KNOW LEDGE ABOUT AI DS AND DRUGS AMONG UNDERGRADUATE STUDENTS I N A
HI GHER EDUCATI ON I NSTI TUTI ON I N THE STATE OF PARANÁ
Sônia Mar ia Soar es dos Sant os1 Magda Lúcia Félix de Oliv eir a2
Santos SMS, Oliveira MLF. Knowledge about Aids and drugs am ong undergraduate students in a higher education inst it ut ion in t he St at e of Paraná. Rev Lat ino- am Enferm agem 2009 j ulho- agost o; 17( 4) : 522- 8.
Th e m ain obj ect iv e of t h is st u dy w as t o m easu r e t h e k n ow ledge of u n der gr adu at e n u r sin g st u den t s abou t Acquir ed I m m unodeficiency Sy ndr om e ( AI DS) and dr ugs. The st udy w as car r ied out in 2 0 0 7 w it h a r andom sam ple of 289 under gr aduat e st udent s at a St at e Univ er sit y in t he Nor t hw est of Par aná, Br azil. The st udent s self–applied a quest ionnair e validat ed by ex per t s. Quest ions w er e divided int o t hr ee levels of com plex it y: low , av er age and high. The lev el of cor r ect answ er s w as higher in t he quest ions of low com plex it y , dim inishing as t he quest ions’ com plex it y incr eased. Thir t een per cent of quest ions concer ning r isk fact or s and v ulner abilit y t o HI V in f ect ion am on g in j ect ion dr u g u ser s ( I DU) an d biological m at er ial f or diagn osis of AI DS w as cor r ect ly an sw er ed b y 9 0 % of st u d en t s. St u d en t s p ossessed k n ow led g e con cer n in g AI DS an d d r u g s, h ow ev er su ch knowledge was considered insufficient , showing lack of inform at ion and gaps in educat ion wit h a dissociat ion of int er disciplinar y and int er - cur r icular cont ent .
DESCRI PTORS: adolescen t ; acqu ir ed im m u n odeficien cy sy n dr om e; k n ow ledge; dr u gs
EL CONOCI MI ENTO SOBRE SI DA Y DROGAS ENTRE ALUMNOS DE GRADUACI ÓN DE UNA
I NSTI TUCI ÓN DE ENSEÑANZA SUPERI OR EN EL ESTADO DE PARANÁ
Est e t r abaj o t u v o com o pr in cipal obj et iv o in v est igar el con ocim ien t o de u n iv er sit ar ios sobr e el sín dr om e de inm unodeficiencia adquirida ( SI DA) y drogas. La invest igación se realizó en el año 2007 a part ir de una m uest ra aleat oria de 289 alum nos de los cursos de graduación de una facult ad est at al de la región noroest e de Paraná, en Br asil. Los alum nos r espondier on un cuest ionar io aut o aplicable, v alidado por especialist as del ár ea. Las pr egu n t as f u er on div ididas en t r es n iv eles de com plej idad: baj a, m edia y alt a. El ín dice de acier t os de los al u m n o s f u e m ay o r en l as p r eg u n t as d e b aj a co m p l ej i d ad , d i sm i n u y en d o co n el au m en t o d el g r ad o d e com plej idad. El índice de 90% de acier t os ocur r ió en 13% de las pr egunt as, que se r efer ían a los fact or es de r iesgo y v u ln er abilidad par a la in fección por el v ir u s de la in m u n odeficien cia h u m an a ( HI V) en u su ar ios de drogas inyect ables ( UDI ) y el m at erial biológico para el diagnóst ico de SI DA. Los alum nos poseían conocim ient os sob r e SI DA y d r og as, sin em b ar g o, est e es in su f icien t e, d em ost r an d o f alt a d e in f or m ación y v acíos en la enseñanza, con disociación de cont enidos int er disciplinar es e int er cur r icular es.
