INTRODUCTION:

A sound mental health is the key component of health. Absence of mental health could create a great deal of burden to the functioning of a nation¹.

Mental illnesses are associated with distress and/or problems functioning in social, work or family activities. Stigma associated with mental illnesses is one of the principal causes for mentally ill people not receiving adequate mental health care and treatment.

Many people who have a mental illness do not want to talk about it. But mental illness is nothing to be ashamed of! It is a medical condition, just like heart disease or diabetes and majority of the mental illness are treatable².

The knowledge about mental health and mental disorders how to seek help and treatment, and reduced stigma against mental illness at individual, community and institutional levels may promote early identification of mental disorders, improve mental health outcomes and increase the use of health services³.

The adverse attitudes to mental illness are found in all societies in the world. The belief that mental illness is incurable or self- inflicted can also be damaging, leading to patients not being referred for appropriate mental health care. Research on attitudes towards the mentally ill is necessary to ensure quality of life for persons with mental illness in the community⁴.^.

Most families are not prepared to cope with learning their loved one has a mental illness. It can be physically and emotionally trying, and can make them feel vulnerable to the opinions and judgments of others⁵.

The study of attitude has occupied and continues to occupy a central place in social- psychological research. Knowledge of attitudes and their functioning is of interest both theoretically and practically. No theory of social behavior can be complete without incorporation of attitude functioning and it is doubtful that complex social behavior can be predicted without knowledge of attitude. To study attitudes requires that they be measured⁶.

Keeping in view these important aspects of public opinion about mental illness, this study on knowledge and attitude of patients’ relatives towards mental illnesses seems meaningful, so that various mental health programs could be formulated and organized. This will also help in proper rehabilitation of the patient.

OBJECTIVES:

1. To assess the knowledge and attitude on existing mental illness among the care givers of mentally ill patient.

2. To find the correlation between the knowledge and attitude on existing mental illness among the caregivers of mentally ill patients.

3. To estimate the association between knowledge and attitude on existing mental illness with selected demographic variables.

MATERIAL AND METHODS:

· Research Approach: Quantitative approach.

· Research Design: Non-experimental descriptive study design

· Setting of the Study: Psychiatric OPD at Pondicherry Institute of Medical Sciences, Puducherry

· Population: Care givers of mentally ill patient attending Psychiatry OPD at PIMS, Puducherry

· Sample: Care givers of mentally ill patient attending Psychiatry OPD

· Sample size: 46 care givers of mentally ill patient attending Psychiatry OPD

· Sampling technique: Convenience sampling technique.

Sampling Criteria:

Inclusion criteria

· Care givers who are available during the study period.

· Care givers who can understand Tamil and English.

Exclusion criteria:

· Care givers who were not willing to participate in the study.

Development and Description of the Tool:

The structured interview questionnaire was developed by the researchers after an extensive review of literature and researchers after an extensive review of literature and with the guidance of experts. The semi structured interview questionnaire consists of 3 sections.

Section A: Socio demographic variables of care givers age, gender, education, occupation, family income, source of information, relationship with patient, and first visit

Section B: Knowledge Questionnaire Regarding Mental Illness. It consists of 15 items related to knowledge regarding mental illness. Each question has three options. One score is allotted to each correct answer and zero score for wrong answer. The maximum score was 15. The knowledge score was ranged from 0 to 15.

Scoring Interpretation:

The knowledge score was ranged from 0 to 15. This score is converted into percentage and interpreted as follows:

Level of knowledge Score:

· Inadequate knowledge < 50 %

· Moderately adequate knowledge 51 – 75 %

· Adequate knowledge 76 – 100%

Section C: A five point scale was used to assess the attitude of care givers of mentally ill. It consists of 15 statements. The attitude score was ranged from 10 to 50. This score was converted into percentage and interpreted. It consists of 15 statements, of which positive and negative statement.

The score was grouped as follows:

Level of attitude Score:

· Unfavorable attitude < 50 %

· Moderately favorable attitude 51 – 75 %

· Favorable attitude 76 – 100%

Validity of the Tool:

The tool was developed after extensive review of literature, internet search, and experts’ advice which helped the investigators to select the most suitable semi structured questionnaire.

Ethical Consideration:

Prior permission was obtained from the Dean, College of Nursing, Medical Superintendent and Head of Psychiatry Department, Pondicherry Institute of Medical Sciences. Informed consent was obtained from individual participants. Data collected were kept confidential.

Data Collection Process:

The data was collected over a period of 2 weeks in Psychiatry OPD at Pondicherry Institute of Medical Science. Forty six caregivers of mentally ill patients who met the inclusion criteria were selected by convenience sampling. The investigator obtained consent from the care givers after explaining the nature and purpose of study. Participation information sheet was also provided for more clarification for participating in the study, prior to the consent.

Data Analysis:

The collected data was tabulated and analyzed using descriptive and inferential statistics.

Descriptive Statistics:

· Frequency and percentage distribution was used for socio demographic variables.

· Frequency, Percentage, Mean and SD were used to determine level of knowledge and attitude.

Inferential Statistics:

· Fisher’s exact test was used to determine the association between level of knowledge and attitude with corresponding socio demographic variables.

· Spearman 2 tail Correlation was done to determine relation between knowledge and attitude on mental illness among caregivers.

