Problemas de salud mental en universitarios durante la pandemia por COVID-19: ¿qué tipo de ayuda buscan? / Mental health problems in university students during the COVID-19 pandemic: What kind of help do they seek?

Introducción: La pandemia por COVID-19 ha tenido un impacto negativo en el bienestar psicológico de la población, siendo los jóvenes un grupo especialmente vulnerable. Objetivo: El presente estudio se propuso examinar los niveles de búsqueda de ayuda (formal e informal) para problemas en salud mental y sus variables asociadas en una muestra de estudiantes universitarios de la Región de La Araucanía, en el contexto de la pandemia por COVID-19. Método: A través de un muestreo no probabilístico por conveniencia, se reclutó a 500 estudiantes de entre 18 y 29 años. Se describió y comparó su nivel de búsqueda de ayuda, así como variables que podrían obstaculizarla o facilitarla, según género. Adicionalmente, se estimaron modelos de regresión lineal múltiple diferenciados por género, con la búsqueda de ayuda informal como variable criterio. Resultados: Se evidenció una renuencia general a buscar ayuda (formal e informal) tanto en hombres como mujeres, una mayor experimentación de malestar psicológico y mayor conocimiento sobre salud mental en mujeres. Finalmente, se observaron diferencias en los predictores de la búsqueda de ayuda informal entre hombres y mujeres, siendo el apoyo social y las emociones negativas en pandemia los únicos comunes entre géneros. Conclusión: Se discuten los bajos niveles de búsqueda de ayuda evidenciados, y las diferencias observadas en variables asociadas, en función de la brecha de género en salud mental.

Introduction: The COVID-19 pandemic has impacted the psychological well-being of the population, with young people being a particularly vulnerable group. Aim: The present study examines help-seeking intention for mental health problems and associated variables among male and female university students in La Araucanía Region during the COVI-19 pandemic. Method: A sample of 500 students aged 18 to 29 was recruited through non-probabilistic convenience sampling. Help-seeking levels and facilitating or hindering variables were compared by gender. Multiple linear regression models were estimated separately by gender to predict the criterion variable of informal help-seeking. Results: The results indicate that both men and women are reluctant to seek help (formal and informal). Women reported higher levels of psychological distress and greater knowledge about mental health than men. Differences in predictors of informal help-seeking between men and women are evidenced, with social support and negative emotions in pandemic being the only common predictors between genders. Conclusion: The low levels of help-seeking evidenced, and the differences observed in associated variables based on the gender gap in mental health, are discussed.

Escala de creencias hacia las vacunas y hacia la vacuna contra el SARS-CoV-2: Evidencia de sus propiedades psicométricas / Psychometric properties of two surveys about beliefs towards vaccines in general and SARS-CoV-2 vaccine

BACKGROUND: Negative beliefs about vaccines can threaten herd immunity and pandemic control. Although beliefs about vaccines influence vaccination intention, there are no valid instruments that evaluate this in the Latin American population. AIM: To evaluate the psychometric properties of two scales that measure negative beliefs towards vaccines in general and against SARS-CoV-2 and provide evidence of their association with vaccination intention (convergent validity) in a Chilean sample. MATERIAL AND METHODS: Two studies were carried out. The first included 263 people who answered the beliefs towards vaccines in general scale (CV-G) and the beliefs towards the SARS-CoV-2 vaccine scale (CV-COVID). Exploratory factor analyses were conducted. In the second study, 601 people answered the same scales. Confirmatory factor analyses and structural equation modeling were performed to provide evidence of validity. RESULTS: Both scales had an unifactorial structure and excellent reliability and showed associations with the intention of vaccination against SARS-CoV-2, providing evidence of convergent validity. CONCLUSIONS: The scales evaluated here are reliable and valid measures that showed associations with vaccination intention in the Chilean population.

