CHAPTER FIVE
DISCUSSION, CONCLUSIONS, RECOMMENDATIONS, AND IMPLICATIONS FOR NURSING PRACTICE
5.1 Introduction
This chapter presents a discussion of the study findings, conclusions drawn, recommendations, and implications for nursing practice.
5.2 Discussion of Results
5.2.1 Risk Factors Contributing to Relapse Among Mental Patients
The study findings revealed that a large proportion of respondents, 21 (70%), strongly agreed that substance abuse significantly increases the risk of relapse among mental patients, while only 2 (6.7%) disagreed. This aligns with findings by Toohill et al. (2014), who established that substance abuse contributes greatly to relapse due to the vulnerability of individuals with mental illness.
Additionally, half of the respondents, 15 (50%), strongly agreed that medication side effects—such as dry mouth, tremors, weight gain, and stiffness—contribute to non-adherence and eventual relapse, while 3 (10%) disagreed. This is consistent with studies on antipsychotic medications, which indicate that fewer side effects improve adherence and treatment outcomes.
The results further showed that 18 (60%) of respondents strongly agreed that a history of previous hospital admissions increases the likelihood of relapse, while 12 (40%) disagreed. This finding supports Silva et al. (2009), who reported that repeated admissions are strongly associated with relapse.
Moreover, respondents identified several social and environmental factors contributing to relapse. These included unemployment (60%), grief due to loss of a loved one (70%), lack of social support (90%), stigma (73.3%), and homelessness or exposure to crime (60%). These findings are consistent with Kazadi et al. (2008), who highlighted the role of stressful life events in triggering relapse.
The study also found that 16 (53%) of respondents strongly agreed that failure to take medication regularly contributes to relapse, while 2 (7%) strongly disagreed. This supports Sariah et al. (2014), who emphasized that medication burden and side effects often lead patients to discontinue treatment, thereby increasing relapse risk.
5.2.2 Protective Factors That Prevent Relapse Among Mental Patients
The findings indicated that 17 (56.7%) of respondents strongly agreed that family support enhances medication adherence, while 4 (13.3%) disagreed. This is supported by Koutra et al. (2015), who emphasized the importance of family involvement in patient recovery and relapse prevention.
Similarly, respondents highlighted that medication supervision, monitoring drug intake, and regular visits to mental health facilities help prevent relapse. This aligns with existing literature indicating that family support systems play a key role in ensuring adherence to treatment.
Furthermore, 22 (73.3%) of respondents agreed that proper adherence to antipsychotic therapy significantly reduces relapse. This is supported by Bowling (2014), who found that family involvement in patient care improves adherence and outcomes.
The study also revealed that 16 (53.3%) of respondents strongly agreed that religion and spirituality contribute positively to recovery, while 47% disagreed. This finding is consistent with Iseselo et al. (2017), who reported that spiritual practices can help individuals cope with mental illness.
In addition, respondents noted that employment plays a crucial role in recovery. Patients who are employed and earn income tend to gain independence, improved self-esteem, and faster recovery, as supported by Zhou et al. (2017).
5.2.3 Strategies Mental Health Nurses Can Use to Prevent Relapse
The study showed that 17 (56.7%) of respondents strongly agreed that educating families on patient care improves outcomes and reduces relapse. This finding aligns with Toohill et al. (2014), who emphasized the importance of caregiver education.
Furthermore, promoting home visits by mental health nurses was identified as an effective strategy, with 17 (56.7%) strongly agreeing. This is supported by Srivastava et al. (2014), who highlighted the role of home visits in improving adherence and patient management.
The study also revealed that 18 (70%) of respondents strongly agreed that educating families about risk factors helps protect individuals who have not yet developed symptoms. This is consistent with literature emphasizing the importance of awareness and early intervention.
Additionally, 21 (70%) of respondents agreed that patient education (psychoeducation) is essential in preventing relapse. Grey et al. (2013) noted that increased patient knowledge enhances adherence and coping mechanisms.
5.3 Conclusion
The study concluded that relapse among mental patients is largely influenced by factors such as poor medication adherence, side effects, substance abuse, lack of family support, and stressful life events. Conversely, protective factors such as strong family support, adherence to medication, employment, and spiritual engagement contribute to improved recovery outcomes.
Furthermore, interventions such as psychoeducation, home visits, and strong therapeutic relationships between healthcare providers and patients are critical in reducing relapse rates.
5.4 Recommendations
The study recommends that management of patients with mental illness, particularly schizophrenia, should focus on addressing relapse-related factors identified in this study. Mental health services should be strengthened to improve patient outcomes.
Mental health nurses should build strong therapeutic relationships with patients and caregivers to enhance communication, trust, and effective care planning. Collaborative teamwork among healthcare professionals is also essential in ensuring comprehensive patient management.
