Assessment of Knowledge of Nurses in Providing Psychosocial Care for Mothers with Sickle Cell Child in Osun State Nigeria

Article history: Received: 4 January 2020 Accepted: 15 February 2020 Introduction: This descriptive study is designed to assess the knowledge of nurses in providing psychosocial care for mothers with sickle cell diseases child in Osun State Nigeria. Methods: Nurses working in the two teaching hospitals were used. Simple self-designed questionnaire was adopted, two hundred (200) respondents primarily the nurses were used in the research study. The questionnaire has three sections: the demographic variables, Knowledge of nurses on use of psychosocial care and mothers’ knowledge on care of child with Sickle Cell Disease (SCD). The data were collected and analysed using a descriptive statistics of percentage and frequency. Results: The results revealed that there is a need to improve nursing skills on psychosocial care among the nurses. The current nursing practices with regard to psychosocial care needs to be reviewed and upgraded so as to give a desired outcome. 46.5% of the nurses reported that mothers do not have confidence in the skills of nurses in providing psychosocial care, 43.5% have confidence in the skills of nurses while 10% were undecided. Besides, 90% of nurses agreed that there is a need for continuous retraining of nurses in providing a positive outcome of psychosocial care while only 10% do not agreed. Conclusion: It was concluded that psychosocial care plays an important role in managing patients with SCD, hence, there is a need to retrain nurses on standard method of psychosocial care.


INTRODUCTION
Sickle Cell Disease (SCD) is the most occurring genetic pathological disorder among black race in the world, it is a chronic non-communicable disorder that largely affects children. It has a negative effects on family as a psychological burden as well the affected child and the caregivers [1]. In 2008, the 63rd Session of United Nation General Assembly recognised Sickle Cell Disease as a public health problem and agreed with member nations to create awareness every June 19 of every year [2]. Non Communicable Disease (NCD) accounts for 22% of premature death in Nigeria which also included SCD [3].
SCD is classified as a major chromosomal defect disorder that is largely dominant in Africa sub-region. A healthy individual has a round shape of red blood cell whereas it's a sickled, crescent moons shape in individual with SCD. The blood vessel enhance easy movements of the round red blood cell, but the sickled red blood cell movements is inhibited and sluggish which results in clogging and clots in the vessel. The sickled blood is characterised with severe pain in the chest, the joints of the body, neck, back, feet and hands. It's also symptomized with sluggish blood flow causing organs damage, bones and muscles. Often time there is weakness, paleness of the eye, and fatigue, and the eye usually present yellowish [4]. Afolayan & Jolayemi (2011) cited that socio-environmental factors plays a major role in coping mechanism of parent which in turns influence the developmental pattern of the child [5]. Parent with poor economic outlook has a great challenge in meeting the child's need and the family thereby experiencing an untold hardship [6].
Various factors has been identified to contribute to child's development affected with SCD. This depends on the severity and the nature of the SCD -(HbSS), sickle cell haemoglobin C (Hb-SC) and sickle cell thalasaemia (Hb-SSthal) [7]. Some related factors include interpersonal relationship, bullying, rejection, emotional distress, poor educational attainment, work failure and many more [8]. Some predisposing factors that causes red blood sickling include dehydration, infection, and sudden change in body temperature especially cold skin, excessive physical exertion and stress [9].
Psychosocial care involves three distinct subjects that is psychological care, social care and spiritual care [10]. Nurses are involved in establishing patients and families' support system, nurses promote professional dialogue with mothers with SCD children by enhancing their psychological stability. This relationship affects the decisions and their strength and capacities to live up with those decisions [11].
Nurses having good communication and assessment skills has a viable rapport with the mother and the child, these two skills enhance the clinical relationship with the patient and the family. Nurses ensure to provide individualised care with specific physical, symptomatic and psychological care [12].
A professional psychosocial care has been found to be greatly beneficial for patients with SCD and the mother, thus reducing both psychological and physical distress which enhance good quality of care, quality of life, promoting coping mechanism and drastically minimised pain threshold which is influenced on the hospitalisation demands [13].

Study design
This is a descriptive research study design. A self-designed questionnaire was formulated, distributed to respondents, and

Sample and Sampling Technique
Two hundred nurses were selected randomly using a non-probability purposive sampling. All the selected nurses were initially asked if they had contact with child with SCD before giving them the questionnaire. This is purposely to avoid a nurse working in a unit that doesn't admit patient with SCD: Paediatric Unit, Emergency Unit, Paediatric Outpatient Unit, General Outpatient Unit, Male Medical Unit, and Female Medical Unit. The self-designed questionnaire was distributed and returned after it was administered.
Consent was given while all information were considered confidential, hence nurses' cooperation was solicited for and granted which was included on the questionnaire.

Analysis of data
The collected data were analysed through a descriptive statistics of frequencies, and percentages.

Ethical Considerations
Informed consent of the respondents was obtained via the instrument used. Also, approval was received from Obafemi Awolowo Teaching Hospital Ile Ife and Ladoke Akintola University of Technology Teaching Hospital, Oshogboy.

DISCUSSION
The findings showed that majority of the