ASSESSMENT OF RELAPSE PREVENTION AMONG PSYCHIATRIC

PATIENTS BY NURSES IN AHMADU BELLO UNIVERSITY TEACHING

HOSPITAL SHIKA-ZARIA, NIGERIA

*BALARABE, F., ISA, A. AND ADAMU, A. U.

Department of Nursing Sciences, Faculty of Medicine, Ahmadu Bello University, Zaria.

ABSTRACT
The purpose of this study was to determine the attitude of nurses towards relapse prevention among
psychiatric patients of Ahmadu Bello University Teaching Hospital (ABUTH),Shika, Zaria. A descriptive
survey design was used for the study. Questionnaire was used as instrument for data collection among 20
respondents working in the psychiatric ward of ABUTH and all the 20 questionnaires were retrieved. Data
were analyzed using frequency distribution tables, and chi-square. Findings from the study revealed that 60%
of the respondents had agreed that educational background of the nurses affected their attitude towards
relapse, 75% agreed that nurses have the ability to prevent relapse, 85% held that the experience of nurses
helps to identify symptoms of relapse, 95% agreed that nurses have the ability to identify a relapsed patient,
90% agreed that poverty predispose psychiatric patient to relapse and 90% agreed that compliance to drug
prevents relapse. The hypothetical tests revealed that the relationship between educational background of
nurses and their attitude towards prevention of relapse was insignificant (P>0.05; X2=2.97). Alsothe
relationship between the experience of nurses and their ability to identify symptoms of relapse
wasinsignificant(P>0.05;X2=0.22). It can therefore be concluded that nurses in Ahmadu Bello University
Teaching Hospital Shika-Zaria have the ability of preventing relapse among psychiatric patients because they
are well trained in the area of psychiatry.

Key words: Attitude, nurses, mental illness, prevention, relapse.

*Correspondence: [email protected]

INTRODUCTION admission. Some patients relapse as soon as they are

discharged home. Others on trial discharge relapse while
Psychiatric illness has fascinated and confounded healers, others still relapse while on admission. Various factors
scientists and philosophers for centuries. Its symptoms ranging from financial problems, lack of adequate staff
have been attributed to possession by demons considered to have contributed to the relapse of patients. Some patients
be punishment by the gods for the evil done or accepted as have about a day or two days journey distance to the
evidence of the inhumanity of its sufferer victims [1]. hospital resulting in poor monitoring and accessibility to
These resulted in enduring stigma for those who were the mental health services. Other factors also include
diagnosed with such disorders. Even today, much of the stigmatization and dependency on care giver. All these
stigma persist although it has less to do with demonic have contributed in the frequency of relapse experienced in
possession than with society’s unwillingness to shoulder the care of these groups of patient leading to the social
the tremendous cost associated with mental illness[2]. disability [7], and hence resulting in untold hardship,
Relapse is one of the most severe problems of mental financial constraints, and societal nuisance.
illness. It is common in about 1.3% of the already treated This study was aimed to determine the attitude of
cases of mental illness or more than two million people [3]. nurses towards relapse prevention among psychiatric
The cost of relapse in terms of individuals and family patients in Ahmadu Bello University Teaching Hospital
suffering are probably inestimable [3]. Shika, Zaria, relative to our hypothesis that there is no
Despite the current trend in modern treatment, significant relationship between attitudes of nurses and
there is still an alarming rate of relapse and the relapse prevention among psychiatric patients.
reoccurrence of psychiatric illness globally. Individual who
ought to be productive and responsible in life are wasting MATERIALS AND METHODS
away on daily basis [4]. Today patients are required to stay
for a short period of time in the hospital and discharge to Descriptive survey design was adopted for this study,
home environment to help reduce dependency on the which also involved the administration of structural
hospital care and reducing relapse. Also this helps to questionnaire to the respondents as instrument for data
reduce stigmatization and prevent complications [5]. collection.The target population were nurses in psychiatric
The frequency of patients having readmission into ward of Ahmadu Bello University Teaching Hospital
the hospital over the last few years has become a problem. Shika, Zaria. The total number of nurses in psychiatric unit
This has made the achievement of good control of patients’ were twenty (20), it was all unanimously agreed that if the
symptoms and cure impossible [6]. Nurses suffered population of the study is less than hundred (100) all the
frustration seeing the readmission of patients, whom were subjects should be used as sample of the study [8].The data
recently discharged home after being stabilized on collected was analyzed using a descriptive statistical

Nigerian Journal of Scientific Research, 15(1): 2016; January-April; njsr.abu.educ.ng

Balarabe et al. (2016); Relapse prevention among psychiatric patients by nurses

method where frequency distribution table was used and

chi-square to test the hypothesis stated at p = ( 0 .05) level
of significance.

