Assessment of Preoperative and Postoperative Anxiety: A Comparison of Two Measures in Elective Major Surgery Patients.

Background: Research on measurement of anxiety in patients booked for surgery in Nigeria is sparse, even though heightened anxiety levels in such patients is commonly observed. Aims: The aim of the study presented here was to compare two well established standard measures of anxiety, the Visual Analogue Scale(VAS) and the State Version of the State Trait Anxiety Inventory (STAI), in the measurement of anxiety in patients awaiting elective major surgery. Methods: Subjects booked for elective major surgery were consecutively recruited from the general surgery, orthopaedic sugery and gynaecology clinics of Wesley Guild Hospital, Ilesa, Osun state, Nigeria. A repeated measures design was used for the study.The VAS and STAI Scales were administered on the subjects the night before surgery and daily for each of the seven post operative days. Results:The VAS compared favourably with the STAI as a measure of anxiety in these patients especially in the post operative period. The pearson correlation coefficients, r, (VAS vs STAI) ranged from .29 to .55) demonstrating moderate concurrent validity in the measures. Analysis of scores for the two instruments using repeated measures ANOVA yielded equivalent results. Conclusion: The one-item VAS is a useful clinical tool for measuring anxiety in patients awaiting surgery. For some users it may require more than one administration to achieve mastery, however it compares favourably with the STAI in anxiety measurement. Setting up preoperative counseling clinics for patients booked for elective surgery may be useful in reducing preoperative anxiety.Key Words: Preoperative, postoperative, anxiety, elective surgery

Religious Coping and Caregivers Burden in Carers of the Mentally Ill In Nigeria: A study from a General Hospital Psychiatric Out- Patient Unit

Background: Nigeria with a population of over 140 million, has so many religious groupings.Despite evidence that people frequently turn to religionfor support in the face of adversity, there are no studies examining the prevalence of religious coping in the carers of the mentally ill in Nigeria.  The association between religious coping and burden levels in these caregivers has also not been assessed. Aim: The study investigated theprevalence of religious coping in caregivers of patients with mental illness, and the association between burden and religious coping. Methods: The burden of mental illness and religious coping was studied using standard instruments. Eighty four caregivers and their relatives recruited from the psychiatric out patient clinic of Wesley Guild Hospital, Ilesa, Osun, State,Nigeria, took part in the study. Results: Fifty four participants  (64.3%) agreed to having received spiritual support in dealing with relative’s illness within past 3 months prior to research contact. Perceiving spiritual and religious beliefs as important in dealing with illness had significant negative correlations with financial burden scores (r=-0.31;P=0.004),burdensome effects on family leisure(r=-0. 23; P=0. 04), effects on family interaction(r=-0. 25;P=0.02) , and total burden score (r=-0.24;P=0.03). However receipt of religious or spiritual support was positively correlated with disruption of family routine, and this was significant (r=+0.30;P=0.007). There were significant positive correlations betweenfrequency of prayers and financial burden(r=+0.35;p=0.001);frequency of visit to religious leaders and effects on family routine(r=+0.32;P=0.003);increased attendance at religious activities and disruption of family routine(r=+0.21;P=0.05). All items of religiosity had negative correlationswith caregiver anxiety, but was significant only with increased attendance at religious activities(r=-0.21- ;P=0.05). Even though we had negative  correlations between caregiver depression and items of religiosity, they did not reach statistical significance. Conclusion: Spiritual leaders or the clergy form part of a patients’ social network, and they are frequently consulted in times of illness/distress. There is therefore a need for mental health professionals to involve faith communities in caregiver intervention research

Reliability and Validity of a Satisfaction Scale in a Nigerian Psychiatric Out-Patient Clinic.

Background :There are no reports from Nigeria of assessment of patients\' satisfaction with outpatient psychiatric services. Aim:The reliability and preliminary validity of the Charleston Psychiatric Outpatient Satisfaction Scale (CPOSS) was investigated in a Nigerian population . Method:The CPOSS was administered to 220 patients seen at the psychiatric clinics of the Obafemi Awolowo University Teaching Hospital , Ile-Ife, Nigeria. They completed this 15 item self-rated instrument that assesses patient satisfaction with services using a 5 point response format. Results:The internal consistency for the scale was high ( a=0.91), and item total correlations ranged between 0.33 to 0.70. Its convergent validity was supported by significant correlations of all items with the overall scale score,with a range of 0.30 to 0.68( Pearson\'s r). Mean scores for items except “ parking area” ranged from 3.0 to 3.7. Bivariate correlations for all items except item “13” ‘parking\' showed significant associations.Seventy one percent of clients rated that they would definitely recommend the service to friends or family members. Subjects were most dissatisfied with time waiting to be seen . Conclusions:These results provide preliminary evidence for the reliability and validity of the scale in a Nigerian outpatient psychiatric clinic service Keywords: Patients' Satisfaction Scale, Psychiatric Care, Nigeria Nigerian Journal of Psychiatry Vol. 6 (1) 2008: pp. 31-3

Violence Against Mental Health Staff in Nigeria: Some Lessons from Two Mental Hospitals

Background: Psychiatric patient violence against staff is frequentlyencountered in mental health settings. Studies from Africa and Nigeria inparticular are few.Aim: The study aimed at comparing the frequency and type of physicalassaults by individuals with mental illness against staff working in twomental hospitals in Nigeria with a view to identifying some staff contextualvariables that could predispose them to these assaults.Methods: The study was a crosssectional descriptive report by questionnaire survey of physical assaults on 189 staff members(doctors and nurses) working at the Federal Neuropsychiatry Hospital,Yaba (FNHY), Lagos and Federal Neuropsychiatry Hospital Calabar(FNHC), Nigeria.Results : One hundred and twelve participants from the two hospitalswere victims of 202 assaults. Staff of FNHC experienced more assaults(70.4%) than staff of FNHY (49.5%), and this was significant. Nursing staffwere more frequently assaulted than doctors for the two hospitals. Eventhough staff of FNHC attended fewer courses on management andprevention of violence than staff of FNHY, not having received training inmanaging patient violence and gender were not significant risk factors forexposure to patient violence in a multivariate analysis.Conclusion. There is a need to formulate policies and guidelines forthe management and prevention of psychiatric patient violence againststaff in our mental health institutions