Cambios en el consumo alcohólico de riesgo en población adolescente en la última década (2004-2013): una aproximación cuanti-cualitativa / Changes in hazardous drinking in Spanish adolescent population in the last decade (2004-2013) using a quantitative and qualitative design

Objetivo: Conocer los cambios del consumo alcohólico de riesgo en los adolescentes en la última década, así como sus motivaciones y vivencias. Diseño: 1) descriptivo transversal: encuesta autoadministrada; 2) cualitativo explicativo: grupos de discusión videograbados, con análisis de contenido (codificación, triangulación de categorías y verificación de resultados). Emplazamiento y participantes: Alumnos de un instituto urbano de educación secundaria, administrando un cuestionario cada 3 años de 2004 a 2013. En el año 2013 se realizan las entrevistas grupales, con muestreo de conveniencia. Criterio de homogeneidad: nivel educativo; criterios de heterogeneidad: edad, sexo y consumo de drogas. Mediciones principales: Cuestionario: edad, sexo, consumo de drogas y cuestionario CAGE. Entrevistas: semiestructuradas sobre un guión previo, valorando vivencias y expectativas. Resultados: Descriptivo: 1.558 encuestas, edad 14,2 ± 0,3años, 50% mujeres. Disminuye la prevalencia de consumo de alcohol (13%), aumentando el consumo de riesgo (11%; p < 0,001 χ2). Relacionado con ser mujer (p < 0,01 χ2), mayor consumo alcohólico (> 6 unidades de bebida estándar/semana; p < 0,001 ANOVA) en fin de semana (56%; p < 0,01 χ2) y policonsumo (p < 0,01 χ2). Cuestionario CAGE: 37% ≥ 1 respuesta positiva (relacionado con consumo de riesgo, p < 0,05 χ2), 18% ≥ 2 respuestas. Cualitativo: 48 entrevistados; se establecen 4 categorías: determinantes personales (edad, género), influencias sociales (familia, amigos), normalización del consumo (accesibilidad, ocio nocturno) y adicción (riesgo, policonsumo). Conclusión: Es preocupante el aumento del porcentaje del consumo alcohólico de riesgo, pese a disminuir las prevalencias del consumo. Se relaciona con el sexo femenino, el consumo binge-drinking y el policonsumo. El ocio nocturno y la normalización social son las principales motivaciones argumentadas por los adolescentes, sin percepción del riesgo de este tipo de consumo (AU)

Objective: To determine the changes in hazardous drinking in adolescents in the last decade, as well as their motivations and experiences. Design: Firstly, a descriptive design using a self-report questionnaire, and secondly an explanatory qualitative design, with video recordings of discussion groups with content analysis (coding, triangulation of categories and verification of results). Setting and participants: Pupils from an urban High School, administering a questionnaire every 3 years from 2004 to 2013. Purposive sampling was used to elect groups in qualitative design. Homogeneity criteria: education level; heterogeneity criteria: age, gender, and drug use. Main measurements: Questionnaire: age, gender, drug use, and the CAGE test. Interviews: semi-structured on a previous script, evaluating experiences and expectations. Results: Descriptive design: A total of 1,558 questionnaires, age 14.2 ± 0.3 years, 50% female. The prevalence of alcohol drinking decreases (13%), but its hazardous use increases (11%; P < .001, χ2). This is associated with being female (P < .01 χ2), higher alcohol consumption (> 6 standard drink units weekly; P < .001, ANOVA), during the weekend (56%; P<.01, χ2) and multiple drug use (P < .01, χ2). CAGE questionnaire: 37% ≥ 1 positive response (related to hazardous drinking, P < .05 χ2), 18% ≥ 2 answers. Qualitative: A total of 48 respondents, classified into 4 categories: personal factors (age, gender), social influences (family, friends), consumption standards (accessibility, nightlife), and addiction (risk, multiple drug use). Conclusion: Despite the decrease in the prevalence of alcohol drinking, the increase in the percentage of the hazardous drinking is a public health problem. It is related to being female, binge-drinking, and multiple drug use. Nightlife and social standards are the main reasons given by adolescents, who have no perception of risk (AU)

Tumor del estroma extragastrointestinal primario hepático gigante / Giant primary extra gastrointestinal stromal tumor of the liver

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[Changes in hazardous drinking in Spanish adolescent population in the last decade (2004-2013) using a quantitative and qualitative design]. / Cambios en el consumo alcohólico de riesgo en población adolescente en la última década (2004-2013): una aproximación cuanti-cualitativa.

