<b>Biopsychosocial risk and perception of the functionality of the family amongst adolescents from sixth grade in the Jesús Jiménez School</b>Abstracts
<b>Aim: </b>Adolescence is a crucial stage in life. It is characterized by profound changes that define the passage from childhood to adulthood. The proactive detection of risk factors and an early intervention are essential to prevent risky behaviors. The objective of the study was to describe the prevalence of bio psychosocial risk and how adolescents perceive the functionality of the family. <b>Methods: </b>The study’s population was composed of 124 adolescents in sixth grade. The study included both men and women, over the age of 10 years, for whom their parents had provided informed consent. They answered 2 questionnaires: <i>Tamizaje de Riesgo del Programa de Atención Integral del Adolescente</i> (Risk Assessment of the Adolescent Integral Care Program); (PAIA) and the Family APGAR. <b>Results: </b>The most frequent risk factors were: absence of confidant (36.3%), feeling of depression (23.4%), participation in fights (12.1%) and death-related ideas (8.1%). The prevalence of a functional family was 68.6%, of mild dysfunction 27.4% and of severe dysfunction, 4%. The perception of a good family function by adolescents was related to low biopsychosocial risk (p=0.011), greater communication with parents (p=0.000), absence of a feeling of depression (p=0.002), absence of death-related ideas (p=0.000) and absence of suicide attempts (p=0.003). <b>Conclusions:</b> The biggest problems found in adolescents were absence of a confidant, feeling of depression, participation in fights and death-related ideas. The functional family was shown as a protective factor against depressive symptoms, death-related ideas and suicide attempts.
Adolescent; family; risk-taking; family and community practice; family relationships.
<span name="style_bold">Objetivo</span>: la adolescencia es una etapa crucial en la vida de las personas, caracterizada por profundos cambios que marcan el paso de la niñez a la vida adulta. La detección proactiva de factores de riesgo y la intervención temprana son fundamentales para prevenir conductas riesgosas. El objetivo planteado fue describir la prevalencia del riesgo biopsicosocial y la percepción de la funcionalidad familiar de las personas adolescentes. <span name="style_bold">Métodos:</span> la población del estudio estuvo constituida por 124 adolescentes de sexto grado. Se incluyó tanto hombres como mujeres, mayores de 10 años, con el consentimiento informado de sus padres. Se les aplicó los cuestionarios Tamizaje de Riesgo del Programa de Atención Integral de la Adolescencia (PAIA) y APGAR Familiar. <span name="style_bold">Resultados: </span>los factores de riesgo con mayor prevalencia fueron: ausencia de confidente (36,3%), sensación de depresión (23,4%), participación en peleas (12,1%) e ideas de muerte (8,1%). La prevalencia de buena función familiar fue del 68,6%, disfunción leve del 27,4% y disfunción severa del 4%. La percepción de buena funcionalidad familiar por parte de los adolescentes estuvo relacionada con bajo riesgo biopsicosocial (p=0,011), mayor comunicación con los padres (p=0,000), ausencia de sensación de depresión (p=0,002), ausencia de ideas de muerte (p=0,000) y ausencia de intentos suicidas (p=0,003). <span name="style_bold">Conclusiones: </span>los mayores problemas encontrados en los adolescentes fueron: ausencia de un confidente, sensación de depresión, participación en peleas e ideas de muerte. La familia funcional se mostró como un factor protector contra síntomas depresivos, ideas de muerte e intentos suicidas.los mayores problemas encontrados en los adolescentes fueron: ausencia de un confidente, sensación de depresión, participación en peleas e ideas de muerte. La familia funcional se mostró como un factor protector contra síntomas depresivos, ideas de muerte e intentos suicidas.
adolescente; familia; asunción de riesgos; medicina familiar y comunitaria; relaciones familiares.
