Psychosocial Variables Affecting the Behavior of Street Inhabitants in Five Panamanian Shelters Miguel A. Cañizales M

I. INTRODUCTION

In this article we identify the psychosocial variables that affect the category of -appearance and behavior- of people living in street situations in Panama. By psychosocial variables we mean those factors that affect the emotional and social well-being of people, as well as their ability to adapt to the environment. Likewise, we analyze the behavior of street dwellers as an expression of social vulnerability, which are complex and multidimensional phenomena, impacting both the material conditions and the subjective perceptions of people, who assume an adaptation to their low self-esteem and precarious living conditions (such as addictions, lack of health care and poor self-control).

Patrício et al. (2019) point out that street dwellers are a vulnerable population facing multiple adversities (such as poverty, exclusion and discrimination) and violence in their daily lives. They also present high levels of psychological problems such as depression, anxiety, stress, suicidal ideation, loss of meaning in life, insomnia, social isolation, drug use and sexual abuse. This contributes to the presence of psychopathological factors in street dwellers. A social problem observed in many cities is that of street people, who are pejoratively referred to as "piedreros" (in Panama). These people usually have a neglected and marginalized appearance, which makes them the target of discrimination and rejection.

With this research we intend to explore some emotional and social factors that may influence the psychopathological behavior of street dwellers. This situation is detrimental to them and to those around them.

This study will make visible and raise awareness about some psychological and social risks that deteriorate the quality of life of street dwellers.

II. METHODOLOGY

2.1 Sample

We investigated the social and psychological profile of the people housed in this center. For this, we will use the non-probabilistic purposive sample, composed of 160 adults who have been housed in a period from May 18, 2018 to May 18, 2023 (five years), within the five shelters that the institution has had, located in: La Chorrera, Calidonia, Santa Ana, San Miguel and Río Hato.

2.2 Instruments

Three instruments were used to assess the degree of lucidity or compromise of consciousness, especially with regard to the difficulty in waking up and responding to external stimuli: A structured interview, Lobo's Mini Cognitive Examination, (1999) and a Mental Examination Protocol. These are detailed below:

2.3 Structured Interview

Includes: Place of birth, date of birth, age, schooling, place of residence, occupation, period of residence, reason for leaving, drug-related problems, start of drug use, last time of drug use, tolerance or dependence.

2.4 Mini-Cognitive Examination (MEC or MMSE)

In this category of instruments it was demonstrated that the constructive validity of the MMSE is good, when compared with other scales and diagnostic measures, such as the one performed with the Diagnostic and Statistical Manual of Mental Disorders DSM-IV (Diagnostic and Statistical Manual-IV, of the American Psychiatric Association, 2000).

2.5 Acosta, (2009, p. 322-324) Indicates:

"Short tests... usually yield important results on a specific population. In this case the population is the polydrug user, and its application was intended to establish the existence of a deterioration in cognitive processes..... In summary, the Mini-Mental test is useful as a screening test because it yields results on the impairment of functions at a general level; however, in these cases, it is of vital importance to use an extensive neuropsychological evaluation battery to specifically determine the altered area".

In the same sense, Aznar, (1999): points out:

The experts now consulted also endorsed the "feasibility" and "content" validity of the SCM. The following previous existing data from the original Spanish standardization support the "construct" validity of the instrument: "concurrent validation" against psychometric instruments or independent clinical tests; discriminative capacity between "organic" and "non-organic" pictures; and validation against external parameters, including the EEG. The results of the test-retest reliability calculation of the SCM, under the demanding conditions of the study, were satisfactory. The majority of individuals fall in the high, normal, range of performance on the MEC, but there is sufficient scatter in the scores and the reliability coefficient was, for the MEC-35: kw = 0.637 (95%CI = 0.596-0.678; z = 12.655; p < 0.01).

2.6 Mental Examination Protocol

In this evaluation it is necessary to perform a mental examination to obtain information regarding possible degrees of impairment of judgment, intelligence, memory, mood, and others. These are aspects that are part of the evaluation of the mental state of a person and it is necessary to know how to identify and analyze them.

This protocol discriminates according to the exploration of the mental status evaluation that reflects some characteristics of higher cortical functions, such as abstract thinking.

