Adegoke Musa Olatunji

CHAPTER FOUR RESULTS AND DISCUSSION OF FINDINGS In this chapter, the results obtained from data analysis are presented and discussed. three hundred and three (303) copies of questionnaire were administered but only 270 copies which is 89% were retrieved and valid. Therefore, the result presented in this chapter is based on the valid 270 copies retrieved from the respondents across the 12 health facilities in Ilorin East Local Government Area. The demographic results were presented in charts while answers to research questions were provided in tables using frequency and percentage. Figure 1: Age distribution of the Pregnant mothers in Ilorin East Local Government Figure 1 showed that majority of pregnant women (154 of 270) participating in the study were young adults between the ages of 18 and 22. While there were fewer women in older age groups, a significant proportion of the study population was still within the reproductive years. This suggests that a significant portion of the pregnancies in the study area occurred among younger women. Figure 2: Distribution of the Pregnant mothers in Ilorin East Local Government based on educational level Figure 2 presents the educational attainment of pregnant women in the study. The majority of women (141, 49.1%) had completed a tertiary education, indicating a relatively high level of education among the participants. A significant number of women (69, 24%) had completed secondary education, while a smaller proportion (64, 22.3%) had no formal education. Only 13 women (4.5%) had completed primary education. The data suggest that a majority of the pregnant women in the study had attained a tertiary education, highlighting the relatively high educational level of the study population. While a portion of the women had no formal education, the overall trend indicates a significant proportion of women with secondary or tertiary education. Figure 3: Distribution of the Pregnant mothers in Ilorin East Local Government based on marital status Figure 3 indicate that the majority of the pregnant women in the study were married. While a significant number of women were single-mothers, the proportion of women who were divorced or widowed was relatively small. Figure 4: Distribution of the Pregnant mothers in Ilorin East Local Government based on Religion Figure 4 presents the religious affiliations of the pregnant women in the study. The majority of women (207, 72.1%) identified as Muslim, followed by Christians (58, 20.2%). A smaller proportion of women adhered to traditional religious beliefs (6, 2.1%), while others (16, 5.6%) identified with different religions. The data indicate that Islam is the predominant religion among the pregnant women in the study. While Christianity is also represented, a significant portion of the women adhere to traditional or other religious beliefs. Figure 5: Distribution of the Pregnant mothers in Ilorin East Local Government based on occupation Figure 5 showed presents the occupations of the pregnant women in the study. The most common occupation among the participants was unemployed (112, 39%), followed by the civil service (68, 23.7%) and business (65, 22.6%). A smaller proportion of women were housewives (42, 14.6%). The data indicate that a significant portion of the pregnant women in the study were unemployed. While the civil service and business were also represented, a considerable number of women were not employed at the time of the study. Answer to Research Questions Research Question One: What is the level of knowledge about puerperium psychosis among pregnant mothers attending health facilities in Ilorin East LGA? Table 2: Descriptive analysis of Knowledge about Puerperium Psychosis ITEM YES NO I DON’T KNOW Have you heard of the term "puerperium psychosis" before? 219 76.3% 61 21.3% 7 2.4% Puerperium psychosis is a mental health condition that occurs after childbirth 221 77.0% 25 8.7% 41 14.3% Puerperium psychosis typically occurs within the first few weeks after delivery. 202 70.4% 42 14.6% 43 15.0% Puerperium psychosis is a common condition among new mothers. 188 65.5% 57 19.9% 42 14.6% Puerperium psychosis can affect both the mother and the baby. 161 56.1% 80 27.9% 46 16.0% Table 2 presents the level of knowledge about puerperium psychosis among the study participants. The majority of women (219, 76.3%) had heard of the term "puerperium psychosis" before, while 61 (21.3%) had not and 7 (2.4%) were unsure. Regarding the understanding of puerperium psychosis, a significant proportion of women accurately identified it as a mental health condition that occurs after childbirth (221, 77%) and as a condition that typically occurs within the first few weeks after delivery (202, 70.4%). However, there was less clarity about the prevalence of the condition, with 188 women (65.5%) believing it to be common among new mothers. Furthermore, while a majority of women recognized that puerperium psychosis can affect the mother (161, 56.1%), there was less awareness of its potential impact on the baby. Only 80 women (27.9%) were aware that the condition could affect both the mother and the baby. In summary, the respondents have knowledge of puerperium psychosis. Research Question Two: What is the level of knowledge Risk Factors of Puerperium Psychosis among pregnant mothers attending health facilities in Ilorin East LGA? Table 3: Descriptive analysis of Knowledge of Risk Factors of Puerperium Psychosis S/N ITEM YES NO I DON’T KNOW 6 A history of mental illness increases the risk of developing puerperium psychosis. 