Revista Adolescência e Saúde

Revista Oficial do Núcleo de Estudos da Saúde do Adolescente / UERJ

NESA Publicação oficial
ISSN: 2177-5281 (Online)

Vol. 15 nº 3 - Jul/Sep - 2018

Original Article Imprimir 

Páginas 36 a 43


Life skills: strategy to prevent the use of psychoactive substances among adolescents

Habilidades de vida: estrategia de prevención del uso de sustancias psicoactivas entre adolescentes

Habilidades de vida: estratégia de prevenção do uso de substâncias psicoativas entre adolescentes

Autores: Nayara Pires Nadaleti1; Eliene Sousa Muro2; Érika de Cássia Lopes Chaves3; Denis da Silva Moreira4

1. Graduation in Nursing by the Federal University of Alfenas - UNIFAL. Master's Degree in Nursing by the Post-Graduation Program in Nursing of the School of Nursing of UNIFAL. Alfenas, MG, Brazil
2. Graduation in Nursing by the Federal University of Alfenas - UNIFAL. Master's Degree in Nursing by the Post-Graduation Program in Nursing of the School of Nursing of UNIFAL. Alfenas, MG, Brazil
3. Post-doctorate by the School of Nursing of Ribeirão Preto/USP. SP, Brazil. Adjunt Professor of the Nursing School at Federal University of Alfenas - UNIFAL. Alfenas, MG, Brazil
4. Post-doctorate in Nursing by the School of Nursing of Ribeirão Preto/USP. SP, Brazil. Adjunt Professor of the Nursing School at Federal University of Alfenas - UNIFAL. Alfenas, MG, Brazil

Denis da Silva Moreira
Rua Gabriel Monteiro da Silva, n° 700 - Centro
Alfenas, MG, Brasil. CEP: 37130-001
(denisunifal@gmail.com)

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Keywords: Substance-related disorders, disease prevention, adolescent, adolescent behavior, school health services.
Palabra Clave: Trastornos relacionados al uso de sustancias, prevención de enfermedades, adolescente, comportamiento del adolescente, servicios de salud escolar.
Descritores: Transtornos relacionados ao uso de substâncias, prevenção de doenças, adolescente, comportamento do adolescente, serviços de saúde escolar.

Abstract:
OBJECTIVE: Check the model of life skills as a strategy to prevent the use of psychoactive substance among teenagers.
METHODS: Quasi-experimental study, of pre and post intervention type with students from the 6o. and 7o. years of a public school in the South of Minas Gerais. The sample was of 78 teens (42.62%) who responded the DUSI-Drug Use Screening Inventory. This instrument evaluates the problems associated with the use of alcohol and other drugs in the context of adolescence. Was applied primarily to know the context of drug use among the students and after conducting workshops based on life skills model. Ten weekly workshops were held addressing issues related to drug use and psychosocial skills. The investigation was approved through the CAEE: 07271012.5.0000.5142. The data was analyzed by Statistical Package for Social Sciences (SPSS), and applied the Fisher exact tests and Wilcoxon, Odds Ratio, all with 5% of significance.
RESULTS: Before the intervention, 12.8% (10) of the teens reported using some type of illicit drug. After the workshops it was noticeable a reduction to 2.6% (2). The Absolute Density (DAP) and relative densities of problems were in the following areas: use of psychoactive substances; psychiatric problems; social competence; family system; school and work were statistically significant and there was a reduction of the problems in each of these areas.
CONCLUSION: The ability of life strategy among teenagers in the school context is an effective tool for changing risky behavior for healthy attitudes, including in relation to the use of drugs.

