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RESEARCH ARTICLES

 


Alcohol consumption among academics in the health area: implications for professional practice

Ingryd Cunha Ventura FelipeI;Antonio Marcos Tosoli GomesII
INurse. PhD student and Master in nursing from the State University of Rio de Janeiro, Researcher in the research group "Health Promotion and Practice of Nursing Healthcare in population groups", Rio de Janeiro, Brazil, Email: ingrydventura@hotmail.com.
IINurse. PhD in Nursing, Full Professor at the School of Nursing and Assistant Coordinator of the Graduate Program in Nursing, State University of Rio de Janeiro. Researcher in the research group Health Promotion and Practice of Nursing Healthcare in Population Groups Rio de Janeiro, Brazil, Email: mtosoli@gmail.com.


ABSTRACT: This research aims to identify alcohol consumption patterns among biomedical academics and to discuss implications in their professional practice. Investigation included 53 academics in the health area from a public university in Rio de Janeiro, RJ, Brazil, in 2012 and data were analyzed on the basis of descriptive statistics. The sample is predominantly female, aging from 19 to 22 years, without partners or children, Evangelical/Protestant or Catholic. 51% reported using alcohol and 86.8% were identified in Zone I (abstainers or low risk). Signs of euphoria, increased
outgoingness, and decreased thinking ability, reaching addiction, traffic accidents, and liver/gastric alterations were reported as side effects of alcohol. Internet sites and contact with friends were mentioned as sources of information, but 11% identified college networks. Thus, students must be prepared to discuss the topic, to approach that reality, and to have assistance in reflecting and changing their future individual and professional conduct.

Keywords: Alcohol drinking; students, health occupations; professional practice; health knowledge, attitudes, practice.


 

INTRODUCTION

 

The complexity of situations involving the question of the use / abuse of alcohol in their political, social, economic, family and individual dimensions and that there are effective interventions for the prevention and control of improper use are becoming increasingly recognized, a profound knowledge of this whole problem is necessary. It is undeniable that the theme on the spread of drugs, in relation to marketing and final consumption, has been present every day since the remotest times of humanity until today, becoming a growing public health problem worldwide, mainly, by having early onset among young people1.

Alcohol is the most widely consumed drug and that brings the most damage to the population2, at the same time, is each day more present in our society, being consumed in an indiscriminate manner by individuals, with no concern for the consequences that the use of alcohol can cause in their own body. However, it is important to emphasize that the same community that welcomes and encourages the consumption of alcohol, as a legal drug, berates and abuses the individual who is dependent on this substance, especially for the problems caused by the disease3.

The consumption of alcohol in the population presents the age of onset of use or experimentation at around 12 years old, being that 22.8% have already made use of illicit drugs at some time in life and 74.6% use alcohol. In the young population, which comprises a range of 18 to 35 years, 48.7% they had consumed some illicit drug and alcohol 86.2%,4, the concern raised by if characterize the population that is in the reproductive age, labor and academic, such as university students.

The young university students of southeast region of Brazil have the second highest prevalence of alcohol use (86.8%) and, with respect to the areas of knowledge, the students of biological sciences present consumption of 86.5%, 86.2% and human, exact, 86.1%, which shows a certain equivalence of this consumption among the various areas4. Some studies carried out with students in the area of health indicate the need of the thematic approach to this group of students for the important role that they will have in their future professional practice. In addition by understanding the real expectations that present toward the consumption of alcohol to assist in the prevention of risks and empowers them for routing situations with their future clients.

Studies become relevant, that aim at the understanding of representations expressed by human groups involved with the healthcare system, once that impress the reconstruction of reality experienced by individuals from their own experiences, as well as help the adjustment policies capable of ensuring qualified and effective care for the population. The development of policies and actions for the prevention and more effective control of alcohol use should be based on more detailed studies on the patterns of alcohol consumption to aid the understanding of the magnitude of this problem, and in the various population groups and provide important information for managers and leaders in the area of healthcare5.

Thus, they present themselves as the study objectives to identify the pattern of alcohol consumption among academics in the area of healthcare and discuss its implications in professional practice.

LITERATURE REVIEW

The consumption of drugs in the whole world was pointed out in World Drug Report, which cites more than 230 million people who consumed some type of illicit drug at least once in the year of 2010, that is, one in every 20 people6. To portray the relevance of alcohol consumption at the expense of other drugs in the Brazilian population, data show the magnitude of its use/abuse, as well as its consequences. At the First National Survey on the Patterns of alcohol Consumption in Brazilian Population, conducted in 2007, the rates reach 57% of the Brazilian population above 18 years who drank at least once in the last year, which was more frequent among men. Of This percentage, 60% of men and 33% of women consumed in the last year more than five doses at the time that they drank and 11% of men drink every day. In all frequencies of consumption, men have a larger percentage than women7.