Escala de creencias hacia las vacunas y hacia la vacuna contra el SARS-CoV-2: Evidencia de sus propiedades psicométricas / Psychometric properties of two surveys about beliefs towards vaccines in general and SARS-CoV-2 vaccine

BACKGROUND: Negative beliefs about vaccines can threaten herd immunity and pandemic control. Although beliefs about vaccines influence vaccination intention, there are no valid instruments that evaluate this in the Latin American population. Aim: To evaluate the psychometric properties of two scales that measure negative beliefs towards vaccines in general and against SARS-CoV-2 and provide evidence of their association with vaccination intention (convergent validity) in a Chilean sample. MATERIAL AND METHODS: Two studies were carried out. The first included 263 people who answered the beliefs towards vaccines in general scale (CV-G) and the beliefs towards the SARS-CoV-2 vaccine scale (CV-COVID). Exploratory factor analyses were conducted. In the second study, 601 people answered the same scales. Confirmatory factor analyses and structural equation modeling were performed to provide evidence of validity. RESULTS: Both scales had an unifactorial structure and excellent reliability and showed associations with the intention of vaccination against SARS-CoV-2, providing evidence of convergent validity. Conclusions: The scales evaluated here are reliable and valid measures that showed associations with vaccination intention in the Chilean population.

Life Satisfaction among Indigenous People from Chile: Evaluation of Measurement Invariance / Satisfacción con la vida en indígenas de Chile: evaluación de la Invarianza de Medida

Abstract Although the Life Satisfaction Scale (SWLS) has been used to establish comparisons among nations/cultures, the measurement invariance of this scale has not always been demonstrated. The forced acculturative experience of indigenous minorities and its differentiation of gender roles could impact how people respond to this scale. The purpose of this study was to examine the measurement invariance of the SWLS when it is applied to a Chilean indigenous group, considering gender and their most frequent acculturative types (i.e., acculturated and bicultural). Eight hundred adults of Mapuche origin answered a Spanish version of the SWLS and the Mapuche Acculturation Scale. The results supported the SWLS strict invariance between acculturated and bicultural and also between acculturated men and women. Partial strict invariance was found between bicultural men and women; specifically, the residual variance of Item 3 was higher in women than in men. Since Spanish is a gendered language, a linguistic explanation is proposed for the non-invariance of this item. The importance of careful wording of the items, when administered in multilanguage acculturation contexts, is discussed.

Resumen Aunque la Escala de Satisfacción con la Vida (SWLS) se ha usado para comparar personas de distintas naciones/culturas, no siempre su invarianza de medición ha sido demostrada. La aculturación forzada de las minorías indígenas y sus particulares roles de género podrían afectar las respuestas de esas personas a esta escala. Este estudio tuvo por objetivo examinar la invarianza de la SWLS en un grupo indígena chileno, considerando el género y los tipos aculturativos más frecuentes (i.e., aculturados y biculturales). Ochocientos adultos mapuches respondieron, en castellano, la SWLS y la Escala de Aculturación Mapuche. Se encontró apoyo para invarianza estricta entre aculturados y biculturales y, además, entre hombres y mujeres aculturados. Se encontró invarianza estricta parcial entre hombres y mujeres biculturales; específicamente, la varianza residual del ítem 3 fue mayor en mujeres que en hombres. Siendo el castellano un idioma con distinción de géneros, se propuso una explicación lingüística para la falta de invarianza de ese ítem. Se discute la importancia de redactar cuidadosamente los ítems cuando son administrados en contextos aculturativos multilingües.

