Factors influencing knowledge about childhood autism among final year undergraduate Medical, Nursing and Psychology students of University of Nigeria, Enugu State, Nigeria

<p>Abstract</p> <p>Background</p> <p>Knowledge and awareness about childhood autism is low among health care workers and the general populace in Nigeria. Poor knowledge about childhood autism among final year medical, nursing and psychology students who would form tomorrow's child health care professionals can compromise early recognition and interventions that are known to improve prognosis in childhood autism. Educational factors that could be influencing knowledge about childhood autism among these future health care professionals are unknown. This study assessed knowledge about childhood autism among final year undergraduate medical, nursing and psychology students in south-eastern Nigeria and determined the factors that could be influencing such knowledge.</p> <p>Methods</p> <p>One hundred final year undergraduate students were randomly selected from each of the Departments of Medicine, Nursing Science and Psychology respectively of University of Nigeria, Enugu State, Nigeria making a sample size of three hundred. A socio-demographic questionnaire and knowledge about childhood autism among health workers (KCAHW) questionnaire were administered to the students.</p> <p>Results</p> <p>The total mean score for the three groups of students on the KCAHW questionnaire was 10.67 ± 3.73 out of a possible total score of 19, with medical, nursing and psychology students having total mean scores of 12.24 ± 3.24, 10.76 ± 3.50 and 9.01 ± 3.76 respectively. The mean scores for the three groups showed statistically significant difference for domain 1 (p = 0.000), domain 3 (p = 0.029), domain 4 (p = 0.000) and total score (p = 0.000), with medical students more likely to recognise symptoms and signs of autism compared to nursing and psychology students. The mean score in domain 2 did not show statistically significant difference among the three groups (p = 0.769). The total score on the KCAHW questionnaire is positively correlated with the number of weeks of posting in psychiatry (r = 0.319, p = 0.000) and the number of weeks of posting in paediatrics (r = 0.372, p = 0.000). The total score is also positively correlated with the number of credit hours of lectures in psychiatry/abnormal psychology (r = 0.324, p = 0.000) and the number of credit hours of lectures in paediatrics (r = 0.372, p = 0.000). The field of study also influenced knowledge about childhood autism (p = 0.000).</p> <p>Conclusion</p> <p>Peculiar situation in this environment as signified by inadequate human resources needed in the area of clinical psychology training often times necessitates employing first degree graduates in psychology into clinical positions. This calls for additional exposure of the undergraduate psychology students to training curriculum aimed at improving their early recognition of symptoms of autism spectrum disorders in this environment.</p

Availability of and barriers to the utilization of harm reduction services in Enugu, south-eastern Nigeria: Service providers’ perspective

The study aimed to determine the availability and barriers to the utilization of three Harm Reduction Strategies (HRS) in Nigeria from service providers’ perspective. This study was a descriptive survey using questions adapted from the harm reduction questionnaire. Eight institutions involved in the drug treatment services in Enugu, South-Eastern Nigeria participated. Only 25% of the agencies did not practice HRS in any form. The commonest internal and external barriers were lack of funding and community resistance, respectively. The heads of the agencies rated themselves and the community unfavorable to accepting HRS generally. However, with regards to specific HRS, they were more favorable to methadone replacement therapy, controlled drinking and condom sharing. The findings of this study enriched our understanding of the various impediments to the utilization of HRS in Enugu, Nigeria. Keywords: Availability; barriers; utilization; harm reduction; services; service providers, Nigeri

Awareness and Acceptance of Harm Reduction Services in a Nigerian Psychiatric Hospital: Patients’ and Family Caregivers’ Perspective

Introduction: There are burgeoning data on harm reduction services (HRSs) as a viable alternative to the traditional means of dealing with substance abuse in the developed countries. Despite the numerous benefits, its awareness and acceptability in developing economies such as Nigeria have been constrained by sociocultural and political factors. However, the specific patients’ and caregivers’ barriers to its uptake have not been evaluated in Nigeria. Aim: This study aimed to examine the awareness and acceptability of HRS among patients and caregivers in Enugu, South‑Eastern Nigeria. Materials and Methods: This study was a descriptive survey of patients with substance use disorders and their family caregivers at Enugu. Awareness and acceptance of HRS were assessed using questions adapted from the harm reduction survey. Results: The majority of patients and caregivers (76.5% and 88.2%, respectively) were not aware of HRS.&nbsp; Compared to family caregivers, the patients were more likely to rate themselves more favourably disposed to accepting HRS (U = 2750.00, p &lt; 0.001). The common reasons given for accepting HRS among the patients were centered on autonomy and the unrealistic nature of abstinence. The reasons for&nbsp; rejection by family caregivers were hinged on encouraging use, community resistance, and scandals to the family. Conclusion: This study highlighted the low awareness of both patients and their caregivers to the availability of HRS as a treatment option in Nigeria. It is hoped that these findings will provide some invaluable data to policy makers and clinicians in designing policies and in public education to improve service utilization by the public

Socio-demographic correlates of treatment response among patients with schizophrenia in a tertiary hospital in South-East Nigeria.

