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Nursing student participation in a community project to prevent drug abuse among teenagers

Abstracts

This is an undergraduate nursing student experience report with a community project to prevent drug use among teenagers. The project consists of preventive educational interventions to teenagers, aged 15 to 17 years, attending the "Programa Agente Jovem de Desenvolvimento Social e Humano - Young Agent Program for the Social and Human Development.' This program, which is coordinated by the Social Services Department of the District of Ribeirão Preto, Brazil, is funded by the Brazilian Federal Government. An interdisciplinary approach is used to address several community issues such as violence, the environment, teenager's sexuality, the use of drugs, and opportunities for engagement in life experience projects. The program uses workshops to provide information, provoke discussions, and stimulate reflections on the main aspects of substance abuse and on strategies teenagers can use to develop coping skills. The program provided the undergraduate nursing student with an excellent experience with community project, which is very important in determining innovative nursing practices.

Substance-related disorders; Substance-related disorders; Adolescent health; Health programs and plans; Adolescent


Relato de experiência de estágio em enfermagem com objetivo de prevenir o uso indevido de drogas entre adolescentes de uma comunidade. As atividades foram realizadas com adolescentes do Programa Agente Jovem de Desenvolvimento Social e Humano, coordenado pela Secretaria da Assistência Social da Prefeitura Municipal de Ribeirão Preto - SP, com recursos do Governo Federal. O programa atendia jovens de 15 a 17 anos e abordava temas como violência, meio ambiente, sexualidade, drogas e projeto de vida. O estágio foi semanal e a temática de drogas foi trabalhada de forma interdisciplinar. Desenvolveu-se oficinas de trabalho que visavam fornecer informações, promover discussão e reflexão sobre os aspectos envolvidos no consumo de substâncias psicoativas, além de desenvolver habilidades de enfrentamento. Criou-se um espaço para reflexão sobre a temática com adolescentes e a aluna de graduação envolvida teve a oportunidade de vivenciar o trabalho comunitário, importante neste momento de remodelação das práticas de enfermagem.

Transtornos relacionados ao uso de substâncias; Transtornos relacionados ao uso de substâncias; Saúde do adolescente; Planos e programas de saúde; Adolescente


Relato de experiencia de prácticas en enfermería con el objetivo de prevenir el uso indebido de drogas entre sadolescentes de una comunidad. Las actividades fueron realizadas con adolescentes del Programa Agente Joven de Desarrollo Social y Humano, coordinado por la Secretaría de la Asistencia Social de la Prefectura Municipal de Ribeirão Preto - SP, con recursos del Gobierno Federal. El programa atendía a jóvenes de 15 a 17 años y abordaba temas como violencia, medio ambiente, sexualidad, drogas y proyecto de vida. Las prácticas fueron semanales y la temática de drogas fue trabajada de forma interdisciplinaria. Se desarrollaron talleres de trabajo que tuvieron por objetivo ofrecer informaciones, promover discusión y reflexión sobre los aspectos involucrados en el consumo de sustancias psicoactivas, además de desarrollar habilidades de enfrentamiento. Se creó un espacio para la reflexión respecto a la temática con adolescentes y la alumna de pregrado involucrada tuvo la oportunidad de vivenciar el trabajo comunitario, importante en este momento de remodelación de las prácticas de enfermería.

Trastornos relacionados al uso de sustancias; Trastornos relacionados al uso de sustancias; Salud del adolescente; Planes y programas de salud; Adolescente


EXPERIENCE REPORT

Clarissa Mendonça Corradi-WebsterI; Larissa Horta EsperII; Sandra Cristina PillonIII

IPosgraduate Student (Doctor), College of Nursing at Ribeirão Preto, University of São Paulo – USP – Ribeirão Preto (SP), Brazil

IIRN, College of Nursing at Ribeirão Preto, University of São Paulo – USP – Ribeirão Preto (SP), Brazil

