Asociación entre la autoevaluación y el estado clínico de salud oral en adultos, Paraguay.

Introduction: Oral health can be defined as the absence of pathologies and disorders that affect the stomatognathic system. Objetives: This study aimed to determine the characteristics of self-assessment oral health status, in the clinical experience of dental caries, periodontal status, periodontal fixation loss and to investigate the association between self-reported and clinical oral health status among Paraguayans adults during early 2017. Material and Methods: The design is cross-sectional. Two dentists carried out the oral examinations following the recommendations of the World Health Organization (WHO). Results: There were 333 adult participants with a mean age of 35 ± 13 years. Most (77.2%) of the participants were female. Missing teeth (5.32±6), filled teeth (3.56±4), and decayed teeth (2.55±3) were also detected. Almost half (48.0%) of participants had dental calculus, while 5.8% had a periodontal pocket and 48.6% periodontal fixation loss. The self-perception of oral health was poor in 12.3% of participants, fair in 29.8%, normal in 31.8%, good in 16.2%, and excellent in 9.9%. Oral health self-assessment was positive in 58.0% and negative in 42.0%. A statistically significant difference was found when comparing the DMFT index according to self-perception of oral health, the score being higher in those who had negative self-perception; obtaining similar results in the decayed component. Conclusion: Negative oral health self-perception was associated with a high DMFT index, of this, the decayed component was the only one that presented statistically significant differences.Introducción: La salud bucodental puede ser definida como la ausencia de patologías y trastornos que afectan el sistema estomatognático. Objetivos: Este estudio tuvo como objetivo determinar las características de la autoevaluación del estado de salud bucal, en la experiencia clínica de la caries dental, el estado periodontal, la fijación de la pérdida periodontal e investigar la asociación entre el estado de salud bucal autoinformado y clínico entre los adultos paraguayos a principios de 2017. Material y Métodos: El diseño es transversal. Dos odontólogos fueron calibrados para el examen bucal, siguiendo las recomendaciones de la Organización Mundial de la Salud (OMS). Resultados: Participaron 333 sujetos, el promedio de edad fue de 34.93 (DE=12.64) años, 77.2% eran mujeres. El 21.1% de las piezas dentarias estaban perdidas, el 12.2% obturadas y el 9.2% cariadas. El 48.0% presentó cálculo dental, 5.8% el bolsa periodontal y el 48.6% pérdida de fijación. La autopercepción de salud bucal fue para el 12.3% pobre, el 29.8% regular, el 31.8% normal, el 16.2% buena y el 9.9% excelente. Tuvieron una autoevaluación de su salud oral positiva el 58.0% y negativa el 42.0%. Se encontró diferencia estadísticamente significativa al comparar el DMFT index según la autopercepción de salud oral, siendo mayor el puntaje en los negativos; obteniéndose resultados similares con el componente cariado. Conclusión: La autopercepción de salud oral negativa se asoció con un elevado DMFT index, de este, el componente cariado fue el único que presentó diferencias estadísticamente significativas

Validación del Perfil de Impacto de Salud Oral en español para adultos paraguayos (OHIP-14Py).

