THE EFFICACY OF PSYCHOEDUCATION ON STRESS AND HEALTHY BEHAVIOUR AMONGST BACHELOR OF EDUCATION STUDENTS IN UNIVERSITY OF NAIROBI AND KENYATTA UNIVERSITY IN KENYA.
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ABSTRACT

Introduction

Stress among university students has been the subject of much research for many years. This is because college life presents many challenges for students and little is known about the sources of stress and coping mechanisms adopted by these students while in campus. Stressful experiences motivate individuals to engage in a variety of behavioural methods, many of which are considered to be negatively motivated.  It is important to appreciate however that stress is an inevitable every day experience, and despite the negative implications on a person’s health, some stress is helpful for individuals in meeting new challenges. Excessive or ongoing high level of stress significantly increases the individual’s risk of health related symptoms and vulnerability to psycho-physiological illness. In addition, high level of stress among young people has been identified as a predictor of depression and suicidal ideation.

Studies in this area indicate that high stress levels in students can lead to poor academic performance, depression, attrition and serious health problems. Stress is also strongly associated with the onset of illness and perceived or actual deterioration in well-being.

According to WHO, health is a resource for life that enables people to lead individually, socially and economically productive lives. On this basis most countries developed national health policies with the aim of providing comprehensive health for all their citizens. To achieve this, Kenya adopted strategies for primary health care to enable individuals, families,and communities to attain productive lives. Among the various strategies put in place in this regard is the health promotion program.

 Health Promotion is the process of enabling people to increase control over, and to improve their health. It is a process directed towards enabling people to take action. Thus, health promotion is done by people either as individuals or as groups. The purposes of these activities are to strengthen the skills and capabilities of individuals to take action and the capacity of groups or communities to act collectively to exert control over the determinants of health and achieve positive change.

At a micro focus level, mental health promotion provides a range of different activities that also include stress management, assertiveness and relaxation that are designed to help one to cope with the negative effects of stress.

Majority of undergraduate students in Kenyan universities and colleges are young adults within the ages 18 to 24 years. In most cases young men in this age group become independent of their parents and assume responsibility of their own lives. At age 18, the law allows one to register as a Kenyan citizen and is issued with an identity card and can therefore engage in socio-political activities e.g. voting e.t.c. and can take a driving license thus legally being allowed to drive among other things. They are challenged with the responsibility for their personal health and in the process may develop behaviours that may become a part of their lifestyle into adulthood. It is therefore essential that efforts are explored and expended for the promotion and maintenance of healthy lifestyles for young adults to avert the development of chronic diseases as they progress through life.

The researcher’s interest in this area of study stems from his observation following many years of interaction with university students since 1985, and in particular from 2007 when dealing with Bachelor of Education students in their accommodation and catering aspects of welfare. Most students’ while on campus socialize within various clusters which are formed on the basis of ethnic origin, socio-economic status and geographical regions of the students’ homes. This perhaps is due to the fact that many of these students move away from home for the first time. Thus, leaving all previously learnt support systems such as parents, siblings and high school friends. They may have difficulty adjusting to more rigorous academic expectations and the need to learn to deal with individuals of differing cultures and beliefs.

The facilities and resources in most public universities are inadequate, leading to excessive congestion on campuses: halls of residence, lecture halls and kitchens/mess. This may lead to discomforts and stress and on several occasions public universities have witnessed riots and disturbances that have been blamed on issues not related to the facilities directly.

To date, there is little understanding of the specific needs of youthful students in tertiary institutions in relation to other levels of stress. Of concern, while the literature does indicate the increasing prevalence of stress in students within tertiary settings, little is known about the specific causes of this phenomenon. Moreover there has been limited research conducted into the development of an understanding of how to proactively work towards reducing the negative impact of life events on the youth in order to reduce engagement in negative health promoting behaviours and improving their bio-psycho-social well-being.

 

Objectives

The general objective of this study was to determine the effectiveness of psycho-education as an intervention on health-promotion behaviours.