DESCRI PTORES: adolescent e; síndr om e de inm unodeficiencia adquir ida; conocim ient o; dr ogas
CONHECI MENTO SOBRE AI DS E DROGAS ENTRE ALUNOS DE GRADUAÇÃO DE UMA
I NSTI TUI ÇÃO DE ENSI NO SUPERI OR DO ESTADO DO PARANÁ
Est e t r abalho t ev e com o pr incipal obj et iv o inv est igar o conhecim ent o de univ er sit ár ios sobr e a síndr om e de im unodeficiência adquir ida ( AI DS) e dr ogas. Realizou- se a pesquisa no ano 2007 a par t ir de am ost r a aleat ór ia de 289 alunos dos cur sos de gr aduação de um a faculdade est adual da r egião nor oest e do Par aná. Os alunos r esponder am um quest ionár io aut oaplicáv el, v alidado por especialist as na ár ea. As quest ões for am div ididas em t r ês nív eis: baix a, m édia e alt a com plex idade. O índice de acer t os dos alunos foi m aior nas quest ões de baixa com plexidade, dim inuindo com o aum ent o do grau de com plexidade. O índice de 90% de acert os ocorreu em 13% das quest ões, que se r efer iam aos fat or es de r isco e v ulner abilidade par a a infecção pelo v ír us da im unodeficiência hum ana ( HI V) em usuários de drogas inj et áveis ( UDI ) e o m at erial biológico para o diagnóst ico de AI DS. Os alunos possuíam conhecim ent o sobr e AI DS e dr ogas, por ém , insuficient e, dem onst r ando falt a de infor m ação e lacunas no ensino, com dissociação de cont eúdos int er disciplinar es e int er cur r icular es.
DESCRI TORES: adolescent e; AI DS; conhecim ent o; dr ogas
Universidade Est adual de Maringá, Brazil: 1Mast er’s st udent , e- m ail: enfso@hot m ail.com ; 2Ph.D., Assist ant Professor, e- m ail: m lfoliveira@uem .br. Disponible en castellano/ Disponível em língua portuguesa
I NTRODUCTI ON
W
ith 18 years of experience in teaching for u n d e r g r a d u a t e p r o g r a m s w e p e r ce i v e d t h a t a significant share of young adult s go t hrough visible and rapid behavioral changes t hat have t he pot ent ial t o com pr om ise t h eir liv es. Th ese ch an ges in clu de acquiring responsibilit ies, financial aut onom y and t he power t o direct t heir act ions and decisions, but t hey also experience greater contact and opportunity to use alcohol, t obacco and pract ice unsafe sex.By o b se r v i n g st u d e n t s’ i n f o r m a l co n v e r sa t i o n s, e sp e ci a l l y n u r si n g st u d e n t s, w e perceived t hat t hey are not very concerned wit h t he potential risk of being infected by sexually transm itted diseases ( STD) , though one cannot attribute this lack of concern to lack of inform ation or knowledge about the high chance of being infected by these diseases.
The close relation between people with Hum an I m m unodeficiency Virus ( HI V) and t hose living wit h Acqu ir ed I m m u n odeficien cy Sy n dr om e ( AI DS) an d “ drugs” is acknowledged. The double epidem ic, drug use and HI V infection, has been a nconcern for societ y, especially in t er m s of public healt h. Dr ug use and associated behaviors can have a strong catalytic effect on the dissem ination of HI V am ong this population(1-2). There is m ore evidence of vulnerability am ong young adult s because people at t his age go t hrough experiences in a phase of life in which biological, social and econom ic changes occur wit h great er int ensit y.
All param eters of vulnerability increase when a young adult leaves secondary school and goes t o college, that is, the consum ption of alcohol and other drugs increase as well as exposure t o risk sit uat ions such as unsafe sex. These people are part of a social group who consider them selves so well inform ed that they are not at risk of being infected by AI DS(1,3).
Based o n t h e ack n o w l ed g ed r el at i o n sh i p between youth and practices that increase the risk of using legal and illegal drugs and to be infected by HI V, and t aking int o account t hat t hese pract ices are part o f t h e cu r r en t so ci o cu l t u r a l co n t ex t , p r ev en t i v e m easures wit h a view t o generat e reflect ion on t he Brazilian cult ure and pract ices are needed.