OBJECTIVE: To determine the changes in hazardous drinking in adolescents in the last decade, as well as their motivations and experiences. DESIGN: Firstly, a descriptive design using a self-report questionnaire, and secondly an explanatory qualitative design, with video recordings of discussion groups with content analysis (coding, triangulation of categories and verification of results). SETTING AND PARTICIPANTS: Pupils from an urban High School, administering a questionnaire every 3 years from 2004 to 2013. Purposive sampling was used to elect groups in qualitative design. Homogeneity criteria: education level; heterogeneity criteria: age, gender, and drug use. MAIN MEASUREMENTS: Questionnaire: age, gender, drug use, and the CAGE test. Interviews: semi-structured on a previous script, evaluating experiences and expectations. RESULTS: Descriptive design: A total of 1,558 questionnaires, age 14.2±0.3years, 50% female. The prevalence of alcohol drinking decreases (13%), but its hazardous use increases (11%; P<.001, χ2). This is associated with being female (P<.01 χ2), higher alcohol consumption (>6 standard drink units weekly; P<.001, ANOVA), during the weekend (56%; P<.01, χ2) and multiple drug use (P<.01, χ2). CAGE questionnaire: 37% ≥1positive response (related to hazardous drinking, P<.05 χ2), 18% ≥2answers. QUALITATIVE: A total of 48 respondents, classified into 4 categories: personal factors (age, gender), social influences (family, friends), consumption standards (accessibility, nightlife), and addiction (risk, multiple drug use). CONCLUSION: Despite the decrease in the prevalence of alcohol drinking, the increase in the percentage of the hazardous drinking is a public health problem. It is related to being female, binge-drinking, and multiple drug use. Nightlife and social standards are the main reasons given by adolescents, who have no perception of risk.

Motivaciones para el consumo de tabaco entre los adolescentes de un instituto urbano / Motivations for tobacco consumption among adolescents in an urban high school

Objetivo Conocer las motivaciones (actitudes, creencias y experiencias) de los adolescentes para el consumo de tabaco. Método Diseño cualitativo con videograbación de seis grupos de discusión (6-8 adolescentes, 50 minutos), curso escolar 2008/09. Muestreo intencional de adolescentes (12-18 años) de un instituto urbano de clase media (Jaén-España), usando el nivel educativo como criterio de homogeneidad y el sexo/consumo como criterio de heterogeneidad. Análisis de contenido: codificación, triangulación de categorías y obtención/verificación de resultados. Resultados Cuarenta y cuatro adolescentes, 54% varones. Fumar relaja y mejora la imagen personal: da seguridad (chicos) y mejora las relaciones con el sexo opuesto, además de controlar el peso (chicas). La familia favorece el tabaquismo por imitación de comportamientos, aunque no lo normaliza. Los amigos constituyen un grupo de presión para el inicio/mantenimiento del consumo. El inicio de la educación secundaria marca el principio del consumo experimental. La sociedad suele normalizar el consumo y es fácil para los menores de edad comprar tabaco. Los universitarios son un modelo a seguir, con libertad para el consumo. Piden ejemplo de abstinencia a progenitores y educadores/sanitarios, dicen estar bien informados, pero recuerdan sólo mensajes impactantes. De forma unánime indican que el tabaco provoca adicción, pero de manera proporcional al tiempo de consumo; sólo les preocupan los síntomas inmediatos provocados por el tabaquismo. Los adolescentes fumadores relacionan el policonsumo con los momentos de ocio. Conclusiones El estudio aporta motivos potencialmente útiles para mejorar la intervención antitabaco en los adolescentes. La influencia de los amigos, las actitudes parentales, la accesibilidad al tabaco y los síntomas de dependencia parecen ser los factores más relevantes(AU)

