RESUMO
Resumen La exposición prenatal al alcohol puede derivar en un espectro de trastornos congénitos, dentro de los cuales el Síndrome Alcohólico Fetal (SAF) es el más severo. Esto es 100 % prevenible si no se consume alcohol durante la gestación, por lo que conocer los factores que determinan que una mujer consuma alcohol estando embarazada es fundamental. El objetivo de este trabajo es evaluar si características del entorno (como son las normas sociales prescriptivas o NSP) se relacionan con el consumo de alcohol durante la gestación en mujeres de la ciudad de Mar del Plata, Argentina. Para ello, se realizó un muestro probabilístico de 852 mujeres gestantes durante el año 2016 en los principales centros de atención primaria a la salud de la ciudad. Se evaluó el consumo de alcohol antes y durante la gestación a través del Test de Identificación de Trastornos por Consumo de Alcohol y las NSP con preguntas construidas ad hoc. El 87 % consideró que las otras gestantes consumen alcohol; de ellas, 53 % cree que el consumo es igual, 10 % cree que es mayor y el resto menor. El 90 % reconoció que las personas importantes para ellas desaprobarían el consumo durante la gestación. Las mujeres con un entorno favorable hacia el consumo se correspondieron con ingesta de alcohol en el embarazo, mientras que se observó lo contrario en los casos en los que el entorno era desfavorable. Estos resultados indican que podría ser beneficioso diseñar estrategias preventivas que se focalicen no solo en la gestante, sino en el entorno cercano.
Abstract Prenatal alcohol exposure can lead to a spectrum of congenital disorders for the fetus with permanent consequences, known as fetal alcohol spectrum disorders (FASD), within which Fetal Alcohol Syndrome (SAF) is its most severe extreme. All FASD are 100 % preventable if no alcohol is consumed during pregnancy, so knowing the factors that determine that a woman decides to drink while pregnant is essential to develop effective prevention plans. Among these factors are the phenomena of social influence such as perceived social norms (PSN), both descriptive and prescriptive. The PSN are transmitted by social interaction and produced based on the perception of the beliefs or behaviors of others, beyond their real actions. It has been identified that PSN predict alcohol consumption in various populations, such as university students, but research is almost non-existent with pregnant women. The aim of this study is to assess whether environmental characteristics (such as PSN) are related to alcohol consumption during pregnancy in pregnant women in the city of Mar del Plata, Argentina. Method: a probabilistic sample of 852 pregnant women was carried out during 2016 in the main primary health care centers of the city of Mar del Plata. Alcohol consumption was assessed before and during pregnancy through the AUDIT and the PSN was assessed with five questions constructed ad hoc by specialists in the area of alcohol consumption. Descriptive analyses were performed to categorized social norms and the prescriptive ones were re-categorized into four groups: 1. It is bad for the health of the baby or the mother; 2. It is wrong for cultural or moral reasons; 3. consumption is accepted; 4. It does not know/does not matter. To describe them based on alcohol consumption, latent class analyses were performed. Models of two to four classes were estimated, reproduced 50 times to avoid local maximums, with the software R. Results: 87 % of pregnant women believed that others in their same condition consume alcohol. 53 % of them believed they consume the same as before pregnancy, 10 % believed they consume more and the rest that they reduced their consumption. The belief about the average amount that other pregnant women would consume is more than three drinks, the equivalent of one bottle of beer per occasion of consumption. 90 % recognized that people important to them would disapprove consumption during pregnancy because doing so would cause harm to the baby, the mother, pregnancy in general or because alcohol is considered harmful to health. 6 % considered that people important to them would approve consumption because few amounts are tolerated or because alcohol is good for breastfeeding. The latent class analysis indicated a better fit for the two-class model. Class 1 was made up of women who claimed that for their people, alcohol consumption during pregnancy was acceptable and they themselves consumed alcohol during pregnancy. Class 2 conglomerated women who thought that others would see their consumption as bad at this stage and there was a low probability that they themselves consumed during pregnancy. Conclusions: These results indicate that it could be beneficial to design preventive strategies that focus not only on the future mother, but on the nearby environment (couple, family, friends), and even throughout the community, where social norms are established and reproduced.