I t is im portant to take into consideration the knowledge young adult s possess. This knowledge is com posed of inform at ion volunt arily and involunt arily acquired, which m odifies t he way people underst and new facts, and also knowledge accum ulated over life, w hereas know ledge of t he peculiarit ies of t he AI DS
epidem ic is an essential condition to devise strategies t o f i g h t i t s p r o g r essi o n( 4 ). St u d i es i n v o l v i n g t h e m onit or ing of k now ledge of fact or s inv olv ed in t he t r an sm ission of HI V h av e b een ack n ow led g ed as im portant instrum ents to understand the dissem ination of the virus(5).
A st udy of undergraduat e st udent s from t he health field including nursing, dentistry and pharm acy program s, which focused on t he st udent s’ knowledge of preventive m easures related to AI DS and other STD concluded t hat , t hough st udent s w er e able t o cit e im port ant m easures for t he prevent ion of HI V/ AI DS and STD, t heir k now ledge on t he subj ect w as v er y poor( 6).
An ot h er st u d y t h at aim ed t o id en t if y an d co m p a r e p sy ch o so ci a l a n d b e h a v i o r a l f a ct o r s associated with the risk of being infected by STD/ AI DS am on g n u r sin g an d m ed ical st u d en t s f ou n d t h at a l t h o u g h t h e y w e r e w e l l i n f o r m e d a b o u t AI D S t ransm ission, t hey present ed som e risk fact ors such as the perception of personal invulnerability( 3).
I nvestigating the knowledge of students about t he int er face of AI DS and dr ugs is j ust ified by t he scarcity of studies addressing this subject in the college populat ion.
We understand that young people receive over t heir life som e t ype of inform at ion about AI DS and drugs and this study aim ed to identify the knowledge a b o u t HI V, AI D S i n f e ct i o n a n d d r u g s a m o n g undergraduate students from the nursing program and t he rem aining program s of an educat ional inst it ut ion in the Paraná state, Brazil.
Th i s st u d y co r r o b o r a t e s o t h e r st u d i e s addressing this subject and supports educative actions for the undergraduate population both for the students’ self- protection and that of others, and the acquisition of com petence needed in their professions to be m ore adequate given the current reality( 3,6).
METHOD
This is a descriptive and cross-sectional study with a random sam ple com posed of students stratified by year and undergraduat e program from t he St at e Un iv er sit y of Ed u cat ion , Scien ces an d Let t er s at Paranavaí (FAFI PA) located in the Northeast of Paraná, Br azil.
t h ey w er e at t en d in g – an d sen ior y ear st u d en t s regularly registered in 2007 in the following program s: Bu si n ess Ad m i n i st r a t i o n , Sci en ces, Acco u n t i n g Scien ces, Phy sical Edu cat ion , Nu r sin g, Geogr aph y, History, Literature, Mathem atics, Education and Social Services, regist ered in 2007.
Of the 1,172 students estim ated for the school year in 2007, a sam ple of 289 st udent s was drawn using the statistical software EpiI nfo version 6. For that, an error of about 5% and sam ple reliabilit y of 95% were est ablished.
Data used to selected students were obtained from the list of students registered at FAFI PA in 2007 by year and program and from the schedule of three periods of classes provided by t he academ ic office.
The inst r um ent used t o collect dat a w as a m odular, structured and self-applied questionnaire with closed m ult iple choice quest ions div ided int o t hr ee part s: st udent s’ socioeconom ic inform at ion, schooling sit uat ion, and specific k now ledge on HI V and AI DS infect ion, and drugs.
The third part was com posed of 30 questions including specific knowledge of HI V and AI DS infection and drugs and t he correlat ion bet ween drug use and HI V t r ansm ission. A br oad r esear ch w as per for m ed on AI DS and dr ugs in official docum ent s and ot her sour ces such as scient ific st udies t o dev elop t hese quest ions.
I nit ially, four quest ions were developed and for w ar ded t o fou r ex per t s for v alidat ion . Th e fou r included t hr ee nur ses and one phy sician fr om t he Cent er for Treat m ent of People wit h HI V/ AI DS of t he Specialt ies Regional Cent er at Paranavaí, PR, Brazil. Of the three nurses, one was a m aster’s degree and a facult y m em ber at t he St at e Univer sit y of Mar ingá, one w as t he coor dinat or of t he STD/ AI DS pr ogr am fr om t he Healt h Secr et ar y of Par anavaí, PR, Br azil, and the third was the director of the STD/ AI DS program from the State Health Secretary of Paraná.