The Search for Knowledge, Attitudes and Practices in the Brazilian Population, published in 2008, tells you the percentage of the use of drugs, according to age group, educational level and sex of individuals aged between 15 and 64 years. In the analysis of the use of licit drugs by age group, with respect to alcohol, presents the proportion of use being higher among individuals 25 to 34 years (84.4% and 41.9%, for use in life and current use, respectively) and lower among those 50 to 64 years (71.4% and 28.2% for lifetime and current use, respectively)8.

The rite of passage for young people in the universities, many times, is demarcated by greater autonomy, enabling new and different experiences. On the other hand, for many, it is a moment of greatest vulnerability, causing them to become more susceptible to drug use/abuse and its consequences4. The exposure of young people to their pressures and external and internal stressors can bring a possibility to escape from the problems experimentation / use / abuse of psychoactive substances, among them alcohol. This, being lawful substance of easy access and that are aggregative and of social relations with other young people, including in the university environment, will bring more ease and predisposition to its use in everyday life4.

The data presented by the national survey I, on the use of alcohol, tobacco and other drugs among college students of 27 Brazilian capitals, carried out by the Secretariat of National Policies on Drugs (SENAD) in 20104, point to a reality impactful: almost 49% of the university students surveyed have already experienced some illicit drug at least once in life and 80% of the interviewees, who declared that they were younger than 18 years, said they have already consumed some type of alcoholic beverage. These data point to the evidence that the consumption of alcohol, tobacco and other drugs among university students is more frequent than in the general population, which reinforces the urgent need of knowledge of this phenomenon for which are drawn up and developed prevention actions, as well as specific policies directed towards that segment4. A world report, which monitors the use of drugs (1975-2012), he pointed out the use of alcohol in 82.7% of the researched individuals between 19 and 30 years of age9.

Research conducted with university students of a course in the state of Sao Paulo shows that, of the 254 students, 83.5% make use of alcohol and 16.5% are abstemious, 63% make use of low risk, 18.5% use of risk and 2% harmful use, and still, 35% consume in the binge pattern. Also identified that students who make problematic use of alcohol arrive later and sleep in the classroom10. It is understood drinking problematic as the act of drinking with the potential to cause health problems or social, being associated with an early stage or less severe dependence11. Another study done in the capital city of Sao Paulo identified that 25.71% of interviewees present use of risk and 40% did not consume alcoholic beverages12.

The National Survey I on Patterns of Alcohol Consumption in the Brazilian Population corroborate these data pointing, with safety, that the drink regular and early comes progressively happening among young people. The first report of use has occurred to 13.9 years and the regular consumption is carried out at 14.6 years, mean age that were higher among the young people of 18 and 25 years of age7.

METHODOLOGY

From the presented objectives, it was decided by cross-sectional study with a quantitative approach. It was used as a field of study by the Rio de Janeiro State University (UERJ) and attended by 53 students from the biomedical center that understands the nursing courses, medicine, biological sciences, nutrition and dentistry. It is worth noting that this study is part of a larger survey conducted with students from various areas, corresponding to 416 participants, which resulted in the Doctoral Thesis on school graduates in the Faculty of Nursing at the UERJ. In the sample were included, by a random drawing, the nursing courses (n=26) and nutrition (n=27) of the biomedical center, focus of the study on screen, and participants were selected during the disciplines at pre and post-class times.

The data collection occurred between November and December of 2012 and was performed by means of an instrument previously translated and validated in Brazil called Test for Identification of Problems Related to the Use of Alcohol, it is more commonly known as AUDIT (Alcohol Use Disorders Identification Test). This together with another instrument elaborated by researchers, pre-tested with a sample similar to the study, comprising seven steps. In this work, were only used the steps corresponding to the identification data, consumption habits and knowledge about alcohol.

For the construction of the database and statistical analysis was performed using the statistical program SPSS (Statistical PackageSocial Science for Windows) 21.0. A descriptive analysis was conducted using frequency distribution. The study followed ethical principles and was approved by the Research Ethics Committee, through the protocol number 003.3.2012 and Statement of Informed Consent was read and signed by the participants.

RESULTS AND DISCUSSION

The data indicate a predominance of females (94.3%), with age between 19 and 22 years (67.9%), without companion (56.6%) or children (94.3%), being evangelical/protestant (41.5%) or Catholic (35.8%). The entire sample confirmed having a computer or portable electronic device the entire sample, with internet access always or almost always (96.2%), as shown in Table 1.