Objective To determine the motivations (attitudes, beliefs and experiences) for tobacco consumption among adolescents. Methods This study was based on qualitative methodology using six 50-minute discussion groups with 6-8 adolescents per group during the 2008/09 school year. Purposive sampling was performed of 12-18 year-old adolescents attending a middle-class urban school (Jaén, Spain). The sample was stratified by educational level as the homogeneity criterion and gender and tobacco consumption as the heterogeneity criterion. Content analysis consisted of coding, triangulation of categories and obtaining and verifying the results .Results There were 44 adolescents (54% male). The participants reported that smoking relaxed and improved self-image, providing security (boys) and improving relations with the opposite sex, as well as weight control (girls). The family encouraged smoking by providing a model to imitate, although many adolescents hid their smoking from their families. Friends constituted a pressure group to start or continue smoking. Starting secondary school marked the beginning of experimental use. Society tended to accept consumption and buying tobacco was easy for minors. University students were a role model and were free to smoke. The adolescents looked to their parents and educators/health workers to provide a model of abstinence and reported that they were well informed but only remembered powerful messages. Participants unanimously indicated that tobacco causes addiction, but in proportion to the duration of consumption, and were concerned only with the immediate symptoms caused by smoking. Teenage smokers associated multiple drug use with leisure time. Conclusions This study provides useful data on motivation that could be used to improve smoking prevention interventions among adolescents. The most important factors seem to be peer influence, parental attitudes, easy access to tobacco and symptoms of dependence (AU)

[Motivations for tobacco consumption among adolescents in an urban high school]. / Motivaciones para el consumo de tabaco entre los adolescentes de un instituto urbano.

OBJECTIVE: To determine the motivations (attitudes, beliefs and experiences) for tobacco consumption among adolescents. METHODS: This study was based on qualitative methodology using six 50-minute discussion groups with 6-8 adolescents per group during the 2008/09 school year. Purposive sampling was performed of 12-18 year-old adolescents attending a middle-class urban school (Jaén, Spain). The sample was stratified by educational level as the homogeneity criterion and gender and tobacco consumption as the heterogeneity criterion. Content analysis consisted of coding, triangulation of categories and obtaining and verifying the results. RESULTS: There were 44 adolescents (54% male). The participants reported that smoking relaxed and improved self-image, providing security (boys) and improving relations with the opposite sex, as well as weight control (girls). The family encouraged smoking by providing a model to imitate, although many adolescents hid their smoking from their families. Friends constituted a pressure group to start or continue smoking. Starting secondary school marked the beginning of experimental use. Society tended to accept consumption and buying tobacco was easy for minors. University students were a role model and were free to smoke. The adolescents looked to their parents and educators/health workers to provide a model of abstinence and reported that they were well informed but only remembered powerful messages. Participants unanimously indicated that tobacco causes addiction, but in proportion to the duration of consumption, and were concerned only with the immediate symptoms caused by smoking. Teenage smokers associated multiple drug use with leisure time. CONCLUSIONS: This study provides useful data on motivation that could be used to improve smoking prevention interventions among adolescents. The most important factors seem to be peer influence, parental attitudes, easy access to tobacco and symptoms of dependence.

Motivaciones para el consumo de alcohol entre adolescentes de un instituto urbano / Motivations for alcohol use among adolescents in an urban high school