Th e ex p er t s ev al u at ed each q u est i o n b y considering t he following requirem ent s: relat ion wit h t he st udy subj ect , clar it y of w or ding, am biguit y of answers due to questions’ lack of clarity, repetition or sim ilarit y bet ween quest ions and level of com plexit y of knowledge required to answer questions, which were classified as low, average or high.
Ba se d o n t h e e x p e r t s’ su g g e st i o n s, t h e quest ionnaire was reform ulat ed and t he final version contained eight questions of low com plexity, with five about AI DS and t hree about drugs; 16 quest ions of
m edium com plexit y, wit h nine about AI DS and seven about drugs; and six highly com plex questions: three about AI DS and three about drugs.
He a l t h p r o f e ssi o n a l s, n o t h i r e d b y t h e institution, applied the questionnaire. After interviewers agr eed t o par t icipat e in t he st udy, t hey at t ended a t raining m eet ing where t he st udy obj ect ives, m et hod and m anagem ent of dat a collect ion were explained.
Before the students’ first class, the researcher talked to the professors on a pre- scheduled date and asked t heir perm ission for st udent s t o part icipat e in the study. After receiving the professors’ authorization, t he int erviewers approached st udent s in classroom s. The select ed st udent s w er e sent t o anot her r oom , where t he st udy’s obj ect ives were explained and t he free and inform ed consent agreem ent was read and t hen t he quest ionnaires were dist ribut ed. There was not a t im e lim it t o fill out t he quest ionnaire and t his stage took an average of 50 m inutes.
D at a co l l ect i o n w as car r i ed o u t i n t h r ee periods: day, evening and night , and st udent s were called according to the availability and needs of each professor, at a scheduled date and tim e over a period of ten days.
Dat a were com piled from t he quest ionnaires int o an Excel spr eadsheet . Scor es w er e est ablished according t o t he FAFI PA int ernal rules, which define the param eters of school perform ance: up to 50% of correct answers – insufficient knowledge; 50.1 to 70% - p oor k n ow led g e; an d ab ov e 7 0 % - sat isf act or y k now ledge.
The st udy w as appr oved by t he Per m anent Com m it t ee on Et hics in Resear ch I nv olv ing Hum an Subj ect s ( COPEP) at t he St at e Universit y of Maringá ( Process No. 049/ 2007)
RESULTS
A t o t a l o f 2 6 6 st u d e n t s a n sw e r e d t h e questionnaire with a sam ple loss of 4.5% . All selected students present in the classroom s at the tim e answered t he quest ionnaire. The sam ple was com posed of 26 nursing st udent s ( 14 freshm en and 12 seniors) , 250 st udent s from t he Business Adm inist rat ion, Sciences, Account ing Sciences, Physical Educat ion, Geography, History, Literature, Mathem atics, Pedagogy and Social Work program s ( 147 freshm en and 103 seniors) .
t han 30 years, and only 10.7% were older t han 30 years in t he rem aining program s.
Th e m aj or it y of t h e p ar t icip an t s f r om all program s reported being white and single. The students’ average incom e ranged from three to seven tim es the m inim um wage, and 74.3% of them had work contracts with a workload above eight hours/ day ( Table 1) .
The m ain source of inform at ion report ed by students was television and only 12% of them did not hav e access t o t he I nt er net . The m aj or it y of t hem ( 5 5 . 8 % ) r ar ely r ead n ew spaper s an d r ead a book every six m ont hs. The nursing st udent s present ed a sm aller p er cen t ag e f or n ew sp ap er s an d b ook s in relation to the rem aining, according to Table 1.
