Psychiatry

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Browsing Psychiatry by Author "Alem Atalay"

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    Lived Experience of Care Givers of People with Dementia (Major Neuro Cognitive Disorders) in Addis Abeba:a Qualitative study.
    (Addis Ababa University, 2019-06) Gashaw Fanuel; Alem Atalay; Alemayehu Biruh
    Introduction:Dementia is a multifactorial syndrome characterized by Impairment in memory, communication, judgment, orientation, problem solving and cognition. People with dementia require increasing amounts of assistance in activities of daily living and behavioral symptoms. In low income countries most of the assistance is provided by informal care givers. There is no available study on care givers of dementia patients and their lived experience. Objective:To explore and describe lived experience of care givers of people living with dementia. Method:A qualitative research design was used. Participants were recruited using purposive sampling. Sampling was until theoretical saturation is achieved. Six in depth interviews were done. The interviews were audio recorded, transcribed in Amharic and translated in English. Thematic analysis was used to identify key themes. Results:The major findings from this study are care givers lack understanding about the diagnosis of dementia .Care givers day to day life is filled with assisting their care recipients and dealing with problematic behaviors. Negative emotional states and financial problems were raised in association with care giving process. They tend to be more involved in religious activities and seek help from other family members to deal with the challenges.
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    The Lived Experience of First Responder Traffic officers in Addis Ababa,Ethiopia.
    (Addis Abeba University, 2020-06) Gezachew Soleyana; Alem Atalay ; Hai Henok
    First responders are among the occupational groups that are susceptible to numerous events that might affect their well-being and may be regarded a "high-risk" occupational category with a wide variety of physical and mental health effects because they have work-related exposure to serious events Stress in first responders is caused by something other than emergencies; it can also be triggered by personal and work-life circumstances. Besides, police staff, including traffic police, may encounter unique occupational stressors. This phenomenological study aims to explore the lived experiences of First Responder Traffic officers in Addis, Ababa, Ethiopia. 15 participants from different sub-cities were selected using convenience sampling and interviewed using topic guide questions then data were analyzed using thematic analysis. Five themes were identified; Challenges faced in the profession, Impacts of being first responder traffic professional, Experience of emotional distress and its effects, coping mechanisms, and Perception of Mental health and being first responder professionals. Results indicate that. First responder traffic officers experience numerous problems arising from their professional duties related to various major road collisions involving tragic deaths and civilian injury. To cope with the distress, first responder traffic officers use various coping mechanisms such as social support; support from colleagues; activities that can help them to relax can also have constructive effects on these professionals. Positive aspects of the profession like educating people, providing care and satisfaction were also identified. This research highly recommends further researches to be done in this area and a possible intervention program for these professionals.
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    Pathway of Patient to Amanuel Specialized Mental Health Hospital: A Facility Based Cross Sectional Study
    (Addis Ababa University, 2021-11) Abdela Tofik; Alem Atalay
    Introduction:-Pathway to care is a process in which a patient with mental illness goes throughbefore seeking help from mental health professional. According to the Goldberg-Huxley modelof the pathway psychiatric care in order to get visit to psychiatrists it should have to pass threefilters starting from community setting. Back ground:- The Pathway the patient influenced by many one of them is distribution ofpsychiatric care facility. In developed country the first focal point in pathway is Generalpractitioner which looks identical to the Goldberg and Huxley model. In low- and middle-incomecountries (LMICs) most of the patients with mental illness seek treatment from the traditionaland religious modality of treatment. A meta-analysis of pathway studies in sub-Saharan Africaindicates approximately equal initial choice of biomedical (49.2%) and alternative (48.1%)mental healthcare pathways. A study done on 2003 at ASMH also showed that less than half ofmental illness patients directly contacted a mental hospital, and the median delay between onsetof illness and arrival at the psychiatric hospital was 38 weeks. Other two studies done inNorthern and South west Ethiopia showed than the median delay was 52 weeks. Objective:- The objective of the study was to measure time of delay to reach Amanuel hospitalfrom the onset of symptom to getting care. The effect of sociodemographic factors on thepathway to way care. It also tried to assess the associated factors which affect the delay toseeking modern psychiatric care. Generally it used to see the change that occurred in the past 18years after implementation of different intervention on development of psychiatric care. Method:- Directly data was collected from patient or attendant of patient who visited AmanuelEmergency and outpatient OPD for the first time from16th, 2021 –July 31st2021 with WHOencounter form. Once the data was collected it was exported to Excel spreadsheet and cleanedand checked for error and missing variable and, then it was exported to SPSS version 26 anddescriptive analysis was done. Result:-The study found the median delay to get psychiatric care at AMSH was 20 week whereas in any modern institution who gave psychiatric service was 14 weeks. The study also foundthat young or old Age, being married or divorced , elementary or secondary school level ofeducation, first point of care to traditional healer or religious treatment were predictors of delayto get psychiatric care.
