Doctor of Philosophy in Counselling Psychology

Influence Of Stress Predictors on Mental Wellness of Nurses in Embu and Tharaka Nithi Counties, Kenya

Wed, 01 Jan 2025 00:00:00 GMT

Influence Of Stress Predictors on Mental Wellness of Nurses in Embu and Tharaka Nithi Counties, Kenya Margaret, Njeru Gatavi Mental health needs of nurses have become a major public concern that has challenged healthcare providers` ability to offer prudent and standard health to the members of the public. The purpose of this study was to investigate the influences of stress predictors on mental wellness among nurses in Embu Level 5 and Chuka County Referral Hospitals in Kenya. Five objectives guided this study and two theories; the Therapeutic Engagement Stress Theory (TEST) and the Person-Environment (PE) Fit Theory also guided the study. The population of the study comprised of 380 nurses and 50 doctors. The Yamane formula was applied to calculate a sample size of nurses and convenient sampling was used to sample doctors. A sample size comprising of 253 nurses was derived from the Yamane formula and 10 doctors were sampled using convenient sampling. Data was collected using online questionnaires for nurses and structured face-to-face interviews for doctors. Questionnaires were designed using the PTSD Checklist 5 (PCL-5), the Positive Mental Health Scale (PMH-Scale), the NIOSH Worker Well-Being Questionnaire (WellBQ), Depression Anxiety Stress Scale-21 (DASS-21), and the General Self-Efficacy Scale (GSE). The reliability of instruments was tested using piloting of research instruments targeting 37 nurses from Kitui County Referral Hospital selected through random sampling method. The research instruments were tested for reliability and validity. An average Cronbach reliability coefficient of 0.736 from all five constructs was recorded, which were above 0.7, an indication the instruments were reliable. In addition, the instruments’ validity was tested using content validity through conceptualization of instruments, identification of domains, and developing instruments to determine their effectiveness in collecting the study data. Descriptive statistics were used to analyze the questionnaires, with the help of SPSS version 27.0, to get frequencies, means, standard deviations, and percentages. The analyzed data was presented using tables. The simple regression analysis was used to analyze the statistical significance of variables and hence, test the null hypothesis. Diagnostic tests of normality, linearity, autocorrelation, heteroscedasticity and multicollinearity were used to check whether data adhered to assumptions of the regression analysis. Also, normality of errors was tested using Histograms and Normal P-P plot. Correlation analysis was used to determine the relationship between independent and dependent variables. The deductive data method was used to analyze qualitative data where themes were identified to find the influence between predictors of stress and mental wellness of nurses. Qualitative data was presented thematically to come up with patterns and codes that were used to generate themes. Findings from regression analysis of variables rejected all null hypotheses. Therefore, the study established that stress predictors namely: physical work environment, organizational factors, nurse-colleague relationship, care recipients` attitudes towards nurses, and self-efficacy as a moderating variable on the stress predictors influenced mental wellness of nurses. The outcome of the research was significant in establishing an evidence-based practical knowledge on the influence of predictors of stress on mental wellness. The study concluded that addressing the stress predictors is critical in enhancing the mental wellness of nurses, thereby potentially improving healthcare service delivery in Kenyan referral hospitals. The study recommended future research focuses on unit- specific stress factors and interventions to tailor support mechanisms for nurses working in different healthcare settings.

Influence of Psychosocial Distress Predictors on Quality of Life in Women With Breast Cancer in Nairobi County