To i d e n t i f y a n d e v i d e n ce k n o w l e d g e o f st udent s concerning peculiarit ies of AI DS and drugs, quest ions w er e st r at ified accor ding t o t heir level of com plexit y and answers were analyzed according t o t he level of correct answers.
s e l b a i r a
V Nursing Other
s m a r g o r
p Total
N % N % N %
* ) W M ( e m o c n I 3
< 5 19.2 34 13.6 39 14.1
7 o t
3 18 69.2 179 71.6 197 71.4
7
> 3 11.6 36 14.4 39 14.1
r e w s n a t o n d i
D - - 1 0.4 1 0.4
) y a d ( k r o w / r u o H k r o w t o n o
D 9 34.6 62 24.8 71 25.7
s r u o h 8 o t p
U 14 53.9 166 66.4 180 65.2
s r u o h 8 r e v
O 3 11.5 22 8.8 25 9.1
r e p a p s w e n / g n i d a e R y li a
D 2 7.7 34 13.6 36 13.1
y a d y r e v e t s o m l
A 3 11.6 53 21.2 56 20.3
y l e r a
R 18 69.2 136 54.4 154 55.8
r e v e
N 3 11.5 27 10.8 30 10.8
* * k o o b / g n i d a e R s k e e w o w t y r e v
E 2 7.7 37 14.8 39 14.1
y l h t n o
M 8 30.8 52 20.8 60 21.7
s h t n o m x i s y r e v
E 8 30.8 84 33.6 92 33.3
r a e y a e c n
O 5 19.2 51 20.4 56 20.3
r a e y
> 3 11.5 25 10 28 10.2
r e v e
N - - 1 0.4 1 0.4
* * * t e n r e t n I / r u o H 9 o t p
U 14 53.9 110 44 124 44.9
0 2 o t 0
1 9 34.6 66 26.4 75 27.1
0 2 r e v
O - - 44 17.6 44 16
r e v e
N 3 11.5 30 12 33 12
* * * * V T / r u o H 9 o t p
U 21 80.8 194 77.6 215 77.9
0 2 o t 0
1 1 3.8 5 2 6 2.2
0 2 r e v
O - - 26 10.4 26 9.4
r e v e
N 4 15.4 25 10.0 29 10.5
Ta b l e 1 – So ci o e co n o m i c ch a r a ct e r i za t i o n o f undergraduate students, FAFI PA – Paranavaí, PR, Brazil 2007
* MI – Brazilian m inim um wage in 2007, * * refers to reading a book, * * * refers to weekly hours, * * * * refers to hours/ day
Only fiv e quest ions ( 16.6% ) w er e cor r ect ly answ er ed by 90% of st udent s in bot h gr oups. These q u e s t i o n s a r e r e l a t e d t o k n o w l e d g e a b o u t env ir onm ent al ex posur e t o cigar et t e pollut ant s and r isk of HI V infect ion ( quest ions 6 and 14) , biological m at er ial in dicat ed f or AI DS labor at or ial diagn osis ( quest ion 22) , condit ions of indiv idual v ulner abilit y t o b e in f ect ed b y AI DS ( q u est ion 2 6 ) an d u se of condom s t o pr ev ent ot her STDs ( quest ion 1 7 ) , all classif ied u n d er t h e su b t h em e AI DS an d f ou r of t h em classif ied as low com plex it y qu est ion s.
T h e l e v e l o f c o r r e c t a n s w e r s t o l o w com p lex it y q u est ion s w as con sid er ed sat isf act or y w it h a per cen t age abov e 7 0 % for all qu est ion s in t h e t w o g r ou p s of st u d en t s. Fou r q u est ion s w er e co r r ect l y a n sw er ed b y a l l n u r si n g st u d en t s a n d com p ar in g t h em t o st u d en t s f r om t h e r em ain in g pr ogr am s, t he lat t er obt ained low er lev els of cor r ect answ er s by quest ion – no quest ion obt ained 100% of cor r ect answ er s in t his gr oup of st udent s.
Ta b l e 2 – N u m b e r a n d p e r c e n t a g e o f c o r r e c t an sw er s t o l o w co m p l ex q u est i o n s, b y g r o u p o f st u den t s, FAFI PA – Paran av aí, PR, Brazil 2 0 0 7
* r efer t o AI DS, * * r efer t o dr ugs
Qu e st i o n s 5 , 2 4 a n d 3 0 f o cu se d o n t h e p ossib ilit y of HI V t r an sm ission t h r ou g h an in sect bit e, t he concept of ‘dr ug’ as a br oad t er m t o r efer t o any subst ance, w hich once consum ed, r epr esent s har m t o healt h, and t he consequences of dr ug use am on g y ou n g adu lt s.
