The Attitude of Health Workers Towards Relapse Prevention Among Psychiatric Patients
CHAPTER ONE
Objective of the Study
- To evaluate the relationship between the educational background of the Nurses and their attitude towards prevention of relapse.
- To ascertain he relationship between the status of the Nurse and her ability to prevent relapse among psychiatric patients.
- To determine the relationship between the experience of the Nurse and their ability to identify symptoms of relapse.
- To find out whether poverty can predispose psychiatric patient to relapse.
- To determine the relationship between drug compliance among psychiatric patient and relapse prevention.
CHAPTER TWO
REVIEW OF LITERATURE
Introduction
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:
- 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
- Theoretical Framework
- Cognitive Behavioral Framework
- Problems of Immediate Gratification
- Abstinence Violation Effect
- Conclusion
Conceptual Framework
Background of the Study
Psychiatric illness comprises of various disorder with some common features. These common features include disturbances in thinking and occupation with self and inner fantasies. The person with a psychiatric disorder may live in a private world. A world inhabited by voices that condemns or accuses the person vile acts and by vision of frightening. The person may be totally withdrawn from external environment and may be preoccupied with an internal fantasy life.
Mary Ann Boyd (2001) defined relapse as a return of the illness symptom which are severe enough tot disrupt daily activities or require unscheduled in patient or outpatient intervention.
Herz (1999) outlined five phases, relapse for psychosis, these are:
- Over Extension: In this phase, patients feel estranged from self and the environment. He/She no longer understands himself (depersonification).
- Boredom and Apathy:Patients become easily tired and withdrawn, there is a bit of clouding of consciousness here.
- Disinhibition:There is return of consciousness, patients has paranoid idea, accuses others etc.
- Disorganization:Patients becomes chaotic sees, hears and believes in all manner of things.
- Resolution:He no longer question beliefs but act on them.
According to Barbara Schoen Johnson (2000), Non-compliance with medications, indulging in alcohol and drug abuses are commonly related to the frequency of rehospitalizations. Clients education about the importance of the following medication regimes and abstaining from alcohol and other substances have been shown to lengthen the time between hospitalization.
CHAPTER THREE
METHODOLOGY
Introduction
This chapter deals with the method the researcher use to carry out the research study. It gives a detailed data and description of research design, setting, target population, sampling technique, instrument for data collection, validity of instrument, method of collecting data, data analysis and ethical consideration.
Research Design
Description survey method of research was adopted for this study .the prospective method of data collection was used which involved the administration of structural questionnaire to the respondent.
CHAPTER FOUR
Introduction
These chapters deal with the presentation of data and the analysis of data collection from the questionnaire to 100 respondents and were analyzed separately using simple percentage table and bar charts.
CHAPTER FIVE
Introduction
This chapter summarizes the discussion of finding, show the relationship of the research to other studies and the implication to Nursing. It also summarize the whole chapter showing the conclusion and recommendations. The study is based on the study conducted in Federal Neuropsychiatry Hospital Barnawa, Kaduna.
Discussion of Findings
The research carried out showed that Attitude of Nures towards relapse prevention among psychiatric patients in Federal Neuropsychiatry Hospital Barnawa Kaduna can play a greater role in reducing the cases of relapse among psychiatric patient. The finding revealed that there is high rate of relapse among psychiatric patient which is common cause of concern to patients, their relations and the general public as a whole. This fact has proven by this research work.
The finding also revealed that relapse affect both the receiving treatment in the hospital and patients after discharge, it was also observed that the majority of the respondent consented that relapse rate should be reduced.
Section A which carries the personal data of the respondent shows that female respondents were the majority which shows the dominance of female respondents in Federal Neuropsychiatry hospital Kaduna. This is shown in Table 1,Table 2 shows that majority of the respondent. Age range from 41-50years of age which shows that this age group is fill of experience in life and were useful in the compilation of the data. Section B respondent in chart 1 agreed that the educational background of the nurse can affect their attitude towards relapse prevention. Chart 2 also indicate that 80% of the Nurses attitude have significant role to play in relapse prevention.
Chart 3,4,5 shows how psycho education ,status of the Nurse and her ability can prevent relapse among psychiatric patient. chart 6 and 7 shows that majority of the respondent agreed that relapse among psychiatric patient can be prevented. Chart 8,9,10 agreed that poverty predisposes and affect the care of patient since they don’t have money for to maintain the care. Chart 11 shows that majority of the respondent agreed that rehabilitation can reduce the rate of relapse.
Chart 12,13,14,15, also agreed that drugs used in psychiatric are effective and patient don’t breakdown while on routine medication. Table 16,17 agreed that patient are well educated on the importance of keeping appointment while Table 17-20 shows that majority of the respondent agreed that the hospital has not formulated policies on prevention of relapse among psychiatric patient, Relapse prevention can be effective in the hospital. Misconception contributes to the relapse of psychiatric patient and also the Government does not subsidize drugs given to psychiatric patients.
