With the closure of all public places, the stay-at-home order and the worsening economic indices occasioned by the fall in the price of crude oil with no foreseeable end, learned helplessness, negative emotions, and other psychosocial problems are bound to thrive. Interventions to improve social capital, coping resources, resilience, and good community and family cohesion are needed to promote psychosocial well-being during and after the COVID-19 pandemic in Nigeria.
Background People with mental health problems are more vulnerable to a broad range of coercive practices and human rights abuses. There is a global campaign to eliminate, or at the very least decrease, the use of coercion in mental health care. The use of coercion in psychiatric hospitals in developing countries is poorly documented. The primary aim of this study was to explore service users’ perceptions and experiences of coercion in psychiatric hospitals in Nigeria. Methods Four focus group discussions were carried out among 30 service users on admission in two major psychiatric hospitals in Nigeria. The audio recordings were transcribed verbatim and then analyzed thematically with the aid of MAXQDA software. Results The Focus group participants included 19 males and 11 females with a mean age of 34.67 ± 9.54. Schizophrenia was the most common diagnosis (40%, n = 12) and had a secondary school education (60%, n = 18). The focus group participants perceived coercion to be a necessary evil in severe cases but anti-therapeutic to their own recovery, an extension of stigma and a vicious cycle of abuse. The experience of involuntary admission revolved mainly around deception, maltreatment, and disdain. Participants in both study sites narrated experiences of being flogged for refusing medication. Mechanical restraint with chains was a common experience for reasons including refusing medications, to prevent absconding and in other cases, punitively. The use of chains was viewed by participants as dehumanizing and excruciatingly painful. Conclusion The experiences of coercion by participants in this study confirm that human rights violations occur in large psychiatric hospitals and underscore the need for mental health services reform. The use of coercion in this context reflects agelong underinvestment in the mental health care system in the country and obsolete mental health legislation that does not protect the rights of people with mental health problems. The study findings highlight an urgent need to address issues of human rights violations in psychiatric hospitals in the country.
Objective Psychosocial aspects of adult cancer patients in sub‐Saharan Africa (SSA) have been described in silos of research articles. Integrative analysis of regional evidence is lacking. This review aimed to describe the scope of existing research on mental health problems, identify research gaps and make informed research, policy and practice recommendations. Methods Search was conducted for original peer‐reviewed research articles, irrespective of their quality, on psychosocial aspects of cancer in all SSA countries using PubMed, Google Scholar, Google search, African Index Medicus and direct searches of reference list of pertinent journal articles. Publications in English or translated to English were included. Case reports, dissertations, abstracts, publications without primary focus on psychosocial issues, psychosocial issues in children and studies conducted with SSA populations living outside the sub‐region were excluded. The methodological framework described by Arksey and O’Malley was used to synthesize and present the results. Inductive approach was used to arrive at the thematic areas. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews guideline was used to describe the review. Results Eighty‐three studies conducted across 15 countries were identified. Six thematic areas emerged namely; psychosocial needs, psychiatric disorders, coping strategies, suicidality, psychometrics and psychosocial interventions. Fifteen of 46 countries had at least one study with the majority of articles emanating from Nigeria. Research articles on psychosocial needs, psychiatric morbidities and coping strategies appears adequate for systematic review in SSA region. Despite the overwhelming evidence of high unmet psychosocial needs, a huge gap exists regarding psychosocial interventions. Conclusion Further research is needed into identified gaps in the region and quality of evidence of these studies need to be improved upon. Comprehensive policies and action plan development are sin qua non for addressing psychosocial problems of adults with cancer in SSA.
