The trajectory of crack users to the street situation in the perspective of family members

Abstract Objective. To understand the family experience regarding the trajectory of crack users for the street situation. Method. Qualitative study using the systemic approach as the theoretical referential and the narrative as methodological referential. We conducted interviews with eleven family members of crack users with street situation experience cared for at a community mental health service. We analyzed the interviews using the inductive content analysis technique. Results. The family members understood the trajectory of the crack users for the street situation from two perspectives. One before the street situation process, for which they described a problematic childhood, the presence of stressor traumas/ events, vulnerabilities in the family environment, and their family members' encounter with the drug world. Moreover, another posterior to the street situation, for which they narrated the perception of alterations in the users, the discovery of crack use, the deepening of the individuals' relationship with the streets, and the adoption of coping strategies. Conclusion. It was made evident that the family adopts an explicative model for the behavior of drug use and contact with the streets based on the life history of the crack user family member.

Resumen Objetivo. Comprender la trayectoria de usuarios de crack en situación de calle desde la perspectiva de los familiares. Métodos. Estudio cualitativo, realizado en un servicio público de salud mental, que utiliza el abordaje sistémico como referencial teórico y la narrativa como referencial metodológico. Se realizó una entrevista en profundidad con cuestión orientadora junto a 11 familiares, y la técnica de análisis de contenido para la exploración de las narrativas. Resultados. Los familiares comprendieron la trayectoria para la situación de calle a partir de dos perspectivas principales: el pasado, donde narraron eventos de la infancia / adolescencia de los usuarios, y el presente, donde contaron específicamente sobre la ocurrencia de la situación de calle. Discusión: Los eventos que justifican el uso de drogas son percibidos como momentos de fragilización, a partir del entendimiento de que el usuario era un "niño-problema". Conclusión. Se evidenció que la creencia familiar puede funcionar como los ajustes para cuidar y mantener la unión y la homeostasis familiar.

Resumo Objetivo. Compreender a experiência familiar sobre a trajetória de usuários de crack para a situação de rua. Método. Estudo qualitativo utilizando a abordagem sistêmica como referencial teórico e a narrativa como referencial metodológico. Foram realizadas entrevistas com 11 familiares de usuários de crack com vivência de situação de rua e atendidos em um serviço de saúde mental comunitário. As entrevistas foram analisadas por meio da técnica de análise de conteúdo indutivo. Resultados. Os familiares compreenderam a trajetória dos usuários de crack para a situação de rua a partir de duas perspectivas. Uma anterior ao processo da situação de rua, onde descreveram uma infância problemática, presença de traumas/eventos estressores, vulnerabilidades no ambiente familiar e o encontro dos seus familiares com o universo das drogas. E uma posterior, onde narraram sobre a percepção de alterações nos usuários, a descoberta do uso de crack, o aprofundamento da relação dos indivíduos com as ruas e a adoção de estratégias de enfrentamento. Conclusão. Evidenciou-se que a família adota um modelo explicativo para o comportamento de uso de droga e contato com a rua baseado na história de vida do familiar usuário de crack.

Occupational stress among nursing technicians and assistants: coping focused on the problem.

OBJECTIVE: To analyze the association between strategies used to cope with occupational stress that are focused on the problem wand the personal characteristics of nursing technicians and assistants. METHODOLOGY: This quantitative and correlational study was conducted in a large teaching hospital in the São Paulo State, Brazil, in 2013. A randomized sample with 310 participants (198 nursing assistants and 112 nursing technicians) comprised the study population. Data were collected using a sociodemographic characteristics questionnaire and Scale of Ways of Coping with Problems. Data were submitted to univariate analysis, and variables with statistical significance (p<0.20) were submitted posteriorly in a multiple regression model. RESULTS: Most employees were women (76.1%) older than 40 years (67.7%), had nine to 11 years of formal education (73.5%), had a partner (58.7%), were Catholic (53.2%), and had children (74.5%). The final multiple regression model consisted of variable years of formal education and number of children. CONCLUSION: In this study, formal education and number of children were more strongly associated with a greater use of coping strategies focused on the problem. Such a strategy is related to minimal vulnerability to stress related to the working environment.

Estructura familiar de usuarios de crack analizada con auxilio del genograma / Family structure of crack users with a genogram

Objetivo: analizar la estructura familiar de usuarios de crack con la ayuda del genograma, identificando las relaciones y los antecedentes familiares de uso de drogas. Metodología: Investigación transversal, teniendo como referencial la Teoría General de Sistemas, particularmente el genograma. Participaron 15 familiares de usuarios habituales o dependientes de crack, en tratamiento en una Comunidad Terapéutica de Paraná, Brasil, en el mes de mayo de 2011. Los instrumentos de recolección de datos fueron la entrevista semiestructurada y el cuestionario de clasificación económica. Los genogramas fueron analizados en un proceso semejante al del análisis de contenido. Resultados: El genograma incluyó 378 familiares; nueve familias eran nucleares, y todas presentaron por lo menos una relación armoniosa con un miembro familiar. Catorce familias presentaban antecedentes de uso de drogas. Conclusión: Se evidenció la reproducción multi-generacional de comportamientos asociados al uso de drogas, con la influencia de aspectos culturales y valores familiares (AU)

Objective: The family structure of crack users was analyzed by a genogram which identified the relationships and family history of illicit drug users. Methods: The cross-sectional survey was based on General Systems Theory, particularly by genogram. The study included 15 family members or dependents of regular crack users treated in a Therapeutic Community in the state of Paraná, Brazil, in May 2011. Data were collected by semi-structured interviews, and a questionnaire economic situation. The genograms were analyzed in a process similar to content analysis. Results: The genograms included 378 family members; nine families were nuclear, and all families had at least a armonious relationship with a family member; 11 had distant relationships; some seven conflicted relationships. Fourteen families had a history of drug abuse, and eight had a history of illicit drug use. Conclusions: The multigenerational reproductive behavior associated with drug use was revealed through an influence of cultural aspects, beliefs and family values (AU)