Objetive: The objective of this study was to culturally adapt and validate the short version of the Oral Health Impact Profile (OHIP) instrument into Spanish for use by Paraguayan adults who attended dental clinics. Material and methods: The design was a cross-sectional observational study based on Classical Test Theory (CTT). The original English language version was subjected to a forward-backward translation processes; a calibration of the examiners and pilot test were performed. The questionnaire was applied by dentists through interviews; the same dentists also made the oral examination. The dimensionality of the questionnaire was evaluated using Confirmatory Factorial Analysis (CFA). The total and item-total internal consistencies were evaluated using Cronbach’s alpha. To evaluate the discriminating validity, the Mann-Whitney and Kruskal-Wallis tests were used. Spearman’s correlation analysis was used to measure convergent validity for total-dimension, self-assessment of oral health, and dental caries experience index with the DMFT Index. Results: Three-hundred-thirty-three patients participated in the study. The CFA indicates the Paraguayan’s OHIP (OHIP-14Py) is considered a multi-dimensional instrument. The Cronbach’s alpha values were appropriate for both the total (?=0.061) and for item total (?=0.80) correlation. The OHIP-14Py discriminated for the variable self-perception of oral health (p=0.001), symptoms of the temporomandibular joint (TMJ) (p=0.026), need of upper dental prosthesis (p=0.001), need of lower dental prosthesis (p=0.001), and ?20 teeth healthy (p=0.001). For measuring convergent validity, all coefficients of correlation were statistically significant (p=0.001). Conclusion: The OHIP-14Py is a reliable and valid questionnaire for the evaluation of oral health-related quality of life in Paraguayan adults.Objetivo: El objetivo del estudio fue adaptar culturalmente y validar el instrumento Perfil de Impacto de Salud Oral (OHIP) en la versión corta de 14 ítems en español, en adultos paraguayos que acudieron a consultorios odontológicos durante el primer trimestre del año 2017. Material y Métodos: El diseño del estudio fue transversal, basado en la Teoría Clásica de los Test (TCT). La versión original en inglés fue sometida al proceso de traducción-retraducción. Se realizó calibración de exa-minadores y prueba piloto. El cuestionario fue aplicado por odontólogos mediante entrevista, quienes además realizaron examen bucal. Se evaluó la dimensionalidad del cuestionario mediante el Análisis Factorial Confirmatorio (AFC). La consistencia interna fue evaluada mediante Alfa de Cronbach (?) para total e ítem-total. Se evaluó la validez discriminante utilizando las pruebas de Mann-Whitney y Kruskal-Wallis, validez convergente utilizando correlación de Spearman para total-dominio, autoevaluación del estado de salud oral e índice de experiencia de caries CPO-D. Resultados: Participaron del estudio 333 pacientes de 18 a 59 años. El AFC se consideró al instrumento multidimensional. Para el total ?=0,861 y para correlación ítem-total al suprimir cada elemento ?=0,80 siendo todos adecuados. Discriminó para las variables autoevaluación de salud bucal (p=0,001), síntomas de ATM (p=0,026), necesidad de prótesis superior (p=0,001) e inferior (p=0,001) y ?20 dientes sanos (p=0,001). Todos los coeficientes de correlación de Spearman resultaron estadísticamente significativos con p=0,001. Conclusión: El OHIP-14Py es un cuestionario fiable y válido para la evaluación de la calidad de vida relacionada con la salud oral en adultos paraguayos

Análisis de calidad de vida relacionada con salud oral en adultos con maloclusión

Introducción: Pacientes que requirieron tratamiento de ortodoncia reportaron impactos negativos en la calidad de vida relacionada con salud oral en comparación con aquellos pacientes con oclusión normal. Objetivo: Analizar la calidad de vida relacionada con salud oral en pacientes con diferentes niveles de severidad de maloclusión que acudieron a consultorios odontológicos públicos de Paraguay durante el año 2017. Metodología: Estudio transversal. Se midieron variables sociodemográficas como sexo, edad, residencia y nivel de estudios y variables clínicas como diastema, máxima irregularidad anterior maxilar y mandibular, resalte incisal y mordida cruzada anterior. Se utilizó el cuestionario Perfil de Impacto de Salud Oral en su versión paraguaya (OHIP-14Py) y el Índice de Estética Dental (IED). Resultados: Formaron parte del estudio 269 pacientes, la mayoría mujeres (75,1%). El puntaje IED fue de 31,35±11,56. Se observó resalte incisal aumentado (>2 mm) en poco más de la mitad (52,4%) y una baja frecuencia de mordida cruzada anterior (5,9%) y mordida abierta (10,0%). Al evaluar por dimensiones, la incapacidad psicológica (p=0,028), social (p=0,034) y minusvalía (p=0,552) aumentaron conforme el nivel de severidad de maloclusión, siendo estadísticamente significativa las dos primeras. Conclusión: Conforme aumenta la gravedad del nivel de maloclusión disminuye significativamente la calidad de vida oral para las dimensiones incapacidad psicológica e incapacidad social

