Browsing by Author "Makiyi, Precious"

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    Barriers and facilitators for screening for anxiety and depression among children and young people attending Pediatric Epilepsy Clinic at Queen Elizabeth Central Hospital, Malawi
    (Kamuzu University of Health Sciences, 2022-05-12) Makiyi, Precious
    Type of Study: A qualitative study Problem: Despite the high prevalence of depression and anxiety among children and young people with epilepsy, screening for these mental disorders in CYP with epilepsy is not routinely done in most health facilities in Malawi. Objectives: Broad objective The broad objective of the study is to assess the barriers and facilitators for implementation of routine and universal screening for anxiety and depression among children and young people (CYP) attending Pediatric Epilepsy Clinic at Queen Elizabeth Central Hospital. Specific objectives The specific objectives of the study are: 1. To assess the acceptability of screening for depression and anxiety among CYP with epilepsy and their guardians. 2. To explore the individual and institutional barriers and facilitators for screening for depression and anxiety among CYP with epilepsy. 3. To explore the views of patients and their carers, and clinical staff (including doctors, nurses and counsellors working in the epilepsy clinic) regarding the following commonly used and free-of-cost screening instruments for anxiety and depression in CYP: Revised Child Anxiety and Depression Scale (RCADS) (8-18 years), Short Mood and Feelings Questionnaire (SMFQ) (8-18 years), Hospital Anxiety and Depression Scale (HADS) (from 12 years), Beck Depression Inventory (from 14 year), Beck Anxiety Inventory (from 14 years), and Patient Health Questionnaire (PHQ-9) (from 13 years). In addition, the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) would be discussed with participants. Although the NDDI-E) has only been validated in adults, we will consider its potential utility because it is specific for patients with epilepsy, short, and free of charge. Methodology: This study shall adopt qualitative research design involving Focus Group Discussions as well as In-depth Interviews with key stakeholders including CYP with epilepsy and their guardians, epilepsy and psychiatric nurses, a pediatrician, a psychiatrist, a hospital administrator, and staff of the Ministry of Health (director of non-communicable diseases (NCD) or his/her representativeā€). Expected Findings: Based on previous studies of barriers and facilitators of screening for mental health conditions in other Low and Middle Income Countries (LMICs), we hypothesize that the barriers may include mental health stigma, lack of appropriate culturally adapted screening instruments, limited training for clinicians about screening, limited time available for clinicians to conduct the screening in addition to their existing workload, and limited opportunity for subsequent mental health assessment and treatment for the CYP identified from the screening 12-May-2022 19 | P a g e Makiyi, Ani, Udedi, and Matanje; Barriers and Facilitators for depression screening among CYP with epilepsy. Protocol version 3- May, 2022 as requiring further support. We hypothesize that facilitators may include strong institutional support for screening. Dissemination of results plan: The findings will be shared with the COMREC, SHARP Program Coordinator, QECH, Ministry of Health, all participants, presented as relevant academic conferences, and published in peer reviewed journals.