<span name="style_bold">Aim: </span>Adolescence is a crucial stage in life. It is characterized by profound changes that define the passage from childhood to adulthood. The proactive detection of risk factors and an early intervention are essential to prevent risky behaviors. The objective of the study was to describe the prevalence of bio psychosocial risk and how adolescents perceive the functionality of the family. <span name="style_bold">Methods: </span>The study’s population was composed of 124 adolescents in sixth grade. The study included both men and women, over the age of 10 years, for whom their parents had provided informed consent. They answered 2 questionnaires: <span name="style_italic">Tamizaje de Riesgo del Programa de Atención Integral del Adolescente</span> (Risk Assessment of the Adolescent Integral Care Program); (PAIA) and the Family APGAR. <span name="style_bold">Results: </span>The most frequent risk factors were: absence of confidant (36.3%), feeling of depression (23.4%), participation in fights (12.1%) and death-related ideas (8.1%). The prevalence of a functional family was 68.6%, of mild dysfunction 27.4% and of severe dysfunction, 4%. The perception of a good family function by adolescents was related to low biopsychosocial risk (p=0.011), greater communication with parents (p=0.000), absence of a feeling of depression (p=0.002), absence of death-related ideas (p=0.000) and absence of suicide attempts (p=0.003). <span name="style_bold">Conclusions:</span> The biggest problems found in adolescents were absence of a confidant, feeling of depression, participation in fights and death-related ideas. The functional family was shown as a protective factor against depressive symptoms, death-related ideas and suicide attempts. The biggest problems found in adolescents were absence of a confidant, feeling of depression, participation in fights and death-related ideas. The functional family was shown as a protective factor against depressive symptoms, death-related ideas and suicide attempts.
Adolescent; family; risk-taking; family and community practice; family relationships.
Biopsychosocial JesúsJiménez School
Author’s affiliations: Centro Nacional de Control del Dolor y Cuidados Paliativos (NationalCenter for Pain Management and Palliative Care).
Abbreviations: EBAIS, Equipos Básicos de Atención Integral en Salud (Basic Health-Team for Integral Attention); PAIA, Programa de Atención Integral de la Adolescencia (Comprehensive Care Program for Adolescents). dulateg@hotmail.com
Tamizaje de Riesgo del Programa de Atención Integral del Adolescente [Risk Assessment of the Adolescent Integral Care Program] (PAIA) and the Family APGAR.
1 Studies had demonstrated that a proactive detection of risk behaviors and an early intervention in a clinical environment, are fundamental to prevent this kind of problem in adolescent.2
3
4
5
Costa Rica, since its validation in 2000. This questionnaire was used in primary care, as a complement of the Caja Costarricense de Seguro Social’s PAIA. It is based in a system of questions related to different risks factors, with a scoring for each answer, and the sum of all points classify the adolescent in low, intermediate and high risk.6
JesúsJiménezSchool, to assess the risk factors and their family’s functionality. This school stands out because of the higher number of registrations in the province of Cartago, and for having the most diverse socioeconomic strata population and diverse geographical zones in the province.
JésusJiménezSchool, during the first semester of 2011.
JesúsJiménezSchool’s sixth grade teenagers, through February to July 2011. Youngsters were ten years old or above, who were current students of sixth grade and had an informed consent from the parents; and those who didn’t wish to be part of the research, or were absent in the questionnaire application date were excluded. To participate in the research, an informed consent must be signed by the parents and an informed assent from the teenagers was requested. The study was approved by the Local Bioethics Committee of Hospital Max Peralta.
CartagoHealthCenter.
CartagoHealthCenter.
Table 1).
Figure 1).
Table 2).
Table 3).
7
7
3
th and 5th graders.8 However, the results are still concerning, when taking the Costa Rica’s IV State of Children and Adolescent Rights as a reference, that reported in 2006 a total of 41 suicide attempts in teenagers 9, the percentage found in the research was only the tip of the iceberg of the great problem suicide represents in the country.
10
United States statistics, where accidents (included those related to reckless driving of vehicles) are the main cause of death among teenagers.11
12
12 The average age for the studied population was 11.66 years old, this number is below the age onset for tobacco smoking and alcohol drinking nationwide, justifying that the prevalence found in national statistics is lower.
3 On national level, 2010’s Sexual and Reproductive Health poll, stages for sexual intercourse, an average of onset age of 15 for males and 16 for females. So, a 0% prevalence of sexual intercourse in a school population with an average age of 11.66 years old is according to Costa Rica’s reality. This indicates that preventive interventions for teenagers must be started, inside the National Sexuality Policy, recently acknowledge by the Ministry of Health.13
3 however, there are important similarities with a 2009’s Spanish study, where teenagers reporting a good family function was presented in 77% of cases.14 The prevalence of family dysfunction is 31.4% in this study, similar to statistics among general populations from different studies, with a family dysfunction between 16 and 35%.7
15
16
7 similar to Santander and colleagues study in Chile, where the risk to present emotional symptoms was slightly superior in families perceived as dysfunctional.3
9
17
3
Conflict of Interests: the author reports none.
Thanks: We thank MSc. Mayra Cartín Brenes for her valuable advice.
