THESIS PROPOSAL PRESENTATION FOR THE DEGREE OF MASTER

THESIS PROPOSAL PRESENTATION FOR THE DEGREE OF MASTER OF SCIENCE THE PSYCHOSOCIAL STATUS OF HAEMODIALYSIS RECIPIENTS IN SELECTED HOSPITALS OF ANAMBRA STATE BY CHUKWUYEM EMMANUELSON 2012636011 F DEPARTMENT OF NURSING SCIENCE FACULTY OF HEALTH SCIENCES AND TECHNOLOGY COLLEGE OF HEALTH SCIENCES NNAMDI AZIKIWE UNIVERSITY NNEWI CAMPUS

OUTLINE • INTRODUCTION/ BACKGROUND • PURPOSE OF STUDY • SCOPE OF THESIS • STATEMENT OF PROBLEM • THEORETICAL FRAMEWORK • METHODOLOGY

INTRODUCTION • HAEMODIALYSIS IS A TEMPORARY REPLACEMENT OF THE KIDNEY USED FOR REMOVING EXCESS FLUID, SALT AND WASTES FROM THE BLOOD. IT IS THE MOST FREQUENT TREATMENT METHOD OF CHRONIC RENAL FAILURE (KIMMEL, 2010). • A PATIENT WITH ESRD WHO USES HAEMODIALYSIS FACES IN ADDITION TO A DEBILITATING AND DISRUPTIVE CHRONIC ILLNESS, A TREATMENT REGIMEN THAT IS COMPLEX, DEMANDING AND INCESSANTLY INTRUSIVE ON PERSONAL AND SOCIAL LIFE AND THE INTRUSIVENESS OF THESE THOUGHTS IS RELATED TO DEPRESSION (CHRISTENSEN AND EHLERS, 2014). • THE IMPORTANCE OF HAVING AN ACCURATE ESTIMATE OF FREQUENCY AND NATURE OF PSYCHOSOCIAL PROBLEMS FACED BY HAEMODIALYSIS RECIPIENTS WHICH IS AFFECTING THEIR COPING WITH THE ILLNESS HAS TRIGGERED THE INTEREST IN THIS STUDY. THEREFORE THIS RESEARCH WAS CONDUCTED TO ASSESS THE PSYCHOSOCIAL STATUS OF HAEMODIALYSIS RECIPIENTS IN SELECTED HOSPITALS IN ANAMBRA STATE.

PURPOSE OF STUDY • THE PURPOSE OF STUDY IS TO ASSESS THE PSYCHOSOCIAL STATUS OF HAEMODIALYSIS RECIPIENTS IN SELECTED HOSPITALS IN ANAMBRA STATE, NIGERIA SO AS TO CREATE AN EVIDENCE BASE FOR THE DEVELOPMENT OF AN INFORMATION BOOKLET FOR A COMPREHENSIVE PSYCHOSOCIAL CARE. • SPECIFIC OBJECTIVES WILL SEEK TO: 1. ASSESS THE LEVEL OF DEPRESSION OF HAEMODIALYSIS RECIPIENTS. 2. ASSESS THE LEVEL OF ANXIETY OF HAEMODIALYSIS RECIPIENTS. 3. EVALUATE THE QUALITY OF LIFE OF HAEMODIALYSIS RECIPIENTS. 4. DETERMINE THE LEVEL OF FATIGUE OF HAEMODIALYSIS RECIPIENTS.

Hypotheses H 01: There is no significant relationship between depression and age of haemodialysis recipients. H 02: There is no significant relationship between anxiety and age of haemodialysis recipients. H 03: There is no significant relationship between quality of life and level of education of haemodialysis recipients. H 04: There is no significant relationship between presence of fatigue and age of haemodialysis recipients.

SCOPE OF THESIS • THIS STUDY WILL BE DELIMITED TO IN PATIENTS AND OUT PATIENTS RECEIVING HAEMODIALYSIS IN NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, ST CHARLES SPECIALIST HOSPITAL ONITSHA, AND IYI-ENU MISSION HOSPITAL OGIDI.

STATEMENT OF PROBLEM • PSYCHOSOCIAL ISSUES ARE UNDERSTUDIED YET AN IMPORTANT CONCERN IN THE OVERALL HEALTH OF HAEMODIALYSIS (HD) PATIENTS. • DUE TO THE PAUCITY OF EMPIRICAL STUDIES SET IN ANAMBRA STATE, NIGERIA, THE RESEARCHER IS MOTIVATED TO EXAMINE THE PSYCHOSOCIAL STATUS OF HAEMODIALYSIS RECIPIENTS IN SELECTED HOSPITALS OF ANAMBRA STATE, NIGERIA.

