Transtornos mentais comuns e uso de risco de álcool em estudantes de graduação em odontologia
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2017-07-14
Autores
Graner, Karen Mendes [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Transtornos Mentais Comuns (TMC) e uso de risco de álcool entre estudantes universitários vêm sendo foco de pesquisas, sendo ainda raros os estudos com alunos de graduação em odontologia. O objetivo desta pesquisa foi investigar a prevalência de TMC e do uso de risco de álcool e suas associações com as características sociodemográficas, de saúde, relacionais, do ambiente acadêmico, de estratégias de enfrentamento e resiliência entre estudantes do curso de Odontologia da Universidade Estadual de Campinas - UNICAMP. Neste manuscrito, estão apresentados três estudos que representam os resultados obtidos: uma revisão integrativa sobre o tema e dois estudos empíricos que focalizaram dois diferentes desfechos: TMC e uso de risco de álcool em estudantes de odontologia. A revisão investigou, em pesquisas publicadas entre 2006 e 2016, fatores de risco e proteção para sofrimento psíquico de estudantes universitários. Os estudos empíricos utilizaram delineamentos transversais, descritivos e analíticos. A amostra nesses estudos foi composta por 230 alunos, 71,8% dos estudantes matriculados nos quatro anos do curso de odontologia. Foram aplicados formulário padronizado para caracterização da amostra e seis instrumentos que investigaram: Transtorno Mental Comum (Self Repporting Questionnarie-20 – SRQ-20), uso de risco de álcool (Alcohol Use Disorder Identification Test-AUDIT), apoio social (Escala de Apoio Social, do Medical Outcomes Study-EAS), percepção do ambiente educacional (Dundee Ready Education Environment Measure-DREEM), estratégias de enfrentamento (Inventário de Estratégias de Enfrentamento-IEC) e resiliência (Escala de Resiliência-ER). Foram realizadas análises descritiva e bivariada, e regressão logística (RL) para modelos sucessivos. Do total da amostra, 30,0% cursavam a primeira série, 21,7% a segunda, 31,2% a terceira e 17,0% na quarta, sendo 75,2% mulheres. A média de idade foi de 20,6 (DP±1,99), maioria referiu não ter companheiro (98,7%), morar com amigos (59,6%), ter pai e mãe (66,1%; 63,5%) com ensino superior completo, renda familiar elevada (65,9%) e ter gasto mensal de até dois salários mínimos (87,6%). A maioria não recebia mesada ou a considerava insuficiente (61,6%), não tinha trabalhado nos últimos seis meses (91,3%), seguia alguma religião (84,3%) e considerava-a muito importante (54,8%). Análise descritiva dos escores obtidos nos instrumentos indicou, em geral, médias elevadas para percepção geral positiva do apoio social (EAS total: 72,7, DP:15,9), ambiente educacional (DREEM total: 119,9; DP:22,9), resiliência (ER: 124,1; DP:16,4). Identificou-se também maior uso de Reavaliação Positiva como estratégia de enfrentamento (13,6; DP:4,7; 1-27) e menor uso de estratégias de Fuga/Esquiva (1,7, DP:1,8) pelos estudantes. A prevalência de TMC foi de 45.2% (95% CI: 38.7- 51.6) e de uso de risco de álcool 29,6% (95%IC: 23,7%-35,9%) com prevalência significativamente maior entre os homens (p<0,01). A análise multivariada permitiu identificar como fatores de risco para TMC: não desempenhar atividades extracurriculares como gostaria (OR:4,5;IC:1,9-10,7), avaliar negativamente sua saúde (OR:4,24;IC:1,9-9,8), e seu desempenho escolar (OR:3,8;IC:1,3-10,5), ter recebido tratamento psicológico/psiquiátrico após o ingresso na universidade (OR:2,65;IC:1,1-6,1), e utilizar coping confronto (OR:1,20;IC:1.0-1.4). Resiliência (OR:0,93;IC:0,9-1,0) foi identificada como fator de proteção para TMC. Em relação aos fatores de risco para uso problemático do álcool, permaneceram no modelo final da RL: cursar a terceira série (OR:3,72;IC:1,55-8,90), ter recebido trote (OR:3,29;IC:1,54-7,03), sexo masculino (OR:3,19; IC:1,57-6,49), renda mais alta (OR:2,87;IC:1,31-6,28). As prevalências de TMC e de uso de risco de álcool foram mais elevadas que as descritas para a população geral. Características individuais (sexo, renda), de saúde (autoavaliação da saúde, histórico de tratamento psicológico/psiquiátrico), comportamentais (coping e resiliência) e, principalmente, as relativas à vida acadêmica (série, atividades extracurriculares, desempenho acadêmico, trote abusivo) desempenharam importante função nos desfechos investigados. Embora tenha sido realizado com população universitária específica, os achados sugerem a relevância de ações de prevenção e cuidado nas instituições de ensino superior de forma a favorecer o bem estar dos estudantes. Estudos longitudinais poderão favorecer o aprofundamento dos dados identificados.
