Effect of a novel pilot support group on distress and quality of life in breast cancer patients in Nigeria.

OBJECTIVE: To assess the effect of a new breast cancer support group (BCSG) on breast cancer patients' self-reported distress and quality of life. METHODS: A single arm pre-post trial providing an eight session healthcare provider led BCSG. Primary outcome variables were distress and quality of life assessed using the National Comprehensive Cancer Network Distress Thermometer (DT) and The Functional Assessment of Cancer Therapy - Breast plus Arm Morbidity (FACT-B+4), respectively. Topics in each session addressed a wide range of issues some of which were pre-selected by the patients themselves. DATA ANALYSIS: Paired sample t-test was used for data analysis on International Business Machine Statistical Package for the Social Sciences 21. RESULTS: The participants (N = 18) had a mean age of 51. Most had secondary school level education (54%), were traders (59%) and had stage 3 or 4 disease (67%). A larger proportion (78% or n = 14) of the patients lived in rural areas, while 4 (22%) of the patients lived in Ibadan. Out of the 8 sessions, 12 (67%) of the participants attended 1-3 sessions while 6 (33%) attended 4-8 sessions. There were, significant improvements in emotional wellbeing (t = -4.253; p < 0.05) and functional wellbeing (t = -2.191; p < 0.05) on the FACT-B+4. There was a significant reduction in the DT score (t = 2.345; p < 0.05) but the number of items on the problem list were not significantly reduced (t = 1.191; p > 0.05). Majority (75%) of the patients rated the support group activities as satisfactory. CONCLUSION: These data show that the support group can benefit breast cancer patients in terms of reduced distress levels along with satisfaction and improvement in the functional and emotional wellbeing indices of quality of life.

Contraceptive intentions of survivors of severe acute maternal morbidity in Kaduna State, Nigeria.

OBJECTIVE: Intention to use modern contraception in women with severe acute maternal morbidity (SAMM) presents a window of opportunity to scale up postpartum family planning to prevent future complications. The aim of this study was to determine the factors that affect the contraceptive intentions of women who survive SAMM in Kaduna State, northern Nigeria. METHODS: SAMM survivors aged 15-49 years were recruited after recovery and interviewed before discharge from hospital. RESULTS: Of the 330 women studied, 246 (74.5%) had wanted the index pregnancy. Although their knowledge of modern contraception was good (89.1%), only 44.5% had ever used modern contraception. The main reason given for not wanting to use modern contraception was that God should decide on the number of children. Injectables, pills, implants and male condoms were the commonest contraceptive methods used. Of the women who gave reasons for stopping these contraceptives, the main reasons in 61% were desire to conceive and fear of side effects. The majority (72.4%) of the women wished to have more children and 69.1% intended to use contraception in the future. The husband's permission was needed by 78.2% of respondents before using contraception. The commonest reason given for not wanting to get pregnant again was to avoid complications (30.4%) and that family size had been completed (28.6%). CONCLUSION: Male partner involvement and counselling to address religious views and fear of side effects are critical to the acceptance of postpartum family planning in SAMM survivors.

Nigerian secondary school children's knowledge of and attitudes to mental health and illness.

BACKGROUND: Children tend to lack knowledge of, and hold negative attitudes towards mental illness. However, most of the work undertaken in Nigeria has been done with adults. AIMS: To establish the views and knowledge about mental health and illness in pupils at four secondary schools in rural and urban Southwest Nigeria. METHODS: A cross-sectional survey based on a questionnaire previously used in the UK and adapted to Nigeria. RESULTS: Data from 145 Nigerian schoolchildren showed little knowledge of, negative attitudes and social distance towards persons with mental health problems. Urban participants and boys appeared less knowledgeable than rural children and girls. CONCLUSIONS: Nigerian schoolchildren, as with Nigerian adults and young people in Western countries, show stigma towards mental illness. This may be underpinned by a lack of knowledge regarding mental health problems. Educational interventions need to be appropriate to area, age and gender to effectively improve mental health literacy, which in turn will influence attitudes and social distance. However, the fact that the schoolchildren were optimistic about recovery is a strength that could be built upon.