A RESEARCH STUDY ON ATTITUDE OF NURSES TOWARDS RELAPSE PREVENTION AMONG PSYCHIATRIC PATIENTS IN FEDERAL NEUROPSYCHIATRIC HOSPITAL BARNAWA
The problem of every hospital when the targeted objective is not achieved is that there is something wrong either with health caregivers, the patients or the general public. In order to improve the standard of health of the patients and keep them progressively fit. The reason why such lapse are present here to be sought and the remedy met in order to achieve the set objective of the hospital.
This study is based on the Attitude of nurses towards Relapse prevention among psychiatric patients in Federal neuropsychiatric hospital Barnawa Kaduna. The aim and objective of this study are all directed towards bringing out lasting solutions to curtail this menace. It also intends to actively involve the management of the hospital especially on employing new and scientific approach to holistic patient care. The instruments used for data collection were from interview and Questionnaire which were represented in tabular form, bar chart, pie chart and percentages. Nurses were used for the study .the data collected were analyzed. The result showed that many factor contribute to the effect of relapse.
All these can be prevented through adequate Education, Family oriented therapies, good social support, compliance and keep the follow-up appointment.
TABLE OF CONTENT
Title page - - - - - - - - - - i
Certification - - - - - - - - - ii
Dedication - - - - - - - - - iii
Acknowledgement - - - - - - - - iv
Abstract - - - - - - - - - - v
Table of Content - - - - - - - - - vi
1.1 Background of Study - - - - - - - 1
1.2 Statement of Problem - - - - - - - 3
1.3 Objective of the Study - - - - - - - 5
1.4 Significance of the Study - - - - - - 5
1.5 Research Questions - - - - - - - 6
1.6 Scope of the Study - - - - - - - 6
1.7 Limitation of the Study - - - - - - 7
1.8 Operational Definition of Terms - - - - - 7
REVIEW OF LITERATURE
2.0 Introduction - - - - - - - - 8
2.1 Conceptual Framework - - - - - - 9
2.1.1 Background of the Study - - - - - - 9
2.1.2 Concept of Attitude - - - - - - - 11
2.1.3 Causes of Relapse - - - - - - - 13
2.1.4 Phases of Psychiatric Illness - - - - - 15
2.1.5 Types of Relapse - - - - - - - 17
2.1.6 Prevention of Relapse among Psychiatric Patients - - 19
2.2 Theoretical Framework - - - - - - 27
2.2.1 Cognitive Behavioral Chain - - - - - - 27
2.2.2 Problem of Immediate Gratification (P.I.G) - - - 27
2.2.3 Abstinence Violation effect (A.V.E) - - - - 28
2.3 Conclusion - - - - - - - - - 28
3.0 Introduction - - - - - - - - 29
3.1 Research Design - - - - - - - 29
3.2 Research Setting - - - - - - - 29
3.3 Target Population - - - - - - - 31
3.4 Sampling Techniques - - - - - - - 31
3.5 Instrument For Data Collection - - - - - 31
3.6 Validity and Reliability of Instrument - - - - 32
3.7 Method of Data Collection - - - - - - 32
3.8 Method of Data Analysis - - - - - - 32
3.9 Ethical Consideration - - - - - - - 32
4.0 Introduction - - - - - - - - 33
4.1 Data Presentation - - - - - - - 33
4.2 Answering Research Questions - - - - - 47
4.3 Data Analysis - - - - - - - - 49
4.4 Conclusion - - - - - - - - 53
5.0 Introduction - - - - - - - - 54
5.1 Discussion of Findings - - - - - - 54
5.2 Relationship with other Studies/Literature Review - 56
5.3 Implication for Nursing - - - - - - 58
5.4 Summary - - - - - - - - - 58
5.5 Conclusion - - - - - - - - - 59
5.6 Recommendations - - - - - - - 60
References - - - - - - - - - - 63
Appendix - - - - - - - - - - 64
1.1 Background of Study
Psychiatric illness has fascinated and confounded healers, scientist and philosopher for centuries, it symptoms have been attributed to possession by demons considered to be punishment by the gods for the evil done or accepted as evidence of the inhumanity of its sufferers victims. Thus explanation resulted in enduring stigma for those whose were diagnosed with such disorders. Even today, much of the sigma persist although it has less to do with demonic possession than with society’s unwillingness to shoulder the tremendous cost associated with mental illness.
Relapse is one of the most severe problem of mental health care givers. It is common in about 1.3% of the already treated cases of mental illness or more than two million people (U.S. Department of Health and Human Services [USDHHS] 1999). Its economic cost is envious. Direct cost of relapse treatment expenses of most psychiatric illness were estimated 2.5% of the total treatment of first hand mental illness care budget in 1998 (American Psychiatric Association [APA] 2000).