Major Findings of the Study and Discussion:

The data obtained has been analyzed and presented under the following headings

· Section-A: Distribution of socio demographic variables among caregivers.

· Section B: Distribution of level of knowledge and attitude among caregivers on existing mental illness.

· Section C: Correlation between knowledge and attitude on existing mental illness.

· Section D: Association between knowledge and attitude of caregivers with selected socio demographic variables.

Section-A: Distribution of Socio Demographic variables among caregivers:

Distribution of socio demographic variables reveals that the majority (37%) of the caretakers belongs to the age group between 21-40 years. With regard to the gender 56.5% of them were male and 45.5% were female. 37% of the caretakers have completed their school education. According to the type of occupation 37% of the caretakers were housewife. 45.7% of the families get the monthly income below Rs 1000 and only 13% draws income above Rs. 20,000. Majority (56.5%) of caregivers has received information about mental illness from family or friend. According to the relationship of the caregivers with the mentally ill patients, majority of samples, 14(30.4%) are spouse, and others 13(28.3%) are parents, 8(17.4%) are off spring, 5(10.9%) siblings, 5(10.9%) are cousins, and 1(2.2%) are others. With regard to the first visit of mentally ill patient, 17.4% of care givers had taken the mentally ill patient to a psychiatrist, 13% were taken to general hospitals and majority (69.6%) took the mentally ill to mosque or temple.

Section B: Distribution of level of knowledge and attitude among caregivers on existing mental illness.

Fig:1 Distribution of level of knowledge among care givers regarding mental illness. (n=46)

Fig 1 depicts that 73.9% of caretakers had moderately adequate knowledge, 17.4% inadequate knowledge and 8.7% had adequate knowledge on mental illness

Fig 2 Distribution of level of attitude among care givers on mental illness. (n=46)

Fig.2 shows that out of 46 samples, majority of them had moderately favorable attitude, i.e 84.8%, and 15.2% had favorable attitude towards mental illness.

Section C: Correlation between knowledge and attitude on existing mental illness:

Spearman correlation coefficient showed that there was a significant correlation between knowledge and attitude at ‘r’ value 0.01 on mental illness among the caretakers.

Section D: Association between knowledge and attitude of caregivers with selected socio demographic variables:

There was no statistically significant association between the knowledge on mental illness with socio demographic variables at the level of p value < 0.05.

There was a statistically significant association between attitude on mental illness with educational status at the level of p value < 0.05.

IMPLICATIONS:

The results of the findings should be implicated in the nursing profession the following heading would show how to implement the above findings to nursing practice, nursing education, nursing administration and nursing research.

Nursing Practice:

· The studies will help the nurses to find out the level of knowledge and attitude of the care givers of mental ill patients.

· Nurses should take the responsibility in educating the care givers regarding the care of the mentally ill patient.

Nursing Education:

The knowledge of the care givers and their coping mechanism with the mentally ill patients will update the nursing educators’ idea for excellent clinical teaching experience.

Nursing Administration:

· The use of mass media can help in the increase of knowledge among the care givers of mentally ill patients.

· The nurse administrator should take initiative to give awareness program in hospital to enhance the level of knowledge of the care givers with active support of the available resources.

Nursing Research:

· Dissemination of findings through conferences and professional journals will make the application of findings more effective.

· The study helps the investigators to develop insight regarding knowledge and attitude on mental illness among care givers.

· The findings of this study will serve as the basis for the nursing professional and also the students to contact for their studies different experts of mentally ill patients.

RECOMMENTATIONS:

On the basis of the study findings, the following recommendations were made for further research.

· Similar study can be replicated on a large sample to generalize the study findings.

· A comparative study can be conducted between care givers and non care givers of mentally ill patients.

· An experimental study can be conducted with structured teaching program.

· A similar study can be conducted among nursing personal to assess their level of knowledge and attitude on mental illness.

CONCLUSION:

The findings revealed that the knowledge and attitude level on mental illness among care givers of mentally ill patients is moderately adequate knowledge and moderately favorable attitude. There is a need to improve it with the help of health education program.

REFERENCES:

1. Canady, Valerie A. "NYS Mental Health Tax Checkoff Law The First In The Nation". Mental Health Weekly 25.46 (2015): 7-7. Web.

2. Guivarch C, Hallegatte S. 2C or Not 2C?. SSRN Electronic Journal.

3. James B, Omoaregba J, Okogbenin E. Stigmatising attitudes towards persons with mental illness: a survey of medical students and interns from Southern Nigeria. Mental Illness. 2012;4(1):8.

4. Gullickson T. Helping families cope with mental illness. PsycCRITIQUES. 2010;41(2).

5. Voigt K, King N. Mental illness weights in the global burden of disease 2010 study: two steps forward, one step back?. Bulletin of the World Health Organization. 2014;92(3):226-228.

6. Chen S, Wu Q, Qi C, Deng H, Wang X, He H et al. Mental health literacy about schizophrenia and depression: a survey among Chinese caregivers of patients with mental disorder. BMC Psychiatry. 2017;17(1).

Received on 02.02.2022 Modified on 10.06.2022

Int. J. Nur. Edu. and Research. 2022; 10(4):285-288.

DOI: 10.52711/2454-2660.2022.00066