1.1 Introduction
The psychiatric patient, in the minds of the Nigerian public, is responsible for their illness, especially when it is an alcohol and/or substance-related problem. This belief denies them the sympathy and understanding traditionally bestowed on the sick in African society (Ewhrudjakpor et al., 2009; Gureje et al., 2005). Moreover, it is the belief of most people in Nigerian society that psychiatric illnesses are afflictions caused by supernatural forces and, as such, require care by traditional and syncratic religious healers, rather than orthodox care (Ewhrudjakpor et al., 2009). Misunderstanding of psychiatric illnesses by the public as outlined above robs the psychiatric patient of, among other things, provision of satisfactory mental and physical healthcare services, even in the tradocultural context (Minas et al., 2009).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 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 problems 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).
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). 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, Aro in Abeokuta Area of Ogun State.
1.3 Statement of Problems
Investigation revealed that 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 relapses as soon as they are discharged home. Other on trials discharge relapses 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: Low manpower, Untold hardship, Financial constraints and 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.
1.4 Aim and Objectives of Study
The aim of the study is to examine the Attitude of Nurses towards Relapse Prevention Among Psychiatric Patients in Federal Neuropsychiatric Hospital. In achieving this aim, the following specific objectives were laid out as follows:
- To evaluate the relationship between the educational background of the Nurses and their attitude towards prevention of relapse;
- To determine the relationship between the experience of the Nurse and their ability to identify symptoms of relapse;
- To examine the relationship between drug compliance among psychiatric patient and relapse prevention;
- To find out whether poverty can predispose psychiatric patient to relapse; and
- To ascertain the relationship between the status of Nurse and her ability to prevent relapse among psychiatric patients.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- Can poverty predispose psychiatric patients to relapse?
- Can drug compliance prevent relapse among psychiatric patient?
- What is the ability of the Nurse towards Relapse prevention among psychiatric patients?
- What is the experience of the Nurse toward identifying symptoms of relapse?
- What is the relationship between the educational background of the Nurse and their attitude toward relapse prevention?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant relationship between the educational background of the Nurse and their attitude toward relapse prevention.
- H1: There is a significant relationship between the educational background of the Nurse and their attitude toward relapse prevention.
Hypothesis Two
- H0: Nurses have no significant experience toward identifying symptoms of relapse.
- H1: Nurses has significant experience toward identifying symptoms of relapse.
1.7 Significance of Study
This study will provide information on the general attitude of Nigerians particularly health workers towards the mentally sick. Also, it will increase the knowledge of people on mental illness in general and correct all misconceptions about the disease and prompt governments and non-governmental agencies efforts in making more readily available resources for treatment facilities and rehabilitation of mentally ill persons.
This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.
1.8 Scope of Study
The scope of the research is focused on the Attitude of Nurses towards Relapse Prevention among Psychiatric Patients in Federal Neuropsychiatric Hospital, Aro. Hence, this study is limited in scope to Abeokuta area of Ogun State as other locations will not be considered.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Establishment Policies: Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this project work. There were lots of information needed from the staffs of this establishment to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
- Research material: availability of research material is a major setback to the scope of the study.
- Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Definition of Terms
Attitude:
It is the manner, disposition, feeling, position, etc., with regard to a person or thing; tendency or orientation, especially of the mind.
Psychiatric Nursing:
This is a branch of medicine that deals with the prevention, treatments, diagnosis, and cause of mental illness.
Prevention:
To keep away from happening or arising of stop from occurring
Psychiatric Patient:
Person who suffers from mental illness which could be minor or major
Nurse:
A person whose job is to care for people who are ill
Rehabilitation:
Restore to effectiveness or normal life by training especially after illness.
Relapse:
The return of disease after an interval of convalescence.
Health Workers:
They are people whose job it is to protect and improve the health of their communities.
Management:
The process of treatment or control of disease or disorders or the care of patient who suffer them
Disability:
Any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being.
…