Common Mental Disorders and hazardous alcohol consumption in university students have been the focus of researchers; however, studies that focus on mental health and risk behaviors of dental students are less frequent. This study aimed to identify the prevalence of CMD and hazardous alcohol consumption, and its associations with sociodemographic characteristics, health conditions, relational aspects, academic life’ perceptions, coping and resilience of dental students in the State of University of Campinas - UNICAMP. Three scientific papers are presented: an integrative review and two empirical studies about CMD and hazardous alcohol consumption of dental students. The review investigated, in publications between 2006 and 2016, risk and protective factors for psychological distress in university students. The empirical studies had cross-sectional, descriptive and analytical design. The sample in these studies was composed by 230 students, 71.8% enrolled in the four years of the dentistry course. Students answered to a standardized questionnaire and six instruments: Self-Repporting Questionnarie-20 (SRQ-20; CMD), Alcohol Use Disorder Identification Test (hazardous alcohol consumption), Social Support Scale of the Medical Outcomes Study (MOS; social support), Dundee Ready Education Environment (DREEM; educational environment’ perception), Ways of Coping (WC; coping strategies) and Resilience Scale (RS; resilience). We conducted a descriptive and bivariate analyzes, and a logistic regression (LR) performed for successive models. Of the total sample, 30.0% were in the first grade, 21.7% in the second grade, 31.2% in the third grade and 17.0% in the fourth grade, 75.2% of which were women. The mean age was 20.6 (SD ± 1.99), the majority reported having no partner (98.7%), living with friends (59.6%), having father and mother with complete higher education (66.1%, 63.5%), high family income (65.9%) and monthly cost more than two minimum wages (87.6%). Most of students did not receive allowance or it was insufficient (61.6%), had not worked in the last six months (91.3%), were religious (84.3%) and considered it very important (54.8%). Descriptive analysis indicated high averages for overall positive perception of social support (total MOS: 72.7, SD: 15.9), educational environment’perception (total DREEM: 119.9; 9), and resilience (RS: 124.1, SD: 16.4). Positive reappraisal was the coping strategy most reported (13.6, SD: 4.7, 1-27) and escape/avoidance the less use strategy (1.7, SD: 1.8). The prevalence of CMD was 45.2% (95% CI: 38.7-51.6), and 29.6% (95% CI: 23.7% -35.9%) of the students presented hazardous alcohol consumption, which was significantly higher among men (p<0.01). Multivariate analysis showed that the risk factors for CMD were having unsatisfactory extracurricular activities (OR: 4.5, CI: 1.9-10.7), having negative perception of their health (OR: 4.24;9-9,8) and of their academic performance (OR: 3.8; CI: 1.3-10.5), having psychological/psychiatric treatment during the course (OR: 2.65; CI: 1,1-6,1), and using confrontive coping (OR: 1.20; CI: 1.0-1.4). Resilience (OR: 0.93; CI: 0.9- 1.0) was identified as a protective factor for CMD. Regarding risk factors for hazardous alcohol consumption identified in LR were being in the third grade (OR: 3.72, CI: 1.55-8.90), having received hazing (OR: 3.29 , CI: 1.54-7.03), being male (OR: 3.19, CI: 1.57-6.49) and having higher family income (OR: 2.87; CI: 1.31-6, 28). In this study, the prevalence of CMD and hazardous alcohol consumption was higher than identified in general population. Individuals characteristics (sex, income), health aspects (self-assessment of health, history of psychological / psychiatric treatment), behavioral (coping and resilience) and especially those characteristics related to academic life (series, extracurricular activities, academic performance) influenced the outcomes. Longitudinal studies may contribute to clarify the findings. Although this study carried out with a specific university population (dental students of one university), the findings suggest the relevance of preventive and care actions in university students contributing to their well-being.
