ABSTRACT
Resumen Introducción: En los últimos años se ha reconocido la importancia de evaluar la supervisión clínica y su rol en el proceso psicoterapéutico. No obstante, son escasos los instrumentos que cumplen con este propósito, particularmente en Latinoamérica. En este estudio, se buscó adaptar al castellano la versión breve del Cuestionario de relación de supervisión (S-SRQ, por sus siglas en inglés de: Short Supervisory Relationship Questionnaire), compuesto de tres dimensiones: base segura, educación reflexiva y estructura; y aportar evidencias sobre su desempeño psicométrico. Método: El S-SRQ fue traducido y retraducido a su idioma original. Posteriormente, fue administrado a 374 psicoterapeutas argentinos (muestra no probabilística). Se realizaron análisis de consistencia interna (alfa de Cronbach), dimensionales (análisis paralelo y factorial confirmatorio), y a nivel del ítem (coeficientes estandarizados y correlación ítem-escala). Resultados: Los coeficientes de consistencia interna fueron adecuados para la escala total y, en general, para cada dimensión. Los análisis dimensionales se ajustaron a un modelo de tres dimensiones, base segura, educación reflexiva y estructura. El desempeño de los ítems fue bueno con relación a la escala total y cada dimensión. Discusión: El desempeño psicométrico del S-SRQ en castellano fue similar al de la escala original, con algunas diferencias. La escala presenta potencial para ser aplicada en el contexto argentino, tanto en el ámbito científico como en la práctica.
Abstract Introduction: In recent years the significance of evaluating clinical supervision and its role in the psychotherapeutic process has been recognized. However, there are few instruments for such evaluation, particularly in Latin América. This study aimed to adapt the three-dimensional (reliable basis, reflexive education and structure) Short Version of the Supervisory Relationship Questionnaire (S-SRQ) to Spanish. Method: The questionnaire was administered to 374 Argentine psychotherapists (non-probabilistic sample). The S-SRQ was translated and retranslated to its original language. It was performed internal onsistency (Cronbach's alpha), dimensional (parallel and confirmatory factor analysis), and item analyzes (standardized coefficients and item-scale correlation). Results: The internal consistency coefficients were adequate for the total scale and, in general, for each dimension. The dimensional analyses were adjusted to a three-dimensional model, reliable basis, reflective education and structure. Item performance was good in relation to the total scale and each dimension. Discussion: The psychometric performance of the S-SRQ in Spanish was like the original scale, with some exceptions. The scale has potential to be implemented in our context, both at a practical and scientific level.
ABSTRACT
Resumen La exposición prenatal al alcohol puede derivar en un espectro de trastornos congénitos, dentro de los cuales el Síndrome Alcohólico Fetal (SAF) es el más severo. Esto es 100 % prevenible si no se consume alcohol durante la gestación, por lo que conocer los factores que determinan que una mujer consuma alcohol estando embarazada es fundamental. El objetivo de este trabajo es evaluar si características del entorno (como son las normas sociales prescriptivas o NSP) se relacionan con el consumo de alcohol durante la gestación en mujeres de la ciudad de Mar del Plata, Argentina. Para ello, se realizó un muestro probabilístico de 852 mujeres gestantes durante el año 2016 en los principales centros de atención primaria a la salud de la ciudad. Se evaluó el consumo de alcohol antes y durante la gestación a través del Test de Identificación de Trastornos por Consumo de Alcohol y las NSP con preguntas construidas ad hoc. El 87 % consideró que las otras gestantes consumen alcohol; de ellas, 53 % cree que el consumo es igual, 10 % cree que es mayor y el resto menor. El 90 % reconoció que las personas importantes para ellas desaprobarían el consumo durante la gestación. Las mujeres con un entorno favorable hacia el consumo se correspondieron con ingesta de alcohol en el embarazo, mientras que se observó lo contrario en los casos en los que el entorno era desfavorable. Estos resultados indican que podría ser beneficioso diseñar estrategias preventivas que se focalicen no solo en la gestante, sino en el entorno cercano.
Abstract Prenatal alcohol exposure can lead to a spectrum of congenital disorders for the fetus with permanent consequences, known as fetal alcohol spectrum disorders (FASD), within which Fetal Alcohol Syndrome (SAF) is its most severe extreme. All FASD are 100 % preventable if no alcohol is consumed during pregnancy, so knowing the factors that determine that a woman decides to drink while pregnant is essential to develop effective prevention plans. Among these factors are the phenomena of social influence such as perceived social norms (PSN), both descriptive and prescriptive. The PSN are transmitted by social interaction and produced based on the perception of the beliefs or behaviors of others, beyond their real actions. It has been identified that PSN predict alcohol consumption in various populations, such as university students, but research is almost non-existent with pregnant women. The aim of this study is to assess whether environmental characteristics (such as PSN) are related to alcohol consumption during pregnancy in pregnant women in the city of Mar del Plata, Argentina. Method: a probabilistic sample of 852 pregnant women was carried out during 2016 in the main primary health care centers of the city of Mar del Plata. Alcohol consumption was assessed before and during pregnancy through the AUDIT and the PSN was assessed with five questions constructed ad hoc by specialists in the area of alcohol consumption. Descriptive analyses were performed to categorized social norms and the prescriptive ones were re-categorized into four groups: 1. It is bad for the health of the baby or the mother; 2. It is wrong for cultural or moral reasons; 3. consumption is accepted; 4. It does not know/does not matter. To describe them based on alcohol consumption, latent class analyses were performed. Models of two to four classes were estimated, reproduced 50 times to avoid local maximums, with the software R. Results: 87 % of pregnant women believed that others in their same condition consume alcohol. 53 % of them believed they consume the same as before pregnancy, 10 % believed they consume more and the rest that they reduced their consumption. The belief about the average amount that other pregnant women would consume is more than three drinks, the equivalent of one bottle of beer per occasion of consumption. 90 % recognized that people important to them would disapprove consumption during pregnancy because doing so would cause harm to the baby, the mother, pregnancy in general or because alcohol is considered harmful to health. 6 % considered that people important to them would approve consumption because few amounts are tolerated or because alcohol is good for breastfeeding. The latent class analysis indicated a better fit for the two-class model. Class 1 was made up of women who claimed that for their people, alcohol consumption during pregnancy was acceptable and they themselves consumed alcohol during pregnancy. Class 2 conglomerated women who thought that others would see their consumption as bad at this stage and there was a low probability that they themselves consumed during pregnancy. Conclusions: These results indicate that it could be beneficial to design preventive strategies that focus not only on the future mother, but on the nearby environment (couple, family, friends), and even throughout the community, where social norms are established and reproduced.