For q u est ion s of av er ag e com p lex it y, t h e n u m b e r o f c o r r e c t a n s w e r s d i m i n i s h e d a m o n g g r ou p s of st u d ied st u d en t s, 7 0 % of an sw er s f or each q u est ion w er e cor r ect ; f iv e q u est ion s w er e cor r ect ly an sw er ed b y n u r sin g st u d en t s an d f ou r b y e a ch g r o u p o f st u d e n t s f r o m t h e r e m a i n i n g p r o g r a m s.
s r e w s n a t c e r r o C n o i t s e u
Q Nursing % Remainingprograms% Total%
*
5 21(80) 241(96) 262(95)
* *
6 26(100) 126(50) 152(55)
* 4
1 26(100) 242(97) 268(97)
* 7
1 25(96) 231(92) 256(93)
* 2
2 26(100) 238(95) 264(96)
* * 4
2 25(96) 223(89) 248(90)
* 6
2 26(100) 240(96) 266(96)
* * 0
Table 3 – Num ber and percentage of correct answers t o q u est i o n s o f m ed i u m co m p l ex i t y b y g r o u p o f studied students, FAFI PA – Paranavaí, PR, Brazil 2007
s r e w s n a t c e r r o C
n o i t s e u
Q Nursing % Remainingprograms % Total%
*
1 2(8) 10(4) 12(4)
* *
2 17(65) 84(34) 101(36)
*
3 1(4) 37(15) 38(14)
* *
4 21(81) 208(83) 229(83)
*
7 16(61) 84(34) 100(36)
* *
8 26(100) 231(92) 257(93)
* 1
1 26(100) 202(81) 228(83)
* * 2
1 - 41(16) 41(15)
* 3
1 17(65) 129(52) 146(53)
* 5
1 19(73) 163(65) 192(69)
* * 6
1 12(46) 143(57) 155(56)
* 9
1 13(50) 73(29) 86(31)
* * 1
2 3(11) 21(8) 24(9)
* 3
2 10(38) 29(12) 39(14)
* * 7
2 7(27) 105(42) 112(40)
* 8
2 22(85) 188(75) 210(76)
* refers to AI DS, * * refers to drugs
I n t he six quest ions of low com plexit y wit h t he lowest num ber of correct answ ers, t here w as a balance bet w een t hose r elat ed t o AI DS and t hose related to drugs as shown in Table 3.
Quest ions 1, 3, 12, 21 and 23 obt ained t he low est lev els of cor r ect an sw er s in all g r ou p s of st u d e n t s. Th e se q u e st i o n s f o cu se d o n t h e characteristics of the current AI DS epidem ic in Brazil, the m ost adequate way to refer to the group of people suscept ible t o HI V infect ion, t he charact erist ics and effects of cocaine on the body and the relation of the e p i d e m i c w i t h t h e m a t e r n a l i n f a n t f i e l d , m o r e specifically t o t he cycle pregnancy/ puerperal and t o t he vert ical t ransm ission of HI V.
Quest ions 4, 8, 16 and 27 focused on drug use r isk fact or s, k now ledge concer ning t he r isk s of shar ing syr inges by inj ect ion dr ug user s ( I DU) , t he effect of dr ugs on t he fet us of a w om an w ho uses drugs during pregnancy and t he t oxicit y of syrups, a m uch used m edicat ion am ong individuals w it hout a m edical pr escr ipt ion.
Fin ally, q u est ion s 1 1 , 1 3 , 1 5 , 1 9 an d 2 8 referred t o form s of t ransm ission and charact erist ics of people infected by HI V, ways to reduce the risk of HI V infection, the use of condom s as the best way to p r ot ect f r om HI V in f ect ion in sex u al in t er cou r se, clinical m anifest at ions of t he disease and for m s of HI V t ransm ission.
I n r egar d t o highly com plex quest ions, t he gener al num ber of cor r ect answ er s w as below t hat obtained in questions of low and m edium com plexity.
No quest ion w as cor r ect ly answ er ed for m or e t han 80% of st udent s in t he t ot al com put at ion. Quest ion t en, w hich focused on t he differ ence bet w een legal an d illeg al d r u g s, w as cor r ect ly an sw er ed b y 2 1 nursing students ( 80.8% ) and 190 students from the rem aining program s ( 76% ) .