234 81.5% 22 7.7% 31 10.8% 7 Stressful life events during pregnancy can contribute to puerperium psychosis. 214 74.6% 36 12.5% 37 12.9% 8 Lack of family support is a risk factor for puerperium psychosis. 201 70.0% 54 18.8% 32 11.1% 9 Sleep deprivation after childbirth can increase the risk of puerperium psychosis. 191 66.6% 65 22.6% 31 10.8% 10 Substance abuse during pregnancy is a risk factor for puerperium psychosis 201 70.0% 58 20.2% 28 9.8% 11 Women who have experienced postpartum depression are more likely to develop puerperium psychosis. 209 72.8% 36 12.5% 42 14.6% 12 Poor nutrition during pregnancy can increase the risk of puerperium psychosis 168 58.5% 83 28.9% 36 12.5% 13 Financial difficulties during pregnancy or after childbirth can contribute to puerperium psychosis. 183 63.8% 67 23.3% 37 12.9% 14 First-time mothers are at higher risk of developing puerperium psychosis. 169 58.9% 82 28.6% 36 12.5% Table 3 presents descriptive analysis of knowledge about risk factors for puerperium psychosis among the study participants. For each listed risk factor, participants were asked to indicate whether they agreed, disagreed, or were unsure. The results show that the majority of women were aware of several risk factors for puerperium psychosis, including a history of mental illness (81.5%), stressful life events during pregnancy (74.6%), lack of family support (70%), sleep deprivation after childbirth (66.6%), substance abuse during pregnancy (70%), and a history of postpartum depression (72.8%). However, there was less awareness of other risk factors, such as poor nutrition during pregnancy (58.5%), financial difficulties (63.8%), and being a first-time mother (58.9%). In summary, the respondents have knowledge of risk factors of puerperium psychosis. Research Question Three: What is the level of Knowledge of Prevention of Puerperium Psychosis among pregnant mothers attending health facilities in Ilorin East LGA? Table 4: Descriptive analysis of Knowledge of Prevention of Puerperium Psychosis S/N ITEM YES NO I DON’T KNOW 15 Early recognition of symptoms can help prevent puerperium psychosis. 205 71.4% 51 17.8% 31 10.8% 16 Regular antenatal check-ups can help in preventing puerperium psychosis 188 65.5% 62 21.6% 37 12.9% 17 Adequate family support after childbirth is essential for preventing puerperium psychosis. 208 72.5% 45 15.7% 34 11.8% 18 Getting enough rest after childbirth can help prevent puerperium psychosis. 181 63.1% 62 21.6% 44 15.3% 19 Avoiding substance abuse during pregnancy can prevent puerperium psychosis. 186 64.8% 74 25.8% 27 9.4% 20 Seeking counselling or therapy during pregnancy can help in preventing puerperium psychosis 184 64.1% 70 24.4% 33 11.5% 21 Proper nutrition during pregnancy plays a role in preventing puerperium psychosis. 211 73.5% 44 15.3% 32 11.1% 22 Open communication with healthcare providers about mental health can prevent puerperium psychosis. 201 70.0% 54 18.8% 32 11.1% 23 Participating in support groups during pregnancy can help prevent puerperium psychosis 195 67.9% 43 15.0% 49 17.1% 24 Managing stress effectively during pregnancy is crucial in preventing puerperium psychosis 207 72.1% 52 18.1% 28 9.8% Table 3 presents the level of knowledge about prevention strategies for puerperium psychosis among the study participants. For each listed prevention strategy, participants were asked to indicate whether they agreed, disagreed, or were unsure. The results show that the majority of women were aware of several prevention strategies, including early recognition of symptoms (71.4%), regular antenatal check-ups (65.5%), adequate family support after childbirth (72.5%), getting enough rest after childbirth (63.1%), avoiding substance abuse during pregnancy (64.8%), seeking counselling or therapy during pregnancy (64.1%), proper nutrition during pregnancy (73.5%), open communication with healthcare providers (70%), participating in support groups during pregnancy (67.9%), and managing stress effectively during pregnancy (72.1%). In Summary, the respondents have knowledge of signs and symptoms of puerperium psychosis. Research Question Four: What is the level of knowledge of signs and symptoms of puerperium psychosis among pregnant mothers attending health facilities in Ilorin East LGA? Table 5: Descriptive analysis of knowledge of signs and symptoms of puerperium psychosis S/N ITEM YES NO I DON’T KNOW 25 Severe mood swings are a symptom of puerperium psychosis. 223 77.7% 34 11.8% 30 10.5% 26 Hallucinations (seeing or hearing things that are not there) can occur in puerperium psychosis. 