In accordance with the National Survey I, on the Use of alcohol, Tobacco and other Drugs among College Students, the age at which they are these academics is between 18 and 24 years (58%), with a greater percentage of females (56.8%)4. At the same time in which the higher education census also points to the predominance of the female group (56.9%) at the expense of males (43.1%)13.

The statistical data published by the census of the state vestibular, 2010 the UERJ, of total enrolled, 55.9% were female and 44.1% male, and the age range that presented higher frequency was less than 21 years (83.2%), with an average age of 20 years, minimum age 15, and the maximum 7514. The higher education census also indicates that the average age of students in 2011 was 25 and the median 2213. Yet according to this Census, the age range expected for taking the undergraduate program is between 18 and 24 years13.

Regarding the use of alcohol, 51% say they consume this substance, being identified 86.8% with standard use in Zone I, i.e. abstemious or with use of low risk. Present frequency of monthly consumption or 2 to 4 times per month (43.4%), 1 to 4 doses (32.1%), being the beer/draft the most consumed beverage (30.2%). About the age of first use, there was no occurrence between 13 to 18 years (51%), indicating the reasons because they wanted to (32.1%) or for fun (22.6%), with friends (43.4%), as shown in Table 2.

On the consumption of alcoholic beverages, the national survey with university identifies that 86.2% of the sample reported having made use of alcohol ever in life4. Comparing this data from the research cited to the population in general, as described in National Survey I on the Patterns of alcohol Consumption in Brazilian Population in 2007, it has been that 52% of people older than 18 years drank at least once a month in the past 12 months, while 48% were abstinent7.

The standard established by AUDIT in this study had the highest prevalence of university ingesting alcohol at low risk (86.8%), Confirming the data of the national survey of college students in 2010 showed that 77% use of low risk, 20% use moderate and almost 4% at high risk4. Two other studies with academics of the Undergraduate Course in Nutrition, one in Ouro Preto (MG), Brazil and another in Joao Pessoa (PB), Brazil, identified elevated percentages of consumption of low risk (40.2% and 47.3%, respectively), revealing data similar to this study. However, they still reveal a significant percentage and also elevated in university students who were in the area of high risk or probable dependence (39.3% in MG and 52.7% in PB), which demonstrates a given concern for this population, which needs guidelines and specific interventions to minimize the imminent damage from this consumption15,16.

Similar Results were identified by study with students of medicine of Belo Horizonte (MG), Brazil, where 60.4% were in zone I (non-drinkers or with low risk); 31.2% in zone II (with risk) and 8.4% in zones III (high risk) and IV (probable dependence) and even suggest that the percentages found for probable dependence represent only the males17. As for nursing students in Marília (SP), Brazil, a study showed that 79.5% were non-drinkers or low risk users and 20.5% had problematic alcohol consumption18.

Regarding the consumption pattern according to AUDIT, it is possible to understand that non-consumption and low-risk drinking predominate in all samples investigated, including this study. However, it is necessary, to also look directly at those who at high risk and are in probable dependence for which actions can have some effect on their future and minimize the damage resulting from the excessive consumption of alcoholic beverages, especially those that relate to violence and accidents.

Their first use of alcohol was before 18 years of age. Therefore, it is perceived that this consumption has begun in adolescence, early on, can cause damage or anticipate the growth and development of these individuals, as well as their education and future attitudes. The survey on the consumption patterns of alcohol drinking among adolescents investigated indicates that early age at onset of use influences the future damage with alcohol. They may have consequences as social problems and study, practice sex without a condom or without consent, increased risk of suicide or homicide and accidents7.

The main reasons for alcohol use mentioned by the students was the desire itself, by having fun with friends and celebrations. The company that more frequently indicated drinking was friends. These findings are similar to a study carried out with students in the healthcare area of Curitiba (PR), Brazil19, where the motivation that leads young people to consume alcohol in the first time was to obtain pleasure or fun, better academic, social or sexual performance, by curiosity or by influence of friends and boyfriends/girlfriends. Already for the frequent use of alcohol, the reasons given were to break the routine, the enjoyment of the effects of substances and the reduction of anxiety or stress. About company for drinking, the most cited were friends / colleagues or alone19.

In relation to the expertise of university students about alcohol, the findings suggest that as the main immediate effects, euphoria, and disinhibition and decrease the ability of reasoning; the effects of frequent use are addiction, traffic accidents or gastric and hepatic changes. The sources of the information, the university mentioned internet sites and dialogue with friends more frequently; however 11% of respondents cited the college / university as a resource of information. This finding is relevant to the extent that it perceives an evolution of the inclusion of such content in undergraduate courses, especially in nursing and medicine, for structuring the assistance provided by these future professionals20.

