CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

The Nigerian health sector is one of the most important and pivotal sectors for the Nigerian economy, its workers though constantly been looked down upon have always been doing their best in ensuring a healthy nations, this is because as the saying goes, that a healthy nation is a wealthy nation. For Nigeria to achieve its economic goals and objectives, the health sector and indeed its workers must be adequately looked after.

In ensuring that health workers in Nigeria are adequately taken care of a lot of factors must be considered; chief amongst these factors are the influence of demographic variables and personality traits on psychological distress of theses health workers. For workers and especially in the health sector to give their best in ensuring a healthy nation, they must be psychological fit and alert to render their service. The personality traits and demographic variables are so important in achieving health workers psychological stability since these workers are constantly being exposed to health hazards.

Psychological distress is widely used as an indicator of the mental health of the population in public health, in population surveys and in epidemiological studies and, as an outcome, in clinical trials and intervention studies. Yet the concept of psychological distress is still vague for some. Indeed, a closer look at the scientific literature shows that the expression “psychological distress” is often applied to the undifferentiated combinations of symptoms ranging from depression and general anxiety symptoms to personality characteristics, functional disabilities and behavioural problems. The aim of this chapter is to provide a critical review of the clinical features, assessment and prevalence of psychological distress of health workers and of the empirical evidence on the risk and protective factors associated with psychological distress in the general Nigerian population. Health Workers deserve special attention since they are exposed to specific risk and protective factors that may modify the impact of more general factors.

Psychological distress is basically defined as a state of emotional suffering characterized by symptoms of lossof interest; sadness; hopelessness and anxiety (e.g., restlessness; feeling tense) (Mirowsky and Ross 2002). These symptoms may be tied in with somatic symptoms (e.g., insomnia; headaches; lack of energy) that are likely to vary across cultures (Kleinman 1991, Kirmayer 1989). Additional criteria have been used in the definition of psychological distress but these criteria do not make consensus. In particular, tenants of the stress-distress model posit that the defining features of psychological distress are the exposure to a stressful event that threatens the physical or mental health, the inability to cope effectively with this stressor and the emotional turmoil that results from this ineffective coping (Horwitz 2007, Ridner 2004). They argue that psychological distress vanishes when the stressor disappears or when an individual comes to cope effectively withthis stressor (Ridner 2004). There is plenty of evidence confirming the effect of stress on distress; however, including stress in the definition of distress fails to recognise the presence of distress in the absence of stress. The status of psychological distress in the psychiatric nosology is ambiguous and has been debated at length in the scientific literature. On the one hand, psychological distress is viewed as an emotional disturbance that may impact on the social functioning and day-to-day living of individuals (Wheaton 2007). As such, it has been the object of numerous studies seeking to identify the risk and protective factors associated with it. On the other hand, distress is a diagnostic criterion for some psychiatric disorders (e.g., obsessive-compulsive disorders; posttraumatic stress disorder) and, together with impairment in daily living, a marker of the severity of symptoms in other disorders (e.g., major depression; generalized anxiety disorder) (Phillips 2009, Watson 2009). Thus, psychological distress would be a medical concern mostly when it is accompanied by other symptoms that, when added up, satisfy the diagnostic criteria for a psychiatric disorder. Otherwise, in line with the stress-distress model, it is viewed as a transient phenomenon consistent with a “normal” emotional reaction to a stressor.

STATEMENT OF THE PROBLEM

The constant depreciation of our health sector that has led to medical tourism has been a cause for serious concern as the economy has been worse for it. A good fortune have been lost on medical tourism, this some may say may be as a result of poor government policies and implementation but health workers should shoulder some portion of the blame. The psychological awareness has severally been called into question owing to the incessant deaths recorded in the hospitals in Nigeria.

In ending this menace of medical tourism in Nigeria, all hands must be on deck and our health workers must be as psychologically distress free.

AIMS AND OBJECTIVES OF THE STUDY

The following are the aims and objectives of the study

1. To examine the psychological alertness of health workers in Nigeria in LUTH Lagos.
2. To examine the relationship between demographic variables and the psychological distress level of health workers in LUTH Lagos
3. To examine the relationship between personality characteristics and psychological distress among health workers in LUTH Lagos.
4. To outline other causes of psychological distress among health workers in LUTH Lagos.

RESEARCH QUESTIONS

• Are health workers in Nigeria in LUTH Lagos psychological alert?
• Is there a relationship between demographic variables and the psychological distress level of health workers in LUTH Lagos?
• Is there a relationship between personality characteristics and psychological distress among health workers in LUTH Lagos?
• What are the other causes of psychological distress among health workers in LUTH Lagos?

RESEARCH HYPOTHESES

H0: There is no relationship between demographic variables and psychological distress level of health workers

H1:There is a relationship between demographic variables and psychological distress level of health workers

H0: There is no relationship between personality characteristics and psychological distress level of health workers

H1: There is a relationship between personality characteristics and psychological distress level of health workers.

SIGNIFICANCE OF THE STUDY

The outcome of this study would be of immense benefit to the government in addressing the challenges of the health workers with a view to improving their working condition and making them psychological task in other to contribute their quota in reducing medical tourism in Nigeria.

This study would of course be of immense benefit to students and researchers who are interested in achieving psychological stability in Nigeria’s health work force.

SCOPE/LIMITATIONS OF THE STUDY

This study is on the influence of demographic variables and personality characteristics in psychological distress among health workers in LUTH Lagos state.

LIMITATION OF STUDY

Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

DEFINITION OF TERMS

Demography:the study of statistics such as births, deaths, income, or the incidence of disease, which illustrate the changing structure of human populations.

Psychology:the mental characteristics or attitude of a person or group.

Distress: extreme anxiety, sorrow, or pain.

Tourism:the commercial organization and operation of holidays and visits to places of interest.

REFERENCES

Al-Krenawi, A., and J.R. Graham. 2000. "Culturally sensitive social work practice with Arab clients in mental health settings." Health and Social Work no. 25:9-22.

Albertsen, K., M.L. Nielsen, and V. Borg. 2001. "The Danish psychosocial work environment and symptoms of stress: the main, mediating and moderating role of sense of coherence." Work and Stress no. 15:241-253.