Relationship with other Studies/Literature Review
This study incorporates with 0ther studies such as related illness symptoms can be severe enough to disrupt daily activities or require unscheduled in patient or outpatient intervention (Murphy and Moller 2002).
Non-compliance with medication, lack of proper follow-up and keeping appointments also are the major factors that contributes to relapse among psychiatric patients.(Barbara Scheon Johnson 2000).Also this study has investigated and found out that if the general public bring relapsed psychiatric patients promptly to the hospital and the patients attended to promptly that relapse rate will be greatly reduced (Denzin 1996).
Feyinsayo A.(2009), today patients are required to stay for short period possible of time in the hospital admission and discharge to home environment to help reduce dependency on the hospital care thereby reducing relapse. Also this helps to reduce stigmatization and prevents complication. Nursing care at the tertiary level of prevention can be administered on individual or group basis and in a variety of setting such as inpatient hospitalization.
Implication for Nursing
The nurse should advise patient on the importance of compliance and follow-up for continuity of care. The relatives should be encouraged to show love to the patients and they should be told the importance of incorporating the patients back into the family and community.
The patients should be advised to keep self occupied and stay away from the company that may influence them negatively especially if the relapse was as a result of drug abuse. Family therapy should be advised in order to prevent relapse because when the family is involve in the care of the patient, it reduce the rate to zero level.
The nurse should encourage rehabilitation from admission to discharge. This enables the patient to be engaged and productive in life and also help in the prevention of relapse.
Summary
The research study was carried out in response to the increasing relapse cases of psychiatric disorders in our society and also the attitude of nurses towards preventing relapse among psychiatric patient. Chapter one deals with introduction of the topic, objective of the study significance of the study, statement of the problem research question, scope, limitation and operational terms were used in this research. Chapter two and three looks at the view of others in relation to the topic of the research while chapter three dealt with the methodology of the research .chapter three and four also dealt with research design and method used. The population which is 100 samples and its also involved the analysis the data acquired in respect to the research questions.
Conclusion
In the course of the study, it was discovered that there are five(5) types of relapse namely primary, secondary, tertiary, partial and total relapse all of which have devastating effect on patients. It was shown in the study that the families and the hospital should be fully involved in the care of the patient in order to prevent relapse. It was also discovered that with frequent relapse rate the might be thrown out of jobs, be divorced.
Attitude of nurses towards relapse prevention plays a vital role in preventing relapse to occur. “prevention they say is better than cure “in line with this statement relapse like any other condition is preventable. Alongside drug therapy, avoidance of stressful situations and good family support systems are good preventive measures. Drug compliance also tremendously assists in the stability of the patient mental state. To this extent, the patient is health educated on the need to comply with drugs.
With proper management and care, the possible complication that may result from frequent relapse, can be reduce as much as possible.
Recommendations
- Nurse and other healthcare giver should enlighten the public on the causes and preventive methods of mental illness. This will help them know what to do and when to act when they come into contact with relapsed patient/patients with mental illness.
- The nurse should at every level of contact with patients relative should health educate them on the importance of active participation in the care of psychiatric patients taught the need of visiting psychiatric hospitals.
- Long hospitalization of patients should also be avoided in order not to make patient lose contact with home environment, community, friends and colleagues as this also trigger relapse.
- The government should formulate a policy to subsidize for drugs given to psychiatric patient as the prices of the drugs are on the increase and some of the patient are unable to buy them.
- The national mental health act should receive reviewed and proper implementation by the government agencies involved.
- Nurses should be send for training so as to be up to date and empowerment of more man power should be made.
- The occupational therapy departments should be well equipped with modernized equipments necessary for the rehabilitation of patients where some of them can learn new trades to practice when discharged from the hospital.
Recommendation for Further Studies
The research urges the general public particularly the health sector to embark on more study in order to reduce the rate of relapse among psychiatric patients.
REFERENCES
- Ademola, A. (2002). Basic Psychiatric Nursing, 2nd Edition. Nigeria: Manisha Printing Press, Ibadan.
- Boyd, M.N. (2001).Psychiatric Nursing: Contemporary Practice. 2nd edition, Lippincott.
- Burgess, A.W. (1997). Psychiatric Nursing Promoting Mental Illness, 3rd Edition. USA: Cappleton and Large Standford, Connecticut.
- Kaplan & Saddock (2005). Synopsis of Psychiatric Behavioral Science, Chemical Psychiatry. 9th edition, USA: Lippincott William and Wilkin, New York.
- Townsend, M.C. (2006). Psychiatric Mental Nursing, 5th edition. Philadelphia: F.A. Davis Company.