209 72.8% 40 13.9% 38 13.2% 27 Delusions (false beliefs) are a common symptom of puerperium psychosis. 199 69.3% 52 18.1% 36 12.5% 28 Confusion and disorientation are signs of puerperium psychosis. 171 59.6% 74 25.8% 42 14.6% 29 Sleep disturbances are associated with puerperium psychosis. 192 66.9% 48 16.7% 47 16.4% 30 Irrational thoughts or behavior can indicate puerperium psychosis. 184 64.1% 68 23.7% 35 12.2% 31 Extreme anxiety or panic attacks may be a symptom of puerperium psychosis. 193 67.2% 55 19.2% 39 13.6% 32 Withdrawal from family and friends is a potential sign of puerperium psychosis. 173 60.3% 74 25.8% 40 13.9% 33 Paranoia or excessive suspicion can be a symptom of puerperium psychosis. 184 64.1% 66 23.0% 37 12.9% 34 A lack of insight into one’s own condition is common in puerperium psychosis. 175 61.0% 75 26.1% 37 12.9% Table 5 presents the level of knowledge about signs and symptoms of puerperium psychosis among the study participants. For each listed symptom, participants were asked to indicate whether they agreed, disagreed, or were unsure. The results show that the majority of women were aware of several signs and symptoms of puerperium psychosis, including severe mood swings (77.7%), hallucinations (72.8%), delusions (69.3%), confusion and disorientation (59.6%), sleep disturbances (66.9%), irrational thoughts or behavior (64.1%), extreme anxiety or panic attacks (67.2%), withdrawal from family and friends (60.3%), paranoia or excessive suspicion (64.1%), and a lack of insight into one's own condition (61%). In Summary, the respondents have knowledge of signs and symptoms of puerperium psychosis. Summary of Findings The study demonstrated that while participants had a general understanding of puerperium psychosis, there were knowledge gaps regarding specific risk factors, prevention strategies, and the potential impact on both mother and baby. Despite a significant proportion being aware of the term "puerperium psychosis" and its symptoms, there was room for improvement in understanding the specific risk factors, such as poor nutrition during pregnancy or being a first-time mother. Additionally, while participants were knowledgeable about prevention strategies like regular antenatal check-ups and family support, there was a need to enhance awareness of other effective measures, such as early recognition of symptoms and avoiding substance abuse. Discussion of Finding The data indicate that a significant proportion of the study participants were familiar with the term "puerperium psychosis" and had a basic understanding of its definition and timing. However, there was a lack of clarity regarding the prevalence of the condition and its potential impact on both the mother and the baby. These findings highlight the need for improved education and awareness about puerperium psychosis among pregnant women and healthcare providers. The study's findings on awareness of puerperium psychosis are similar to those of previous study conducted in India by Sankalpa, Bhingardive and Priyanka (2022) among Primigravida in Selected Hospitals of the City. The study found that from the total 200 Relatives of Primigravida, 25.5% were having Poor, 57% were having average, and 17.5% were having Good Level of Knowledge. No participant had Very Good Level of Knowledge regarding Postpartum Psychiatric Disorders. The Scoring for assessment of level of knowledge was prepared by the Researcher. The study is Statistically significant for the selected Demographic Variables which are: Gender, Education and Monthly Income at the p-value of <0.05. Despite efforts to raise awareness, there remains a significant gap in knowledge among many women. This highlights the need for continued education and outreach programs to improve understanding of the condition. The data indicate that while a significant proportion of the study participants were knowledgeable about several risk factors for puerperium psychosis, there was a lack of awareness regarding other important factors. These findings highlight the need for improved education and awareness about risk factors for puerperium psychosis among pregnant women and healthcare providers. The participants' understanding of risk factors aligns with established literature in the study of Ademiliyu et al (2022) on the knowledge of puerperal psychosis among Pregnant Women Attending Antenatal Clinic in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State which documented that about one-fifth of the respondents had good knowledge of the causes/risk factors of puerperal psychosis, Ademiliyu et al (2022) on kknowledge of puerperal psychosis among Pregnant Women Attending Antenatal Clinic in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State which documented that about one-fourth had good knowledge of signs, symptoms. This indicates that educational efforts have been effective in disseminating information about risk factors. However, further research is needed to explore the specific factors contributing to the development of puerperium psychosis