Resumen:
OBJETIVO: Verificar el modelo de habilidades de vida como estrategia en la prevención del uso de sustancias psicoactivas entre adolescentes.
MÉTODOS: Estudio cuasi-experimental, del tipo pre y post intervención con alumnos del 6º y 7º años de una escuela pública del sur de Minas Gerais. La muestra fue de 78 adolescentes (42,62%) que respondieron al DUSI - Drug Use Screening Inventory. Este instrumento evalúa los problemas asociados al uso de alcohol y otras drogas en el contexto de la adolescencia. El DUSI fue aplicado primero para conocer el contexto del uso de drogas entre los estudiantes y después de la realización de talleres basados en el modelo Habilidades de Vida. Se realizaron diez talleres semanales abordando temas sobre el uso de drogas y habilidades psicosociales. La investigación fue aprobada por medio del CAEE: 07271012.5.0000.5142. Los datos fueron analizados por el Statistical Package for Social Sciences (SPSS), y aplicados las pruebas Exacto de Fisher y Wilcoxon emparejado, OddsRatio, todos con un 5% de significancia.
RESULTADOS: Antes de la intervención, 12,8% (10) de los adolescentes relataron el uso de algún tipo de droga ilícita. Después de los talleres se observa una reducción al 2,6% (2). Las Densidades Absolutas de Problemas (DAP) y Densidades Relativas de Problemas fueron en las áreas: uso de sustancias psicoactivas; problemas psiquiátricos; competencia social; sistema familiar; escuela y trabajo; fueron estadísticamente significativas y hubo reducción de los problemas en cada una de esas áreas.
CONCLUSIÓN: La estrategia de vida entre adolescentes en el ámbito escolar es una herramienta eficaz para el cambio de comportamiento de riesgo para actitudes saludables, incluso en relación al uso de drogas.

Resumo:
OBJETIVO: Verificar o modelo de habilidades de vida como estratégia na prevenção do uso de substâncias psicoativas entre adolescentes.
MÉTODOS: Estudo quase-experimental, do tipo pré e pós intervenção com alunos do 6º e 7º anos de uma escola pública do sul de Minas Gerais. A amostra foi de 78 adolescentes (42,62%) que responderam ao DUSI - Drug Use Screening Inventory. Este instrumento avalia os problemas associados ao uso de álcool e outras drogas no contexto da adolescência. O DUSI foi aplicado primeiramente para conhecer o contexto do uso de drogas entre os estudantes e depois da realização de oficinas baseadas no modelo Habilidades de Vida. Foram realizadas dez oficinas semanais abordando temas sobre uso de drogas e habilidades psicossociais. A investigação foi aprovada por meio do CAEE: 07271012.5.0000.5142. Os dados foram analisados pelo Statistical Package for Social Sciences (SPSS), e aplicados os testes Exato de Fisher e Wilcoxon emparelhado, Odds Ratio, todos com 5% de significância.
RESULTADOS: Antes da intervenção 12,8% (10) dos adolescentes relataram o uso de algum tipo de droga ilícita. Após as oficinas observa-se uma redução para 2,6% (2). As Densidades Absolutas de Problemas (DAP) e Densidades Relativas de Problemas foram nas áreas: uso de substâncias psicoativas; problemas psiquiátricos; competência social; sistema familiar; escola e trabalho foram estatisticamente significativas e houve redução dos problemas em cada uma dessas áreas.
CONCLUSÃO: A estratégia habilidade de vida entre adolescentes no âmbito escolar é uma ferramenta eficaz para a mudança de comportamento de risco para atitudes saudáveis, inclusive em relação ao uso de drogas.

INTRODUCTION

Adolescence is a phase marked by various changes in the biological, cognitive, emotional and social, in which the adolescent seeks to sign their identity and develop new behaviors, both positive and negative, capable of interfering with their health. In addition, this is a phase in which the adolescent seeks to discover and experience the new, such as, for example, experimentation with drugs. In this sense, it isn´ted that the consumption of licit and illicit substances intensified in contemporary society and in a precocious manner1.

It isn´t characterized as a rule that the consumption or experimentation of any substance triggers any problem associated with chemical dependence, since it is possible to establish various ways of relating to drugs. Thus, the reasons or feelings that lead the adolescent to enter the world of drugs are different such as free time, companies, places or situations, personal problems and feelings of anger, loneliness or anxiety1.

However, the consumption of substances can bring biopsychosocial consequences in the coexistence in society, related to crime, as well as financial damages, breach of the rules and values and the development of an antisocial personality and behavior. In addition, habitual and abusive use harms the social, family and work relations of the individual, radically affecting their quality of life and mainly their health2.

Therefore, it is very important to use prevention actions and control of the consumption of substances by this population, so that parents, teachers and health professionals can intervene in a way that there is reduction or interruption of consumption, as well as the possible damages produced by these substances3.

It should be noted that the school is an environment that exerts a great influence on the adolescent's development, in the cognitive, social and emotional aspects. Thus, the relevance of monitoring the health situation of adolescents isn´ted, with the purpose of offering information that makes them reflect on the complex changes inherent to the age group3.

In view of the above, the workshops based on the Life Skills model stand out as an important intervention in the prevention of consumption and promotion of adolescent health.