The last year for which these data were available (USDHHS, 1999). In 1997, this accountant for $23.6 billion of mental health care dollar spent. The indirect cost such as lost of wages, premature death and incarceration were estimated to be $46 billion in the first half of 1998 (APA, 2000).
Further unemployment among permanent disability is 10% (APA 1998). The cost relapse in terms of individuals and family suffering are probably inestimable.
Despite the current trend in modern treatment, there is still an alarming rate of relapse and the reoccurrence of psychiatric illness globally. Individual who ought to be productive and responsible in life are wasting away on daily basis.
Today patients are required to stay for a short period of time in the hospital admission and discharge to home environment to help reduce dependency on the hospital care and reducing relapse. Also this helps to reduce stigmatization and prevent complications (Feyinsayo, A. 2009). This study will attempt an overview of Nurse and also to show how proper utilization of psychiatric Nursing service will go a long way in reducing and eradicating the ever growing cases of relapse among psychiatric patients in Federal Neuropsychiatric Hospital Barnawa, Kaduna.
1.2 Statement of Problem
The frequency of patients having readmission into the hospital over the last few years has become a problem. This has made the achievement of good control of patients’ symptoms and cure impossible.
Nursing Staff and the Hospital has suffered frustration seeing the readmission of patients, whom were recently discharged home after being stabilized on admission. Some patient relapse as soon as they are discharged home. Other on trials discharge relapse while other still relapse while on admission. Various factors ranging from financial problems, lack of adequate staff have contributed to the relapse of patients.
Some patients have about a day or two days journey distance to the hospital resulting in poor monitoring and accessibility to the mental health services. Other factors also include stigmatization and dependency on care giver. All these have contributed in the frequency of relapse experienced in the care of these groups of patient leading to the social disability.
Hence, resulting in the following:
a) Low manpower
b) Untold hardship
c) Financial constraints
d) Societal nuisance
If not properly handled and solutions found, the economy may suffer and the society will be at a loss apart from the untold hardship. This is what motivated the researcher to investigate the cause, give suggestions, remedy the situation and also reduce the high rate of relapse.
1.3 Objective of the Study
1. To evaluate the relationship between the educational background of the Nurses and their attitude towards prevention of relapse.
2. To ascertain he relationship between the status of the Nurse and her ability to prevent relapse among psychiatric patients.
3. To determine the relationship between the experience of the Nurse and their ability to identify symptoms of relapse.
4. To find out whether poverty can predispose psychiatric patient to relapse.
5. To determine the relationship between drug compliance among psychiatric patient and relapse prevention.
1.4 Significance of the Study
The significance of this study is to help Nurses develop a positive attitude towards the care to the psychiatric patient thereby reducing the incidence of relapse.
1.5 Research Questions
1. What is the relationship between the educational background of the Nurse and their attitude toward relapse prevention?
2. What is the ability of the Nurse towards Relapse prevention among psychiatric patients?
3. What is the experience of the Nurse toward identifying symptoms of relapse?
4. Can poverty predispose psychiatric patients to relapse?
5. Can drug compliance prevent relapse among psychiatric patient?
1.6 Scope of the Study
The scope of this study is restricted to Federal Neuropsychiatric Hospital Barnawa Kaduna which is one of the tertiary healthcare institutions owned by the federal Government of Nigeria.
1.7 Limitation of the Study
Financial Constraint as there is no adequate Funds.
The limitations of this study were due to lack of time due to the limited time within which the study had to be carried out.
1.8 Operational Definition of Terms
1. Attitude: The way you think and feel about something.
2. Disability: Any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being.
3. Management: The process of treatment or control of disease or disorders or the care of patient who suffer them.
4. Nurse: A person whose job is to care for people who are ill.
5. Psychiatric Nursing: This is a branch of medicine that deals with the prevention, treatments, diagnosis, cause of mental illness.
6. Prevention: To keep away from happening or arising of stop from occurring.
7. Psychiatric Patient: Person who suffers from mental illness which could be minor or major.
8. Rehabilitation: Restore to effectiveness or normal life by training especially after illness.
9. Relapse: The return of disease after an interval of convalescence.
REVIEW OF LITERATURE
This chapter deals with the review of relation literature and is based on Attitude of Nurse toward Relapse Prevention among psychiatric patients in Federal Neuropsychiatric hospital Barnawa and in this chapter also it covers:
1. Conceptual Framework
⦁ Background of the Study
⦁ Concept of Attitude
⦁ Causes of Relapse
⦁ Phases of Psychiatric Illness
⦁ Types of Relapse
⦁ Prevention of Relapse among Psychiatric Patients
2. Theoretical Framework
⦁ Cognitive Behavioral Framework
⦁ Problems of Immediate Gratification
⦁ Abstinence Violation Effect