiente en los adultos mayores evaluados. Por lo tanto, resultan equivalentes y concordantes para el diagnóstico de la estabilidad estática con apoyo unipodal(AU)

Introduction: Postural balance is part of the functional assessment for risk of falling in aged adults. The Chilean Ministry of Health applies the Unipodal Station Test to assess static unipodal stability as a health prevention tool. Objective: To determine concordance or diagnostic equivalence between the Unipodal Station Test and the Unipodal Test for static body stability, in the open eyes modality. Methods: Cross-sectional study of diagnostic concordance applied in sixty self-supporting aged adults belonging to sports workshops of the Olympic Gymnasium of San Miguel, in the Metropolitan Region of Chile, who voluntarily completed two static unipodal stability tests and answered a consultation instrument at the end of the assessment concerning the Unipodal Test for static body stability. Results: Between the two unipodal stability tests, in the open eyes modality, a significant concordance was present upon assessing good or poor stability (p = 0.0005). The aged adults who underwent assessment perceived the Unipodal Test for static body stability as a test of easy application and low level of physical risk and fatigue, as well as declared their intention to complete it again if their stability needed to be reassessed. Conclusion: Both the Unipodal Station Test and the Unipodal Test for static body stability, in the open eyes modality, were effective methods to classify good stability or poor stability correctly in the aged adults who underwent assessment. Therefore, they are equivalent and concordant for the diagnosis of static stability with unipodal support(AU)