Juventude, drogas e internação hospitalar : ampliando o conceito de evento sentinela

Abstract

This study aims to put into operation the procedure of epidemiological surveillance of sentinel events, among youngsters admitted into hospital with diagnoses of acute intoxication or secondary effects resulting from drug abuse. The study, of thedescriptive and transversal type, was conducted in the city of Maringá, Paraná, from data by the Center for Intoxication Control (CCI), located in the Maringá Regional University Hospital (HUM). The study sample was comprised of youngsters, ages 10 to 24, who were admitted as inpatients at HUM or at the Maringá Municipal Hospital (HMM), residents of the city of Maringá, and who were registered with CCI from February to July 2006. The data sources used were inpatient listings, the record of active search notification of HMM cases and an investigation based on the sentinel event procedure. The documents used were toxicology case file, hospital records and an itinerary for home interview. Ten cases were investigated, and it was noticed several common elements among the youngsters, such as early use of drugs (100%); the use associated and concomitant of several drugs (60%); school evasion (60%) and school eviction (20%); precocious pregnancy of all young girls, and the high number of children of one of them; the constant "escapes" from home (40%); a lack of family bonding among them (50%); and the violence as the triggering factor for the sentinel event (80%). In all families, it was possible to observe there were risk precedents for drug abuse in the family (80%), in the school (60%); in social contact (80%), and in access to healthcare (50%).The analysis of the cases points that the view of the problem restricted to the family context or to the youngster's individual characteristics, is limited. Most of the causes mentioned by the families, subjacent to the proximal causes, are related to the absence or precariousness of public politics. Based on that characterization, we elaborated a synthesis model of the underlying causes, codified by family context, life culture/style, education, religion, access to health, social care, economy, and public safety. This epidemiologic investigation diverges from more traditional patterns in its less pragmatic character and more qualitative approach, and pointed risk factors in several areas, involving answers of several public policies. The interface among policies of Education, Public Safety, Social Attendance, Economy and Health, all inadequate and deficient, seems to determine the occurrence of drug use in the investigated cases.