ABSTRACT
The problem of every hospital when the targeted objective is not
achieved is that there is something wring either with health care givers, 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
CHAPTER ONE
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
CHAPTER TWO
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
CHAPTER THREE
METHODOLOGY
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
CHAPTER FOUR
4.0 Introduction - - - - - - - - 33
4.1 Data
Presentation - - - - - - - 33
4.2
Answering Research Questions - - - - - 47
4.3 Data
Analysis - - - - - - - - 49
4.4
Conclusion - - - - - - - - 53
CHAPTER
FIVE
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
CHAPTER ONE
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.
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