Emotional distress and its care in empowered indigenous women exposed to domestic violence and the demands of child rearing / Malestares emocionales y su atención en mujeres indígenas empoderadas expuestas a violencia doméstica y exigencias de crianza de los hijos

Abstract Introduction Indigenous girls and women in Mexico suffer emotional distress due to marital violence and adherence to gender roles. They are unlikely to denounce violence or treat their health in a timely manner. Women can cope with their distress by participating in empowerment processes. Objective Describe in indigenous empowered women the emotional distress caused by domestic violence in their childhood and the current demands of raising their children and the actions they take to cope with them. Method Qualitative and phenomenological qualitative research, in-depth interviews, and participant observation were conducted with nine migrant indigenous women to explore experiences during their upbringing, emotional reactions, and current mental health problems. Results The software Atlas. ti V 7 was used to undertake a theoretical categorization of the data. Findings included exposure to violence, the influence of a good mother, and past and present emotional distress overcome through empowerment and professional care. Discussion and conclusion Participating in urban empowerment activities enables participants to reflect on the violence experienced and the attendant distress, identify them as gender violence, and use them in their favor. They are strategic when coping with current distress due to the conflictive upbringing of their children, using psychological services and the urban upbringing prescriptions of children's rights, and incorporating indigenous parenting practices, which encourage community commitment, responsibility, and early self-sufficiency in children. Empowerment is suggested as an effective means of improving the health of indigenous women in Mexico.

Resumen Introducción En México, niñas y mujeres indígenas padecen malestares emocionales por la violencia conyugal y el cumplimiento de roles de género. No es común que se denuncie la violencia o se atienda oportunamente su salud. Las mujeres pueden emprender la atención de sus malestares al participar en procesos de empoderamiento. Objetivo Describir en mujeres indígenas empoderadas los malestares emocionales causados por la violencia doméstica en su niñez; por las exigencias actuales en la crianza de sus hijos/as y las acciones que realizan para atenderlos. Método Mediante una investigación cualitativa situada y fenomenológica, se realizaron entrevistas en profundidad y observación participante con nueve mujeres indígenas migrantes. Con estas herramientas se exploraron experiencias durante su crianza; reacciones emocionales y problemas actuales de salud mental. Resultados Mediante el software Atlas. ti V 7, se realizó una categorización teórica de los datos. Así se encontraron: exposición a la violencia; la influencia de la buena madre; malestares emocionales antiguos y actuales sobrellevados con el empoderamiento y la atención profesional. Discusión y conclusión Participar en actividades urbanas de empoderamiento lleva a las participantes a reflexionar sobre la violencia vivida y sus malestares asociados; resituarlos como violencia de género, y usarlos en su favor. Se muestran estratégicas al enfrentar malestares actuales por la conflictiva crianza de su hijos/as, usando servicios psicológicos y las prescripciones de crianza urbana del derecho infantil, e integrando prácticas de crianza indígenas, que estimulan el compromiso comunitario, responsabilidad y autosuficiencia temprana en los hijos/as. Se sugiere aprovechar la eficacia del empoderamiento para mejorar la salud de las mujeres indígenas del país.

El consumo de inhalables en las prácticas de socialidad de dos grupos de estudiantes de secundarias públicas / Inhalant use in the sociality practices of two groups of students at public middle schools

INTRODUCCIÓN: La extensión del consumo de inhalables hacia distintas poblaciones de México ocurre en el macrocontexto de la legalidad y la deficiente regulación sanitaria y policial de dichas sustancias, así como su gran disponibilidad y bajo costo, en combinación con los efectos placenteros de su inhalación, los cuales varían según el contexto y los usuarios. OBJETIVO: Aquí se describen las prácticas de coconstrucción de los contextos de consumo de inhalables. También, los efectos de éstos en dos grupos de estudiantes mexicanos de educación secundaria. MÉTODO: Se utilizó la metodología de la photo elicitation, analizando, en grupos de discusión, dos videograbaciones producidas por los mismos estudiantes, en las que consumen inhalables. RESULTADOS: Se realizó la categorización teórica de los datos con el software Atlas.ti. Se encontró que, a pesar de que los estudiantes inhalan tolueno, sólo una de las estudiantes experimentó mareo y dolor de cabeza, en tanto que otra compañera se sintió somnolienta. Sin embargo, el segundo video muestra que los estudiantes experimentaron la prendidez (euforia, desinhibición afectiva) y alucinaciones. El mareo, el dolor y la somnolencia parecen determinados mayormente por el consumo de tolueno y alcohol, pero los efectos disímiles, por la socialidad de los contextos de consumo del inhalable, la subjetivación de los estudiantes y su veteranía en el consumo. DISCUSIÓN Y CONCLUSIÓN: Se discute que los estudiantes prefieren el consumo de inhalables porque la "prendidez" fortalece su socialidad. Se concluye que conviene desalentar el consumo de inhalables incorporando la agencia y la subjetivación juvenil, sin desatender los factores macrosociales de la producción, comercialización y regulación de los inhalables.