Autopercepción de salud en adultos mayores: moderación por género de la situación financiera, el apoyo social de amigos y la edad / The influence of financial situation and friends' support on health self-perception of older adults

Background: The Chilean population is aging rapidly. This socio-demographic change imposes psychosocial and economic challenges that are relevant for the health care of older people. Aim: To assess the association between perceived financial situation, perceived social support by friends, and age with health self-perception in older people. Material and Methods: A questionnaire about health self-perception, financial situation, and social support perceived by friends was applied to 383 occupationally active adults aged 68 ± 5 years (66% women) living in urban areas of Southern Chile. A gender-based multi-group path model was specified, which evaluated the association of health self-perception with the assessment of the financial situation, social support, and age. Results: The final model was moderated by gender. However, age was not associated with health self-perception. For men and women, the perceived financial situation showed a positive association with health self-perception. The perceived social support of friends was only significant for women. Conclusions: The financial situation and friends' support (among women) are factors that should be considered in the evaluation of the health perception of older adults.

Cell Saver en Obstetricia. Primer caso reportado en Chile / Cell Saver in Obstetrics. First case reported in Chile

La hemorragia obstétrica representa un desafío para el equipo médico, aportando con importante morbilidad y mortalidad a las pacientes embarazadas.El manejo adecuado, precoz y expedito beneficia el logro de resultados favorables para la madre e hijo; es por esto que debemos reconocer activamente aquellas pacientes en riesgo de presentar un sangrado obstétrico significativo.Presentamos el primer caso reportado en Chile de una paciente embarazada con mala inserción placentaria, sometida a cesárea y decómo se realizó el manejo del sangrado intraoperatorio, con énfasis en el uso de Cell Saver como técnica ahorradora de sangre.(AU)

Obstetric hemorrhage is a challenge for the medical team, contributing with significant morbidity and mortality to the pregnant patient.An appropriate, early, and expeditious management eases the achievement of favourable results for mother and son. We must recognizeactively those patients at risk of a significant obstetric bleeding.We present the first case report in Chile of a pregnant patient with abnormal placentation, undergoing a caesarean section and howbleeding was handled during the surgery, with emphasis on the use of a Cell Saver device as a blood-saving technique.(AU)

What do Chilean and Costa Rican psychologists believe and advise about parenting? / ¿Qué creen y aconsejan psicólogos (as) chilenos (as) y costarricenses sobre la crianza de los (as) hijos (as)?

Abstract This research investigates the subjective theories of 12 Chilean and Costa Rican psychologists who work with children, with the purpose of describing and interpreting their explanations about child rearing. Episodic interviews were used and analyzed using a Grounded Theory model. The interviewees point out that they use their own experience and beliefs when advising parents. Results indicated that, according to the interviewees, the topics most frequently consulted by parents were children's high impulsivity and disciplining. The interviewees believe the most common parenting styles are the authoritarian and the permissive ones, the latter being associated with parents' fear and anxiety.

Resumen Este estudio investigó las teorías subjetivas de 12 psicólogos(as) chilenos(as) y costarricenses que trabajan en temáticas de infancia, a objeto de poder describir e interpretar sus explicaciones sobre la crianza. Esta investigación fue de carácter cualitativo, con un diseño metodológico descriptivo-interpretativo. Se realizaron entrevistas episódicas, analizadas utilizando el modelo de la Grounded Theory (teoría fundamentada). Los participantes señalaron usar sus propias experiencias y creencias al aconsejar a los padres y a las madres. Según los (as) entrevistados (as), los padres y las madres consultan principalmente sobre la impulsividad y disciplina de los (as) hijos (as). De acuerdo a los (as) entrevistados (as), los estilos parentales más recurrentes son el autoritario y el permisivo, este último asociado con el miedo y ansiedad de los padres y madres.

Parto Natural. ¿Qué nos dice la evidencia? / Natural birth. What does the evidence tell us?

