Psychology
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Item Phychological well-being and coping with surgical stress of the patients after open heart surgery(2025) Khatri, Pratima; Nandita SharmaPsychological well-being (PWB) and coping strategies for surgical stress in patients after major surgery are the less explored areas in countries with low and moderate incomes. The aim of this research is to find out the status of PWB and coping of the patients after open heart surgery (OHS). This Mixed methods study was carried out at Manmohan Cardiothoracic Vascular and Transplant Center, Maharajgunj including patients who underwent OHS from June 2022 to July 2023 and their caretakers. Four hundreds and twenty four patients were recruited by using the Cochran formula (n= z 2 pq/d 2 ) with a 5% error and a confidence interval of 95% for the QUAN part of the study. Six caretakers were included in the in- depth interview for the QUAL part. Caretakers were interviewed from day 4 to day 10 after OHS. Ryff PWB scale and coping with OHS stress scale were used to collect data for the QUAN portion. The Institutional Review Committee (IRC) of the Institute of Medicine provided ethical approval, and administrative approval from the hospital before the data collection. Informed consent and assent (for those under 18) were taken both from the patients and caretakers. The study result found the patient‘s average age in years of 48.8 (±16.93) ranging from 13 to 88 years. Among them 232 (54.71%) were male, and 344 (81.13%) were married. 240 (56.61%) of patients were living in the municipality, 245 (58.02%) were physically inactive, 248 (58.49%) of patients had age-appropriate body physique, and 275 (64.86%) of caretakers were their spouses. Regarding their vital signs, 220 (51.89%) had normal vital signs without using medicine to increase blood pressure, and 300 (70.75%) of patients experienced no incisional pain postoperatively at the time of data collection. Likewise, 185 (43.64%) had to pay from their pocket for their surgery and service charges. The study showed that 301 (72.17%) of patients had high psychological well- being, out of this, 293 (69.11%) in personal growth, and 288 (67.93%) in autonomy had high PWB. Whereas, 266 (62.73%) of OHS patients had moderate coping skills, followed by 118 (27.83%) of them had effective coping skills and 40 (9.43%) had ineffective coping skills in five coping strategies such as reflecting, believing and supporting, reassurance, religious, and acceptance. The PWB of OHS patients was significantly associated with sex, living location, incisional pain, and age-appropriate physique. Male patients (OR=2.199), patients living in the municipality (OR=1.751), patients with no incisional pain (OR=5.102), and age- appropriate physique (OR=1.729) had higher PWB than females, patients living in the rural municipality, those having incisional pain, and no age-appropriate physique respectively. However, sex, incisional pain, and respiratory rates were significant predictors of PWB. Regarding coping with OHS stress, the marital status and vital signs of the patients were nsignificantly associated with the coping. Effective coping skill was adopted by the patients who were married (OR=2.278), and those with normal vital signs without using medicine to increase blood pressure (2.331) were higher than in single patients, and those vital signs were normal with using medicine to increase blood pressure. Regarding the QUAL aspect, the changing pattern of behaviors among the patients started from seeking information, experiencing stress, making decisions for OHS with peak levels of fear and anxiety, to gradually adapting to the stress levels. The common thought of the OHS patients was related to operation and its success rate, medication, incisional pain, fear of death, financial burden, and physical health issues. The relationships between the OHS patient and caretaker were that of openness and emotional intimacy. Reflection, belief and support, reassurance, religious, and acceptance were common strategies that patients used to cope the OHS stress. The majority of OHS patients have high PWB, and moderate to effective coping skills to cope the OHS stress. They often go through successive stages starting from seeking information to making a big decision to undergo OHS. Various high-risk groups (females, rurality of origin, single status, incisional pain, use medicine to increase blood pressure, and less than ideal age-appropriate body physique) need attention regarding PWB and coping respectively. Key Words: Coping with surgical stress, health psychology, Nepal, open heart surgery, psychological well-beingItem Mental health cosequences of childhood maltereatment among Nepali adolescents living in institutions and communities(2024) Dhakal, Sandesh; Shanta NiraulaAvailable in full textItem Mental health status of women in Lamjung and Dhanusha of Nepal(Faculty of Humanities and Social Sciences, Psychology, 2022) Cadel, Kabita RajVariation in psychosocial problems related to geographical situation, socio cultural conditions, religions, economic status, political situation and biologicalmake-up the status of women’s mental health has been questioned in Nepal. The purpose of the present study was to document and analyze mental health status of women. Along with this the influence of demographic variables on women’s mental health, association between psychological and sociocultural factors in relation to women’s mental health conditionwas also analyzed. An explorative and descriptive approach was applied to women living in plain region (Dhanusha) and Hilly (Lamjung). Both quantitative and qualitative method was applied with 460 adult women of age ranging from 19 to 60 years. Mental Health Inventory, PGI-Social Support Questionnaire, and WHO Quality of Life-Brief were applied to 400 women representing two regions. Further, 60women were interviewed with KII, FGD methods to collect qualitative information in relation to dimensions of mental health. Descriptive as well as inferential statistics were used to analyze the quantitative data and an inductive method was to analyze the qualitative data. The triangulation process was utilized to reconcile the quantitative and qualitative result to bring out the major findings. The overall result showed that the Mental Health Status (MHS) of women was very low. The MHS was found 78% indicating very low mental health. Prevalence of mental health condition differed in two regions (Lamjung and Dhanusha). The status of mental health was found higher in Hill (Lamjung) than Tarai (Dhanusha) area with score of 145.29 in Hilly area and 135.21in the Tarai area. Significant difference was also found in MHS and socio economic status, caste and ethnicity and religion. mental heath status was found higher in upper and medium socio-economic class than lower group. A significant difference was also found in caste and ethnicity, Madhesi, Janjatiand Brahman/Chhetri castes no almost any difference between Dalit and Madhesi caste, and Janjatigroup and Brahmin and Chhetri castes. Social support and quality of life