 

Specific Objectives

  1. Determine the factors that cause stress and coping with stress in B.Ed. students both in Kenyatta and Nairobi universities;
  2. Identify the health promoting behaviours that B.Ed. students use;
  3. Compare the health promoting behaviours in the two universities;
  1. Determine the correlation between socio-demographic variables and stress levels;
  2. Determine the effectiveness of psycho-education intervention on health promoting behaviour across the three assessments.

 

Study Design and Setting

This was a clinical trial that tested the efficacy of psycho-education in the promotion of healthy behaviour among Bachelor of Education (B. Ed) university students as a stress management strategy during their campus life.

 

The respondents were regular full-time B.Ed. (Arts, Early Childhood, and Science) students from two public universities i.e. University of Nairobi and Kenyatta University.

 

One hundred and eighty one (181) respondents from University of Nairobi consented and constituted the experimental group; while 192 respondents from Kenyatta University were the control group. All these participated in all the three rounds of assessments.

 

Study Instruments

Self administered questionnaires were used which included;- (i) Demographic data (ii) Daily Stress Inventory (DSI) (iii) Health-Promoting Lifestyle Profile II (iv) General Health Questionnaire (GHQ).

 

Method

Ethical approval for the study protocols was obtained from Kenyatta National Hospital/University of Nairobi Research and Ethics Committee. Authority to carry out the study was granted by the University of Nairobi and Kenyatta University administrations. All respondents were duly explained in every round of assessment, the nature of the study, personal benefits that accrue from the study, their voluntary participation and the right to withdraw at any time in the course of the study without any loss of benefit and were assured of anonymity and confidentiality. There was no invasive procedure that was administered on them.

Three rounds of assessment at intervals of three months apart were conducted to both the control and experiment groups; in addition the experiment group was given two psycho-education interventions on heath promotion activities and its benefits. Each psycho-education session lasted 2 hours; each participant was also given a handout that outlined activities that one can perform and would enhance health and good physical appearance in managing daily stress.

 

Data Analysis

Double entry of data was done by two separate data entry clerks and the data checked and cleaned by a biostatistician who performed statistical analysis using Statistical Package for Social Sciences (SPSS) Version 16.0.

 

Results

The overall results indicate all respondents in the two study sites suffered daily stress; 53.4% moderately while 46.6% had high and chronic stress. Study participants in the two universities (UoN and KU) engaged moderately in health promotion behaviours at base line. After intervention, respondents in the experimental group made significant improvement by follow-up 1(p<0.05) assessment unlike those in the control group. There was an insignificant drop in the experimental group compared to control group at follow-up 2. Respondents in the experimental group engaged in health responsible and nutrition activities more frequently than the control group. The female gender engaged in physical activities more often compared to male respondents in both study sites. Both in UoN and KU, respondents aged 22 years engaged more frequently in nutrition and stress management related activities

 

The results also indicated that psycho-education as an intervention was effective in reduction of symptoms in all the GHQ sub-scales. The experiment group indicated a significant reduction in caseness following interventions at baseline and at follow-up 1.This was also supported by a significant improvement in coping with daily stress as reflected in the mean scores between the experimental and control groups.

 

Conclusions

1. The university of Nairobi and Kenyatta university B.Ed students suffer from chronic daily stress.

2. Students in both institutions had low involvement in health promoting behaviours.

3. Psycho-education on health promotion behaviour was effective in reducing chronic daily stress among B. Ed students.

 

Recommendations:

  1. University management needs to improve and expand facilities that will encourage students to engage in physical activities often
  2. University management needs to create forums for students to develop/improve interpersonal skills and enhance personal competencies besides the structured academic programs
  3. Develop counselling units that will encourage voluntary self referral
  4. Improve catering services to include a variety of food types and fruits
  5. Further research need to carried out to include respondents in other disciplines
  6. Further research to investigate specific social support needs for students and identify cost effective methods of implementation.
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