THEORETICAL FRAMEWORK THE BIOPSYCHOSOCIAL MODEL OF HEALTH AND ILLNESS BY GEORGE ENGEL WILL BE ADOPTED FOR THE STUDY. IT COMPRISES: • BIOLOGICAL INFLUENCES ON HEALTH • PSYCHOLOGICAL INFLUENCES ON HEALTH • SOCIAL INFLUENCES ON HEALTH

• ASSUMPTIONS • IT IS ASSUMED THAT; • PATIENTS WITH END STAGE RENAL FAILURE MAY HAVE BOTH PLEASANT AND UNPLEASANT EXPERIENCE. • HAEMODIALYSIS PATIENTS WILL HAVE MORE PSYCHOSOCIAL PROBLEMS

METHODOLOGY • RESEARCH DESIGN • A NON-EXPERIMENTAL DESCRIPTIVE RESEARCH DESIGN WILL BE ADOPTED FOR THE STUDY. • AREA OF THE STUDY THE LOCATION OF THE STUDY WILL BE THE DIALYSIS UNIT OF NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, ST CHARLES BORROMEO SPECIALIST HOSPITAL ONITSHA AND IYIENU MISSION HOSPITAL OGIDI ALL IN ANAMBRA STATE.

METHODOLOGY (CONT’D) TARGET POPULATION THE TARGET POPULATION FOR THE STUDY WILL COMPRISE HAEMODIALYSIS RECIPIENT PATIENTS WHO WILL BE ACCESSIBLE AT THE THREE CENTRES. INCLUSION CRITERIA WERE: • IN PATIENTS OR OUT PATIENTS RECEIVING HAEMODIALYSIS (NOT LESS THAN 2 WEEKS). • BOTH MALE AND FEMALE PATIENTS AGED BETWEEN 20 TO 60 YEARS. • ABLE TO UNDERSTAND, SPEAK ENGLISH AND IGBO LANGUAGE.

METHODOLOGY (CONT’D) THE EXCLUSION CRITERIA • UNCONSCIOUS PATIENTS • CLIENTS WITH DOCUMENTED DIAGNOSIS OF ALZHEIMERS OR SIMILAR MEMORY LOSSES. • CLIENTS WITH INTERRUPTIONS OF THEIR REGULAR DIALYSIS SCHEDULED BECAUSE OF ILLNESS, ACCESS MALFUNCTIONS OR VACATIONS. THE EXCLUSION CRITERIA WERE NECESSARY TO OBTAIN PARTICIPANTS WHO UNDERSTOOD THE DETAILS OF THE

METHODOLOGY (CONT’D) • SAMPLE SIZE • THE SAMPLE OF THIS RESEARCH WAS CALCULATED USING TARO YAMANE’S FORMULA WITH 95% CONFIDENCE LEVEL. (YAMANE, 1967) • THE CALCULATION FROM A POPULATION OF 172 (PREVIOUS POPULATION APPROXIMATION) BECAME 120 HAEMODIALYSIS RECIPIENTS FROM ALL THE THREE RENAL CENTERS • SAMPLING TECHNIQUE • MULTI STAGED CLUSTER SAMPLING TECHNIQUE WILL BE ADOPTED FOR THE STUDY.

METHODOLOGY (CONT’D) • INSTRUMENT OF DATA COLLECTION • AN ADAPTED STRUCTURED RATING SCALE QUESTIONNAIRE WILL BE USED FOR DATA COLLECTION. • VALIDITY OF THE INSTRUMENT • THE INSTRUMENT (QUESTIONNAIRE) DESIGNED BY THE RESEARCHER WILL BE VALIDATED BY THE RESEARCH SUPERVISOR, CLINICAL NURSE PSYCHIATRIST, CLINICAL MEDICAL PSYCHOLOGIST AND TWO OTHER LECTURERS IN THE DEPARTMENT OF NURSING TO ENSURE VALIDITY AND TO EXAMINE THE ITEMS FOR AMBIGUITY AND CLARITY.

METHODOLOGY (CONT’D) • RELIABILITY OF THE INSTRUMENT • TEST- RETEST WAS USED TO DETERMINE THE RELIABILITY OF THE INSTRUMENT, AND IT WAS CALCULATED USING CRONBACH’S ALPHA. A RELIABILITY MEAN OF 0. 772 WHICH INDICATED HIGH RELIABILITY WAS OBTAINED.

METHODOLOGY (CONT’D) • ETHICAL CONSIDERATION • ETHICAL CLEARANCE WILL BE OBTAINED FROM THE THREE HOSPITALS THAT WILL BE USED FOR THE STUDY. • METHOD OF DATA COLLECTION • DATA COLLECTION PROCEDURE WILL BE EXPLAINED TO EACH STUDY PARTICIPANT WHILE PROVIDING PRIVACY AND CONFIDENTIALITY OF THE DATA. • METHOD OF DATA ANALYSIS • THE DATA WILL BE ANALYZED USING DESCRIPTIVE AND INFERENTIAL

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