The Life Skills model proposed by the World Health Organization (WHO) has the purpose of preventing and / or reducing risk behaviors, in which it proposes to develop positive and socially appropriate adaptive behaviors for children and adolescents4. Thus, the proposals of this model are based on decision-making, effective communication, self-knowledge, empathy, the management of emotions, stress management, problem solving, interpersonal relationship, creative thinking and critical thinking4. In this sense, the present study aims to verify the Life Skills Model as a strategy in the prevention of the use of psychoactive substances among adolescents.


METHOD

This is a quasi-experimental study, of the pre- and post-intervention type, carried out with students of the sixth and seventh years of the Fundamental Teaching II of a public school in southern Minas Gerais. The study is an unfolding of the thematic project path truth and life: living without drugs, linked to the Tutorial Education Program - PET of the nursing course of a public university in the south of Minas Gerais/Brazil.

All 183 students regularly enrolled in the aforementioned years were invited to participate in the research, but the final sample was constituted by 78 adolescents (42.62%) who were present in the classroom on the day of application of the data collection instrument. The exclusion criteria established were: absence in the classroom after three successive contact attempts; the minimum of two absences in the educational workshops, and not give the consent of the parents and/or responsible and/or their own consent.

An anonymous self-applicable questionnaire was used to collect data. The data were collected in the second semester of 2014, by academics trained for the application process of the collection instrument, linked to PET/Nursing. The questionnaire was applied in two moments, first to serve as a parameter to know the reality of the context of drug use among students, and then to carry out workshops based on the Life Skills model.

The workshops were held in ten weekly meetings in the reserved room of the school itself, with each class and lasting one hour each session. During the meetings the Life Skills model was applied, which is a strategy that contributes to the reduction of behavior and risk and offers resources to face the daily challenges of contemporary society6. In these workshops, issues related to drugs were addressed (classification according to the mechanism of action of drugs, such as: depressants, stimulants, disturbing), physical, psychological and social problems generated by the use of these, risk factors and protection. In the case of drugs, issues related to self-knowledge, decision-making, problem solving, construction of critical and creative thinking, how to deal with stress and feelings and emotions, interpersonal relationships, empathy and effective communication were addressed.

The methodological strategies used in the workshops were: presentation of videos/songs, sports activities, group dynamics, theater and discussion in small groups after the end of the activity.

In order to make comparisons with other studies, this research was conducted with an instrument developed at the University of Pennsylvania that was adapted and validated in Brazil by researchers from the Federal University of São Paulo5. This instrument called DUSI - Drug Use Screening Inventory, allows evaluating the problems associated with the use of alcohol and other drugs in the context of adolescence. This allows us to investigate the prevalence of the use of 13 psychoactive substances and then presents 149 questions that show the profile of the intensity of problems related to drug use, divided into 10 areas: substance use; behavior; Health; psychiatric disorders; social competence; family system; the school; to work; relationships with friends and recreation/recreation. The students spent an average of 50 minutes to fill the DUSI instrument.

For the calculation of the DUSI the absolute problem density (DAP) was used, which indicates the intensity of problems in each area of the instrument, and the relative density of problems (DRP) that indicates the percentage contribution of each area in the total number of problems5.

The execution of this research was subsidized by Resolution 446/12, which deals with the guidelines for carrying out research with human beings. The research protocol was sent to the Ethics and Research Committee of the Federal University of Alfenas-UNIFAL-MG and received the opinion of approved by means of the CAEE: 07271012.5.0000.5142.

The information collected was inserted into a spreadsheet, double-typed and then the data was imported into the Statistical Package for Social Sciences (SPSS), version 20. Descriptive statistics were used for calculations of frequency, mean (), median (Md) and deviation- standard (s). The tests used were Exact Fisher and Wilcoxon paired. In addition to these, the odds ratio was estimated through OddsRatio. All tests were performed with 5% significance.


RESULTS

The study involved 78 adolescents, aged between 10 and 15 years (average of 11.4 ± 0.9 years), 53.8% (42) were female and 46.2% (36) were sex male. When investigating the profile of the consumption of alcohol and other drugs before and after the educational interventions based on the Life Skill model, it was observed that before the intervention, 9% (7) used alcohol and 12.8% (10) ) of adolescents used some type of illicit drug. After the interventions, the consumption of illicit drugs reduced to 2.6% (2) and alcohol consumption increased in just one adolescent (Table 1).