Quest ions 9, 18 and 25 included knowledge concer ning m easur es t o be t ak en w hen ex posed t o biological m aterial, the latent period of AI DS and signs and sym ptom s of HI V infection. Questions 20 and 29 asked about the effects of cocaine on the hum an brain and about t he concept of social drug use.
Nu r sin g st uden t s cor r ect ly answ er ed m or e q u est ion s of h ig h com p lex it y t h an t h e r em ain in g students, however, the level of correct answers, even am ong t hese st udent s, indicat ed poor knowledge.
s r e w s n a t c e r r o C
n o i t s e u
Q Nursing % Remainingprograms% Total%
*
9 21(81) 128(51) 149(54)
* * 0
1 21(81) 190(76) 211(76)
* 8
1 12(46) 44(18) 56(20)
* * 0
2 3(11) 79(32) 82(30)
* 5
2 9(35) 56(22) 65(23)
* * 9
2 5(19) 53(21) 58(21)
Table 4 – Num ber and percentage of correct answers of quest ions of high com plexit y by group of st udied st udent s, FAFI PA – Paranavaí, PR, Brazil 2007
* refer to AI DS, * * refer to drugs
DI SCUSSI ON
According to data from the National I nstitute for Educat ional St udies and Research Anísio Teixeira – I NEP, t he variable t hat had t he largest im pact on t h e p er f or m an ce of st u d en t s p ar t icip at in g in t h e Nat ional Ex am for Secondar y Schools in 2001 w as f am i l y i n co m e. St u d en t s o f f am i l i es w i t h h i g h er incom es usually have parents with higher educational levels and facilitated access to cultural goods such as books, com put ers, m ovies t heat ers and t ravels( 7).
Considering that m ost of the studied students worked eight hours or m ore a day, attended theoretical classes, supervised training and other activities related to their program s, it was pertinent to investigate other m eans, t hose considered non- didact ic, t hat st udent s used t o acquire inform at ion and knowledge and t heir availabilit y of t im e for t his acquisit ion.
their free tim e to read books other than those required by t heir respect ive program s. This fact m ight explain t he st udent s’ habit of not reading m any newspapers and books, especially nursing st udent s.
Television was the m ost cited and used m eans of inform ation during free tim e, which is in accordance w it h t he nat ional t r end of Br azilian under gr aduat e students obtaining inform ation m ainly through TV. This com m u n icat ion v eh icle is cu r r en t ly an im p or t an t sou r ce of in f or m at ion an d of t en t im es f ills gaps in education that should be offered at school and by the fam ily.
A U.S. study reports that television is the m ain source of inform at ion about sexualit y for adolescent s and t he count ry has t he highest rat e of STD am ong t his group am ong West ern count ries( 8).
Ot h e r st u d i e s, w h i ch a l so i n v e st i g a t e d students’ knowledge about AI DS , pointed to television as a gr eat infor m at iv e v ehicle on t he subj ect( 9- 10). Access t o different sources of inform at ion, especially t elevision and t he I nt ernet , was shown t o affect t he knowledge of st udent s, bot h in t he t ot al com put at ion of answers as in the analysis of questions by level of com plex it y. We h ad ex pect ed t h at st u den t s w ou ld obt ain a lar ger n u m ber of cor r ect an sw er s in low com p lex it y q u est ion s r eg ar d less of p r og r am an d period because the issues addressed in these questions are highly dissem inat ed in cam paigns of t he Nat ional Program of STD and AI DS in healt h services and by t he m edia.
Th e st u d y ’ s r e su l t s, i f co m p a r e d t o t h e socioeconom ic char act er izat ion of st udied st udent s seem t o be adequat e because t he m aj orit y of t hem pointed to audiovisual m edia, especially television and t he I nt ernet , as t he m ain sources of inform at ion. I f one t ak es int o account t he high num ber of cor r ect answers, t his result indicat es t hat knowledge is not subj ect only t o t he school env ir onm ent but also t o the private, public and fam ily spheres and other social relat ions( 11).
We ob ser v ed t h at t h e n u m b er of cor r ect a n sw e r s t o q u e st i o n s o f a v e r a g e co m p l e x i t y d ecr eased i n st u d en t s f r om al l p r og r am s. Th ese questions required students to have technical- scientific knowledge and know ledge acquired t hrough several so u r ces o f i n f o r m at i o n i n cl u d i n g r ead i n g o n t h e subj ect .