IIIPhD, Professor at the Department of Psychiatric Nursing and Human Science at the College of Nursing at Ribeirão Preto, University of São Paulo – USP – Ribeirão Preto (SP), Brazil

Corresponding Author

ABSTRACT

This is an undergraduate nursing student experience report with a community project to prevent drug use among teenagers. The project consists of preventive educational interventions to teenagers, aged 15 to 17 years, attending the "Programa Agente Jovem de Desenvolvimento Social e Humano - Young Agent Program for the Social and Human Development.' This program, which is coordinated by the Social Services Department of the District of Ribeirão Preto, Brazil, is funded by the Brazilian Federal Government. An interdisciplinary approach is used to address several community issues such as violence, the environment, teenager's sexuality, the use of drugs, and opportunities for engagement in life experience projects. The program uses workshops to provide information, provoke discussions, and stimulate reflections on the main aspects of substance abuse and on strategies teenagers can use to develop coping skills. The program provided the undergraduate nursing student with an excellent experience with community project, which is very important in determining innovative nursing practices.

Keywords: Substance-related disorders/nursing; Substance-related disorders/prevention & control; Adolescent health; Health programs and plans; Adolescent

RESUMEN

Relato de experiencia de prácticas en enfermería con el objetivo de prevenir el uso indebido de drogas entre adolescentes de una comunidad. Las actividades fueron realizadas con adolescentes del Programa Agente Joven de Desarrollo Social y Humano, coordinado por la Secretaría de la Asistencia Social de la Prefectura Municipal de Ribeirão Preto – SP, con recursos del Gobierno Federal. El programa atendía a jóvenes de 15 a 17 años y abordaba temas como violencia, medio ambiente, sexualidad, drogas y proyecto de vida. Las prácticas fueron semanales y la temática de drogas fue trabajada de forma interdisciplinaria. Se desarrollaron talleres de trabajo que tuvieron por objetivo ofrecer informaciones, promover discusión y reflexión sobre los aspectos involucrados en el consumo de sustancias psicoactivas, además de desarrollar habilidades de enfrentamiento. Se creó un espacio para la reflexión respecto a la temática con adolescentes y la alumna de pregrado involucrada tuvo la oportunidad de vivenciar el trabajo comunitario, importante en este momento de remodelación de las prácticas de enfermería.

Descriptores: Trastornos relacionados al uso de sustancias/enfermería; Trastornos relacionados al uso de sustancias/prevención & control; Salud del adolescente; Planes y programas de salud; Adolescente

INTRODUCTION

Adolescence is a phase in which the individual is preparing for adult life, and is testing different roles. It is a time to question identity, values and dreams. During this period, it is important to get away from the family, to have autonomy and to be close to peers and friends with whom discoveries and fears are shared. Adolescents want to experience new sensations, to test their limits, to know how far they can go(1). These characteristics makes adolescence a period of great vulnerability for the use of psychoactive substances, as these substances can offer adolescents some "solutions" to what they are looking for. The use of these substances may provide the experience of different emotions, can set them against parental control, giving a feeling of autonomy and control over their own lives and may facilitate the entry and acceptance into a group of peers and encourage the adolescent to approach the opposite sex(2).

It has been observed that consumption of psychoactive substances by adolescents is high. An epidemiological study in the use of psychoactive substances carried out in Ribeirão Preto, interior of São Paulo State, with adolescents between 13 and 19 years old, found that 88.9% of them had consumed alcohol at least once in their lifetime, 37.7% had consumed tobacco, 31.1% solvent, 6.2% marijuana and 2.7% cocaine. According to this study, the majority of adolescents experimented with psychoactive substances for the first time between 14 and 16 years of age(3).

The impact of this use by adolescents is very high, causing losses in development with consequences for future life. The consumption of these substances in adolescence seems to be associated with a greater number of absences in school, poor school performance and a greater number of failures(4) . In relation to sexual risk behavior, regarding the use of condoms, it seems that the higher the number of psychoactive substances consumed, the lower the frequency of condom use(5). It is also associated with other risk behaviors such as drink driving and involvement in fights and violent situations(6).