in different populations. The data indicate that a significant proportion of the study participants were knowledgeable about various prevention strategies for puerperium psychosis. These findings suggest that the majority of women are aware of the importance of proactive measures in preventing this condition. However, further efforts may be needed to enhance awareness and implementation of these strategies, particularly among those with limited knowledge or access to resources. The study's findings on participants' knowledge of prevention strategies are comparable to those of previous study of Ademiliyu et al (2022) on knowledge of puerperal psychosis among Pregnant Women Attending Antenatal Clinic in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State which documented that about one-forth of the respondents had knowledge effects of puerperal psychosis while the majority of the respondents had good knowledge on treatment/prevention of puerperal psychosis. Generally, this study concludes that about one-fourth of the respondents attending the antenatal clinic in Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, had good knowledge about puerperal psychosis. This suggests that there is a growing awareness of preventive measures, but further efforts are needed to ensure consistent implementation and access to these interventions. The data indicate that a significant proportion of the study participants were knowledgeable about various signs and symptoms of puerperium psychosis. These findings suggest that the majority of women are aware of the potential manifestations of this condition. However, further efforts may be needed to enhance awareness and understanding of these symptoms, particularly among those with limited knowledge or access to resources. CHAPTER FIVE SUMMARY, CONCLUSSIONS AND RECOMMENDATION This chapter dealt with the summary of findings obtained from the study as well as the conclusion and recommendations. Summary This study examined the knowledge of puerperal psychosis among pregnant women attending primary health care facilities in Ilorin East Local Government. The research addressed four specific questions. The population of this study included all pregnant women attending health facilities in Ilorin East Local Government, totalling 5,000. A sample of two hundred and seventy women participated in this study. Descriptive research design of cross-sectional type was employed for the study. Two stages sampling technique which involved cluster, and purposive, the respondents in the study. Researcher developed questionnaire, validated by three (3) experts from Department of Community Health, University of Ilorin Teaching Hospital, Nigeria was used for data collection. The instrument was pilot tested at Civil Service Hospital through test-retest method was used to analyse the data obtained, a reliability co-efficient of r = 0.79 was obtained. The research instrument (questionnaire) was administered by the researcher together with four trained research assistants to the sampled respondents. Charts were used to describe the demographic information of the respondents, and to answer the research questions, frequency and percentages were employed. Conclusions Based on the findings obtained from the analysis, this study recommends that: i. despite a general awareness of puerperium psychosis, there are significant gaps in knowledge regarding specific risk factors, prevention strategies, and the potential impact on both mother and baby. ii. the findings highlight the need for enhanced education and awareness campaigns to address these knowledge gaps and promote early intervention. iii. the study identified demographic factors such as age and marital status that may influence the prevalence of puerperium psychosis. iv. the findings suggest that social and cultural factors, such as socioeconomic status and religious beliefs, may also play a role in the development and severity of the condition and v. the importance of early recognition and intervention for puerperium psychosis is emphasized to prevent severe consequences for both mother and child. Recommendations Based on the conclusion from the study, this study recommended that: i. Create informative resources, such as pamphlets, videos, and online courses, that provide detailed information about puerperium psychosis, including its symptoms, risk factors, prevention strategies, and available resources. ii. Integrate information about puerperium psychosis into antenatal and postnatal care programs to ensure that women in Ilorin East Local Government receive timely and accurate information. iii. Provide training to healthcare providers, including midwives, doctors, and nurses, on the recognition and management of puerperium psychosis. iv. Provide tailored interventions: Offer targeted interventions, including counseling, therapy, and support groups, to address the specific needs of vulnerable women. v. Promote early symptom recognition: Encourage women to be vigilant for any unusual symptoms and to seek help promptly if they are concerned.