الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 98 |  |  |
| | | from | 98 | | |
Abstract
Lack of MHL is thought to be a major contributor to the rise in morbidity and mortality rates among individuals with mental illnesses. If the community merely had more understanding about mental health issues, the ability to recognise such conditions, and the search for appropriate and timely treatment a significant number of additional lives could be spared.
Positive mental health can be understood as varying degrees of physical (health and fitness), social (relationships with others and society), spiritual (the belief that life has significance), and psychological (positive activities) wellbeing. The concept of positive mental health is aimed at moving the focus away from illnesses and problems. It is based on the idea that positive mental health is more than the absence of mental health disorders. Positive mental health can be developed despite the existence of a mental health disorder.
The aim of this study was to Assess the level of mental health literacy among psychiatric patients’ family caregivers. The study utilized descriptive research design. It was conducted at the
Outpatient Clinic of El-Maamoura Hospital for Psychiatric Medicine.
The study subject composed of 270 family caregivers of patients with psychiatric disorders who meet the following criteria:
1. Adult family caregivers of psychiatric patients (not including those diagnosed with substance use disorders).
2. Living with the patient in the same household.
3. The main caregiver who is currently engaged in physical, financial, and/or emotional caregiving for this patient.
Two tools were developed and used by researcher to collect the necessary data: Tool one: Patients and Family Caregivers Socio-Demographic and Clinical Data Structured Interview Schedule: which entailed two parts:
Part I: This part covered patient’s socio-demographic and clinical data such as sex, age, marital status, educational level, employment, residence, diagnosis, age of onset of illness, duration of illness, number of previous psychiatric hospitalization, and medications presently taken .
Part II: This part covered patient’s family caregiver’s socio-demographic data such as kinship to the patient, sex, age, educational level, marital status, employment, residence, and duration of caregiving role. Tool two: Mental Health Literacy Scale: The Mental Health Literacy Scale (MHLS) was first developed by O’Connor & Casey, (2015). The scale (MHLS) is a 35- items distributed in six attributes which include; ability to identify disorders )8 items( , knowledge of where to go for information )4 items), knowledge of risk factors and causes )2 items( , knowledge of self-treatment )2 items( , knowledge of professional help available )3 items( , and behaviours that encourage acknowledgment or proper help-seeking attitudes )16 items). The first 15 items are scored on a 1-4 likert scale. Items 16-35 are scored on a 1-5 likert scale. All items are added together to produce the final score.. Questions with a 4-point Likert scale are rated from 1 ( very unlikely/unhelpful) to 4 (very likely). Questions with a 5-point Likert scale are rated from 1 (strongly disagree/definitely unwilling) to 5 (strongly agree/definitely willing). A higher total score indicates greater levels of mental health literacy; it varies from 35 to 160 after adding together all the components. (O’Connor & Casey, 2015). Study steps: Administrative steps: - An approval from the Research Ethics Committee, Faculty of Nursing- Alexandria University was obtained. - A written permission for conducting the study was obtained from the responsible authorities at Faculty of Nursing- Alexandria University. - A written permission for conducting the study was obtained from the General Secretariat of Mental Health and the director of El-Maamoura Hospital for Psychiatric Medicine. Tools preparation: - Tool I (A Socio-Demographic and Clinical Data Structured interview Schedule) was developed by the researcher. - Tool II was adapted to the Egyptian Culture and tested for content validity by a jury of 5 experts in the field. - Tool II reliability was tested using the Cronbach’s alpha method (0.801). Actual study: - A pilot study was carried out on 27 family caregivers of those attending the outpatient clinic and meet the criteria of the study sample to assess the clarity, applicability and the time needed to complete the study tools. Accordingly, any necessary adjustments were done. These family caregivers would be excluded from the actual study subjects. - All medical charts of patients who attend the outpatient clinic were screened daily to identify those who are matching the inclusion criteria. - Family caregivers who match the established criteria and accompany the patients described above were chosen as study participants. - The researcher collected data by interviewing the recruited family caregivers on an individual base in the outpatient clinic. - The process continued until the decided upon number of family caregivers is reached.
- The Statistical Package for Social Sciences (SPSS) version 20 programme was used to classify, code, computerise, tabulate, and analyse the obtained data.
