Psychology
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Item Evaluation of the effect of cognitive therapy on perioperative anxiety and depression among Nigerian surgical patients(2003-12) Osinnowo, H. O.; Olley, B. O.; Adejumo, A. O.Study Objective Surgical patients have been known to benefit immensely from psychological interventions. This study set out to assess the pre and post operative anxiety levels and depression and the effect of cognitive therapy among Nigerian surgical patients. The effects of gender and educational status on perioperative anxiety and depression were also evaluated. Study design. The study utilized a controlled outcome design to evaluate the efficacy of self-instructional training (SIT) and rational emotive therapy (RET) in surgical patients. Preoperative anxiety and depression scores were used as co-variants. Patients Thirty-three (33) elective surgical patients were sampled randomly, divided into 3 groups of eleven (11) patients each. Eight (8) subjects underwent gynaecological procedures while the remaining 25 subjects had general surgical procedures. The mean age was 32.72± 15.83 years (range = 17-16 years.) Measurements The major instruments used in the study were the State Anxiety Subscale of the Speilberger State Trait Anxiety Inventory (STAI) and Hospital Anxiety and Depression Inventory. Main results SIT had the potential to reduce anxiety level among subjects postoperatively (t = 2.06; df= 10; P <0.05). The use of RET reduced depression among surgical patients (t= 1.23; df = 10; P <0.05). Conclusions It was concluded that surgical patients manifest varying degrees of anxiety preoperatively and postoperatively. Patient's pre and postoperative anxiety and depression can be reduced by the introduction of SIT and RET.Item Influence of social support, depression, and self-esteem on burden of care among caregivers of oncology patients(International Hospital Federation, 2009) Adejumo, A. O.This study investigated the influence of social support, depression and self-esteem on the burden of care among informal caregivers of oncology patients. The cross-sectional correlational study included 278 informal oncology caregivers. Results showed a significant main effect of self-esteem (F(1,277) = 5.35; p<.05), and interaction effect of social support and depression (F(1, 277) = 4.86; p<.05) on caregivers’ burden. Caregivers with high level of depression (t=4.06, df=282, p<.001), and others with high levels of social support (t=4.06, df=282, p<.001) recorded significantly higher levels of caregivers’ burden. This suggests the need for improving the psychological well-being of informal caregivers of oncology patients in the expanding role of family community members in caring for cancer patients.Item Approaches in handling ethical challenges of cancer treatments and research in Nigeria(2009) Adejumo, A. O.The diagnosis of cancer can devastate the physical, emotional, and socio-economic life of an individual. Caring for most cancer patients presents serious ethical challenges to physicians and other health workers. Inclusion of cancer patients in research could be no less challenging, These ethical problems become significantly magnified in the context of patients who have cancer in a low resource environment characterized by high illiteracy rate, poverty and poor health care infrastructure, Some of the ethical problems include: palliative care and end of life issues, particularly since most patients present in advanced stages, withholding or withdrawal Of life support, global equity and justice in drug availability, drug pricing, cancer research and breaking bad news, Adherence to ethical guidelines ill conducting cancer research would go a long way in reducing harms and unethical conducts. Similarly, the relevance of clinical and research ethics committees in resolving complex ethical issues in clinical practice has been suggested. However, where these are in place, the need for recourse to philosoph ical approach, especially virtue ethics in analyzing and resolving ethical concerns in clinical practice cannot be overemphasized. This paper highlights the burden of cancer in Nigeria and the ethical challenges of clinical management of cancer patients, using a case study. The role of clinical ethics and health research ethics committees as well as the justification for virtue ethics above principlism in handling ethical issues in cancer management and research in Nigeria were highlighted.Item Constraints in nurses´ use of HIV protective barriers in the care of PLWHA in the University College Hospital (UCH), Ibadan, Nigeria(2009) Olatunji, O. O.; Adejumo, P. O.; Adejumo, A. O.This survey examines the constraints limiting nurses’ use of protective barriers in the care of people living with HIV/AIDS in Ibadan, Nigeria. 