It was observed that the gender of the adolescents wasn´t significant in determining the consumption of alcohol and other drugs, since women and men used alcohol and / or other drugs in the same proportion. In addition, there was no statistically significant relationship (p = 0.217 before, p = 0.222 after) between age and consumption of alcohol and/or other drugs. Table 2 presents the types of drugs used by students before and after the application of workshops based on the Life Skills model, it should be noted that the same individual may have used more than one type of substance.




Among the substances used by adolescents, alcohol was the most prevalent, before and after educational interventions. It should be noted that after the educational workshops, there was no consumption of hallucinogens, inhalants/solvents, anabolic agents, phencyclidine, tobacco, tranquilizers and opioids.

With regard to the use of psychoactive substances by the relatives of the adolescents analyzed, 7.8% (6) of them used marijuana or cocaine in the last 12 months and 16.9% (13) have some member of the family that used alcohol and cause problems at home, work or with friends. Regarding the family relationship, 14.3% (11) of the students had frequent discussions with their relatives involving shouting and screaming, 32.5% (25) hardly do leisure activities with their family and 20, 8% (16) responsible for these adolescents stay away from home most of the time.

When relating the areas of the DUSI with the Absolute Densities of Problems (DAP), statistically significant results were found and there was reduction of the problems in the following areas: use of psychoactive substances; psychiatric problems; social competence; family system; school and work (Table 3).




When relating the DUSI with the Relative Densities of Problems (DRP) before and after the intervention, a percentage decrease of problems in the areas was observed: use of psychoactive substances; psychiatric problems; social competence; family system; the school; work and relationships with friends (Table 4).




DISCUSSION

The consumption of alcoholic beverages has been inserted into human society since ancient times and it is believed that its high prevalence is influenced by its legal nature, by the media, by the beer industry that drives the capitalist system and dictates leisure situations through fiestasopen bar. Studies show that the initiation of its consumption occurs at increasingly early ages, mainly among adolescents7-8.

Thus, it is highlighted that the phenomena related to the consumption of alcoholic beverages in adolescence are complex, since this phase is impregnated by biological, cognitive, psychic, emotional and social changes that require adaptations for the adoption of new practices, behaviors and autonomy to adult life1,3.

These changes added to the search for the consolidation of the personality, the construction of the personal identity, the need to integrate to new groups, curiosity and difficulty that the adolescents have of dealing with the anguishes and weaknesses, make them vulnerable and more exposed to risks, predisposing to the risk of consumption of alcohol and other drugs9.

The adolescent has the expectation that through the use of these substances he will present behaviors of disinhibition and sociability. In addition, usually the first contact with alcohol occurs in the residence itself, to imitate the behavior of relatives, or by the fact of having friends who consume it10. The friends exert great influence on the behavior of the adolescent, leading them to use this substance to insert themselves in the groups and create some popularity11.

Regarding the differences between the genders, it was possible to observe through this study that the consumption between both sexes was similar. These results are analogous to other studies, which show homogeneous consumption among adolescent girls and boys. It is important to point out that the deleterious effects of substance use are more exacerbated in females3,12-13.

The family system can facilitate risk behavior by influencing the use of psychoactive substances in adolescents. A negative family relationship, permeated by conflict and the consumption of alcohol, marijuana or cocaine by family members can be an inducing factor or facilitate the use by adolescents14,15. Paternal influence is observed as a motivating factor for the adolescent's use of drugs16. However, the role of the family in relation to the support and monitoring of adolescents is configured as a space of protection for situations of risk. Well-structured family ties and open dialogue are essential in the prevention of behaviors considered harmful, such as the use of psychoactive substances17.

The realization of the workshops using the life skills model for health promotion and prevention of the use of psychoactive substances was shown to be adequate in the present study, corroborated by the literature, thus expanding knowledge, identifying risk factors and actions for the development of psychosocial skills by adolescents18-19.

It is recognized as a limitation of the study the difficulty of generalization of the results due to the characteristics of the scenario under study, the size of the sample and its intentionality.


CONCLUSION

The implementation of strategies based on the model of life skills among adolescents in the school environment is an effective tool for the change of risk behavior for healthy attitudes and even in relation to the use of drugs.

Thus, working on the skills present in the life skills model is a priority action, and should be carried out early in the school context, since it contributes significantly to minimizing risk factors and promoting protection factors in relation to the use of substances psychoactive among adolescents and also empowers them and trains them to face the daily demands implicit in the adolescence process.


FINANCIAL SUPPORT

The study was promoted by the Research Amparo Foundation of the State of Minas Gerais - FAPEMIG through Process APQ-03262-12. The study doesn´t present a conflict of interest.


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