Electroconvulsive Therapy in the Eyes of Undergraduate Nursing Students

Monday N. Igwe^1*, Appolos C. Ndukuba², Chukwuma M. Attama³, Pleasure N. Ogbonna⁴, Chinonyerem Igwe¹

¹Department of Psychological Medicine, Federal Teaching Hospital, Abakaliki, Nigeria.
²Department of Psychological Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Nigeria.
³Federal Medical Centre, Umuahia, Nigeria.
⁴Federal Neuropsychiatric Hospital, Enugu, Nigeria.

DOI: 10.4236/ojn.2014.412087                

Abstract

Despite the fact that electroconvulsive therapy (ECT) is an established safe and effective procedure, its use has continued to attract controversy with considerable stigma associated with it. This often overshadows the established effectiveness. Poor knowledge, negative attitude and bias towards ECT by the nurses may translate to poor education and support to patients from whom they are expected to obtain informed consent before an ECT procedure. This study assessed the perception of undergraduate nursing students of a Nigerian university about ECT. A total of 81 students who had completed all relevant lectures and practical/clinical exposures in psychiatry as prescribed in their academic curricular participated in the study. All the consenting students were administered the socio-demographic questionnaire and modified questionnaire on attitude and knowledge of electroconvulsive therapy (QuAKE). Majority of the students responded appropriately to the principal uses of ECT. Few believed that ECT was an out-moded form of treatment, that the procedure was cruel and barbaric, that psychiatrists who still administered ECT were wicked and not responsible physicians, and that it caused permanent brain damage. The total mean score of the students was 7.53 ± 2.65. Fifty eight (71.6%) students observed an ECT procedure and followed up the patients during the posting. They scored 7.17 ± 2.55 while 23 (28.4%) students who had not observed the procedure scored 6.98 ± 1.92 on the QuAKE (t = -0.36, p = 0.72). Thirty one (38.3%) students who would accept the procedure if indicated scored 7.14 ± 2.21 while 50 (61.7%) of them who would not allow ECT carried out on them scored 6.88 ± 1.96 (t = 0.56, p = 0.58). The mean score of 29 (35.8%) students who might pursue psychiatry as a career was 8.10 ± 1.90 while 52 (64.2%) of them who would not specialise in psychiatry scored 6.05 ± 1.79 (t = 5.00, p < 0.001). The total mean score on the QuAKE was low among the student nurses. Therefore, there is a need to improve undergraduate nursing education on ECT.

Keywords

Electroconvulsive Therapy, Undergraduate, Nursing Students

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Fink, M. (1984) Meduna and the Origins of Convulsive Therapy. American Journal of Psychiatry, 141, 1034-1041.
[2]	The UK ECT Review Group (2003) Efficacy and Safety of Electroconvulsive Therapy in Depressive Disorders: A Systematic Review and Meta-Analysis. The Lancet, 361, 799-808. http://dx.doi.org/10.1016/S0140-6736(03)12705-5
[3]	American Psychiatric Association (1990) The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, Privileging. American Psychiatric Association, Washington DC.
[4]	Fink, M. (1979) Convulsive Therapy: Theory and Practice. Raven Press Ltd., New York.
[5]	Sadock, B.J. and Sadock, V.A. (2007) Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 10th Edition, Wolters Kluwer/Lippincotts Williams & Wilkins, Philadelphia.
[6]	McDonald, A. and Walter, G. (2001) The Portrayal of ECT in American Movies. The Journal of ECT, 17, 264-274. http://dx.doi.org/10.1097/00124509-200112000-00006
[7]	Byrne, P., Cassidy, B. and Higgins, P. (2006) Knowledge and Attitudes towards Electroconvulsive Therapy among Health Care Professionals and Students. The Journal of ECT, 22, 133-138. http://dx.doi.org/10.1097/00124509-200606000-00011
[8]	Shakya, D.R. and Lama, S. (2010) Electroconvulsive Therapy (ECT): In the Eyes of Nurses of a Tertiary Care Hospital. Health Renaissance, 8, 85-89.
[9]	Kavanagh, A. and McLoughlin, D.M. (2009) Electroconvulsive Therapy and Nursing Care. British Journal of Nursing, 18, 1370-1377. http://dx.doi.org/10.12968/bjon.2009.18.22.45564
[10]	Wood, J.H., Chambers, M. and White, S.J. (2007) Nurses’ Knowledge of and Attitude to Electroconvulsive Therapy. The Journal of ECT, 23, 251-254. http://dx.doi.org/10.1097/yct.0b013e31813e0692
[11]	Gass, J.P. (1998) The Knowledge and Attitudes of Mental Health Nurses to Electro-Convulsive Therapy. Journal of Advanced Nursing, 27, 83-90. http://dx.doi.org/10.1046/j.1365-2648.1998.00507.x
[12]	James, B.O., Lawani, A.O., Omoaregba, J.O. and Isa, E.W. (2010) Electroconvulsive Therapy: A Comparison of Knowledge and Attitudes of Student Nurses and Staff Mental Health Nurses at a Psychiatric Hospital in Nigeria. Journal of Psychiatric and Mental Health Nursing, 17, 141-146. http://dx.doi.org/10.1111/j.1365-2850.2009.01487.x
[13]	Lutchman, R.D., Stevens, T., Bashir, A. and Orrell, M. (2001) Mental Health Professionals’ Attitudes towards and Knowledge of Electroconvulsive Therapy. Journal of Mental Health, 10, 141-150. http://dx.doi.org/10.1080/09638230124779
[14]	Burns, C.M. and Stuart, G.W. (1991) Nursing Care in Electroconvulsive Therapy. Psychiatric Clinics of North America, 14, 971-988.
[15]	Andrade, C. and Rao, N.S. (1996) Medical Students’ Attitudes toward Electroconvulsive Therapy: An Indian Perspective. Convulsive Therapy, 12, 86-90.
[16]	James, B.O., Omoaregba, J.O. and Olotu, O.S. (2009) Nigerian Medical Students’ Attitudes to Unmodified Electroconvulsive Therapy. The Journal of ECT, 25, 186-189. http://dx.doi.org/10.1097/YCT.0b013e31818c7701