INTRODUCTION: Inhalant use among various populations in Mexico occurs within the context of its legality, inadequate health regulation and supervision of its production and sales, high availability and low cost, combined with the pleasurable effects of inhaling, which vary according to the context and users. OBJECTIVE: This paper describes the social practices involved in the co-construction of inhalant use contexts of two groups of Mexican middle school students and their reported effects. METHOD: Photo elicitation methodology was used, with two videotapes produced by students on school sociality practices where inhalants we are used and then analyzed in discussion groups. RESULTS: The theoretical categorization of the data was performed using Atlas.ti software. It was found that although the students inhaled toluene, only one of the students experienced dizziness and headaches, while another classmate felt sleepy. The other video was different; students got high, experiencing euphoria, emotional disinhibition and hallucinations. Dizziness, pain and drowsiness seem largely determined by toluene and alcohol use, whereas the different effects appear to be caused by the sociality of the contexts of inhalant use, students' subjectivity and their length of consumption. DISCUSSION AND CONCLUSION: It is argued that students enjoy inhalant use because getting high reinforces their sociality. The article concludes that inhalant use should be discouraged by incorporating the agency and subjectivity of youth, without neglecting the macro-social factors involved in the production, marketing and regulation of inhalants.

Evaluación de la efectividad de una intervención interactiva para el manejo del estrés en profesionales de la salud / Evaluation of the efectiveness of an interactive intervention for stress management in health professionals

ANTECEDENTES: Los efectos del estrés dependen de la percepción de los estresores y de las habilidades para afrontar situaciones estresantes. OBJETIVO: Evaluar una intervención interactiva para desarrollar recursos y habilidades para un manejo adecuado del estrés en profesionales de la salud. MÉTODO: Esta intervención se probó utilizando un Cédula diseñada para evaluar componentes de Conocimientos, Habilidades y Actitudes sobre manejo del estrés, conformada por 17 afirmaciones para dimensión de Conocimientos, 11 sobre Habilidades para manejo del estrés; y 20 sobre Actitudes para reaccionar ante el estrés. Participaron 165 profesionales y pasantes de carreras afines. Se hicieron análisis estadísticos para comparar los puntajes de los tres componentes antes y después de la intervención utilizando la prueba t de Student, se aplicó la prueba de McNemar para comparar los resultados. RESULTADOS: Sobre la efectividad de la intervención, en los análisis de comparación de los puntajes, se encontraron diferencias estadísticamente significativas a favor de la intervención en los tres componentes: Conocimientos (t = -9.77, gl = 164, p = .000), Habilidades (t = -10.19, gl = 164, p = .000) y Actitudes (t = -4.80, gl = 164, p = .000).Los análisis por reactivo mostraron incrementos estadísticamente significativos en el número de respuestas correctas después de la intervención en los tres componentes. DISCUSIÓN Y CONCLUSIÓN: Los resultados de esta intervención interactiva fueron estadísticamente significativos en Conocimientos, Habilidades y Actitudes para manejo del estrés. Además de ser una intervención innovadora, breve, basada en la traslación del conocimiento (4 semanas), y disponible en Internet, la evidencia de su efectividad hace que se perfile como una herramienta válida para el manejo adecuado del estrés.

BACKGROUND: The effects of stress depend on the perception of stressors and a person's skills for coping with stressful situations. OBJECTIVE: Evaluate an interactive intervention to develop resources and skills for proper stress management among healthcare professionals. METHOD: This intervention was tested using a chart designed to evaluate the knowledge, skills and attitudes components of stress management, consisting of 17 statements about Knowledge, 11 about Stress management; 20 about Attitudes for reacting to stress. A total of 165 professionals and interns from related careers participated. Statistical analyses were conducted to compare the scores of the three components before and after the intervention using the Student's t test. McNemar's test was used to compare the results. RESULTS: In regard to the effectiveness of the intervention, an analysis of the comparison of scores found statistically significant differences in favor of intervention in the three components: Knowledge (t = -9.77, df = 164, p = .000), Skills (t = -10.19, df = 164, p = .000) and Attitudes (t = -4.80, df = 164, p = .000). The item analysis showed statistically significant increases in the number of correct answers after the intervention in the three components. DISCUSSION AND CONCLUSION: The results of this interactive intervention were statistically significant in Knowledge, Skills and Attitudes for stress management. In addition to being a brief, innovative intervention, based on knowledge translation (4 weeks) and available on the Internet, the evidence of its effectiveness suggests it is a valid tool for proper stress management.

