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19PREVENTION OF ADOLESCENT DRUG ABUSE AND PREVENTION OF YATROGENIA DURING PROPHYLAXIS
1Pogosov Sergey Andreevich, 2Shernazarov Farrux Farhod o'g'li, 3Sharapova Dilfuza Nematillayevna, 4Turayev Bobir Temirpulotovich
1Northwestern State Medical University I. I. Mechnikova, Russian Federation city of Saint-Petersburg
2608 group students of Samarkand State Medical University Faculty of Medicine 3Samarkand State Medical University Clinical ordenator in the direction of psychiatry 4Assistant of the department of psychiatry, medical psychology and narcology, Samarkand State Medical University, Samarkand, Republic of Uzbekistan https://doi.org/10.5281/zenodo.10362257
Abstract. The relevance of substance abuse (Surfactants) is the most pressing problem all over the world due to the medical, social and economic consequences caused. The range of psychoactive substance use has expanded significantly: new synthetic drugs for our country have appeared - hallucinogens, psychostimulants, the number of people who use two or more psychoactive substances together has increased.
Keywords: drug prophylaxis, adolescents, yatrogenia, psychoactive substances.
Introduction. Currently, the General Dynamics of drug addiction is indicative of the generalization of the epidemic, the penetration of this phenomenon into previously relatively prosperous regions. Adolescents ' abuse of drugs quickly leads them to a criminal lifestyle from full-fledged promising members of society, depriving them of the opportunity to work, start a family and raise children in the future [1].
One of the most important areas of work of a psychiatrist is preventive work with students of educational institutions and their parents, including explaining the medical and legal consequences of the consumption of psychoactive substances. In this case, various forms and methods of activity are used. Thus, preventive conversations, consultations, psychocorrectional training, social adaptation activities are carried out without diagnosis (risk group) with minors seen in the one-time use of psychoactive substances [2, 3].
All of them are aimed at preventing episodic and systemic consumption of psychoactive substances. The educational institution as a social institution has unique opportunities for the successful implementation of its functions, since systematic work on prevention can be carried out throughout the entire educational period. Work on the Prevention of drug use in educational institutions and the promotion of a healthy lifestyle is carried out in several directions and has a complex character [4].
In educational institutions in the city of Krasnodar, preventive work is carried out, which has a positive direction in the initial prevention of substance abuse. It is by reducing the use of drugs in the entire educational institution, involving a group of students (non-drug users) in joint promotions, conversations, film lectures, sports competitions, " drugs and alcohol are not in fashion! » [5, 6].
With this principle of communication of a psychiatrist-narcologist with young consumers, the problem of adhering to the Hippocratic principle of "do not harm" and preventing yatrogenia, which is closely related to it, seems relevant. The term, as a rule, refers to the deterioration of the patient's health (or even the appearance of a new disease) during treatment, the actions or words of senior medical personnel were used for this development. The term" yatrogenia "was first used
in 1925 by the German psychiatrist and scientist Oswald Bumke in his work"medicine as a cause of mental illness" [7-10].
According to the International Classification of diseases (ICD-10), yatrogenia is understood as unwanted or negative consequences of preventive, diagnostic and therapeutic interventions or procedures, which leads to impaired body function, restriction of normal activity, disability or death; complications of medical measures developed as a result of improper and correct actions of a doctor. During preventive work to prevent various types of yatrogenies and other psychogenies, a survey was carried out to determine the level of anxiety of adolescents [1116].
In all countries of the world, statistics on the non-medical use of psychotropic substances are growing. The increase in the number of drug users indicates that the problem of addiction is growing globally, which requires certain actions from the world community to prevent it as a negative social phenomenon, a disease that causes great material, intellectual and moral harm to humanity [17]. The priority area for solving the problem of addiction is prevention. The constant increase in the number of dependent chemicals in our country, unfavorable forecasts of the development of the situation, the complexity and responsibility of preventive work against addiction determine the importance of primary drug prevention [18-22].