RESULTS Table 2: Relationship between educational background of

nurses and their attitude towards relapse
The results was analyzed and presented using frequency prevention
table and Chi-square test, differences were regarded as Variable Educational Attitude of nurses Total
significant with P< 0.05. background towards relapse
of Nurses prevention
Table 1: Socio-demographic variables Agree 12 17 29
Variable Frequency Percentage (%) Disagree 8 3 11
(1) Sex Total 20 20 40
(a) Male 3 15% X2= E (Oi-Ei)2/Ei
(b) Female 17 85%
Total 20 100% From table 2 above, the calculated X2=2.97 on 1 degree of
(2)Age (years) freedom. Here tabulated chi-square on 1 degree of freedom
(a) 20-30 8 40% at 5% is 3.84. Do not reject Null hypothesis if P>0.05,
(b) 31-40 4 20% therefore association between educational background of
(c) 41-50 5 25% nurses and their attitude towards relapse prevention was
(d) 51 and above 3 15% statistically insignificant.
Total 20 100%
(3) Marital status Table 3: Relationships between the status of nurses and
(a) Single 8 40% their ability to prevent relapse among psychiatric
(b) Married 12 60% patients
Total 20 100% Variables The status Nurses ability to Total
(4) Religion of nurses. prevent relapse.
(a) Muslim 8 40% Agree 12 15 27
(b) Christian 12 60% Disagree 8 5 13
Total 20 100% Total 20 20 40
(5) Professional Rank X2= E (Oi-Ei)2/Ei
(a) CNO 4 20%
(b) ACNO 3 15% From table 3 above, the calculated X2=0.67 on 1 degree of
(c) SNO 3 15% freedom. The calculated chi-square is smaller than the
(d) NO 10 50% tabulated chi-square and therefore P>0.05. Here tabulated
Total 20 100% chi-square on 1 degree of freedom at 5% is 3.84. Do not
(n=20) reject Null hypothesis if P>0.05, therefore association
between status of nurses and their ability to prevent relapse
From Table 1 above, it shows that 3 (15%) of the among psychiatric patients was statistically insignificant.
respondents were Males while most of the respondents
were 17 (85%) are Females. It also shows that, 8 (40%) of Table 4: Relationship between the experience of nurses
the respondents were within the ages of 20-30 years, 4 and their ability to identify symptoms of relapse
(20%) were within the ages of 21-40 years, 5 (25%) were Variable The Nurses ability to Total
within the ages of 41-50 years, while 3 (15%) were within experience of identify the
the ages of 51 years and above. It therefore shows that, nurses. symptoms of relapse
most of the respondents were between the ages of 20-30 Agree 17 19 36
years. Disagree 3 1 4
More than half 12 (60%) of the respondents were Total 20 20 40
married, 8 (40%) were single, while none were divorced. X2= E (Oi-Ei)2/Ei
Most of the respondents 12 (60%) were Christians, 8 (40%)
From table 4 above, the calculated X2=0.22 on 1 degree of
were Muslims, while none were others. It also shows that, 4
freedom. The calculated chi-square is smaller than the
(20%) of the respondents were Chief Nursing Officers
tabulated chi-square and therefore P>0.05. Here the
(CNO), 3 (15%) were Assistant Chief Nursing Officers
tabulated chi-square on 1 degree of freedom at 5% is 3.84.
(ACNO), 3 (15%) were Senior Nursing Officers (SNO),
Do not reject Null hypothesis if P>0.05, therefore
and 10 (50%) were Nursing Officers (NO) that is half of
association between the experience of nurses and their
the respondents were Nursing Officers (NO).
ability to identify symptoms of relapse was statistically
insignificant.

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Balarabe et al. (2016); Relapse prevention among psychiatric patients by nurses

Patient can breakdown due to non-tolerance to the

drug and their effectiveness while adherence to drug
regimen prevent relapse [11]. Non-compliance with
medications is commonly related to the frequency of re-
Table 5: Methods of preventing relapse hospitalization [12]. In addition, non-compliance with
Variables Frequency Percentage medication, lack of proper follow-up and keeping
(%) appointment is the major factor that contributes to relapse
(a) Referral of cases from 2 10% among psychiatric patients [13]. Relapse can be effective
community to hospital through referral of cases from community to hospital, by
(b) By employing the right 1 5% nurses by employing the right professional.
professional This study incorporates with others studies such as related
(c) By provision of 2 10% illness symptoms can be severe enough to disrupt daily
enough facilities activities or require unscheduled in-patient or out-patient
(d) All of the above 15 75% intervention [14]. Today patients are required to stay for a
short period of time in the hospital admission and discharge
From the table 4 above, it shows that 2 (10%) of the to home environment to help reduce dependency on the
respondents are of the view that by referral of cases from hospital care thereby reducing relapse, also this helps to
community to hospital, relapse of psychiatric conditions reduce stigmatization and prevent complications. It also
can be prevented, 1 (5%) choose by employing the right found out that if the general public bring relapsed
professionals, 2 (10%) choose by provision of enough psychiatric patients promptly to the hospital and the
facilities and 15 (75%) choose all of the above. patients are attended to promptly, that relapse rate will be
greatly reduced [14].
DISCUSSION
CONCLUSION
Findings from the study indicates that majority of the
respondents are females constituting 85% while male It was concluded that poverty predisposes psychiatric
nurses are 15%. Most of the respondents nurses fall within patient to relapse and also non-compliance with drugs can
the age range of 20-30 years 40%, 20% are within the increase incidence of relapse despite the fact that the
range of 31-40years, 25% are within the age of 41-50years hospital have trained psychiatric nurses.
while few fall within the range of 51years and above with
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