الفهرس | Only 14 pages are availabe for public view |
Abstract ECT is a widely practiced treatment that is extremely effective for certain severe or resistant psychiatric conditions and has a mortality rate comparable to or lower than universally accepted antidepressant medication. Despite evidence that electroconvulsive therapy (ECT) is effective and safe, and leads to shorter and less costly inpatient treatment, it is rarely used as the first line of treatment and is generally reserved for older and resistant cases of depression and other psychiatric disorders. Certain factors such as social stigma, inadequate undergraduate training, doubts about its efficacy and safety, ambivalence among psychiatrists and doubts about its being a costeffective alternative to antidepressant treatment, might have limited the use of ECT in the management of depression. Aim of the study This study aims to assess the psychological distress, knowledge and attitude toward electroconvulsive therapy among family caregivers of mentally ill patients in Almamoura hospital. Summary 131 Research Question - What are the psychological stress, knowledge and attitude toward electroconvulsive therapy among family caregivers of mentally ill patients in Al-Mamoura hospital? Subjects and Methods The study portrayed under the four main designs as follows:- I- Technical design The technical design included research design, setting, subjects and tools for data collection. Research Design: A descriptive design was utilized in this study. Setting: This study was conducted at Almamoura hospital for mental health in Alexandria governorate. Subjects: A sample size included all available family caregivers of mentally ill patients who subjected to ECT (100). Inclusion criteria Exclusion Criteria: Family care givers who don‟t provide care to their mentally ill patients. Summary 132 Tools of data collection: I- Interviewing questionnaire sheet including four parts:- Part 1: Socio-demographic data: such as (age, residence, marital status and monthly income). Part 2: Knowledge of family caregivers toward ECT: It is designed by the researcher and valid and reliable questionnaire to assess their level of knowledge about indications, side effects, mechanism of action about ECT. Part 3: Attitude of family caregivers toward ECT: It is designed by the researcher to identify their thoughts, beliefs, holistic view toward ECT; it includes positive and negative statements with five Likert scale ranging from strongly agree to strongly disagree. Part 4: Psychosocial stressors of family caregivers toward ECT: It is designed by the researcher to assess psychosocial stress toward ECT. It consists of two parts first part to assess psychological stressors and the second part is designed to assess social stressors with five Likert scale ranging from strongly agree to strongly disagree. Summary 133 II- Operational design It included the preparatory phase, content validity, reliability, pilot study and field work. A) The preparatory phase It included reviewing of related literature and theoretical knowledge of various aspects of the study using books, articles, internet periodicals and magazines to develop tools for data collection. B) Content validity and Reliability: The tools used to assess knowledge; attitude and psychosocial stress toward ECT were valid and reliable tools and specifically designed to assess them. C) A Pilot study: Before performing the actual study, a pilot study was carried out on 10% of sample size to test clarity, efficiency and applicability of the tools. Field work: - The researcher introduced himself to family caregivers of mentally ill patients. The purpose of the study and how-to fill-in the questionnaire was explained to the caregivers who agreed to participate in the study prior to any data collection. Approval was obtained orally before Summary 134 taking socio-demographic data and after explaining purpose of the study. The family caregivers were assured that information collected would be treated confidentiality and it would be used only for the purpose of the research. The tools of data collection were filled in and completed by the researcher. The researcher was available 3 days/week morning shift (Sunday, Tuesday and Thursday) to collect data and implement this study. III- Administrative design An official permission letter to conduct the study was obtained from the faculty of nursing, Ain Shams University to the director of Almamoura hospital for mental health in Alexandria in which the study was conducted. IV- Statistical design The collected data was organized, analyzed using appropriate statistical significant tests. Ethical considerations Prior study conduction the ethical approval was obtained from scientific research, ethical committee of Faculty of Nursing, Ain-Shams University. An informed consent was obtained from each study subject. The researcher clarified the aim of the study to the participants who are Summary 135 included in the study. The researcher maintained confidentiality of participants’ data and gave them the choice to participate or not and the right to withdraw from the study at any time. Result: The results of the study revealed the following: the results showed that (75%) of the studied subjects were males (50%) were in age group (>40 ) yrs., (72%) of the studied subjects were married, (85%) were employed and their monthly income not sufficient while (74%) lived in urban places area,(42%) had a poor knowledge while (55%) had an average knowledge toward ECT, (60%) of family caregivers had a negative attitude toward ECT and (77%) had a high level psychosocial stress. There is a significant relation between knowledge and education monthly income and residence. There is a significant relation between level of attitude and education, occupation, and residence and there is a significant relation between knowledge and attitude. There is a significant relation between level of psychosocial stressors and education, monthly income and residence. Summary 136 Conclusion It is concluded that the family caregivers whose patients were subjected to ECT had a poor level of knowledge, a negative attitude and a high level of psychosocial stress toward ECT. There is a statistical significant relation between level of knowledge and their attitude in which highest knowledge is associated with positive attitude. Recommendations All the medical staff members should answer all the patients and their relatives question and providing them with the correct evidence based information to overcome their misconceptions. Regular in-service programs to provide nurses and family caregivers with updated necessary knowledge and practices about ECT. Channels of communication for expressing family caregivers’ feedbacks positive or negative should be available. Educational courses should be made for training instructors to increase the awareness and overcome misconceptions regard ECT. Summary 137 Increase the awareness and benefits of ECT could be through video films about ECT information developed by specialists and available through media to give enough information for patients and their relatives. Further studies are recommended to assess family caregivers’ psychosocial stressors knowledge attitude and identifying factors affecting them |