III. RESULTS

The results obtained from the data analysis are shown below.

3.1 Description of results obtained in the Structered Interview

Figure 1 shows the distribution of ages in a range of seven years, from the highest to the lowest number of statistical results, 58-64 years represented 23 people (14.4%), 51-57 years and 65-71 years represented 22 people (13.8%), 72-78 years represented 20 people (12.5%), 79-85 years represented 15 people (9.4%), age 44-50 represented 13 persons (8.1%), age 37-42 represented 12 persons (7.5%), no data represented 8 persons (5.0%), age 30-36 represented 6 persons (3.8%), age 23-29 represented 9 persons (5.6%), and age 86 and older and age 22 and younger represented 5 persons each (3.1%).

This indicates a higher percentage of people in the 51+ age range than in the 50+ age range in the shelters of the John Paul II Center.

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Figure 1: Graph of age distribution over a seven-year range

Figure 2 shows the distribution of the level of schooling from the highest to the lowest number, No data represents 27 persons (16.9%), in the level up to Pre-medium not completed it represented 25 persons (15.6%), in the level up to Primary completed it represented 23 persons (14.4%), in the level up to High School completed it represented 19 persons (11.9%), at the level up to Pre-media completa represented 18 people (11.3%), at the level up to Media no completo and Universidad Completa represented 14 people each (8.8%), at the level of Universidad no completo represented 12 people (7.5%), and at the level of Primaria no Completa represented 8 people (5.0%).

This indicates a high level of people who did not complete school. It is observed that the people in this sample have a very low level of schooling.

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Figure 2: Graph of Schooling Level Distribution

Figure 3 shows the distribution of the reasons for arrest from highest to lowest number, with 54 persons not arrested (33.8%), 32 persons (20.0%) in the category of No data, 17 persons (10.6%) in the category of Carrying drugs, 14 persons (8.8%) in the category of Violence, 10 persons (6.3%) in the category of Robbery or Theft, 8 persons (5.0%) in the category of Other, 6 persons (3.8%) in the category of Alcoholism (3.8%), 4 persons (2.5%) in the category of Weapons Carrying (2.5%), 4 persons (2.5%) in the category of Raiding while under age (2.5%) in the category of Weapons Carrying (2.5%). 0%, in the category of Alcoholism corresponded to 6 persons (3.8%), in the category of Batida while under age corresponded to 4 persons (2.5%), in the category of Carrying Weapons corresponded to 3 persons (1.9%), in the categories of Sexual Abuse- Slander-Homicide- Pandemic Curfew-Street Fighting corresponded to 2 persons each (1.3% each category), and the categories of Unjustified shooting and Migratory Status corresponded to one person each (0.6%).

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IV. INFERENTIAL STATISTICS FOR THE CATEGORY "APPEARANCE AND BEHAVIOR". CORRELATION

Hypothesis:

Hypothesis Ho: There are no psychosocial factors that influence the behavior of a homeless person in Panama.

Hi: r≠0

Hypothesis Hi: There are psychosocial factors that influence the behavior of a homeless person in Panama.

• Statisical test: chi cuadrado

• Level of confidence: a 0.05

Region of rejection:

• Reject Ho p ≤0.05

• Accept Ho p >0.05

Table 1: Appearance and behavior vs. diagnosed mental illnesses

Table 2: Appearance and behavior vs. Alcohol tolerance

Due to the inclusion and exclusion criteria, there were 160 data collected where 147 records of persons obtained were completed. According to the chi-square value of 3.628, with a degree of freedom of 2, and a p-value of 0.163, we observe that there is a negative correlation since its significance level is greater than 0.05, so there is sufficient evidence to accept the Ho, which coincides with the fact that these psychosocial factors do not influence the behavior of a person in street conditions in Panama.

Table 3: Appearance and behavior vs. Cigarette tolerance

Due to the inclusion and exclusion criteria, there were 160 data collected where 147 records of persons obtained were completed. According to the chi-square value of 2.536, with a degree of freedom of 2, and a p-value of 0.281, we observe that there is a negative correlation since its significance level is greater than 0.05, so there is sufficient evidence to accept the Ho, which coincides with the fact that these psychosocial factors do not influence the behavior of a person in street conditions in Panama.

