title: Perceived sources of stress amongst Chilean and Argentinean dental students.
abstract: BACKGROUND
  The prevalence of high levels of stress as well as its multilevel consequences is well documented amongst students in the health sciences, and particularly in dentistry. However, investigations of perceived stress amongst Spanish-speaking student groups are sparse. This study aimed to (i) describe the translation, adaptation and psychometric properties of a Spanish version of the Dental Environment Stressors questionnaire and (ii) to examine the perceived sources of stress and their associations with the students' study year and gender in two dental schools in Latin America.
  
  
  METHODS
  All students officially registered in the dental schools of the University of San Sebastian (USS) in Chile and the Catholic University of Cordoba (CUC) in Argentina were invited to participate in the study. The DES30 questionnaire was adapted in Spanish using translation/back-translation, an expert bilingual committee, and consensus building. Cronbach's alpha was used to measure the instrument's internal consistency, and iterated principal factor analysis with promax rotation was employed to explore its underlying factor structure. Descriptive, bivariate and multivariate methods were used to examine the patterns of association between individual stressors, factor scores and students' characteristics.
  
  
  RESULTS
  Three hundred and four students comprised the study's analytical sample, with two-thirds of those being female. The DES30-Sp demonstrated good internal consistency (Cronbach's α = 0.89). A four-factor solution emerged and included 'academic workload', 'clinical training', 'time constraints' and 'self-efficacy beliefs' factors. 'Fear of failing a course or a year', 'examinations and grades' and 'lack of time for relaxation' were amongst the top individual-item stressors reported by students in both schools. Amongst this group of undergraduate dental students, those in Argentina, in higher study year, and females reported higher perceived stress.
  
  
  CONCLUSIONS
  Increased workload, time constraints and some aspects of clinical training were the top stressors of approximately 300 Chilean and Argentinean dental undergraduates. Some variations between schools, males and females and study years were noted. The Spanish version of the DES30 questionnaire performed well, but future studies should evaluate the instrument's properties in larger and more diverse dental student populations.
authors.affiliation: Adults Clinic, School of Dentistry, University of San Sebastian, Puerto Montt, Chile.
authors.forename: J
authors.initials: J
authors.lastname: Fonseca
authors.forename: K
authors.initials: K
authors.lastname: Divaris
authors.forename: S
authors.initials: S
authors.lastname: Villalba
authors.forename: S
authors.initials: S
authors.lastname: Pizarro
authors.forename: M
authors.initials: M
authors.lastname: Fernandez
authors.forename: A
authors.initials: A
authors.lastname: Codjambassis
authors.forename: L
authors.initials: L
authors.lastname: Villa-Torres
authors.forename: A
authors.initials: A
authors.lastname: Polychronopoulou
mesh_terms: D000704:Analysis of Variance; D001118:Argentina; D002677:Chile; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D012575:Schools, Dental; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D013335:Students, Dental / Q000523:psychology*; D011795:Surveys and Questionnaires; D014177:Translations; D016526:Workload / Q000706:statistics & numerical data*; D055815:Young Adult