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    Patient Satisfaction on Inpatient Psychiatric Care at Amanuel Mental Specialized Hospital. Addis Ababa; Ethiopia. A Qualitative Study
    (Addis Ababa University, 2018-11) Fanta Biruk ; Alem Atalay
    Background:-Patient satisfaction has been recognized as essential component and reliable indicator for quality of patient care. Identifying factors which affect patient satisfaction and working to improve it will improve patient related treatment out comes like compliance to treatment. There are factors that are considered to affect psychiatric inpatient satisfaction such as relation with staff, environmental factors and treatment related factors etc. Objective: - The objective of this study was to explore patient satisfaction in psychiatric inpatient care and associated factors in a specialized mental hospital. Method:-User led semi-structured in depth interview was done on sixteen patients who were using the inpatient care in the hospital. Results: - Participants reported that they had high level of satisfaction with regards to; relation with staff,safety of self, ward cleanliness and comfort, opportunity for activity and the treatment for their illness.However less satisfaction was reported in other areas of need such as involvement in treatment decision,information provision, safety of property, freedom of movement, quality of food and duration of stay in the hospital. Conclusion:-The results of this study are generally in line with the results established in the literature. It provides insight about areas of the inpatient care that can be improved to optimize patient satisfaction in this setting and so the quality of care which in turn could bring about desired patientbehaviors with regard to their treatment to enhance their mental wellbeing and quality of life
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    The Pattern of Engagement to Care After First Emergency Psychiatry Visit at Amanuel Specialized Mental Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2018-12) Girma Abayneh; Alem Atalay
    Background: - Aim of this study was to give an overview of how patients were engaging tothe service at the Hospital after first emergency visit to identify the gaps in the service andfactors associated with disengagement to care. Psychiatric service in Ethiopia has beenprovided by Amanuel Hospital for the entire country for many years and the service was notyet decentralized well. But there has not been systematic study conducted to see how patientswere engaging to care after visit. We believe the findings will help to plan to improve theservice and it will also raise questions for further research. Objective: - To describe the pattern of engagement to care after first emergency psychiatryvisit at Amanuel Specialized Mental Hospital. Methods: - A retrospective study was conducted involving those who visited emergencyoutpatient department unit at ASMH from December /2015 to November /2016. Data extraction sheet were used to collect information for the study. All cases who visitedemergency OPD of ASMH for the first time during the study period were included forstratified simple random sampling and 385 participants were included in the study. The datasheets were coded and data entry, cleaning and analysis was done using the StatisticalPackage for the Social Sciences (SPSS) version 20.bivariate and Multivariate logisticregression was done to see socio-demographic and other determinants of disengagement to care Results: -Three hundred and eighty five cases were included in the study. Of these, 57.4%were males. The mean age of the participants was 31 years. In terms of region, majority ofthe participants (near to 71%) come from either from Oromia (47%) or Addis Ababa(23.6%).In majority of the participants (83.1%) the main reason for emergency visit was either aggression or other behavioral disturbance and near to 76% got diagnosis of nonaffectivepsychotic spectrum disorder. Near to 81% of the participants have disengaged fromcare and from those who were disengaged 44.5% had no re-visit to the hospital. Amongparticipants 90.3% of female and 77.4% of male who were included in the study disengagedfrom care. Majority of the participants (75.6%) were seen by Master or BSC psychiatryprescriber’s and only 9.9% of the participants were seen by either psychiatrist or psychiatryresidents at first visit. Near to 95% of those participants seen by non-psychiatry professionalswere disengaged from care. Conclusion: - disengagement from care has deleterious effect on over all prognoses ofpatients and mental health care system in general. Proper emphasis should be given forpsychosocial interventions specially giving due emphasis on psycho-education about illness,lifestyle management, family intervention and support, relapse prevention strategies. Recommendation: - Giving proper psycho-education and patient centered care should bethe rule than the exception. Improving the referral system, working in co-ordination andcollaboration with other health institutions and religious leaders might help to improvepatient care and engagement.