Background: Many patients with schizophrenia respond poorly to antipsychotic medication. Few studies have systematically examined the relationship of social and demographic characteristics of these patients to treatment response in our environment. Objective: To identify the social and demographic variables associated with treatment response in patients with schizophrenia. Method: A total of 172 participants with a diagnosis of schizophrenia receiving antipsychotics took part in the study. Participants were consecutively recruited involving patients presenting for the first time, or relapsed patients who had stopped antipsychotics in the previous six months. Both in-patients and out-patients who met the inclusion criteria were studied. Socio-demographic interview schedule and the Positive and Negative Syndrome Scale (PANSS) were administered at the initial encounter and between 4 and 6 weeks, subsequently. Results: Defining good treatment response as 65 20% reduction in PANSS score, 68% had a good response while 32% had poor response. Good response to treatment was associated with late age of onset of illness, satisfactory family relationship, acquisition of skilled occupation and being married. However, there was no association between treatment response and gender. Conclusion: Knowledge about these variables in relation to treatment response would improve mental health services as regards articulation of prognosis and psycho education

Relationship between religiosity, religious coping and socio-demographic variables among out-patients with depression or diabetes mellitus in Enugu, Nigeria.

Background: Religion is a powerful coping strategy. Diabetes and depression are common conditions in our environment that induce psychological distress, thus requiring coping for better outcome. Studies indicate that increased religiosity is associated with better outcome in clinical and general populations. Therefore, studies of the distribution of religiosity and religious coping among these populations are essential to improve outcome. Objectives: To assess the association between religiosity, religious coping in depression and diabetes mellitus, and selected sociodemographic variables (age, gender and occupational status). Methods:Using simple random sampling we recruited 112 participants with diabetes and an equal number with depression consecutively, matching for gender. Religiosity was determined using religious orientation scale (revised), religious coping with brief religious coping scale and socio-demographic variables with a socio-demographic questionnaire. Results: Intrinsic religiosity was greater among older people with depression than among older people with diabetes(t=5.02,p&lt;0.001); no significant difference among young people with depression and diabetes(t=1.47,p=0.15).Positive religious coping was greater among older people with depression than among older people with diabetes(t=2.31,p=0.02); no difference among young people with depression and diabetes(t=0.80,p=0.43). Females with depression had higher intrinsic religiosity scores than males with depression(t=3.85,p&lt;0.001); no difference in intrinsic religiosity between females and males with diabetes(t=0.99,p=0.32).Positive religious coping was greater among participants with diabetes in the low occupational status(t=2.96,p&lt;0.001) than those in the high occupational status. Conclusion: Religion is indeed a reliable coping method, most commonly used by the elderly and females with depression. Positive religious coping is more common among diabetic patients who are in the low occupational status

Assessment of knowledge about childhood autism among paediatric and psychiatric nurses in Ebonyi state, Nigeria