Within this context, preventive work becomes very important and the nurse must be prepared to develop strategies for this age group (adolescence), with the focus on preventing the misuse of psychoactive substances. With this aim, a university extension activity was proposed, where the undergraduate student participated in activities with groups of adolescents, aiming to work with this issue.

This study aimed to report the experiences gained during this training/activity, focusing on the description and discussion of the workshops used, aiming at sharing the experience of nursing work in preventing psychoactive substances misuse among adolescents.

REPORT

The activities were held during the year 2007 with groups of adolescents participating in the Youth Agent Program of Social and Human Development (Programa Agente Jovem de Desenvolvimento Social e Humano), coordinated by the Department of Welfare of the Municipal Council of Ribeirão Preto - SP. This program was developed with funds from the federal government and assisted adolescents from 15 to 17 years old, in risk situation and social vulnerability. These adolescents took part in the program for one year, participating in thematic discussions and conducting activities within the community in which they lived. They participated in daily meetings coordinated by a professional with a university degree and each month they received a scholarship valued at R$ 95.00. The federal government stipulated the issues to be worked with during the year and they comprised the modules of the program. Among these subjects, there is: violence, environment, sexuality, drugs and project of life. Each mixed sex group consisted of approximately 25 adolescents.

A Nursing undergraduate student from the third year, who had studied the optional discipline "Alcohol and Drugs", began to participate with the groups of adolescents, as the facilitator. She participated in four groups of around eight to twelve weeks each. She participated once a week and the meetings were of two hours duration. She worked with the issue of substance use in various modules, following the principles of interdisciplinarity(6).

Workshops were used to work with this issue, which aimed to provide information, promote discussion of and reflection on the issues involved in the consumption of psychoactive substances, and to develop skills for coping. The workshops were created during the work, following suggestions from literature, questions from the adolescents and the coordinators of the program. The following resources were used for this: group dynamics, films, simulated juries, role-plays, classroom discussion and didactic games.

WORKSHOPS

The first, second and third meetings took place within the Module "Drugs". At the first meeting, the objective of the workshop was to gather information about psychoactive substances, clarify doubts and to think about its consequences. The game "Types of drugs" was used, where the adolescents was asked to name all the drugs they knew. This workshop was important to draw special attention to the legal drugs, which are often forgotten. Then the facilitator investigated what they knew about each of the substances, both the pleasurable aspects and negative consequences. In the end there was a discussion where the pros and cons of using substances were balanced.

In the second meeting, the goal was to exploit the adolescent's resources to cope with their difficulties and not use drugs. The workshop "Why young people use drugs?" was used for this. The adolescents listed several reasons and then, other resources that could be used to achieve the same goals were investigated. One example was drinking in order to relax and dance at a party. The other possibilities reported were: to dance at home in front of the mirror to learn the steps, dancing with a group of close friends to gain confidence or asking friends to teach some different steps.

In the third meeting, the myths related to the topic were explored. The workshop "Myth and Fact" was used. The group was divided into two teams, who chose their leaders and the name of the team. The facilitator chose a statement and read it aloud. Each team discussed among themselves and decided if it was a myth or a fact. The leaders presented to the whole group the conclusion of his team, justifying it. There was a discussion between the two teams about what had been brought up, with the participation of the facilitator to clarify questions and to direct reflections. Examples of statements used: The most dangerous drug is cocaine. The risk of having problems due to alcohol is lower when consuming beer rather than wine, whiskey and brandy.