Table 4: Appearance and behavior vs. Marijuana tolerance

Due to the inclusion and exclusion criteria, there were 160 data collected where 147 records of persons obtained were completed. According to the chi-square value of 9.171, with a degree of freedom of 2, and a p-value of 0.010, we observe that there is a positive correlation since its significance level is less than 0.05, so there is sufficient evidence to accept the Hi, which coincides with the fact that these psychosocial factors influence the behavior of a person in street conditions in Panama.

Table 5: Appearance and behavior vs. Cocaine tolerance

Due to the inclusion and exclusion criteria, there were 160 data collected where 147 records of persons obtained were completed. According to the chi-square value of 5.830, with a degree of freedom of 2, and a p-value of 0.054, we observe that there is a negative correlation since its significance level is greater than 0.05, so there is sufficient evidence to accept the Ho, which coincides with the fact that these psychosocial factors do not influence the behavior of a person in street conditions in Panama.

Table 6: Appearance and behavior vs. Compulsive gambling

Due to the inclusion and exclusion criteria, there were 160 data collected where 147 records of persons obtained were completed. According to the chi-square value of 7.824, with a degree of freedom of 2, and a p-value of 0.020, we observe that there is a positive correlation since its significance level is less than 0.05, so there is sufficient evidence to accept the Hi, which coincides with the fact that these psychosocial factors influence the behavior of a person in street conditions in Panama.

Table 7: Appearance and behavior vs. Occupation Source: Psychosocial Variables that Influence the Behavior of Street Inhabitants in Five Panamanian Shelters.

Due to the inclusion and exclusion criteria, there were 160 data collected where 147 records of persons obtained were completed. According to the chi-square value of 37.874, with a degree of freedom of 40, and a p-value of 0.566, we observe that there is a negative correlation since its significance level is greater than 0.05, so there is sufficient evidence to accept the Ho, which coincides with the fact that these psychosocial factors do not influence the behavior of a person living on the street in Panama.

Table 8: Appearance and behavior vs. Cognitive impairment

Due to the inclusion and exclusion criteria, there were 160 data collected where 147 records of persons obtained were completed. According to the chi-square value of 7.090, with a degree of freedom of 2, and a p-value of 0.029, we observe that there is a positive correlation since its significance level is less than 0.05, so there is sufficient evidence to accept the Hi, which coincides with the fact that these psychosocial factors influence the behavior of a person in street conditions in Panama.

V. DISCUSSION

The statistical hypothesis establishes that there are psychosocial factors that influence the behavior of a homeless person at the John Paul II Center in Panama City.

Our findings contrast with those of De León and Cañizales (2021), who reported that most of the participants showed inadequate appearance and behavior. Likewise, we differ from the survey data of Ayano et al. (2017), which indicated that a high percentage of people presented some psychotic or schizophrenic disorder.

The results of this research are related to those of Grandón et al. (2018), who noted in their studies that more people had dropped out of education. They also mentioned that the majority of homeless people with mental health problems did not recognize their condition. In addition, they coincide with those of Alvarado (2017), who found that street dwellers in the municipality of Facatativá were mostly people who had left school at an early age, and that most people were affected mainly by marijuana use, followed by other substances.

VI. CONCLUSION

This research has made it possible to analyze the factors that influence the behavior of people living on the streets who are cared for at the John Paul II Center. It has been found that tolerance to marijuana consumption, gambling habits and cognitive impairment are relevant factors that affect the appearance and behavior of these people; however, it has not been possible to establish a causal relationship between psychosocial factors and the category of-Appearance and behavior- in a generalized way.

Within the sociodemographic variables, we also found that there is a high level of school dropout and There is a high frequency of people who have accepted to be housed in this institution, most of whom are over 51 years of age and older.

Since there is a higher percentage of people who do not have a mental diagnosis, it can be interpreted that this category of -diagnosed mental illnesses- does not influence the appearance and behaviors of these people.

Similarly, as there is a high frequency of people who do not apply (or do not consume) in alcohol tolerance, cigarette tolerance, cocaine tolerance and occupation are presented as not influencing the appearance and behavior of these people.

The results presented in this article are specific to the category of Appearance and behavior, so other items such as thought content process, mood, thought processes and content, and others are not emphasized.