The World Health Organization defines prevention as a set of social, educational and medico-psychological activities carried out by public and public organizations aimed at preventing the spread and use of drugs, developing and eliminating the negative personal, social and medical consequences of substance abuse [23-26].
Prevention refers to measures of a social, economic, legal, medical and/or psychological nature aimed at reducing the use of substances that contribute to the development of addiction, reducing the risk of addiction in people prone to it or reducing other negative consequences of drug use [27].
According to the World Health Organization classification, primary prevention is aimed at preventing the first samples of drugs among young people, as well as helping to stop accidental and experimental use. This type of prevention is mainly social, the most popular, aimed at the general population of children, adolescents and young people. Primary prevention solves problems aimed at the formation of a healthy lifestyle, maintaining or strengthening health [25-28]. The objectives of primary preventive activities in the educational environment are as follows:
- the formation of moral principles, values, beliefs and models of behavior in adolescents and young people, the formation of personal responsibility for their behavior, which leads to a decrease in the demand for psychoactive substances in the environment of children and young people;
- to prevent the desire to consume psychoactive substances by promoting a healthy lifestyle in adolescents and young people, forming socially significant relationships and carrying out preventive work in educational institutions.
The main tasks of the primary prevention of addiction are as follows:
-formation of motivation for explanatory and educational activities, effective physical and socio-psychological development;
- formation of motivation for socially supportive behavior;
- development of protective factors of healthy socio-effective behavior;
- development of conflict resolution strategies, effective communication and formation of decision-making skills [29-31].
This type of prevention is the most effective, since it seeks to avoid pathological results, to reduce the number of individuals who can initiate a pathogenetic process. Primary preventive
actions change some developing behaviors to others and are aimed not at preventing disease, but at forming healthy behaviors [32].
Recently, in the practice of special literature and socio-pedagogical work, the need to expand the arsenal of methods of primary prevention of addiction, increase its effectiveness is growing. The active use of new sources of information in the practice of educational and educational organizations, such as projectors, educational TVs, as well as computers with an interactive board, allows you to consider videometod as one of them. This method of socio-pedagogical work is mainly based on the visual perception of information. It has a wider range of possibilities for influencing human consciousness and includes inductive and deductive methods of knowledge acquisition, allowing different ways of managing the process of knowledge [33-35]. The educational and educational functions of this method are determined by the high efficiency of the effect of visual images. The information presented in the visual form is associated with the emotional perception of the material, so it is most convenient, easier and faster to perceive it [36]. The use of videomaterials in narcoprophylaxis provides an opportunity to provide complete, reliable information about the processes and phenomena under study, to form effective feedback skills, to provide emotional and reflective understanding of what is seen, to ensure effective interaction of family and educational organizations [37].
This work used an expert assessment method (on the selection of video products), which is based on the analysis, generalization of the opinions of specialists about the possibility of applying one or another film to solve the problems of Early Drug Prevention. The expert group includes experts in youth politics, sociology, cultural studies, media communication, social pedagogy, age and Social Psychology [38].
The creation of a video library video production began with the identification of selected criteria. The following criteria are outlined as the film's cinematographic significance, which determine the high level of its quality and the appropriateness of its use as a cinematographic medium for the purposes of narcoprophylaxis:
- the artistic significance of the film (the film or its authors were nominated for an award or award in the field of Film Arts, participated in film festivals, were shown internationally, the techniques used in the film were studied at a higher educational institution or included as an example in textbooks of film art);
- the film was shown in wide circulation (nationally or globally) or broadcast on a nationwide television channel;
- the film was created by two or more people with a reputation in the field of cinema;
- presence of narcoprophilactic potential video film shown by experts [39-42].
An expert assessment of more than 100 video products reflecting the screenisation of various aspects of addiction resulted in the selection of 7 feature films and 7 videos. After watching the video products included in the video library funds, the expert group developed methodological recommendations for the use of each of the proposed films for primary narcoprophylaxis purposes. Experts made the following recommendations: target audience (Junior School student, teenager, senior school student, students, teachers, parents); issues that are intended to be discussed before viewing the film; forms and characteristics of discussing the emotional attitude of the audience; the expediency of inviting experts to discuss the film collectively. Expert reviews made it possible to draw conclusions about films and videos that can be used when discussing with viewers after viewing [43-45].