The fourth meeting occurred in the Module "Sexuality" and the objective of the workshop was to draw attention to the influence of substance use in the adoption of risk behaviors. Thus, the Game "Sex, Drugs and Rock & Roll" was proposed, and the facilitator asked them to form two teams. At each round of the game, each team received a statement. They had to discuss its validity and to present their proposal to the other group. If they were correct, they gained one point and if they were wrong, the other team had a chance to try to present it. In the end, the points were added up and there was reflection on the subject. Some statements used: The guy who drinks a lot has more chances to fail when having sex. In the first months of pregnancy the mother can ingest alcohol and it will not affect the baby.

The fifth meeting was held within the Module "Environment" and the Workshop "Propaganda" was chosen for use, with the objective to reflect critically on the influence of the media in the consumption of alcoholic beverages. Four subgroups were formed and each one received a beer advertisement. The groups discussed the message passed by their advertisement and then presented this to the other groups. After the discussion, the subgroups were asked to get together again and to propose a new advertisement, which would address the issue from a different angle (i.e. if the propaganda had a beautiful woman drinking, another one was made with a woman with a big belly, alcohol breath, droopy eyes).

The sixth meeting was within the Module "Health" and as a requirement of the adolescents the workshop "First Aid" was held. The objective of this workshop was to inform the adolescents how to proceed in cases of intoxication by psychoactive substances. The facilitator gave a brief introduction on first aid and asked them to form subgroups, which each received a story reporting an emergency situation (vomiting, fainting or seizures) due to the use of these substances. Each group discussed among themselves how to act in this situation and then they made a simulation for the rest of the group. The undergraduate student led the discussion on the proposed intervention, informing about the ideal intervention. It is important to note, that in some situations, the guidance was to call the emergency services. An example of a situation used: Carol went out with friends and drank beer, wine, and spirits. At first she was funny, had a good time, but then began to feel ill and to vomit. The friends did not know what to do.

The seventh meeting took place within the Module "Violence". The workshop "Simulated Jury" was used to promote reflection on the use of psychoactive substances from different angles, integrating into it the consequences related to its illegality and violence. The facilitator explained to the group that the activity was about the simulation of a trial in a case of the use of substances and that each person would perform a predefined role (prosecution, defense, judge or observers). Each participant received a paper containing the report of the case which was subsequently read by the judge. After a time for reflection each member of the prosecution and defense presented their position on the case. The jury gave their views and finally the judge closed the trial summarizing the presentations of participants and making their final considerations. The case used was about a teenager who began to smoke marijuana and was caught by police. To encourage reflection some descriptions about the adolescent, his family, the place where he lived and his group of friends, were added to the case.

The eighth and ninth meetings occurred within the Module "Project of Life". In one of the meetings, the movie "City of God" was used. The adolescents watched the film with the commitment to be alert to the following questions: What was the life project of the main characters? What did they do to achieve this project? How did their story end? At the end, there was a discussion on this topic.

In the ninth meeting the workshop "Journey to the future" was held, aiming to reflect on the influences of substance use in the project of life. For this, at first, each adolescent drew a character the same age as themselves. Secondly, they were asked to make another drawing of the same character as it would be in ten years time, exploring information about their family, friends, work, school and health. Then, each adolescent received a paper with information about the involvement of the character with psychoactive substances. Based on the information of the paper, they had to make another drawing of this character in ten years time. The group discussed how the use of substances could affect the project of life. Examples of information: On weekends, goes out to drink with friends, then they race back home. He started to sell drugs to raise some money quickly.

The final meetings took place within the Module "Action in the community". The adolescents had meetings to create an educational brochure for this. It was decided that the focus would be the use of alcohol and tobacco, as they are the more commonly used substances. The adolescents did the drawings, wrote the text and organized the structure of the leaflets. The undergraduate student attended these meetings, supervising the activities. Finally, the work was given to a professional who did the final art and printed it. A picture of the groups of adolescents, as authors of the material, was inserted at the back of the leaflet. This material was used by them for preventive actions in the schools and in the community where they lived.

FINAL CONSIDERATIONS

The consumption of psychoactive substances among adolescents can bring different consequences therefore, it seems essential to develop preventive actions directed at this age group. The nurse can play an important role in this prevention; however, this issue needs to be introduced during their graduation.