<p>Abstract</p> <p>Background</p> <p>There is increasing public and professional awareness of autism spectrum disorders with early recognition, diagnosis and interventions that are known to improve prognosis. Poor knowledge about childhood autism among paediatric and psychiatric nurses who are members of multidisciplinary teams that care for such children may be a major barrier to early interventions that could improve quality of life and prognosis in childhood autism. Factors that influence knowledge about childhood autism among these nurses are not known. This study assessed knowledge about childhood autism among paediatric and psychiatric nurses in Ebonyi state, Nigeria and determined the factors that could be influencing such knowledge.</p> <p>Methods</p> <p>Forty specialist paediatric and forty psychiatric nurses, making a total sample of eighty, were randomly selected from all the health care facilities in Ebonyi state, Nigeria. A socio-demographic questionnaire and knowledge about childhood autism among health workers (KCAHW) questionnaire were administered to them and the study was a point survey.</p> <p>Results</p> <p>The total mean score on the KCAHW questionnaire among the nurses that participated in the study was 12.56 ± 3.23 out of a total of 19 possible. The mean score for the paediatric nurses was 11.78 ± 3.64 while psychiatric nurses had mean score of 13.35 ± 2.58. The mean scores in Domain 1 were 6.17 ± 1.75 for the paediatric nurses and 6.52 ± 1.43 for the psychiatric nurses. The mean scores in Domain 2 were 0.65 ± 0.48 for the paediatric nurses and 0.80 ± 0.41 for the psychiatric nurses. Domain 3 showed mean scores of 1.97 ± 1.25 for the paediatric nurses while psychiatric nurses scored 2.62 ± 1.23. Domain 4 yielded the mean scores of 2.97 ± 1.54 and 3.42 ± 0.98 for the paediatric and psychiatric nurses respectively.</p> <p>There was significant relationship between the total mean score on the KCAHW questionnaire for the two groups and the area of specialisation of the nurses (t = -2.23, df = 78, p = 0.03) and there was also significant relationship between previous involvement in managing children with childhood autism as a specialist paediatric or psychiatric nurse and the total mean score on the KCAHW questionnaire (t = 6.90, df = 78, p = 0.00).</p> <p>Conclusion</p> <p>The scores reflect deficits in knowledge about childhood autism among the study cohorts. Paediatric and psychiatric nurses as members of multidisciplinary teams that care for children with childhood autism are expected to provide holistic care and adequate counselling to the families of these children. Unfortunately in this environment, they are not fully equipped with enough knowledge about childhood autism. Education on childhood autism is therefore needed and can be provided through continuing medical education and emphasizing childhood autism in their training curriculum. This will enhance early identification and diagnosis of childhood autism with early interventions that are known to improve prognosis.</p

Medical education in the COVID-19 era: A qualitative study of impact on and implications for a low-income country

Background: Medical education is fundamentally an extremely rigorous process. In Nigeria, facility shortage and schedule disruption following&nbsp; recurrent strikes, insecurity and political uncertainties adversely affect medical education. COVID-19 pandemic and associated restrictive&nbsp; containment measures worsened the disruption. In response to these disruptions due to the restrictions imposed for the pandemic, institutions&nbsp; including Nigerian schools devised various modifications to how they deliver education to ensure continuation while the pandemic lasts. Our school,&nbsp; Enugu State University College of Medicine introduced online learning. The objective of this study was to ascertain clinical lecturers' and&nbsp; clinical-level medical students' perception about the impact of COVID-19 pandemic and associated nonmedical containment measures on medical&nbsp; education and implications for our country. Methods: We conducted a qualitative study using focus group discussion involving clinical lecturers and clinical-level medical students. Two focus&nbsp; groups were recruited and constant comparison analytical method used. Results: Participants believed that online learning will be ineffectual due to poor electricity supply, inadequate internet infrastructure and poor&nbsp; access by students. They also agreed that suspension of training was an extreme response which could worsen prevailing poor medical manpower,&nbsp; cause anxiety and stress for students and multiply financial burdens for parents. Participants suggested that government synergized with&nbsp; information technology companies to provide internet access to universities; use of recorded videos for the delivery of education and computer&nbsp; based testing (CBT) for some examinations. Conclusion: Medical education is prone to disruptions by health-related crisis. Relevant authorities should explore the possibilities of remote&nbsp; learning and problem-based learning among other interventions to ensure continuation of medical education in such situations.&nbsp

Perception of Nigerian healthcare professionals about substance abuse and their willingness to seek substance related help: a pilot study

Background: With the poor health indices in most developing countries, the consequences of substance abuse by healthcare professionals are grave. While studies from western countries observed that a significant proportion of healthcare professionals abuse substances; and are less likely to seek help, the prevalence is largely unknown in Nigeria. The healthcare professionals in this region poorly perceive the problem and thus, are unwilling to seek help.Objective: This study aimed to assess the prevalence and patterns of abuse of substances by healthcare professionals in a Nigerian tertiary health institution; their perception of substance abuse and willingness to seek help. Methodology: This was a cross-sectional study of 149 healthcare workers who were screened for substance abuse using the alcohol, smoking and substance involvement screening test (ASSIST) version 3. Their perception and willingness to seek help were assessed using questions developed by the researchers based on literature.Results: Excess workload/stress of work was perceived as the most common reason for abusing drugs. Overall, substance abuse was perceived as a mental health problem. However, those that abuse substances more readily perceived it as a habit problem rather than a mental health challenge. Moreover, there was lower readiness to seek and pay for treatment among them.Conclusion: The study has brought to the fore the need to provide mental health education especially to healthcare professionals and to expose them to healthier methods of coping with stress.Keywords: Addiction, medical personnel, screening, treatmen