On the knowledge about the effects of alcohol on people, the Brazilian Center of Information on Drugs (OBID) signals that the consumption of alcohol can cause disorders such as stimulant effects and depressant of the central nervous system. Immediately, its intake causes euphoria, disinhibition and talkativeness, and lack of motor coordination lack of control, sleep, malaise and headache. The continuous use can cause various pathologies in individuals, mainly related to the liver, the digestive tract and the cardiovascular system21.

A Study performed with young university students in Rio Claro (SP), Brazil identified the effects of alcohol use associated with diseases in the liver and heart, causing motor reactions or of reasoning and behavior changes22. The awareness of the actual physical damage, social and psychological acquired by the use of alcohol and other drugs is essential, because the knowledge is not the only agent of change and behaviors. Paradoxically, knowing does not, necessarily, the young depart of drug consumption, since the reasons that lead them to experience something different beyond the knowledge and until the conscience, but test their limits in society23.

In the search for information on alcohol, the national survey on university students of 2010 points out more effective key strategies for educational campaigns on the theme, the dissemination of information on television, internet and through discussion groups and, as less effective in educational courses, leaflets and newspapers4.

In a study conducted with undergraduate students from Parana, Brazil on knowledge about alcohol and drugs, it was identified that the learners respond to questions of drugs with the knowledge derived from other sources of information, which is not the curriculum content. Thus, they correlate the findings with the media most used by the students in the research - television and internet over newspapers and books24.

The majority of the university students reported that the information on alcohol are obtained from reliable sources, that may come from reliable sources such as scientific books, specialized web sites, healthcare units, schools and colleges. The information linked to undergraduate education are ratified by a study about teaching about drugs in nursing undergraduate courses, indicating the relevance of the approach of content relating to alcohol consumption, with support of participatory methodologies, propitiating the interactive discussion of involved psychic and social aspects25.

Education on alcohol and drugs in undergraduate studies, mainly in the area of healthcare is questionable. Since there are not formal disciplines in the curriculum to address the issue with the academics and this approximation ends by going through the personal experiences or proximity of the assistance provided during the stages. This makes the association between the theory and the practice, minimizes the magnitude of damage caused by problematic consumption of alcoholic beverages and does not prevent risk behaviors in the future. The importance of this content during learning in the academy if the, primarily, through situations problematizing attitudes, with discussions that might bring the reality and experiences experienced by learners in order to empower them with more precise information and prepare them for professional practice15,17,20.

It is imperative that the professionals acquire specific knowledge about the physical, psychological, social problems and legal consumption of alcohol, in order to promote their clients guidelines, interventions and referrals appropriate to each case. A survey identified that nursing professionals have disinterest and misinformation of the problems arising from the abusive use of alcohol and lack of professional training, impairing effectively the actions for the promotion of health and prevention of risks26. Different approaches are needed to account for multifaceted themes such as the use/abuse of alcohol, indicating that all the scholars in the healthcare courses require some kind of approach on alcohol, within their area of knowledge and activity, printing characteristics of experiences during the course.

It also indicates the approach of the drug phenomenon during undergraduate courses is paramount and crosses all of the content. Therefore, it can create opportunities of this discussion in order adapting requirements and demands of each profession as well as prevention strategies based on reality through collective construction. As much as this discussion is superficial, it can help future professionals in search of information focused on the problems encountered and subsidize various ways of coping with personal injuries. Some studies recommend differentiated teaching strategies capable of being adapted to the most diverse areas of knowledge, in order to facilitate the inclusion in undergraduate curricula and structuring intervention actions in the long term with different perspectives for multiple approaches3,4,25.

CONCLUSION

It is evident, the importance of the inclusion of content about alcohol in undergraduate curricula, highlighting the nursing and nutrition in this research. Future professionals within their area of ​​expertise, need to know and prevent the damage caused by alcohol dependence and make appropriate referrals of the clients to be cared for. The scholars in the healthcare area must be prepared to discuss these topics, thus making them close to this reality.

Despite the relevance of this study, it is not possible to generalize these findings to other students and institutions, since the sample is small and specific, mostly part of a larger study. Therefore, it is essential to carry out specific studies for this academic area on the consumption of alcohol among students and their approach during their training.

It is necessary to include academic and personal experiences of these young people in everyday approaches and make them active participants in this paradigm shift within the undergraduate courses that they are inserted. These actions can promote reflection during the learning of specific content as much as the change in future conduct of individuals and professionals.

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Direitos autorais 2014 Ingryd Cunha Ventura Felipe, Antonio Marcos Tosoli Gomes

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