In work with adolescents, it is important for professionals to develop the ability to listen and to search for stories and experiences which the adolescent has had(7). It is important to accept the challenge of working not only with the negative aspects of substance use, but also with the positive ones. From this experience, we ask the adolescents to reflect on the reasons that lead young people to use drugs, and the opportunity is taken to strengthen the development of other patterns of behavior, increasing the repertoire of these adolescents to face situations where the use of drugs seems to be a good option.

The inclusion of the theme "drug use" into the other contents of the program proved to be adequate, making it possible to work with this issue in an integrated manner with the various issues of the adolescent's life. The literature recommends that there should be more investment in projects to prevent substances misuse among adolescents (8-9), and suggests that on these projects, the adolescents should be the protagonist(7). This experience of training in nursing provided the opportunity, bringing information and ideas of adolescents, always in a dialogue-based way, working with their knowledge and beliefs, preventing consumption and forming multipliers. At the end of the project, the adolescents created educational brochures, which were distributed in their communities.

With this activity the undergraduate nurse could experience the work of prevention in the community. At present this activity is essential, considering the large insertion of nurses into primary health care, which is remodeling its practices, and its integration in schools, planning activities for an adolescent audience.

AKNOWLEDGMENT

The authors acknowledge the Fund for Culture and University Extension, University of São Paulo, for the financial support received for the implementation of this project. Acknowledge the social worker Rachel Torrezan for the support given to the conduction of this project. Acknowledge Martin Webster for the English version of this material.

REFERENCES

  • 1. Osório LC. Adolescente hoje. Porto Alegre: Editora Artmed; 1989.
  • 2. Schenker M, Minayo MCS. Fatores de risco e de proteção para o uso de drogas na adolescência. Ciênc Saúde Coletiva. 2005;10(3):707-17.
  • 3. Muza GM, Bettiol H, Muccillo G, Barbieri MA. Consumo de substâncias psicoativas por adolescentes escolares de Ribeirão Preto, SP (Brasil). I- Prevalência do consumo por sexo, idade e tipo de substância. Rev Saúde Pública = J Public Health. 1997;31(1):21-9.
  • 4. Tavares BF, Béria JH, Lima MS. Prevalência do uso de drogas e desempenho escolar entre adolescentes. Rev Saúde Pública = J Public Health. 2001;35(2):150-8.
  • 5. Scivoletto S, Tsuji RK, Abdo CHN, Queiróz S, Andrade AG, Gattaz WF. Relação entre consumo de drogas e comportamento sexual de estudantes de 2ş grau de São Paulo. Rev Bras Psiquiatr. 1999;21(2):87-94.
  • 6. Pechansky F, Szobot CM, Scivoletto S. Uso de álcool entre adolescentes: conceitos, características epidemiológicas e fatores etiopatogênicos. Rev Bras Psiquiatr. 2004;26(Supl 1):Sl14-7.
  • 7. Brêtas JRS, Silva CV. Orientação sexual para adolescentes: relato de experiência. Acta Paul Enferm. 2005.18(3):326-33.
  • 8. Vilela EM, Mendes IJM. Interdisciplinaridade e saúde: estudo bibliográfico. Rev Latinoam Enferm. 2003;11(4):525-31.
  • 9. Canoletti B, Soares CB. Programas de prevenção ao consumo de drogras no Brasil: uma análise da produção científica 1991 a 2001. Interface Comun Saúde Educ. 2004/2005;9(16):115-29.
  • Nursing student participation in a community project to prevent drug abuse among teenagers

    La enfermería y la prevención del uso indebido de drogas entre adolescentes
  • Publication Dates

    • Publication in this collection
      16 July 2009
    • Date of issue
      June 2009

    History

    • Accepted
      18 June 2008
    • Received
      10 Apr 2008
    Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
    E-mail: actapaulista@unifesp.br