Research materials and methods. The study was conducted on the basis of the Department of children and adolescents. The object of the study was 60 minors under the supervision of psychiatrist-narcologists, who formed the main group. The control group includes
many unregistered students who have undergone primary prevention work. The groups were comparable in age (14,1±3,0 years) and other socio-demographic parameters. The Social interview method and the psychometric method-the Spielberg Anxiety Scale-were used. Results processing used MS Excel, SPSS 10.0 statistical analysis programs. The study was carried out in two stages: before carrying out preventive work.
Research results and their discussion. At the first stage of the study, minors of the main group received the actions of medical personnel with sufficient caution, which was confirmed both during the interview process and during psychometric analysis, which revealed a very high level of anxiety (87,9 %). In the control group, students were sufficiently calm and passionate about primary preventive measures. During statistical analysis, anxiety levels in the main group exceeded the control group indicator (23,04±0,75 points, p<0,05). In the second stage, viz. after taking many preventive measures, the level of anxiety decreased almost twice in both groups: in the main group by 40,6%, in the control group - by 47,3%, and in the control group-by 12,3%. At this stage, in interviews of adolescents, an increase in confidence in the psychiatrist-narcologist was found.
The film can be used to solve the following tasks of basic narcoprophylaxis: informatization; formation of motivation for effective socio-psychological and physical development; formation of motivation for socially supportive behavior; development of protective factors of healthy socio-effective behavior.
Target audience: senior schoolchildren (prevention of risks associated with the life of Future Students); Students; teachers; parents.
Issues that need to be discussed clearly before watching this movie:
- the priority of values in human life. The role of family, friends in the life of the child. How to form in a person the ability to constantly refuse drugs and give up offers to try drugs;
-how parents participate in the life of a student's child;
- what signs can indicate drug use and should alert your loved ones;
- what are the reasons why many parents cannot see the problem of drug use.
Forms and features of discussing the emotional attitude of viewers after watching the film: "effective activity in the formation of a successful personality (hobby, hobby, sports) and the role of a healthy lifestyle", a conversation on the topics "the role of family and lifestyle in the formation of value orientations" (discussion)., the responsibility and life position of the child", "the role of the family in the formation of the child's self-esteem and protective behavior". Forms of work with subjects of drug prophylaxis, within the framework of which it can be recommended to organize watching a film: class hour, curatorial hour, parent meeting, family film session, parent conference. Film excerpts that require additional attention and explanation (comments) when discussing after viewing: a father's conversation with his daughter about drug addiction (special attention should be paid to the girl's behavior (annoying) when talking to her father); the content of a letter written by a former drug addict (confession).
Specialists for whom it is advisable to invite the film to a collective discussion: a psychologist (to interpret the psychological and pedagogical characteristics of a teenager and a teenager, the characteristics of children and parents ' relationships, the possibilities of psychotherapeutic practices); psychiatrist-narcologist (to interpret what happens under the influence of the drug and what happens in its cancellation).
Conclusions (reviews) of specialists that can be used when discussing with the audience after watching the film: family support is important for the full, comprehensive development of the child's personality; the formation of normative ideas about lifestyle and interaction with
surrounding people and reality begins in the family and among peers and should include behavior that leads the child to a quality
Thus, appropriate methodological support is necessary for the effective use of video products for the initial prevention of addiction. The study of the features of this type of pedagogical influence in the context of narcoprophilactic tasks seems to be an urgent direction of scientific and pedagogical search.
Non-medical use of drugs by minors remains an urgent problem of modern Narcology. The study showed a sufficiently high level of anxiety in" at risk " adolescents, which can be reduced by the effective organization of preventive care, based on the tactful and friendly attitude of the doctor, who strictly adhered to medical ethics, creating the mildest regime.
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