were significantly and positively correlated with mental health score. The qualitative findings explore the various sociocultural environments shaping the cognition and behavior regarding the mental health experience of women. The result, aholisticframework, provides an important implication for women’s mental health area in relation to socio-demographic, sociocultural and psychological factors. Keywords: Mental Health, Psychosocial, Social support, Quality of Life, Women, CultureItem A Study of Prevalent Stress and Life Satisfaction Among Five Star Hotel Employees in Nepal(Department of Psychology, 2004) Neupane, GopilalThis research has two pronged aims. The first aim is to develop life Event Inventory after collection of stressful life events from 800 sample of professionals (N=700) and students (N=100). The Nepalese life stress Inventory was administered on 10.18% employees (N=250) sample from all (six) five star hotels. Systematic random sampling technique was used to represent the population universe of 2455. The sample (N=250) consisted of males (N=208) and females (N=42). Methods of study usedwere Standardized Questionnaire: Locus of Control Inventory (Rao, 1985), General Health Questionnaire (Goldberg and Williams, 1988), Life Satisfaction Scale (Warr, 1989), informal interview and participatory observation. The second aim is to compute analysis of variables, showed that married employees were less stressed, enjoyed good health and showed more satisfaction in life than unmarried. Married were found to be more internal than the unmarried. Married were high risk takers. Employees from terai were high internality oriented than the employees from Hill and Mountain. Urban employees showed high internality than the rural employees. Similarly Sino- Tibetan employees showed high internality. Female employees also showed high internality, good health andhigh life satisfaction. Further attempts were made to test hypotheses. The difference of stress score in males and females were not found significant (null hypothesis was retained). There was positive and significant relation between life satisfaction and locus of control. The difference of stress due to gender (biological) was not significant. Employees scoring high in internality showed high life satisfaction. The mean score of life events at hill region was greater than mean score of life events at mountain and terai. Pearson correlation between life satisfaction and general health was significant. Stress has negative effect on the well-being. In covariate analysis age has significant effect on life satisfaction, and religion has effect on health. The interaction effect of work experience and salary together has the significant relation to life satisfaction.Item Psychosocial Factors Determining Quality of Life Among Cancer Patients in Nepal(Faculty of Psychology, 2011) Shah, TaraThe cancer disease is on the rise in Nepal but lacks exact data to estimate its burden insociety and the psychosocial suffering of the patients. The cancer patients are beingintervened with varieties of medical treatment in Nepal but growing literaturesindicate that single (medical) treatment approach is not adequate. It is important tolook into the other side of the treatment. The social and emotional impact of thedisease, in Nepal, are not seriously examined, and attended leaving the patients,families and friends alone to cope, often ill-equipped to deal with the illness andunfamiliar with assistance and resources. Cancer patients are forced unintentionally toexperiencepersonal crisis affecting their psychological and social integrity in thought,feeling, and interpersonal relationship and behavior, increasing psychosocial problemsand endangering one’s sense of self and to deal with health problem. Withoutpsychosocial support, people feebly struggle, feel isolated in coping with living andsense of dying issues, accentuating vulnerability and affecting quality and quantity oftheir lives. In general, seriousness of the diagnosis, strictness of the treatment procedure andspecific psychosocial reactions of the ill person are the main objectives,which refersto the patient's ability to enjoy normal life activities. A methodological triangulationapproach was used to assess the demographics, disease characteristics andpsychosocial factorsto answerthe researchquestionsand see the relation with qualityof life. The importance of assessing the psychosocial factors both positive andnegative and quality of life of cancer patients may generate awareness of inner worldand understanding of patient, the nature and level of social support, enhancement ofcoping strategies and facilitating re-adjustment. Parametric and non-parametricstatistical tests were used to analyze the data and draw conclusion for this study. Present study was conducted among 300 Nepalese cancer patients from hospitals aswell as from their door-steps. The study covered 18 to 80 years old cancer patients,majority (64.4%) of them were female, married, illiterate and from low socio-economic status. Majority of the samples were stage III and IV cancer, receivingmultiple modalities of treatment and had financial problem for treatment. Quantitative result revealed that duration of diagnosis ranges from 2 to 72 months. This study alsorevealed that majority of research participants had less than one fourth (22.5%)psychosocial adjustment factors such as perceiving high of level of social support,self-esteem and coping. Majority of the samples were suffering from anxiety (67.1%)and depression (70.9%). There was significant statistical association betweeneducational status and psychological domain of QOL, gender and social relationshipdomain of QOL, stages of cancer andquality of life and itsenvironment domain too.Role in the family and modalities of treatment were not associated with quality of life.Non-linear relationship revealed that coping was positively correlated with quality oflife all its domains. Social support and self-esteem were negatively correlated withquality of life and all its domains.Anxiety and depression was inversely correlatedwith environment domain of quality of life among cancer patients in Nepal. On the basis of both qualitative and quantitative result, this study concluded thatpsychosocial factors determine the quality of life of the cancer patients in Nepal.Social support and coping were proved as strong predictors for quality of life. On theother hand, qualitative data revealed that the young aged, educated, from low socio-economic status and with a longer duration of diagnosis required additional care toimprove quality of life. Emotional/informational social support, especially from closepersons (spouse/ relatives/ friends), positive attitude of providers, willpower,engagement coping, lessening the symptoms of anxiety and depression are essentialcomponents of quality of life. Psychological aspect of cancer can be strengthened bypsychosocial care and social aspects of cancer patients can be empowered by psycho-education. Special training to the health care providers is required to improve thequality of life of cancer patients in Nepal.