Disonancias cognitivas en la intervención antitabaco motivacional en adolescentes / Cognitive dissonance in the motivational smoking intervention in adolescents

Objetivo. Conocer las disonancias cognitivas más frecuentes de los adolescentes entre las motivaciones para fumar y dejar de fumar. Material y métodos. Estudio descriptivo realizado en 5 institutos de secundaria tras intervención motivacional a adolescentes (< 20 años) para dejar de fumar. Se recoge por escrito una balanza de motivos para fumar/dejar de fumar, edad, sexo, tests de Fagerström/Richmond, edad de inicio y patrón del consumo. Resultados. Participan 82 adolescentes (52% hombres, edad 15,6 años±1,4). Motivos para fumar: amigos (55%), «me gusta» (44%), «estar enganchado» (28%), diversión (19%), autoafirmación (18%). Motivos para dejar de fumar: mejorar la salud (91%), «es caro» (55%), no gusta sabor/olor (23%), conflictos con padres (23%). La diversión se asocia al inicio precoz del consumo (p=0,025; Student). La dependencia aparece en adolescentes de mayor edad (p=0,075; Student). La sensación de relajación se asocia a mayor consumo (p=0,018; Student), sobre todo en mujeres (p=0,046; χ2). La autoafirmación es más frecuente en hombres (p=0,045; χ2). El test de Richmond empeora si le gusta fumar (p=0,035; Student) y mejora si tiene problemas económicos (p=0,082; Student). El rechazo al sabor/olor se relaciona con menor dependencia (Fagerström) (p=0,069; Student). Disonancias cognitivas: / (OR 4,14), / (OR 0,44), / (OR 0,38) y (OR 0,24), /< autoafirmación> (OR 0,22), / (OR 0,21). Un 54% dejan de fumar y se relaciona con el entorno, la sensación de placer y la dependencia (p<0,05 test X2). Conclusión. Las disonancias cognitivas son un elemento motivacional muy importante para conseguir el cese del consumo tabáquico entre adolescentes y deben incorporarse a la intervención antitabaco realizada por los sanitarios (AU)

Objectives. To find out the most common dissonances between smoking and giving up motivations in adolescents. Material and methods. A five Secondary Schools descriptive study after motivational interviewing of adolescents (less than 20 years) who wanted to quit smoking. A written balance sheet of reasons for smoking and quitting smoking, age, sex, Fagerström/Richmond test, beginning age, consumption pattern, was collected. Results. A total of 82 adolescents participated (52% male, age 15.6 years±1.4). Reasons for smoking: friends (55%), «I like it» (44%), «addicted» (28%), for fun (19%), and self-assertiveness (18%). Reasons for quitting smoking: better health (91%), «It's expensive» (55%), don’t like taste/smell (23%), and conflicts with parents (23%). Fun is associated with earlier onset of smoking (p=.025; Student) while dependency is recognised in older adolescents (p=.075; Student). Relaxation feeling is associated with greater cigarette consumption (p=0,018; Student) especially in women (p=.046; χ2); assertiveness is more common in men (p=.045; χ2). Richmond test results get worst if they like smoking (p=.035; Student) and get better if they have economical problems (p=.082; Student). Rejecting taste/smell is related with less dependency (Fagerström) (p=.069; Student). The most common dissonances were between / (OR 4.14), // (OR=0.38) and (OR 0.24) / (OR 0.22), / (OR 0.21). A total of 54% quit smoking and was related to the environment, the feeling of pleasure and dependency (p<.05; X2 test). Conclusions. Cognitive dissonances are a very important motivational element for the adolescent to quit smoking, and must be incorporated into anti-smoking interventions by health professionals (AU)

[Psychological malaise and the sociodemographic and familial characteristics of the over-user of primary care]. / Malestar psíquico y características sociodemográficas y familiares del hiperfrecuentador en atención primaria.

OBJECTIVES: To find the social, demographic and family characteristics, the psychological malaise and reasons for consultation of normal and hyper-attenders at a primary care practice. DESIGN: Crossover study with a control. SETTING: Primary care. PATIENTS: 127 hyper-attenders (they attended the practice as often as, or more often than, the mean number of visits, stratified by sex and age) and 120 normal attenders chosen by stratified random sampling. INTERVENTIONS: Questionnaire with characterisation data, family demography, psychological malaise (Goldberg general health questionnaire) and reasons for consultation. RESULTS: To be considered a hyper-attender, the number of attendances per year ranged from > or = 8 (in 15 to 44-year olds) to > or = 20 (in men over 65). Hyper-attenders were about 12% of almost all groups, except in men between 45 and 64 and women over 64, in whom it was around 18%. We found no relevant differences between normal and hyper-attenders as to demography or perception of family function. In almost 60% of hyper-attenders and 34% of normal attenders (p < 0.001), psychological malaise was detected. CONCLUSIONS: If the definition of hyper-attenders is stratified by age and sex, their social and demographic characteristics are very different from in other studies, even though there are a similar number of them. However, these demographic and/or family characteristics are similar in normal and hyper-attenders.