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    The Practice of Psycho-Education for People with Mental Illness Receiving Treatment at Amanuel Specialized Mental Hospital
    (Addis Ababa University, 2018-01) Oldisha Addisalem; Alem Atalay
    Background: Psycho-education has been one of the core components of psychiatric treatmentmethods for some time. However, there is no information about the practice of psycho-educationamong clinicians at Amanuel Hospital.Aim: The purpose of this study was to assess the practice of psychoeducation provided for peoplewith mental illness receiving treatment at Amanuel Specialized Mental Hospital and to see itsassociation with treatment adherence. Method: Quantitative approach was employed to conduct the study. The study was conducted onselected consecutive outpatients attending follow-up clinics at Amanuel Hospital. Records of 1128patients were obtained from the outpatient clinic for sampling. Of these, 120 were selected fromdifferent types of disorders using simple random sampling technique. A questionnaire developed by the PI and MMAS were used to collectdatafromtherespondents. Data analysis was conductedusing SPSS version 20. Results: The majority of the participants (54.2) were men, 52.5% were single, and 60.0%Christians and 40.0% were Muslims. Over 80.0% were unemployed and 45.0% had attained high school level of education. 58.3% of the participants reported that they had not received anyinformation about their illness. Among those who had received psycho-education, only 42% of themsaid patients receive information about precautions to take to prevent relapse. This study showed that there is a significant association between gender, age, educational level, marital status, employment status, residence, and psycho-education. These socio-demographic variables were also associated with medication adherence. The participants who reported to have received psychoeducationwere more likely to adhere to treatment compared to those who had not received it. Conclusion: The finding suggests that the practice of psycho-education provided for outpatients at Amanuel Hospital is very limited.
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    Socio-Demographic and Clinical Characteristics of New Cases Seen, and Initial Clinician Decisions at Amanuel Mental Specialized Hospital, AA, Ethiopia: A Retrospective Chart Review
    (Addis Abeba University, 2020-10) Bacha Abdi; Abera Selam; Alem Atalay
    Background: Amanuel Mental Specialized Hospital which is situated in the capital, Addis Ababa is the only mental health hospital in Ethiopia. The hospital has a huge burden in offering both inpatient and outpatient services for patients who come from all regions of the country.Having access to this hospital for treatment and continuing follow-up is also a challenge formany patients. Studying the characteristics of patients seen at this hospital will be a good inputfor the decentralization of mental health services which the country is implementing. Objective: To assess socio-demographic and clinical characteristics of new patients seen, anddecisions made by clinicians who did the first evaluation, at AMSH. Methodology: A retrospective chart review of 384 new cases who had been seen at AMSH fromSeptember 11, 2019, to March 9, 2020, was done in August 2020. Sampling was done bysystematic random sampling method. Data analysis was done by using SPSS V25. Result: The majority of patients were from Oromia 196(51%) followed by Addis Ababa 105(27.3 %). The majority of cases 298(77.6%) were labeled as regular after triage. The majority ofpatients 327 (85.2%) came without a referral. Schizophrenia spectrum and other psychotic disorders 180(46.9%) were the most common diagnosis followed by depressive disorders 63(16.4%) and epilepsy 29(7.6%). The majority of cases 338(88%) were managed as outpatient and prescribers with BSc or MSc in psychiatry 91(48.4%) were the most common cliniciansidentified to do the first evaluation for the new cases followed by GPs 48(25.5%). Of tota patients, 359(93.5%) did not require medications other than risperidone, chlorpromazine,haloperidol, diazepam, clonazepam, amitriptyline, fluoxetine, sodium valproate, phenobarbital,and benzhexol(Artane). Conclusion: The majority of new patients come to AMSH for a service that can be provided atprimary health care units. Increasing public awareness about mental health services and strengthening mental health services provided in primary health care units and other hospitals bystakeholders is recommended to decrease patient overload at AMSH and help the patients ingetting mental health services in their vicinity.