Introduction Pain is a very frequent symptom that is reported by patients when they present to health professionals but remains undertreated or untreated, particularly in low-resource settings including Nigeria. Lack of training in pain management remains the most significant obstacle to pain treatment alongside an inadequate emphasis on pain education in undergraduate medical curricula, negatively impacting on subsequent care of patients. This study aimed to determine the effect of a 12-week structured e-Learning course on the knowledge of pain management among Nigerian undergraduate medical students. Methods Prospective, multisite, pre-post study conducted across five medical colleges in Nigeria. Structured modules covering aspects of pain management were delivered on an e-Learning platform. Pre- and post-test self-assessments were carried out in the 12-week duration of the study. User experience questionnaires and qualitative interviews were conducted via instant messaging to evaluate user experiences of the platform. User experience data was analysed using the UEQ Data Analysis Tool and Framework Analysis. Results A total of 216 of 659 eligible students completed all sections of the e-Learning course. Participant mean age was 23.52 years, with a slight female predominance (55.3%). Across all participants, an increase in median pre- and post-test scores occurred, from 40 to 60 (Z = 11.3, p<0.001, effect size = 1.3), suggestive of increased knowledge acquisition relating to pain management. Participants suggested e-Learning is a valuable approach to delivering pain education alongside identifying factors to address in future iterations. Conclusion e-Learning approaches to pain management education can enhance traditional learning methods and may increase students’ knowledge. Future iterations of e-Learning approaches will need to consider facilitating the download of data and content for the platform to increase user uptake and engagement. The platform was piloted as an optional adjunct to existing curricula. Future efforts to advocate and support integration of e-Learning for pain education should be two-fold; both to include pain education in the curricula of medical colleges across Nigeria and the use of e-Learning approaches to enhance teaching where feasible.
Purpose The purpose of this paper is to assess the level of psychological distress of offenders newly brought into prison custody in a Nigerian prison and investigate the relationship with socio-demographic and penal characteristics. Design/methodology/approach A cross-sectional study involving 236 new prison entrants who were assessed for psychological distress using the 12-item General Health Questionnaire (GHQ-12) and the Hospital Anxiety and Depression Scale (HADS). Findings A total of 267 prison inmates were newly brought to prison custody over a three-month period. Out of this, 236 (88.4 per cent) of them participated in the study. Majority of the inmates were males 225 (95.3 per cent), awaiting-trial inmates 208 (88.1 per cent), single 144 (61 per cent), Christian 224 (94.9 per cent), first time offenders 218 (92.4 per cent) and charged with violent offences 136 (57.6 per cent). Majority of the inmates scored above cut-off points on the GHQ-12 and the HADS. In total, 157 (66.5 per cent) on HADS anxiety subscale, 201 (85.2 per cent) on HADS depression subscale and 199 (84.3 per cent) on GHQ-12. Significant relationship was observed between GHQ-12 “caseness”, prison category and type of offence. Prison situation and type of offence were significantly associated with HADS depression subscale, whereas age was associated with HADS anxiety subscale. Research limitations/implications Some limitations were encountered in the course of the study. First, the study relied on self-report questionnaires for collection of data. Second, information given by the respondents could neither be corroborated by family members, who were not present during the interview, nor by the officers and men of the Nigeria Prisons Service, who knew little or nothing about the respondents. Participants in this study had spent maximum of three days in prison during the interview, thus certain levels of distress within three days after incarceration may not entail “caseness” in the sense of the presence of a psychiatric disorder. Therefore assessment over a longer period is needed. Practical implications Screening prison inmates on reception into prison custody provides a vista of opportunity to identify mental health problems and socio-demographic and forensic correlates of psychological distress among new entrants into prison custody. This will facilitate early identification and management of prison inmates with health needs. Health screening on reception will also help in identifying the various penal or forensic characteristics of prison inmates, which will be put into consideration during selection of appropriate rehabilitation and reformation activities that best fit a particular prison inmate. Early screening of prison inmates upon reception in the prison will also help in identifying prison inmates who have high risk of suicide and self-harm, thus preventing cases of death that may arise as a result of these mental health problems. Findings from this study will also enrich the body of knowledge on mental health problems of prison inmates entering the prison; this will also help the criminal justice system in decision making, especially with emphasis on psychological evaluation of prison inmates before dispensing judgment. On the part of the prison authority, the prison inmates identified to have psychological distress and some forensic characteristics can be properly classified, and kept in cells that will not aggravate their distress. Finally, this is the first study of prison inmates on reception into Enugu Maximum Security Prison, Enugu State Nigeria. The implication of this is that findings from this research will form a baseline on which further research on prison inmates upon reception in the prison can be conducted. Originality/value This study demonstrated that prison inmates are faced with high level of psychological distress during their early days in prison, and that some socio-demographic and forensic variables had significant association with psychological distress as itemised in Tables III and IV. Therefore, screening new inmates on prison reception will help in early identification and treatment of vulnerable groups. This will also help in proper classification and allocation into appropriate cells of prison inmates by the prison authority.
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