270 females and 5 male nurses working in UCH were purposively selected. A self-developed questionnaire was used during data collection. Data was analyzed using descriptive statistics and chi square. Results about nurses’ use of protective devices (eg gloves) showed that 206 (94.2%) use PB always, 15 (5.5%) frequently use PB and 1(0.4%) occasionally use PB. Chi-square test shows significant differences between constraints in the use of PB in the care of PLWHA and adherence to HIV/AIDS universal precautions (X1=15.22, 1df, p<0.05). It was concluded that nurses in the selected setting were faced with constraints in the use of PB and as such were inadequately protected from blood-borne diseases especially when caring for PLWHAItem Perceived role of dietary factors in cancer causation and prevention among university undergraduates(Department of Psychology, University of Ibadan, Nigeria, 2009) Adejumo, P. O.; Adejumo, A. O.; Anisu, D. F.The impact of cancer on patients, care givers and family could be extremely traumatic, yet predisposition to the disease could be curtailed. Excess fat and calories; inadequate intake of fruits, vegetables, fibre, calcium and other dietary imbalances as well as alcohol, smoking and chronic infections are essential cancer aetiological factors. The purpose of this study was therefore to determine the association between perceived role of dietary factors in cancer causation and prevention. The cross sectional study adopted an exploratory survey technique. It took place in the University of Ibadan, Ibadan, Nigeria. Using multi-stage sampling, 346 undergraduates whose ages ranged between 20 and 30 years participated. They responded to a 51-item questionnaire which tapped information on their demographic characteristics, knowledge of cancer; awareness about dietary factors in cancer causation and prevention, and perception of the role of dietary factors in cancer causation and prevention. Results showed that the respondents' level of awareness of cancer was generally high ((91.9%) with few differences across demographic characteristics. However; the relative importance of the relationship between cancer and diet was underestimated (37.3%), and 12.1% of them completely missed the correct cancer risk factors. Similarly, 92 participants (16.6%) believed that cancer is a supernatural disease that cannot be prevented. One hypothesis was tested using chi square, it revealed that there is a significant association between awareness of cancer and knowledge of the role of dietary factors in cancer causation and prevention (X2=-50.24, df =-2, p=- 0.001). With the relatively high degree of awareness of cancer and acceptance of dietary factors as cancer risk determinants, campaigns which involve skill transfer and removal of barriers to change would enhance cancer preventive behaviour among university undergraduate. It is recommended that improvement in health education through inclusion of contents related to cancer causes, prevention and management, as well as social support programmes including subsidized cancer limiting feeding of undergraduates would be necessary in cancer prevention.Item Theatre personnel’s perception of operating room resource allocation(2009-06) Adejumo, A. O.; Adejumo, P. O.Operating rooms (OR) in hospitals represents big investments and must be utilized efficiently. Inaccurate scheduling of OR resources often results in delays of surgery or cancellations of procedures. These are costly to the patient, surgical team and hospital. Existing literatures in the OR management lack consensus on the method of evaluating management decisions from the perspectives of personnel or those affected by management decision-making processes. Eight key informant interviews were conducted. Also, 50 Operating Theatre Personnel (OTP) i.e. Surgeons, OR Nurses, Anaesthetists, and Executive Officers in the Nigeria's premier University Teaching Hospital were asked to complete a survey questionnaire concerning operating theatre resource allocation in the hospital. Five close ended and 10 open-ended questions were used. (For example, how are the decisions to allocate OR resources in this hospital made?) Thematic analysis and descriptive statistics were done. The theoretical framework, accountability for reasonableness was applied. Forty-eight percent of the participants were ignorant of the framework guiding OR resource allocation. 54% of the respondents admitted the current mechanism for publicizing management decisions on OR resource allocation is ineffective. Another 50% of the respondents knew little about the mode of appealing against unfavourable allocation decisions. Participants' open ended responses revealed that hospital executives and a few consultant surgeons control the allocation of OR resources, with, little recourse to OR personnel's concerns. If operating theatre stake holders are excluded in the planning, allocation and evaluation of OR resources, the efficiency required in surgical services would never be realized irrespective of the dexterity of the surgical team.Item Influence of social support, work overload and parity on pregnant career women’s psychological well being(Wiley Periodicals, Inc., 2008) Adejumo, A. O.The influence of social support, work overload and parity on psychological well-being of pregnant career women was investigated. Women executives (N200) attending antenatal clinics were selected. A 2 x 2 x 2 analysis of variance (A NOVA) revealed significant independent influence of social support (F (1. 