Introducción: Es deseable que el proceso del parto concluya con una madre y un recién nacido sano, y sea un momento especial e íntimo. El Parto Natural, ha sido propuesto como una opción para mejorar la satisfacción de las mujeres con el proceso del parto. Sin embargo, no existen definiciones serias respecto a qué es el Parto Natural, introduciendo dificultades en la atención de mujeres que solicitan un Parto Natural. Métodos: El objetivo de este artículo es revisar la mejor evidencia disponible para entender cómo debe definirse un Parto Natural y analizar si se asocia a riesgos mayores que los de la atención médica habitual del parto. Resultados: Hemos comprobado que no existen definiciones científicas consensuadas para precisar qué es el Parto Natural, dejando espacio para discusión sobre su verdadero significado. No existen estudios de diseño aleatorizado y controlado que comparen el resultado materno/perinatal del parto natural comparado con la atención habitual del parto. Las intervenciones médicas, usadas en la atención médica del parto, y que podrían ser evitadas en el Parto Natural, producen algunos cambios favorables y otros deletéreos respecto de la salud materna y perinatal. Conclusiones: La decisión de optar por el Parto Natural debe ser discutida con las mujeres que lo solicitan, precisando con ella y su pareja cuál es su concepto de parto natural o qué es lo que desean incluir o evitar, los riesgos y beneficios asociados a cada una de las intervenciones deben ser expuestos por el equipo médico, para adoptar un plan de manejo individualizado.(AU)

Introduction: It is desirable that the birth process concludes with a healthy mother and newborn, while at the same time being a special and intimate moment. Natural childbirth has been proposed as a recent option to improve the satisfaction of women with the process of childbirth. However, there are no serious definitions regarding what is or should be a Natural Childbirth, introducing difficulties in the care of women who request a Natural Birth. Methods: The objective of this article is to review the best available evidence to understand how Natural Childbirth should be defined and to analyze if it is associated with greater maternal or perinatal risks than those of usual medical care at birth. Results: We verified that there are no agreed scientific definition to specify what Natural Childbirth is, leaving space for discussion about its true meaning. There are no randomized, controlled trials comparing the maternal/ perinatal outcome of natural childbirth compared to usual medical care during labor/delivery. Medical interventions used in childbirth are that could be avoided in natural birth produce some favorable changes and some deleterious changes in maternal and perinatal health. Conclusions: The decision to choose Natural Childbirth must be discussed with the women who request it, specifying with her and her partner´s concept of natural childbirth or what they wish to include or avoid, the risks and benefits associated with these interventions must be exposed by the medical team, to adopt an individualized management plan.(AU)

Manejo de la pancreatitis aguda litiásica en la embarazada / Management of acute lithiasic pancreatitis in pregnant women

Resumen: La pancreatitis aguda (PA) es una patología poco frecuente durante el embarazo, siendo la colelitiasis una de sus principales etiologías y Chile uno de los países con más altas prevalencias de colelitiasis en el mundo. Esta patología clásicamente ha reportado altas tasas de mortalidad materno-fetal, así como también riesgo de morbilidad fetal. Sin embargo, gracias a los avances en terapia de soporte y mejoras en unidades de neonatología, en la actualidad el pronóstico con un adecuado tratamiento es alentador. Nos parece imperativo tener protocolos adecuados de toma de decisión en la embarazada con pancreatitis aguda, puesto que, a pesar de ser una patología de baja prevalencia, un correcto enfrentamiento puede mejorar el resultado materno-fetal. El presente trabajo propone una guía de manejo clínico interdisciplinario de la embarazada con pancreatitis y aporta una revisión actual sobre este tema.(AU)

Acute pancreatitis (PA) is a rare disease during pregnancy, with cholelithiasis being one of its major etiologies and Chile one of the countries with the highest prevalence of cholelithiasis in the world. This pathology has traditionally reported high rates of maternal- fetal mortality, as well as the risk of fetal morbidity. However, thanks to the advances in supportive therapy and improvements in neonatal units, the prognosis with an adequate treatment is now encouraging. It seems imperative to have adequate decision-making protocols in the pregnant woman with acute pancreatitis, since despite being a pathology of low prevalence a correct confrontation can improve the maternal-fetal outcome. This paper proposes an interdisciplinary clinical management guide for pregnant women with pancreatitis and provides a current review on this topic.(AU)