References
References
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1. Díaz M, Garita C, Sequeira M, Alarcón N. Programa Nacional de Atención Integral a la Adolescencia: Lineamientos del modelo de atención integral a la salud de las y los Adolescentes en la Caja Costarricense de Seguro Social. San José: Caja Costarricense de Seguro Social; 2006. En: http://www.binasss.sa.cr/adolescencia/modelocompleto.pdf.
» http://www.binasss.sa.cr/adolescencia/modelocompleto.pdf. -
2. Greene JP, Ahrendt D, Stafford EM. Adolescent Abuse of Other Drugs. Adolesc Med Clin. 2006; 17: 283-318.
-
3. Santander S, Zubarew T, Santelices L, Argollo P, Cerda J, Bórquez M. Influencia de la familia como factor protector de conductas de riesgo en escolares chilenos. Rev Med Chil. 2008; 136: 317-24.
-
4. Bellón-Saameño J, Delgado-Sánchez A, Luna-del Castillo J, Lardelli-Claret P. Validez y fiabilidad del cuestionario de función familiar Apgar-familiar. Aten Primaria. 1996; 18:289-96.
-
5. Pasternak RH, Geller G, Parrish C, Cheng TL. Adolescent and Parent Perceptions on Youth Participation in Risk Behavior Research. Arch Pediatr Adolesc Med. 2006; 160:1159-66.
-
6. Garita-Arce C, Rodríguez-Rojas J. Desarrollo y validación de un instrumento discriminador de riesgo psicosocial para el primer nivel de atención y su vinculación con el proceso de modernización institucional. Adolescencia y Salud. 2000; 2. En http://www.binasss.sa.cr/revistas/ays/2n1/art5.htm.
» http://www.binasss.sa.cr/revistas/ays/2n1/art5.htm. -
7. Pérez-Milena A, Pérez-Milena R, Martínez-Fernández M, Leal-Helmling F, Mesa-GallardocI, Jiménez-Pulido I. Estructura y funcionalidad de la familia durante la adolescencia: relación con el apoyo social, el consumo de tóxicos y el malestar psíquico. Aten Primaria. 2007; 39: 61-7.
-
8. Morales-Bejarano A, Chávez-Víquez R, Ramírez-Mora W, Sevilla-Vargas A, Yock-Cabezas I. Desesperanza en adolescentes: una aproximación a la problemática del suicidio juvenil. Adolescencia y Salud. 1999; 1. En http://www.binasss.sa.cr/revistas/ays/1n2/0515.html.
» http://www.binasss.sa.cr/revistas/ays/1n2/0515.html. -
9. Universidad de Costa Rica, PRIDENA, UNICEF. VI Estado de los Derechos de la Niñez y la Adolescencia en Costa Rica. A diez años del Código de la Niñez y la Adolescencia. San José: Universidad de Costa Rica; 2008.
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10. Breinhauer C, MagdalenoM. Jóvenes: opciones y cambios. Promoción de conductas saludables en los adolescentes. Washington: Editorial Organización Panamericana de la Salud; 2008. Publicación Científica y Técnica 594.
-
11. Stephens MB. Preventive health counseling for adolescents. Am Fam Physician. 2006;74: 1151-6.
-
12. Instituto sobre Alcoholismo y Farmacodependencia. La juventud y las drogas: encuesta nacional sobre percepciones y consumo en población de educación secundaria, Costa Rica: IAFA, 2007.
-
13. Ministerio de Salud. Política Nacional de Sexualidad. Análisis de situación: propósito, enfoques, asuntos críticos y áreas de intervención de la política de sexualidad. Primera edición. Costa Rica: Ministerio de Salud, 2011.
-
14. Pérez-Milena A, Martínez-Fernández M, Mesa-Gallardo I, Pérez-Milena R, Leal-Helmlinge F, Jiménez-Pulido I. Cambios en la estructura y en la función familiar del adolescente en la última década (1997–2007). Aten Primaria. 2009; 41: 479–86.
-
15. Dulanto E, coordinador. El adolescente. México: McGraw-Hill Interamericana; 2000.
-
16. Roustit C, Chaix B, Chauvin P. Family breakup and adolescents psychosocial maladjustment: Public health implications of family disruptions. Pediatrics. 2007; 120: e984-e91.
-
17. Camacho-Cantillano EM, Carmona-Suárez M, León-Rojas MG. Perfil de los casos referidos por depresión a la Clínica de Adolescentes.