Violencia en el entorno laboral del trabajo sexual y consumo de sustancias en mujeres mexicanas / Violence in the work environment of sex work and substance use in a group of Mexican women

Objetivo Conocer la violencia que viven las trabajadoras sexuales en el ejercicio de su actividad y si ésta se asocia con su consumo de alcohol y otras sustancias. Método Es un estudio de campo tipo no experimental, descriptivo, con una muestra no probabilística de 103 trabajadoras sexuales seleccionadas por conveniencia. Se utilizó un instrumento diseñado ex profeso, consistente en una entrevista semi-estructurada. Resultados El 50.8% trabajaba en un bar, el 39.0% en la calle y el 10.2% en un cabaret. Más de la mitad (52.4%) refirió haber vivido experiencias violentas en el lugar de trabajo; de éstas, el 95.8% sufrió violencia física, el 26.0% violencia sexual y el 24.0% violencia emocional. Respecto a los actores involucrados en episodios violentos, en el 97.9% de los casos fueron compañeras de trabajo, en el 77.2%, clientes; en el 30.2%, propietarios o empleados de los bares y en el 25.0%, la policía. El 98% de las trabajadoras sexuales reportaron haber consumido alcohol en el último mes, el 23.3% cocaína y el 11.7% mariguana. Cabe señalar que 40% fuma tabaco. El 75% de las trabajadoras sexuales se reporta como bebedora alta. El 97% informó que generalmente los clientes las presionan para beber alcohol y un porcentaje similar refirió que consumen por las exigencias de los encargados de los lugares de trabajo. Las experiencias de violencia en el trabajo se asociaron con el consumo de cocaína [χ²= 6.417, (100, 1) gl p<.05] y de tabaco [2=7.486 (100,1) gl p<.01]. Esta asociación se mantuvo si la violencia había ocurrido en el último mes. El consumo de alcohol se relacionó con las experiencias de violencia física [χ²=5.180 (100,1)gl p<.05], y de violencia emocional [χ²=4.514 (100,1)gl p<.05]. Discusión Los resultados muestran que la violencia es una experiencia frecuente en su ambiente de trabajo, y es ejercida por múltiples actores; destaca el que se mencione a otras trabajadoras sexuales como quienes la ejercen, lo que no se reporta en la bibliografía. El consumo de alcohol y otras drogas se asocia con esta violencia, por lo que debe explorarse más este vínculo en futuros estudios. Se discuten los hallazgos, haciendo recomendaciones para la atención de esta problemática en las mujeres.

Objective The aim of this paper is to explore in women sex workers the violence they experience in the exercise of their activity, and if it is associated with alcohol use and the consumption of other substances such as cocaine, mariguana and tobacco. Method This is a descriptive, non-experimental study, developed with a non-random sample of 103 sex workers selected for convenience type field. The selection criteria were being between 18 and 65 years of age, being a sex worker, and literate. An expressly designed instrument consisting of a semi-structured interview was used. Results Regarding the workplace, 50.8% of them worked in bars, 39.0% on the streets, and 10.2% in cabarets. More than a half reported having suffered violent experiences in the workplace; of these, 95.8% experienced physical violence, 26.0%, sexual violence, and 24.0%, emotional violence. Regarding the actors involved in violent episodes, they were other sex workers (97%), customers (77.2%), owners or employees of bars (30.2%), and police (25.0%). Regarding substance use, 98% of the sex workers reported having consumed alcohol in the past month; 23.3%, cocaine; and 11.7%, marijuana. Likewise, 40% smoked tobacco. Seventy-five percent of the sex workers reported being a high drinker. Most of the women reported that customers generally pressed them in to drinking alcohol and a high percentage reported that they consumed it because of the demands of bar or cabaret managers. The experiences of workplace violence were associated with cocaine use (χ2 = 6.417 [100, 1] df p <.05) and tobacco (χ2 = 7.486 [100.1] gl p <.01). This association remained if violence had occurred in the last month. Alcohol consumption was associated with experiences of physical violence (χ2 = 5.180 [100.1] gl p <.05), and emotional abuse (χ2 = 4.514 [100.1] gl p <.05). Discussion The results show that violence is a common experience in the work environment of these women, and that this is carried out by multiple actors. Findings highlight that sex workers point out to other sex workers as those who exercise more violence. High alcohol use and the use of other drugs are associated with this violence, requiring future studies to explore in-depth this link. The findings are discussed, with recommendations for the care of these problems in female sex workers.