Impact of oral health on the quality of life of Paraguayan adults

Introduction: Alterations in the oral cavity can affect people’s quality of life, hence it is important to determine how the individual perceives their own health. Objective: To determine the oral health-related quality of life in adults who received dental care at establishments managed by the Ministry of Public Health and Social Welfare of Paraguay, the School of Dentistry of Universidad Nacional de Asunción, and the “Chacarita” Community Center, in Paraguay, in the first quarter of 2017. Material and Methods: A cross-sectional study was carried out. The Paraguayan version of the Oral Health Impact Profile (OHIP-14Py) was used. Spearman's correlation, Kruskal-Wallis, and Mann-Whitney tests were used to relate the impact of oral health with demographic, labor, educational, and clinical variables. Results: 333 subjects participated in the study. The most affected domains were physical pain, psychological distress, and psychological disability. The correlation between OHIP-14Py and DMF-T was positive but poor (r=0.236; p=<0.001). The oral health-related quality of life was significantly lower in subjects with abnormal oral mucosa (p=0.020), presence of TMJ symptoms (p=0.026), need for prostheses (p<0.001), higher level of severity of DMF-T (p<0.001), use of upper (p=0.004) and lower (p<0.001) prostheses, and absence of functional dentition (p<0.001). Conclusion: Primary and secondary preventive measures should be promoted since oral health status can negatively influence people’s quality of life and may even cause total inability to carry out daily activities

El Trabajo Final de Grado en la titulación de Enfermería. Organización, evaluación y cambios para la mejora de la calidad docente

Podeu consultar la Vuitena trobada de professorat de Ciències de la Salut completa a: http://hdl.handle.net/2445/66524Objetivo: Presentar la organización, evaluación continuada de resultados y propuestas de mejora implementadas durante los tres cursos de desarrollo de la asignatura TFG. Presentación: La asignatura de Trabajo Final de Grado (TFG) se imparte en el séptimo semestre de la titulación. Para el óptimo desarrollo del TFG, la orientación que se realiza a los estudiantes (en el Plan de Acción Tutorial y del TFG) se basa en los criterios uniformes i consensuados de una Guía docente. Los tutores del PAT–TFG son profesores titulares y colaboradores, profesionales del ámbito docente, asistencial e investigador. El equipo de tribunales está integrado por profesores titulares doctores o con estudios de master universitario. Metodología: Durante los tres cursos de desarrollo del TFG hemos realizado una evaluación continuada con estudiantes, tutores y equipo de tribunales. Han valorado cuantitativa y cualitativamente la organización, tutela, presentación y evaluación del TFG. Resultados y conclusiones: Destacamos como aspectos positivos la disponibilidad, interés y responsabilidad de los tutores, y su participación en los seminarios de formación y en las reuniones de reflexión e intercambio de opiniones; la Guía docente, periódicamente revisada y reeditada; el trabajo cooperativo del equipo de tribunales en la revisión de las rúbricas de evaluación y valoración del diseño y proceso; los seminarios de formación continuada y la coordinación conjunta TFG y PAT. Las áreas de mejora identificadas se concretan en profundizar la reflexión y unificar criterios metodológicos, tanto de tutorización como de evaluación; implicar más a los estudiantes en la mejora de la calidad de los trabajos iniciando la formación con seminarios específicos desde tercer curso, ya que, a pesar de la formación recibida en las diferentes asignaturas de la titulación, presentan dificultades en la búsqueda bibliográfica, redacción y síntesis de la información. Los estudiantes viven la asignatura con dificultad porque es donde deben desarrollar y demostrar su capacidad de trabajo autónomo

Examining the association between evidence-based practice and the nurse-patient therapeutic relationship in mental health units: a cross-sectional study

