EFFECT OF CHILD AND ADOLESCENT MENTAL HEALTH EDUCATIONAL INTERVENTION ON THE PERCEPTION OF PUBLIC HEALTH NURSING STUDENTS IN SOUTHWEST NIGERIA

Abstract

Background: Child and adolescent mental health has received limited attention from policy makers, the public and even healthcare workers, and despite progress in scientific knowledge of mental disorders and their treatment, there continues to be prejudice, stereotyping and stigma towards mental illness. The reason for such is that there is still lack of knowledge and dearth of literature on the issue of knowledge and attitude towards children with mental health disorders. Public health nursing students who are undergoing training to work in the community where majority of children and adolescents with mental health disorders are found play important roles in the identification and management of this group of patients. It is not known if providing training in child and adolescent mental health for public health nursing students will improve their abilities to perform these roles by improving their knowledge and attitudes. This study was therefore designed to assess the effect of a single session of mental health education on knowledge and attitude of public health nurses on knowledge and attitude of child and adolescent mental health disorders in southwest Nigeria. Methodology: This study was a quasi-experimental intervention study involving 78 public health nursing students drawn from two purposively selected public health nursing schools in Ibadan, Oyo State and Ilese-Ijebu, Ogun State. The intervention group and control group comprised 38 and 40 students respectively. The study was carried out in four different stages: a needs assessment which involved a focus group discussion, a baseline or pre-intervention phase, an intervention phase and a post-intervention phase. The instruments used were a focus group discussion guide, Modified knowledge and Attitude towards Child and Adolescent Mental Disorders Scale, and questions on the Mental Health Gap Action programme trainingmodule on Developmental and Behavioural Disorders. A question was adopted from the vignette questionnaire on depression for the two groups. Both groups had study instruments administered at baseline. Participants in the intervention group received a four-hour training session followed by a post-intervention assessment 3-weeks post intervention. The control group received no training, but was also assessed after 3 weeks. The control group was exposed to the intervention by giving them the training manual after the post test data collection, as an ethical obligation of beneficence. Data were analysed using chi-square test for test of association between categorical variables and the t-test (individual and paired) to compare means. ANCOVA analysis was done to compare the control and intervention groups at post-intervention phase, while adjusting for baseline scores. The level of significance was set at 5%. Results: Response rate was a 100%. The mean age of the entire sample was 40.17 years, majority (80.8%) were female and (70.5%) were married. The study showed that the educational intervention was effective in improving knowledge and attitude of public health nursing students towards child and adolescent mental health disorders, with post-intervention mean knowledge scores of 18.82 (SD 8.08) and 16.30 (SD 4.04) in the intervention and control groups respectively (p=0.002). The effect of the mental health education intervention on knowledge and attitude was further examined using ANCOVA analysis of the post-intervention mean scores in the intervention and control groups, controlling for baseline scores, with p values of 0.003, <0.001 and <0.001 for knowledge of mental health disorders, conduct disorder and ADHD, and attitude respectively. These differences all showed statistical significance. Conclusion: A four-hour training of public health nursing students was found to be effective in improving their perceptions towards child and adolescent mental health. This study provides further data to support the importance of mental health educational interventions in improvingknowledge and attitude of healthcare providers towards child and adolescent mental health disorders