Presbyterian Psychiatric Hospital, Bolgatanga, Ghana.
Department of International and Global Health, University for Development Studies, Tamale, Ghana.
BMJ Open. 2024 Mar 18;14(3):e079933. doi: 10.1136/bmjopen-2023-079933.
Schizophrenia is a chronic condition, of which the diagnosis and management require comprehensive care. The role mental health nurses play in this management cannot be overemphasised. In an effort to give their best, several challenges confront them which need to be sought and addressed. This study aimed to explore the factors that influence the management of schizophrenia by mental health nurses in the Upper East Region.
A descriptive phenomenology design was used in this study. Individual in-depth interviews were conducted among 18 purposively sampled mental health nurses using a semistructured interview guide. Audio-recorded interviews were transcribed verbatim and analysed thematically using Colaizzi's approach.
The study was conducted in five primary and secondary-level health facilities in the Upper East Region of Ghana.
Five themes were deduced from the theoretical framework, which were as follows: individual factors, interpersonal factors, organisational factors, community-level factors, and policy-level factors. At the individual level, factors such as the condition of the patient at presentation, medication side effects, inadequate knowledge, and poor adherence were identified. Interpersonal factors identified were poor communication, lack of mutual respect, and poor communication, while organisational factors such as inadequate staff, inadequate infrastructure and logistics, and unavailability of antipsychotics were reported. Moreover, the study identified community-level factors such as stigma and cultural beliefs, while policy-level factors such as laws regarding suicide, patient rights, and non-inclusion of mental health services into the National Health Insurance Scheme were reported as factors influencing the management of schizophrenia by mental health nurses.
Addressing these factors is essential to ensure sustainable improvements and the effective management of schizophrenia. It is imperative to consider these factors when designing interventions and policies to optimise the management of schizophrenia by mental health nurses in Ghana.
精神分裂症是一种慢性疾病，其诊断和管理需要全面的护理。精神科护士在这方面的管理中扮演着至关重要的角色。为了能够尽善尽美，他们面临着一些挑战，这些挑战需要被发现并加以解决。本研究旨在探索加纳上东部地区精神科护士在管理精神分裂症方面的影响因素。
本研究采用描述性现象学设计。通过半结构式访谈指南，对 18 名有目的地抽取的精神科护士进行了个体深入访谈。使用 Colaizzi 方法对音频记录的访谈进行逐字转录和主题分析。
研究在上东部地区的五个初级和二级卫生设施进行。
从理论框架中推断出五个主题，分别是：个体因素、人际因素、组织因素、社区水平因素和政策水平因素。在个体层面，确定了诸如患者就诊时的病情、药物副作用、知识不足和药物依从性差等因素。人际因素包括沟通不畅、缺乏相互尊重和沟通不畅，而组织因素如人员不足、基础设施和后勤不足以及抗精神病药物短缺等也被报道。此外，研究还发现了社区层面的因素，如耻辱感和文化信仰，以及政策层面的因素，如关于自杀、患者权利和不将精神健康服务纳入国家健康保险计划的法律等，这些都是影响精神科护士管理精神分裂症的因素。
解决这些因素对于确保可持续的改善和有效地管理精神分裂症至关重要。在设计干预措施和政策时，必须考虑到这些因素，以优化加纳精神科护士管理精神分裂症的工作。