References
-
1. Díaz M, Garita C, Sequeira M, Alarcón N. Programa Nacional de Atención Integral a la Adolescencia: Lineamientos del modelo de atención integral a la salud de las y los Adolescentes en la Caja Costarricense de Seguro Social. San José: Caja Costarricense de Seguro Social; 2006. En: http://www.binasss.sa.cr/adolescencia/modelocompleto.pdf.
» http://www.binasss.sa.cr/adolescencia/modelocompleto.pdf. -
2. Greene JP, Ahrendt D, Stafford EM. Adolescent Abuse of Other Drugs. Adolesc Med Clin. 2006; 17: 283-318.
-
3. Santander S, Zubarew T, Santelices L, Argollo P, Cerda J, Bórquez M. Influencia de la familia como factor protector de conductas de riesgo en escolares chilenos. Rev Med Chil. 2008; 136: 317-24.
-
4. Bellón-Saameño J, Delgado-Sánchez A, Luna-del Castillo J, Lardelli-Claret P. Validez y fiabilidad del cuestionario de función familiar Apgar-familiar. Aten Primaria. 1996; 18:289-96.
-
5. Pasternak RH, Geller G, Parrish C, Cheng TL. Adolescent and Parent Perceptions on Youth Participation in Risk Behavior Research. Arch Pediatr Adolesc Med. 2006; 160:1159-66.
-
6. Garita-Arce C, Rodríguez-Rojas J. Desarrollo y validación de un instrumento discriminador de riesgo psicosocial para el primer nivel de atención y su vinculación con el proceso de modernización institucional. Adolescencia y Salud. 2000; 2. En http://www.binasss.sa.cr/revistas/ays/2n1/art5.htm.
» http://www.binasss.sa.cr/revistas/ays/2n1/art5.htm. -
7. Pérez-Milena A, Pérez-Milena R, Martínez-Fernández M, Leal-Helmling F, Mesa-GallardocI, Jiménez-Pulido I. Estructura y funcionalidad de la familia durante la adolescencia: relación con el apoyo social, el consumo de tóxicos y el malestar psíquico. Aten Primaria. 2007; 39: 61-7.
-
8. Morales-Bejarano A, Chávez-Víquez R, Ramírez-Mora W, Sevilla-Vargas A, Yock-Cabezas I. Desesperanza en adolescentes: una aproximación a la problemática del suicidio juvenil. Adolescencia y Salud. 1999; 1. En http://www.binasss.sa.cr/revistas/ays/1n2/0515.html.
» http://www.binasss.sa.cr/revistas/ays/1n2/0515.html. -
9. Universidad de Costa Rica, PRIDENA, UNICEF. VI Estado de los Derechos de la Niñez y la Adolescencia en Costa Rica. A diez años del Código de la Niñez y la Adolescencia. San José: Universidad de Costa Rica; 2008.
-
10. Breinhauer C, MagdalenoM. Jóvenes: opciones y cambios. Promoción de conductas saludables en los adolescentes. Washington: Editorial Organización Panamericana de la Salud; 2008. Publicación Científica y Técnica 594.
-
11. Stephens MB. Preventive health counseling for adolescents. Am Fam Physician. 2006;74: 1151-6.
-
12. Instituto sobre Alcoholismo y Farmacodependencia. La juventud y las drogas: encuesta nacional sobre percepciones y consumo en población de educación secundaria, Costa Rica: IAFA, 2007.
-
13. Ministerio de Salud. Política Nacional de Sexualidad. Análisis de situación: propósito, enfoques, asuntos críticos y áreas de intervención de la política de sexualidad. Primera edición. Costa Rica: Ministerio de Salud, 2011.
-
14. Pérez-Milena A, Martínez-Fernández M, Mesa-Gallardo I, Pérez-Milena R, Leal-Helmlinge F, Jiménez-Pulido I. Cambios en la estructura y en la función familiar del adolescente en la última década (1997–2007). Aten Primaria. 2009; 41: 479–86.
-
15. Dulanto E, coordinador. El adolescente. México: McGraw-Hill Interamericana; 2000.
-
16. Roustit C, Chaix B, Chauvin P. Family breakup and adolescents psychosocial maladjustment: Public health implications of family disruptions. Pediatrics. 2007; 120: e984-e91.
-
17. Camacho-Cantillano EM, Carmona-Suárez M, León-Rojas MG. Perfil de los casos referidos por depresión a la Clínica de Adolescentes.
Publication Dates
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Publication in this collection
01 Aug 2013 -
Date of issue
Mar 2013
History
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Received
16 Nov 2011 -
Accepted
23 Aug 2012