RESUMO
Introducción: las expectativas hacia el consumo de alcohol se definen como creencias de los efectos del alcohol sobre el comportamiento y podrían predecir su consumo. El objetivo de este trabajo es resumir la información disponible sobre los cuestionarios que las miden y su validez. Métodos: se realizaron búsquedas en las bases de datos Pubmed, Scopus, PsycINFO, Lilacs y Scielo, seleccionando estudios sobre la validez de los cuestionarios. La calidad del material se evaluó con la guía CASP y la síntesis de datos fue cualitativa. Resultados: de las 133 referencias resultantes, 56 se eliminaron por repetirse, 52 por no ser de la temática/objetivo, y se agregaron 7 de otras fuentes. Se hallaron 16 instrumentos con buenos índices de fiabilidad y validez, algunos de ellos utilizados eficazmente para predecir el consumo de alcohol. Conclusión: los cuestionarios de expectativas hacia el consumo de alcohol podrían constituir una herramienta útil para la investigación, evaluación clínica y tamizaje.
Assuntos
Humanos , Alcoolismo , Peneiramento de LíquidosRESUMO
El consumo intensivo episódico (CIEA) constituye un problema de salud pública que afecta a los más jóvenes. El estudio de los determinantes cognitivo motivacionales de este patrón de consumo es un área reciente y en creciente desarrollo. Una de las teorías que se ha mostrado adecuada para la explicación de esta conducta es la Teoría del Comportamiento Planeado (TCP). Este trabajo tiene como objetivo estudiar la relación entre la intención de CIEA, la actitud, la norma subjetiva y la percepción de control conductual en estudiantes secundarios diferenciándolos por género. Método: La muestra fue intencional, de estudiantes secundarios (n = 185) de la ciudad de Mar del Plata (Argentina) de 12-18 años. Se utilizó un cuestionario que indagaba sobre: patrones de consumo, variables de la TCP, edad y sexo. Se realizaron análisis de regresión jerárquica para varones y mujeres por separado, considerando la intención como variable dependiente. Resultados: La principal variable que predice la intención de CIEA, tanto para varones como mujeres es la actitud. La norma subjetiva resultó predictora únicamente en mujeres. Conclusiones: las creencias y evaluaciones respecto al CIEA juegan un importante papel en la disposición para realizar el comportamiento. En el caso de las mujeres también incide la norma subjetiva. Si bien este estudio posee algunas limitaciones, sus resultados permiten aproximarse al estudio de los factores cognitivos motivacionales relacionados con el CIEA en adolescentes, de acuerdo al género.
Binge drinking (BD) is a public health problem that affects younger people. The study of cognitive motivational determinants of this consumption pattern is a growing and recently developed area. One theory that has proved to be adequate for the explanation of this behavior is the Theory of Planned Behavior (TPB). This paper aims to study the relationship between BD intention, attitude, subjective norm and perceived behavioral control in high school students, by gender. Method: The sampling was intentional, comprising high school students (n = 185) of the city of Mar del Plata (Argentina) from 12 -18 years old. A questionnaire was developed inquiring about: habitual consumption pattern, TPB variables, age and gender. Hierarchical regression analyses were conducted for men and women separately, considering intention as the dependent variable. Results: The main variable that predicted intention of BD, for both, males and females, was the attitude. The subjective norm was a predictor only in females. Conclusions: Beliefs and evaluations regarding the BD play a significant role in the disposition for the behavior. For females, subjective norms also affected intention of BD. While this study had some limitations, results highlight the importance of the study of cognitive motivational factors related to BD in adolescents by gender.