Qu e st i o n s o f a h i g h l e v e l o f co m p l e x i t y required knowledge acquired in regular program s in t he healt h field or specific cour ses on t he subj ect ,
t hat is, st udent s would need knowledge acquired in sp eci f i c co u r ses i n t h e su b j ect w h et h er t h r o u g h curricular courses, speeches or t raining. The general num ber of cor r ect answ er s w as below 50% in t he m aj orit y of quest ions of high com plexit y and in bot h groups of students, whereas only two questions were cor r ect ly an sw er ed by m or e t h an 8 0 % of n u r sin g st udent s.
I t is wort h not ing t he low num ber of correct answers to questions concerning vertical transm ission of HI V becau se t h e m aj or it y of r espon den t s w er e f em ale. Con sid er in g t h at t h e AI DS ep id em ic h as changed its transm ission dynam ics with the increased n u m b e r o f ca se s i n t h e f e m a l e p o p u l a t i o n , t h e st udent s’ low level of knowledge about t his aspect is reason for concern, because it is known that m aternal-child t ransm ission is t he m ain cause of HI V infect ion am ong children( 5,12- 13).
Additionally, the low level of knowledge about dr ugs obser v ed am ong st udent s is consonant w it h obser vat ions of a st udy car r ied out in t he sout h of Brazil, which focused on attitudes and beliefs of nursing st udent s about t he phenom enon of drugs and point s to the need of sensitizing higher education institutions t o invest in t he inclusion of cont ent on alcohol and ot h er p sy ch oact iv e su b st an ces t o u n d er g r ad u at e st udent s in t he nursing program and ot hers( 14) .
This infor m at ion can indicat e t hat st udent s an sw er ed q u est ion s ab ou t d r u g s w it h k n ow led g e acqu ir ed in sou r ces of in for m at ion ot h er t h an t h e program s’ curricula. Again, it is possible to relate these findings and sources of inform ation used by the studied st udent s, who use m ore t elevision and t he I nt ernet and rarely use newspapers and books as sources of infor m at ion.
The knowledge presented by students seem s t o coincide w it h t he w ay t he m edia addr esses t he subj ect , which privileges illegal drugs, m any t im es in an em otional and alarm ing tone and can also indicate inadequat e com plem ent at ion of t he curricula due t o lack of com pulsory content in the nursing program or addit ional cont ent in t he rem aining program s( 15).
t o pr ev en t blood- bor n e diseases, especially AI DS, which j ust ifies t he num ber of correct answers( 11,16).
FI NAL CONSI DERATI ONS
Access t o differ ent sour ces of infor m at ion, especially t elevision and t he I nt ernet was shown t o influence st udent s’ k now ledge bot h in t he gener al com p u t at ion of q u est ion s an d in t h e an aly sis of questions by level of com plexity. Questions considered of low com plexit y, m ore sensit ive t o t he influence of the m edia, obtained a large num ber of correct answers in all groups of students.
The poor level of answers is a worrying fact since it is im possible to address HI V prevention without b r o a d l y a p p r o a ch i n g h e a l t h , t h a t i s, w i t h o u t ad d r essin g sex u al h ealt h an d d r u g u se. Th u s, it
j ust ifies r et hink ing t he inclusion of specific cont ent into curricula, prom oting interdisciplinary and didactic act ivit ies in order t o int egrat e program s wit h a view t o dissem inat e and socialize knowledge.
These results provide support to the reflection about t he educat ional process in t he inst it ut ion and show t he need t o im prove t he way AI DS and drugs are addressed in t he courses of t he nursing program as well as in the curricula of the rem aining program s. Th e i n st i t u t i o n f o cu sed o n i n t h i s st u d y pr om ot es educat ion and t her efor e has an essent ial role in providing knowledge that will support students’ self- protection as well as the protection of others. I ts role is to provide conditions prom oting the acquisition of com pet ence in undergraduat e program s necessary t o m axim ize t heir pr ofessions, pr epar ing t he fut ur e n u r se t o car e f or h u m an b ein g s in v olv ed in t h is cont ex t .
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