Aims: to examine the relationship between the dimensions of evidence-based practice and the therapeutic relationship and to predict the quality of the therapeutic relationship from these dimensions among nurses working in mental health units. Design: a cross-sectional design. Methods: data were collected between February-April 2018 via an online form completed by nurses working at 18 mental health units. Multiple linear regressions were used to examine the relationship between the dimensions of evidence-based practice and therapeutic relationship. Questionnaires were completed by 198 nurses. Results: higher levels of evidence-based practice were a significant predictor of a higher-quality therapeutic relationship (β: 2.276; 95% CI: 1.30-3.25). The evidence-based practice factor which most influenced an improved therapeutic relationship was the nurses' attitude (β: 2.047; 95% CI: 0.88-3.21). The therapeutic relationship dimension which was most conditioned by evidence-based practice dimensions was agreement on tasks, which was most favourable with a better attitude (β: 0.625; 95% CI: 0.09-1.16) and greater knowledge and skills for evidence-based practice (β: 0.500; 95% CI: 0.08-0.93). Conclusion: in mental health settings, the therapeutic nurse-patient relationship is positively enhanced by evidenced-based practice and the nurse's level of experience, with a great influence on shared decision-making. Impact: this research sought to examine the relationship between the evidence-based practice and the therapeutic relationship in mental health nursing. This study demonstrates that an improved attitude and knowledge of evidence-based practices of mental health nurses increases shared decision-making with patients, which is a basic requirement for person-centred care. Because the therapeutic relationship is considered the backbone of nursing practice in mental health units, this research will have an impact on both mental health nurses and mental health unit managers

Resilience and job satisfaction among out‐of‐hospital emergency medical service professionals: a cross‐sectional multi‐centric study

Aim: We aim to describe the relationship between job satisfaction and compare levels of resilience among out-of-hospital emergency medical service professionals. Background: The study of the impact of the working environment on health professionals has raised great interest. Job-related variables and resilience can be a protective factor against stressful and demanding events at work. Methods: A cross-sectional survey comprising sociodemographic and job-related variables was conducted among 406 workers (doctors, nurses, psychologists, and ambulance technicians) from the out-of-hospital emergency medical system in Spain. Resilience was self-reported using the Connor-Davidson Resilience Scale. Results: Nursing professionals were less resilient compared with ambulance technicians (score difference 1.709, p = .008). As age increased, resilience was lower (r = -.118). Professionals with higher resilience scores were more satisfied in their work (OR = 1.06, 95% CI: 1.02-1.11), and professionals with higher psychological strength, gained from working with other colleagues, also showed greater job satisfaction (OR = 5.47, 95% CI: 2.55-11.73). Conclusion: There was a positive association between resilience, job satisfaction and collaborative work. Professionals with greater psychological strength, gained from working with other colleagues, also showed higher levels of job satisfaction. Implications for nursing management: Managers can use these results to influence the work environment to enhance job satisfaction and hence improve the resilience of the out-of-hospital emergency health care professionals

Adaptación y validación de un cuestionario para evaluar las prácticas de autocuidado en población infantil sana residente en España

Altres ajuts: Departament de Salut (SLT006/17/00098) de la Generalitat de Catalunya per a la intensificació investigadora en el marc del Pla Estratègic de Recerca i Innovació en Salut (PERIS)Adaptar y validar el Child and Adolescent Self-Care Performance Questionnaire (CASPQ) al contexto de la población infantil sana de 8 a 12 años residente en España y evaluar sus propiedades métricas. Estudio de validación fundamentado en la Teoría Clásica de los Tests. Cuatro centros educativos participantes en el programa «Salut i Escola» de un centro de atención primaria de Barcelona (España). Un total de 498 alumnos y alumnas de educación primaria participaron en el estudio durante los primeros seis meses de 2016. Se realizó la adaptación cultural del cuestionario. Se evaluó el proceso de respuesta, la estructura factorial y se analizaron las relaciones de las puntuaciones del CASPQ con las del cuestionario KIDSCREEN-27. Asimismo, se evaluaron la consistencia interna y la reproducibilidad de las puntuaciones. Se obtuvieron 489 cuestionarios. El análisis factorial confirmatorio de su estructura teórica mostró un ajuste suficiente. Se observó una asociación positiva entre las puntuaciones del cuestionario y las del KIDSCREEN-27. La consistencia interna global fue satisfactoria; no obstante, la de cada factor fue marginal o moderada. La reproducibilidad de las puntuaciones fue óptima. El CASPQ adaptado a la población infantil sana de 8 a 12 años muestra unas propiedades métricas adecuadas y similares a las del cuestionario original. Por ello, es un instrumento útil para evaluar las prácticas de autocuidado y planificar intervenciones dirigidas a su promoción

