Psychosocial factors associated with perceived psychological health, perception of menopause and sexual satisfaction in menopausal women and controls.

OBJECTIVES: The study investigated factors associated with attitude towards sex-role, self-image and marital satisfaction on psychological health status, perception of menopause and sexual satisfaction in climacteric women in Ibadan, Nigeria. SUBJECTS AND METHODS: 45 female participants were randomly selected from Ibadan. The mean age was 51.42 +/- 8.05 years (range = 36 - 70 years). The mean age for the 13 non-menopausal women was 42.79 +/- 3. 91 years (range = 42 - 47 years) while the mean age for the 32 menopausal women was 5.16 +/- 6.08 years (range = 47 - 70 years). The mean age of the children of the participants was 16.05 +/- 8.09 years (range = 1 - 36 years). A questionnaire having several subsections (consisting of the psychological health status of women in the climacteric, attitude towards sex role, perception of menopause, social support, marital satisfaction, self-image and sexuality scales was used for the assessment. RESULTS: Post-Menopausal women reported better psychological health compared to the pre-menopausal women (t = 1.86, p < .05) but no significant differences in their attitude to sex role. Post menopausal women had more positive attitude to sex (t = 3.15, p < .01) and were more knowledgeable about menopause (t = 2.15, p < .03). Women with conservative/reactionary preference for traditional sex roles reported negative perception of menopause compared to those with liberal attitude toward sex role (t = 1.82, p < 0.05). Menopausal Status, Educational level and social support predicted positive attitude to sex, (F = 3.62, P < .01). Age, self-image and attitude to sex domain of the marital satisfaction scale predicted better psychological health, and marital cordiality predicted better psychological health as measured by GIIQ (R2 = 25, beta = -43, t = -2.38, P < .02). Marital satisfaction significantly predicted better sexuality, (F = 5.47, R square = 0.11, p <0.05). Sources of information on menopause included health institutions, books, doctors, and books/health workers. CONCLUSION: The study highlights the need for sensitizing menopausal Nigerian women on how to improve their self-image, marital satisfaction, and sexual satisfaction. Conventional treatment options emphasizing hormone replacement therapy, need for nutritional supplement, dietary changes, marital and sex therapy are emphasized.

Evaluation of the effect of cognitive therapy on perioperative anxiety and depression among Nigerian surgical patients.

STUDY OBJECTIVE: Surgical paients have been known to benefit immensely from psychological interventions. This study set out to assess the pre and postoperative 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.

Psycho-educational therapy among Nigerian adult patients with epilepsy: a controlled outcome study.

Psychological interventions in relation to epilepsy are worthy of empirical investigation since there is broad agreement that the psycho-social problems of epilepsy are often more disabling than the seizure attacks. The present study using a controlled outcome design evaluated the efficacy of a 2-day psycho-educational program among patients with epilepsy in Nigeria. The psycho-educational program is the consequence of a two-stage study design, which set out to identify and evaluate psycho-social factors that determine interictal psychopathology in people with epilepsy. Thirty out-patients matched according to seizure type and frequency of seizures were randomly assigned to treatment (n = 15) or waiting-list control (n = 15) groups. The major outcome measures used were knowledge about illness schedule, the Becks depression inventory and the Crown-Crisp experiential index. Significant differences between the two groups were found on the three major scales used. The treatment group by within-group analyses, showed a substantial significant decrease in level of depression, a significant increase in the knowledge about epilepsy as well as a significant decrease in all measures of neurotic disorders except for hysterical sub-scale.