Common Mental Disorders and hazardous alcohol consumption in university students have been the focus of researchers; however, studies that focus on mental health and risk behaviors of dental students are less frequent. This study aimed to identify the prevalence of CMD and hazardous alcohol consumption, and its associations with sociodemographic characteristics, health conditions, relational aspects, academic life’ perceptions, coping and resilience of dental students in the State of University of Campinas - UNICAMP. Three scientific papers are presented: an integrative review and two empirical studies about CMD and hazardous alcohol consumption of dental students. The review investigated, in publications between 2006 and 2016, risk and protective factors for psychological distress in university students. The empirical studies had cross-sectional, descriptive and analytical design. The sample in these studies was composed by 230 students, 71.8% enrolled in the four years of the dentistry course. Students answered to a standardized questionnaire and six instruments: Self-Repporting Questionnarie-20 (SRQ-20; CMD), Alcohol Use Disorder Identification Test (hazardous alcohol consumption), Social Support Scale of the Medical Outcomes Study (MOS; social support), Dundee Ready Education Environment (DREEM; educational environment’ perception), Ways of Coping (WC; coping strategies) and Resilience Scale (RS; resilience). We conducted a descriptive and bivariate analyzes, and a logistic regression (LR) performed for successive models. Of the total sample, 30.0% were in the first grade, 21.7% in the second grade, 31.2% in the third grade and 17.0% in the fourth grade, 75.2% of which were women. The mean age was 20.6 (SD ± 1.99), the majority reported having no partner (98.7%), living with friends (59.6%), having father and mother with complete higher education (66.1%, 63.5%), high family income (65.9%) and monthly cost more than two minimum wages (87.6%). Most of students did not receive allowance or it was insufficient (61.6%), had not worked in the last six months (91.3%), were religious (84.3%) and considered it very important (54.8%). Descriptive analysis indicated high averages for overall positive perception of social support (total MOS: 72.7, SD: 15.9), educational environment’perception (total DREEM: 119.9; 9), and resilience (RS: 124.1, SD: 16.4). Positive reappraisal was the coping strategy most reported (13.6, SD: 4.7, 1-27) and escape/avoidance the less use strategy (1.7, SD: 1.8). The prevalence of CMD was 45.2% (95% CI: 38.7-51.6), and 29.6% (95% CI: 23.7% -35.9%) of the students presented hazardous alcohol consumption, which was significantly higher among men (p<0.01). Multivariate analysis showed that the risk factors for CMD were having unsatisfactory extracurricular activities (OR: 4.5, CI: 1.9-10.7), having negative perception of their health (OR: 4.24;9-9,8) and of their academic performance (OR: 3.8; CI: 1.3-10.5), having psychological/psychiatric treatment during the course (OR: 2.65; CI: 1,1-6,1), and using confrontive coping (OR: 1.20; CI: 1.0-1.4). Resilience (OR: 0.93; CI: 0.9- 1.0) was identified as a protective factor for CMD. Regarding risk factors for hazardous alcohol consumption identified in LR were being in the third grade (OR: 3.72, CI: 1.55-8.90), having received hazing (OR: 3.29 , CI: 1.54-7.03), being male (OR: 3.19, CI: 1.57-6.49) and having higher family income (OR: 2.87; CI: 1.31-6, 28). In this study, the prevalence of CMD and hazardous alcohol consumption was higher than identified in general population. Individuals characteristics (sex, income), health aspects (self-assessment of health, history of psychological / psychiatric treatment), behavioral (coping and resilience) and especially those characteristics related to academic life (series, extracurricular activities, academic performance) influenced the outcomes. Longitudinal studies may contribute to clarify the findings. Although this study carried out with a specific university population (dental students of one university), the findings suggest the relevance of preventive and care actions in university students contributing to their well-being.
Descrição
Palavras-chave
Transtornos mentais comuns, Sofrimento psíquico, Álcool, Uso de risco de álcool, Estudantes, Fatores de risco, Common mental healh, Psychological distress, Alcohol, Hazardous alcohol consumption, Students, Risk factors