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INTRODUCTION
The theme of World Mental Health Day 2009 is Mental Health in Primary Care and it stresses the importance of identifying and treating mental illness in general health care settings. Mental health disorders continue to be a serious and expensive global health issue, affecting people of all ages and from all cultures and socio economic status.
SIGNIFICANCE AND NEED FOR THE STUDY In a study of a general medical clinic in an American hospital. It has been found that one third of psychiatric problems were undetected in medical patients [Brody et al., (1972)] This is for the first time in the history of nursing, a research has been carried out in assessing the prevalence of psychological morbidity among medically ill patients.
OBJECTIVES
To determine the prevalence of distress in patients admitted to non-psychiatric wards.
Cont.
To determine the prevalence of anxiety in patients admitted to non-psychiatric wards. To determine the prevalence of Somatization in patients admitted to non-psychiatric wards.
HYPOTHESES
There will be a significant association between
psychological
morbidity
and
selected
EXPLOITATION PHASE
Nurse researcher collects data on psychological morbidity by means of 4DSQ through interview schedule
RESOLUTION PHASE
Nurse researcher thank the medically ill patient
Interaction
Transaction
&
METHODOLOGY
RESEARCH APPROACH
Survey Approach
Descriptive Co relational Design Government Rajaji Hospital - Madurai
RESEARCH DESIGN
SETTING
Cont
STUDY POPULATION
SAMPLE
Cont.
SAMPLING SIZE SAMPLING TECHNIQUE Two Hundred and Ten Medically ill Patients
Stratified Random & Simple Random {Cardiology, Respiratory, Gastro-Enterology, Nephrology, Endocrinology and Infection Wards}
Part-II
RESEARCH TOOL
Part-I
Demographic Variables
Cont.
Part-II
1. Distress 2. Depression 3. Anxiety 4. Somatization Cronbachs Alpha scores {Distress 0.90. Depression 0.89. Anxiety 0.88 & Somatization 0.84} 5 Experts in the field of Psychiatry, Psychiatric Nursing and Clinical Psychology
RELIABILITY
VALIDITY
Cont..
PILOT STUDY
DATA ANALYSIS
Cont..
(43.4% of the samples with cardiac disorder suffered from moderately high level of depression. 10% of the samples with endocrinology disorder had very high depression) In anxiety, an overwhelming majority (97%) of the samples were under low level of anxiety were as only a very few (3%) are with moderately high level of anxiety. (16.6% of the samples with endocrinology disorder were under moderately high level of anxiety)
Cont.
An overwhelming majority of samples (93%) had low somatization, and very few (3%) of them had moderately high somatization. (16.6% of patients with cardiac disorder had moderately high somatization)
There was a statistically significant association between demographic variables like age [2 (48.1), (P<0.01***)], marital status [2 (7.6), (P<0.05*)], education [2 (62.2), (P<0.01***)], occupation [2 (6.0}, (P<0.05*)], social support [2 (11), (P<0.05*)], physical dependence [2 {25.4), (P<0.01***)] and distress of the medically ill patients.
Cont..
There was a statistically significant association between the demographic variables like age [2 (66.1), (P<0.01***)], marital status [2 (9.5), (P<0.02**)], education [2 (55.3), (P<0.01***)], monthly income [2 (13.7), (P<0.01***)], physical dependence [2 (10.3), (P<0.05*)], diagnosis [2 (28.2) (P<0.01***)], and the depression of the medically ill patients
Cont.
There was a statistically significant association between demographic variables like, age [2 (7.0), (P<0.01***)] and the anxiety of the medically ill patients. For other variables the association was insignificant. There was a statistically significant association between demographic variables like age [2 (11.9), (P<0.02**)] and education [2 (16.9), (P<0.05*)] and somatization of the medically ill patient.
Cont
There was a significant positive correlation between distress & depression (r = 0.8) distress & anxiety (r= 0.30) distress & somatization (r= 0.54) depression & anxiety (r= 0.42) depression & somatization (r = 0.57) and anxiety &
somatization (r = 0.39)
IMPLICATIONS
Implications for Nursing Practice The study findings revealed the importance of identifying psychological problems of medically ill patients in general settings. The study findings signify the importance of constructing Self Instruction Module for nurses working in medical wards in identifying psychological problems of the medically ill patients.
Cont.
Mental health aspects of the medically ill patients must also be considered in daily care planning by the nurses working in general wards. Nurses must be trained in identifying psychological problems of the medically ill patients. The study findings stress the importance of collaborative management of medically ill patients by various health team personnels. And it also emphasizes the World Mental Health Day 2009 theme MENTAL HEALTH IN PRIMARY CARE.
Psychosocial care of general medical and surgical patients must be stressed by nursing educators to the nursing students. Nursing students in all levels should be trained in identifying and managing psychological problems of the medically ill patients. Implications for Nursing Research
The implications for the nursing research are given in the form of recommendation.
Administrators can organize an in-service education programme for nurses on capacity building in identifying psychological problems among medically ill patients. Administrators can organize a workshop for nursing students and staff nurses on integrating mental health services in medical care settings. Nursing administrators can issue pamphlets on common psychological problems present during the time of medical illness.
LIMITATIONS
This study was conducted only among general patients; surgical patients were not included in the study. So generalization must be done with caution.
RECOMMENDATION
A similar kind of study can be done among patients in different settings such as out patient department, emergency department and surgical wards. Similar study can be conducted among cancer patients and HIV / AIDS Patients.