Psychometric properties of the self-administered version of the 'Self-Care Requisites Scale' among carers for the mentally ill

Introduction: people with schizophrenia frequently need the assistance of a family member who may then become the main carer for the patient. For the carer this may be a difficult and complicated situation that needs to be taken into account in the design of healthcare intervention. Our plan was to carry out an evaluation of the carer, using the 'Self-care Requisites Scale' of Roldan (2011). The aim of the study was to adapt the scale in such a way that it could be self-administered. Methodology: the design was carried out in two phases. First the questionnaire was adapted so that it could be self-administered; this was done by consensus among a group of experts. In the second phase we analyzed the psychometric properties of the results in terms of reliability and validity. Results: the definitive questionnaire consisted of 35 items and 6 dimensions. The internal consistency coefficient for the instrument overall was 0.85. The strongest correlations were obtained between the majority of the sub-scales and the total scale. Conclusions: the 'Self-care Requisites Scale' is easily self-administered by the carers of people suffering schizophrenia. The results, in terms of both reliability and validity, were good

Adaptation of the person centered therapeutic relationship patient version (PCTR‐PT) to a version for physiotherapists (PCTR‐PHYS) and evaluation of its psychometric properties

[EN] Background and Purpose The therapeutic relationship is a central component for developing person-centered care within physiotherapy services. However, it is necessary to understand how this relationship is perceived by both parties involved. The Person Centered Therapeutic Relationship-Patient scale (PCTR-PT) was constructed to identify patients' perceptions. No instruments are currently available to correlate patients' and physiotherapists' perceptions of the therapeutic relationship. This study sought to adapt the PCTR-PT to develop a version for physiotherapists, the Person Centered Therapeutic Relationship Scale for Physiotherapists (PCTR-PHYS) and to determine its psychometric properties. Methods A three-stage study was performed: (1) item generation, (2) pretesting of the questionnaire, (3) analysis of psychometric properties. Factor validity and psychometric properties were analyzed by confirmatory factor analysis (CFA). Convergent validity was calculated. Internal consistency was verified using the Cronbach's alpha coefficient. The intraclass correlation coefficient (ICC) was used to examine temporal stability. Results Thirty-three physiotherapists participated in two rounds of cognitive interviews and 343 participated in the analysis of psychometric properties. The CFA confirmed the four-structure model. Reliability of the tool was confirmed by Cronbach's alpha (α = 0.863) for all four dimensions, as all were above 0.70, ranging from 0.704 (relational bond) and 0.898 (therapeutic communication). Test-retest was performed with 2-week intervals, indicating an appropriate stability for the scale (ICC = 0.908). Discussion The Person Centered Therapeutic Relationship Scale for Physiotherapists is a useful, valid and applicable instrument to evaluate the person-centered therapeutic relationship during physiotherapy interventions. It will enable the comparison of patients' and physiotherapists' perceptions. To provide person-centered care in physiotherapy services, there is a clear need to incorporate specific resources into clinical practice to evaluate the quality of the therapeutic relationship from the perspective of both the persons being treated and the professionals providing care.SIPublicación en abierto financiada por el Consorcio de Bibliotecas Universitarias de Castilla y León (BUCLE), con cargo al Programa Operativo 2014ES16RFOP009 FEDER 2014-2020 DE CASTILLA Y LEÓN, Actuación:20007-CL - Apoyo Consorcio BUCL