Validez y confiabilidad del cuestionario de ansiedad y miedo dental IDAF- 4C+ en embarazadas chilenas / Validity and reliability of the Index of Dental Anxiety and Fear (IDAF-4C+) in Chilean pregnant women

Introducción: La ansiedad dental influye notablemente en el estado de salud oral, entorpeciendo el manejo del paciente durante la atención dental y la adherencia al tratamiento. Por ello su detección es central, sobretodo en grupos vulnerables como las mujeres embarazadas. Debido a la escasez de instrumentos con adecuadas propiedades psicométricas es que se buscó determinar la validez de contenido, validez de constructo y confiabilidad del cuestionario IDAF-4C+ versión en español en mujeres embarazadas en servicios de atención primaria de la Región Metropolitana, Chile. Material y Métodos: Estudio transversal descriptivo. La validez de contenido se determinó mediante el juicio de expertos, la validez de constructo a través del análisis factorial confirmatorio, mientras que la confiabilidad se determinó por consistencia interna, a través del coeficiente alfa de Cronbach. Resultados: Fueron evaluadas 72 mujeres embarazadas. El juicio de expertos no realizó modificación al IDAF-4C+ versión en español. El análisis factorial confirmó la presencia de un solo factor, el cual explicó el 61,86% de la varianza, mientras que la confiabilidad arrojó un alfa de Cronbach de 0,908, considerado excelente. Discusión: El cuestionario IDAF-4C+ presentó una adecuada validez de contenido, validez de constructo y una excelente confiabilidad. Su uso es adecuado para la medición de ansiedad dental en mujeres embarazadas que acuden a servicios de atención primaria en Chile

Introduction: Dental anxiety is a problem that greatly affects oral health and dental compliance in adults. There are many instruments to assess dental anxiety in general population. IDAF-4C+ has a modular structure that allows to identify dental anxiety levels and feared stimuli related to dental setting. The aim of this study is to determine the construct and content validity, and the reliability of the Spanish version of IDAF-4C+ in pregnant women from primary health care centers in Santiago, Chile. Methods: 72 pregnant women ranged from 18 to 40 years old were recruited at primary health care centers from Santiago, Chile. To determine content validity the agreement among experts was assessed. Confirmatory factor analysis was used to demonstrate the construct validity, meanwhile reliability was determined in terms of internal consistency by undertaken Cronbach's alpha coefficient. Results: The results indicated that the prevalence of dental anxiety is 33.34% in women. The experts did not modify the Spanish version of IDAF-4C+. Confirmatory factor analysis yielded a single factor that accounted for 61,86% of variance. A high Cronbach's alpha (a = 0,908) confirm the internal consistency of the instrument. Conclusion: IDAF-4C+ presents an appropriate construct and content validity, and an excellent reliability. It is a proper instrument to be used in pregnant women enrolled in primary health care centers in Chile

[The efficacy of sleep hygiene measures in the treatment of insomnia]. / Eficacia de las medidas de higiene del sueño en el tratamiento del insomnio.

In order to compare the efficacy of sleep hygiene to the effect of a placebo and to a treatment with benzodiazepines in psychophysiologic insomnia. We performed a clinical assay in 150 patients from a primary care unit in Chihuahua, Chih. Patients were allocated in three groups according to a non-systematic random procedure. Patients from group I received an instructive booklet with 10 recommendations about sleep hygiene, group II received placebo, and group III benzodiazepines. Patients were interviewed three weeks after the maneuver was delivered. The effect of the maneuver was classified as success or failure. In Group I, the result was of 65% success vs 35% failure; in Group II. 50% success vs. 50% failure; and group III, 73% success vs. 23% failure (p = 0.06). In conclusion, all three types of treatment have similar efficacy in the management of insomnia. Sleep hygiene is effective and does not have risk of secondary effects. Thus, we recommend sleep hygiene as the therapy of first choice for insomnia.