Knowledge, Attitude and Management Skills of Nurses towards Substance Dependent Patents at Mathari Hospital, Nairobi
Introduction: Substance use is significantlv related to a number of health issues ~ J • including HIV /AIDS, sexually transmitted diseases, and other health problems (Incardi, 1995. Trapido & Lewis 1990). Several studies have been done to explore the aspects of community statistics on substance dependence. However, Very few studies focusing on the nurses' knowledge, attitude and skills towards substance dependent patients have been done worldwide and actually none-in Kenya. The objective of this study was to determine the nurses' knowledge, attitude and skills towards management of substance dependent patients and the effect of post-basic psychiatric training on them .. Methods: A cross sectional descriptive study was done. The study population was nurses in direct care of mentally ill patients at Mathari hospital. A sample of 184 nurses was randomly selected from all the 242 eligible nurses. Data on participants' knowledge, attitude and skills was collected using a semi-structured questionnaire, self administered: . ",by the participants. The data was entered, cleaned and analyzed in epi-info soft ware 2000 version 3.3.2 and standard normal distribution (z-value) to compute the frequencies and the associations between knowledge, attitude and practice with participants' experience, post-basic psychiatry training and other ,~emographic variables. These associations were tested using chi-square tests of statistical significance . Results: One fifty five (155) participants responded of whom 66% (101) were females. 80% (124) of the participants were from the civil department. Working experience ranged from 1 to 33 years with a mean and median of 15 years. 27.7% (43) of all the participants had a post basic psychiatric training. 43.2% (67) of the respondents had heard about heroine, 29% (45) correctly identified its formulations while 29.7% (45) correctly identified the route of heroine use. 49% (21) of those with post-basic training correctly identified the route of heroin administration while 21% (24) of those without post-basic correctly identified its use, OR 3.5 (95% CI 1.7-7.4), P=0.0007. 74% (114) would not prefer nursing substance dependent patients as their first choice. 74.8% (115) of the participants felt like quitting their profession due to nursing these patients. 54% (23), of those with post-basic training felt like quitting, 83% (93) of those without felt like quitting OR 0.2 (95% CI 0.1-0.5) l ==14.3 P= 0.0001. 16% (25) of all the nurses had drawn a nursing care plan for patients with substance induced psychosis. 40% (17) of those with post-basic psychiatric training had drawn a nursing care plan for a patient with substance dependent psychiatric problem as compared to 7% (8) of those without, OR 8.5 (95% CI 3.3- 21.8), P < 0.0001. Discussion: This study of nurses' knowledge, attitude and skills at the biggest referral mental hospital in Kenya showed that nurses lack adequate knowledge on substances. Other studies have shown that inadequate knowledge leads to negative attitude and poor skills, (Horne 1985), as was shown in this study. Nurses with post-basic training were shown to be having more knowledge of substances which translated to better skills and more positive attitude towards substance dependent 'Psychiatric patients. Recommendation: As a strategy to improve nurses' attitude and skills towards substance dependent psychiatric patients, more nurses caring for mentally ill patients should be encouraged to go for post basic psychiatric . training to improve their knowledge .