Experiencias de violencia física ejercida por la pareja en las mujeres en reclusión

resumen está disponible en el texto completo

Abstract: Violence against women is an everyday problem which is expressed in various ways, whether physically, sexually or emotionally, and it may occur at either public or private level. The subject of violence against women has been regarded as a worldwide priority, since it obstructs every area of women's development. Society has acknowledged the fact that this violence "prevents the achievement of the objectives of equality, development and peace and that it violates, reduces or prevents (women's) enjoyment of human rights and fundamental liberties. A recent report by the Johns Hopkins School of Public Health and the Center for Health and Gender Equity shows that at least one out of every three women has been physically mistreated, forced to engage in sexual relations or suffered some type of abuse in the course of their lives. In Mexico as in other countries, violent behavior has been regarded as "natural" in relation to the way how to treat women; norms and everyday life have kept it hidden. Epidemiological surveys, however, show figures that reflect the scope of the problem, which in turn has meant that it is now considered as a serious health problem. Consequently, approaching the issue of intra-familial violence compels one to consider a characteristic cultural aspect: the questionable fact of referring to its existence solely within the private sphere. It is felt that what goes on inside a home is an intimate affair and that outsiders should not be aware of this, far less intervene. The same happens when one discusses the violence experienced by women living in prison, since they often continue to experience violence or abuse when they receive their conjugal visits; or else at the hands of other prisoners or from the institute itself and no-one seems willing to intervene. Women living in a penitentiary environment designed essentially for men, occupy a secondary position and are marginalized as regards planned work, cultural, sports, and recreational programs, partly due to the fact that the prison population is thought to be primarily male (1990 to 1994 reports). As Barquín notes, most women in prison experienced violence from their parents or witnessed their mothers being mistreated, and therefore became used to this type of behavior and more tolerant of it. This does not mean that these experiences should be regarded as the reason why women commit a crime or the main cause why they were admitted to the penal system. The cycle of violence that begins in the family is perpetuated in marriage and would appear to be completed in prisons, recommencing when women are released from prison. Being deprived of freedom as a result of imprisonment, together with the abuse that take place in jail appear to be a further link in the chain of multiple types of violence which constitute the path for some part of this population. Human Rights Watch is an organization that has undertaken specialized research in prisons since 1987 and in its 1988 report points out that Venezuelan prisons housed a total population of 25381 individuals, 4% of which were women. This same source reported that drug-related crimes led to a 55% increase in the jail population. In 1991, the percentage of female prisoners held in US state prisons for violent crimes was 32.2%, although that the majority had been imprisoned for non-violent crimes. Donzinger points out that the majority of women prisoners that had been sentenced for the murder of someone close to them had been victims of mistreatment or sexual abuse at some time in their lives, and thus violence against women should become an important issue for the authorities, as it is one of the most outstanding problems that reflects the current situation of the living conditions in prison centers. Given the importance that has violence against women in general, and the lack of statistical indicators on the issue of women in prison, the main objective of this paper was to describe the types of physical violence exercised by the partners of 213 women, interviewed at a Preventive Center and at Social Re-adaptation Center, in order to determine the scope of the problem and to propose intervention strategies. A non-probabilistic sample of 213 women, selected for reasons of convenience, was used. A specially designed instrument was used, consisting of a semi-structured interview with 242 questions, covering the following areas of the lives of the women interviewed: demographic data, school history, current family, family of origin, legal status, previous history of imprisonment, work experience, social networks depression, suicide risk, anguish, alcohol consumption variables, alcohol consumption measurement, variables for measuring the use of medical and non-medical drugs, scale of motives for consumption, treatment barriers, intimate relationships and sexuality, sexual abuse, violence/victimization, criminal violence, post-traumatic stress, prison environment, general health, and life styles and impulsiveness. The most important demographic characteristics of women found were: most were in the group aged from 28 to 40 year (45.5%), had six years or less of schooling (41.3%), secondary school (36.2%) and high school or technical college (16.4%) and were single (48.6%) or living with their partners (21.6%) while 50.7% had children under the age of 18. Of the 213 women interviewed, only 161 reported having suffered violence at the hands of their partners; 29.2% had experienced 1 to 5 acts, 23.4% had experienced 6 to 10, and 23.4% had been the object of 11 to 17 acts of violence. Statistics presented in this article in various research studies on family violence in most countries only show a small part of all the violence produced in families, and the results found in this research show that violence is higher among the group of female prisoners. One should not forget that prison reflects an exercise of the system that performs a marginalizing function, as it includes the poorest women from the most disadvantaged sectors, with low educational level. As Lima suggests, women are doubly stigmatized in prison, as they suffer first as women and second as criminals, not only because they belong to an underprivileged group in every social aspect, but because they belong to the group that has violated the classic image of women imposed by society, a fact for which they are severely punished, while the violence and abuse they have suffered is ignored.