199) = 26.51, p<0.05) and work overload (F (1.199) =461.76, p<0.05), and significant joint effect of social support and work overload. There was no significant effect of parity (F (1.199) = 0.72, p < 0.05). Combinations of parity, social support and work overload were also not significant (F (1. 199) = 0.80, p> 0.05). Social support and appropriate work incentives are helpful in assisting pregnant women executives in coping with psychological changes during pregnancy.Item Socio-cultural factors influencing consent for research in Nigeria: lessons from Pfizer’s trovan clinical trial(2008) Adejumo, A. O.This paper discusses the controversial Trovan study conducted by Pfizer in 1996 in Kano, Nigeria, the peculiar socio-cultural factors that researchers should consider as well as the relevance of the 2007 National Code for Health Research Ethics in enforcing researchers' compliance with ethical standards in informed consent process. Researchers are expected to be sensitive to the many sources of exploitable vulnerability in those whose participation they invite. The failure to give attention to peculiar socio-cultural factors influencing the process of informed consent in Nigeria might have contributed to the failure of many investigators to apply and conform to related local and international research regulations Genuine respect for human dignity requires deeper understanding of patients' values, culture, family and community. Nigeria is socio-culturally diverse in terms of language, religion, economy, and traditions. Investigators require adequate familiarity with the local socio-cultural characteristics in order to meaningfully communicate the research purpose and method upon which free and informed consent is based. The centrality of informed consent in socio-behavioural and health related researches cannot be over emphasized. Negotiating informed consent with the designated authorities in human research with non-Western populations requires investigators to move beyond narrow definitions of personhood, autonomy, and "self" determination. Without these, researchers' efforts would be mere exploitation and abuse of fellow human beings.Item Informed consent in international research: perspectives from India, Iran and Nigeria(2006) Bhan, A.; Majd, M.; Adejumo, A. O.The amount of international biomedical research is increasing and much of this is happening in developing countries. It is important to place adequate focus on the issue of obtaining voluntary informed consent. Researchers need to understand local socio-cultural realities and also respect local cultural beliefs and indigenous research guidelines. Through examples from India, Iran and Nigeria the authors highlight the diversity within and between developing country situations. Emphasis is placed on the importance of informed consent in research as well as clinical practice settings, and the need to be enterprising and innovative in obtaining it.Item Evaluation of the effect of cognitive therapy on perioperative anxiety and depression among Nigerian surgical patients(2003) Osinowo, H.O.; Olley, B. O.; Adejumo, A. O.Study Objective: Surgical patients have been known to benefit immensely from psychological intervention. This study sets out to assess the pre and post operative anxiety levels and depression and the effect of cognitive therapy among Nigerian surgical patients. The effects of gender and educational status on preoperative anxiety and depression were also evaluated. Study design: The study utilized a controlled outcome design to evaluate the efficacy of self- instructional training (SIT) and rational emotive therapy (RET) in surgical patients. Preoperative anxiety and depression scores were used as co-variants. Patients: Thirty-three (33) elective surgical patients were sampled randomly, divided into three groups of eleven (11) patients each. Eight (8) subjects underwent gynaecological procedure while the remaining 25 subjects had general surgical procedures. The mean age was 32.72± 15.83 years (range= 17-16 years). Measurements: the major instruments used in the study were the State Anxiety Subscale of the Speilberger State Trait Anxiety Inventory (STAI) and Hospital Anxiety and Depression Inventory. Main results: AIT had the potential to reduce anxiety levels among subjects postoperatively (t=2.06; df-10; p<0.05). The use of RET reduced depression among surgical patients (t=1.23; df=10; p<0.05). Conclusions: it was concluded that surgical patients manifest varying degrees of anxiety preoperatively and postoperatively. Patient’s pre and postoperative anxiety and depression can be reduced by the introduction of SIT and RET.