Thu, 01 Aug 2024 00:00:00 GMT

Influence of Psychosocial Distress Predictors on Quality of Life in Women With Breast Cancer in Nairobi County MURIITHI, ANASTASIA WANJIRU Breast cancer diagnosis and treatment affect a woman's physical, emotional, social, and sexual wellbeing, making quality of life a crucial treatment outcome. The aim of this study was to uncover some predictors of psychosocial distress and their influence on breast cancer patients’ quality of life. To achieve this purpose, the study focused on establishing the prevalence of psychological distress, the influence of socio-demographic variables, treatment-related side effects, body image, and the link between social support and quality of life in Kenyan women with breast cancer. The Stress Process Model (SPM), the Social Cognitive Theory of Health Promotion (SCTHP), and the Fundamental Cause Theory (FCT) served as the study's three guiding theories. The study design was sequential exploratory mixed-methods. Data were collected from two cancer hospitals in Nairobi County. With phenomenology explaining the breast cancer patients lived experiences, qualitative data was gathered through interview schedules with 20 patients, two 6-member focus group discussions, and 8 healthcare practitioners. A questionnaire was used to gather quantitative data from 256 patients from two hospitals, revealing a median age of 47 years. Thematic analysis found that breast cancer patients experienced both losses and unexpected gains. Financial hardship hit hardest. The effects of breast loss were enduring; the financial model had gaps; positive social support was plentiful, but there was also negative social support. Descriptive statistics found that psychosocial distress was prevalent and severe, with 63% of participants reporting severe distress and 23% reporting clinically significant distress. Additionally, 91% of participants reported financial distress, with 36% reporting clinical depression and 40% reporting anxiety. Of the individuals, 75% had comorbid clinical-severe depression and anxiety. In order to ascertain the factors that predicted psychosocial distress, a multinomial logistic regression analysis was conducted. Factors affecting outcomes included income (p<0.05, OR 5.50), early diagnosis (p<0.05, OR 0.31), severe treatment side effects (p<0.05, OR 2.89), poor body image (p<0.05, OR 1.83), and decreased sexual function (p<0.05, OR 3.83). Social support moderated psychosocial distress (p<0.05, OR 0.69). The results of the multivariate logistic regression analysis, which investigated the influence of psychosocial distress predictors on quality of life, indicated statistically significant relationships. The presence of some income (p<0.05, OR 1.08), early diagnosis (p<0.05, OR 2.03), mild treatment side effects (p<0.05, OR 1.88), negative body image (p<0.05, OR 0.915), diminished sexual function (p<0.05, OR 0.288), and adequate social support (p<0.05, OR 1.65). Social support moderated the influence of distress on quality of life (p<0.05, OR 1.57). All hypothesised psychosocial distress predicators correlated with quality of life. However, social support ameliorated the harmful effects of distress on participants' quality of life. The main unattended issues in treatment were body image and sexual function. Distress and emotional disorders such as anxiety and depression were either disregarded or not addressed effectively. Financial distress stood out; this calls for a reassessment of the SHIF cancer financing policy to close gaps. Furthermore, non-disease factors have an influence on the quality of life for women with breast cancer. As a result, it is critical to incorporate distress screening into cancer care and to adopt a multidisciplinary approach to managing both the disease and the psychosocial challenges that breast cancer patients face. The incorporation of psychotherapy and social interventions into breast cancer care is necessary to achieve the fundamental treatment goal of enhancing quality of life

Influence of Psychosocial Interventions in Enhancing Cancer Patients' Psychological Well-Being in Oncology Clinics in Meru County, Kenya

Sun, 01 Sep 2024 00:00:00 GMT

Influence of Psychosocial Interventions in Enhancing Cancer Patients' Psychological Well-Being in Oncology Clinics in Meru County, Kenya Magambo, Margaret Ndiah Cancer patients undergo immense physical, emotional, and psychological distress that influences overall well-being. Without adequate psychosocial interventions, their mental health deteriorates further, complicating treatment. Despite advancements in medical care, a gap exists in understanding and addressing cancer patients' psychosocial needs in many clinics. Psychosocial interventions are critical for coping, recovery, and healing. This study evaluated how psychosocial interventions influence the psychological well-being of cancer patients at oncology clinics in Meru County, Kenya. The objectives were to assess the influence of individual counselling, family counselling, support groups, and psycho- education on the psychological well-being of cancer patients and assess the moderating effect of financial constraints. Guided by person-centered and social cognitive theories, the study utilized a convergent survey research design. This study was conducted at oncology clinics in Meru County, Kenya. It adopted systematic and random sampling and purposive sampling techniques to select participants from a target population of 2580 cancer patients, 2580 caregivers, and 53 clinicians, respectively. Of these, 335 cancer patients, 40 caregivers and six clinicians were sampled. Data collection tools were questionnaires, interviews, and focus groups. An overall reliability Cronbach‘s alpha of 0.779 was established, and also checked content, construct and face validity. Piloting was done at the oncology clinic in Chogoria Hospital in Tharaka Nithi County. Descriptive and inferential statistical analysis was applied to quantitative data, while thematic analysis was used on qualitative data. The overall response rate was 83%. The study noted that most cancer patients display resilience and optimism, although their psychological well being could be further enhanced through more personalized and patient-centered approaches, better financial support, and improvements in counseling, psycho-education, and support groups. Such interventions positively affect well-being by reducing stigma, enhancing decision-making and problem-solving skills, and increasing empowerment and preparedness. However, their effectiveness is often limited by inadequate psycho education, insufficient infrastructure, incomplete psychosocial care information, lack of personalization in care, and inflexible oncology clinics. Financial difficulties also significantly distress patients. Comprehensive, multifaceted psychosocial interventions that include collaborative social support networks and address individual experiences and financial concerns are crucial for enhancing the psychological well-being of cancer patients. This study therefore recommends the strengthening support networks, prioritizing education, investing in suitable healthcare infrastructure and workforce development programs, engaging families, promoting experience sharing in support groups and ensuring available access to psycho- education. The government should address financial burdens through policy reforms, infrastructure development, partnerships, education and other direct assistance programs. The implications for this study for theories, policies and practice are personalized interventions, self-efficacy, social support, assessments, education, development, integrated care and financial assistance. It indicates a need for tailored psychosocial care, skills training, trust-building, collaboration, and addressing financial burdens to optimize cancer patients' psychological health through adapted comprehensive interventions. The study contributes new knowledge in the field of oncology and psychosocial oncology.