The following were the main results of the present study:
*The Socio-demographic characteristics of the studied patients (n=270):
- One half of the studied patients were males and the other half were females (50% each)
- Their age ranged between 25 and 60 years, with the greatest percentage (42.6 %) of patients were in the age group ranging between 30 to less than 45 years.
- More than half of them were single (55.2%) and two fifth (40.7%) of them were illetrete.
- More than half (57.4 %) of the studied patients were unemployed, majority of them (74.8%) had enough income and more than half of them (53 %) lived in urban areas.
- The majority of the studied patients (98.1%) were living with their families.
*The clinical characteristics of studied patients (n=270):
- More than half of patients (54.5% / 53.5%) were patient with schizophrenia and had aduration of illness more than 10 years.
- Half of them (50%) were previously admitted to psychiatric hospital.
- Majority of them (70.4%) had no family history of mental illness.
- Almost all of them (99.2%) their current treatment was medication only.
- Majority of them (71.1%) were compliant to medication.
- The main cause of medications non compliance for majority of patients were stigma of mental illness medication followed by poor insight.
* The clinical characteristics of studied family caregivers (n=270):
- More than half (59.6% /61.1%) of them were females and aged more than 45 years old.
- Two fifth (40.4%) of them were parents (father&mother).
- Majority of them (71.9%) were married.
- One third (33.7%) of them were illetrete.
- Nearly half (44.8%) of them were housewives.
- Majority of them (88.5%) had enough income.
- Two fifth of them (40.4%) their family was the source of income.
- Majority of them (95.5%) were not complain from physical / mental illness.
- More than half of them (54.5%) their patient had insight from their point of view.
*Distribution of the studied caregivers according to their total levels of mental health literacy:
- Majority of studied caregivers (80.4%) had amoderate level of mental health literacy with a mean score 59.99 ± 7.90 of overall MHL.
- Majority of them (73%) had a high ability to recognize disorders with a mean score 69.35 ± 10.79.
- More than half of them (58.1%) had a moderate knowledge of where to seek information with a mean score 60.77 ± 13.15.
- Majority of them (98.5%) had a high knowledge of risk factors and causes with a mean score 84.94 ± 9.61.
- Around two third (67.8%) of caregivers had a high knowledge of self treatement with a mean score 38.78 ± 19.18.
- Two fifth of them (41.1%) had a high knowledge of professional help available with a mean score 54.35 ± 27.05.
- Majority of them (78.1%) had a moderate level of help seeking behaviors with a mean score 57.36 ± 11.01.
The relationship between Patient’s family caregiver’s Level of overall MHLS and their socio-demographic data (n = 270)
- Generally speaking, there was a statistically significant relation between caregivers’ level of MHL and their educational level, occupation, gender, age, income and patients’ insight. On the other hand, there was no statistically significant relation between caregivers’ level of MHL and degree of kinship, marital status and caregiver complain of any physical or mental illness.
- Male caregivers were found to have a higher MHL level than female.
- Caregivers who aged more than 45 years old was found to have a higher MHL level than of any other age.
- Caregiver who had a university education was found to have a higher MHL level.
- Employee caregiver was found to have a higher MHL level than others.
- Caregiver who had enough income was found to have a higher MHL level.
- Caregiver whose patient had insight was found to have a higher MHL level.
*It was concluded that most of the studied family caregivers had a moderate MHL level. Level of MHL correlates positively with caregivers’ educational level, occupation, gender, age, income and patients’ insight.
The main recommendations are:
I- Recommendations geared toward psychiatric nurses:
- Psychiatric nurses should assess the level of MHL of caregivers periodically and participate in conducting educational workshops related to it.
Psychiatric nurses should create a positive educational environment through Which caregivers can get accurate knowledge and information they need.
II- Recommendations geared toward patients with mental disorders and their caregivers:
- Increasing patient understanding of their condition and how to increase their mental health.
- Psycho- educational interventions should be provided for the patients and their families to help them gain knowledge about recovery process and develop skills on how to increase their relapse resistance.
III- Recommendations for future research:
- Future empirical research will examine the impact of particular therapy interventions on mental health literacy levels among psychiatric patients’ family caregivers.
- Prospective longitudinal studies are important to gain more insight and deep understanding about factors affecting mental health literacy among caregivers.