ObjetivosConocer las motivaciones (actitudes, creencias y experiencias) de los adolescentes para el consumo de alcohol.DiseñoMetodología cualitativa con método explicativo. Uso de técnicas conversacionales (grupos de discusión con 6–8 adolescentes/grupo, 50min duración) registradas mediante videograbación durante el curso escolar 2008–09.Participantes y contextoAdolescentes de 12–18 años de un instituto urbano de clase media (Jaén, España). Muestreo intencional estratificado por niveles educativos; criterios de heterogeneidad: sexo y consumo de alcohol.MétodoProceso de análisis cualitativo de contenido: codificación, triangulación de categorías y obtención/verificación de resultados.ResultadosSe realizan seis entrevistas grupales, incluyendo 44 adolescentes (54% varones). El tipo de consumo varía con la edad, existiendo diferencias de género en las motivaciones. El alcohol se relaciona con actos lúdico-sociales desde las primeras experiencias familiares, y con el ocio nocturno al entrar en el instituto y aumentar las relaciones entre iguales. Los modelos sociales preferidos son los jóvenes universitarios, con un consumo excesivo en fin de semana que es entendido como un acto de independencia. Se rechazan las figuras de autoridad (profesores/sanitarios), criticando la información recibida (solo de contenidos, sin elementos motivacionales) y la omisión en la educación sobre este tema. Existen una accesibilidad para la compra de alcohol elevada, una sensación de control del consumo y una tendencia a entender las intoxicaciones agudas como parte del ocio. Salvo pocas discrepancias, se relaciona el consumo de alcohol con el consumo de tabaco y de otras drogas.ConclusionesLa intervención sobre el consumo alcohólico de los adolescentes debe incorporar sus motivaciones para lograr una mayor eficiencia(AU)

ObjectivesTo find out the motivation (attitudes, beliefs and experiences) behind adolescent alcohol consumption.DesignQualitative methodology, explanatory method, using conversational techniques (discussion group with 6–8 adolescents/group, 50min duration) recorded by videotape during the school year 2008/09.Participants and contextAdolescents 12–18 years-old of a middle-class urban school (Jaen-Spain). Purposive sampling stratified by level of education; heterogeneity criteria: sex and alcohol consumption.MethodProcess of content analysis: coding, triangulation of categories and obtain/verify results.ResultsSix group interviews, including 44 teenagers (54% males). The rate of consumption varies with age, and there are gender differences in motivations. Alcohol is related to social and leisure activities from early family experiences, and the nightlife on entering school and as peer relationships increase. The preferred social models are university students, with excessive consumption at the weekend that is understood as an act of independence. Rejection of authority figures (teachers/health), critical attitude to the received information (content only, without motivational elements) and failure in education on this topic. There is high accessibility for the purchase of alcohol, a sense of controlled consumption and a tendency to understand acute poisoning as part of leisure. The adolescents related alcohol consumption, tobacco and drug use (except for minor discrepancies).ConclusionsThe intervention on alcohol consumption of adolescents should incorporate their motivation to achieve greater efficiency(AU)

[Motivations for alcohol use among adolescents in an urban high school]. / Motivaciones para el consumo de alcohol entre adolescentes de un instituto urbano.

OBJECTIVES: To find out the motivation (attitudes, beliefs and experiences) behind adolescent alcohol consumption. DESIGN: Qualitative methodology, explanatory method, using conversational techniques (discussion group with 6-8 adolescents/group, 50min duration) recorded by videotape during the school year 2008/09. PARTICIPANTS AND CONTEXT: Adolescents 12-18 years-old of a middle-class urban school (Jaen-Spain). Purposive sampling stratified by level of education; heterogeneity criteria: sex and alcohol consumption. METHOD: Process of content analysis: coding, triangulation of categories and obtain/verify results. RESULTS: Six group interviews, including 44 teenagers (54% males). The rate of consumption varies with age, and there are gender differences in motivations. Alcohol is related to social and leisure activities from early family experiences, and the nightlife on entering school and as peer relationships increase. The preferred social models are university students, with excessive consumption at the weekend that is understood as an act of independence. Rejection of authority figures (teachers/health), critical attitude to the received information (content only, without motivational elements) and failure in education on this topic. There is high accessibility for the purchase of alcohol, a sense of controlled consumption and a tendency to understand acute poisoning as part of leisure. The adolescents related alcohol consumption, tobacco and drug use (except for minor discrepancies). CONCLUSIONS: The intervention on alcohol consumption of adolescents should incorporate their motivation to achieve greater efficiency.