EFFECTS OF NURSE-LED RESILIENCE-BASED TRAINING AND PEER-SUPPORT ACTIVITIES IN SCHOOLS ON PSYCHOSOCIAL HEALTH OUTCOMES OF ORPHANS AND VULNERABLE CHILDREN IN OSUN STATE, NIGERIA

Abstract

Globally, meeting psychosocial health needs of Orphans and Vulnerable Children (OVC) in school is an important aspect of caring for children. Public Health Nurses (PHN) and teachers are strategically positioned to meet these needs, but available evidence shows that they lack necessary knowledge and skills. This study was therefore designed to determine the effects of a nurse-led psychosocial intervention on nurses’ and teachers’ knowledge of psychosocial support of OVC and its impact on children’s resilience, anxiety, depression, self-esteem and social connection.

In this quasi-experimental study, participants were randomly allocated to Experimental Group (EG) and Control Group (CG). The EG included all 10 PHN in Primary Health Care Facilities (PHCF), 13 teachers and 339 OVC from public junior schools in Ilesa East Local Government Area (LGA) while the CG included 12 PHN, 23 teachers and 411 OVC in Ife Central LGA. Nurses in the EG were given resilience-based and life skills training as trainers to train teachers in the EG. The OVC in the EG were assigned to Resilience-based Group (RG) and Peer-support Group (PG) for resilience and life skills training respectively. Participants in CG received no training. The PHN and teachers’ knowledge on psychosocial support of OVC were assessed using a 94-point knowledge scale while a validated self-administered questionnaire containing 140-point resilience, 54-point anxiety, 45-point depression, 30-point self-esteem and 24-point social-connection scales were used to collect data from OVC. These data were collected at pre-intervention, three-month (P1) and six-month (P2) post-intervention. Data were analysed using descriptive statistics, Student t-test and repeated measure ANOVA at p=0.05.

The knowledge scores of PHN (38.8±13.1) and teachers (35.8±7.4) in the EG at pre-intervention significantly increased to 76.0±12.1 and 69.4±9.4 respectively at P1. The knowledge scores further increased to 79.7±12.2 and 75.3±9.8 at P2 respectively while there was no significant increase in the control group at P1 and P2. The resilience score of OVC increased significantly in the EG from 65.9±15.9 to 114.0±19.8 at P1 and 114.81±19.1 at P2 while no significant increase was observed in the CG. Children in RG had higher resilience score than those in PG at P1 (118.7±17.7 versus 108.9±20.7) and P2 (118.1±18.8 versus 111.4±18.8) respectively. In EG, there was significant improvement in self-esteem score from 12.6±4.7 to 18.0±3.6 at P1 and 19.3±4.5 at P2; and social connection from 13.2±3.6 to 16.4±4.3 at P1 and 16.4±4.5 at P2. Also in the EG was a significant reduction in anxiety score from 29.9±8.2 to 12.4±8.6 at P1 and 12.3±8.8 at P2; and depression score from 11.9±6.4 to 10.7±8.0 at P1 and 10.8±8.6 at P2. No significant improvement was observed in the same variables in the control group. Self-esteem score of OVC in RG was significantly higher than PG at P1 (18.5±3.6 versus 17.6±3.6). The anxiety score was significantly lower in RG than PG at P1 (10.9±8.3 versus 11.4±7.9) and P2 (10.9±3.8 versus 13.6±7.2 P2) respectively.

Nurse-led psychosocial training implemented by teachers improved children’s resilience and psychosocial health outcomes. In-service training for nurses and teachers is recommended to enhance capacity to support vulnerable children.

Keywords: School-based intervention, psychosocial support, Public health nurses, Orphans and vulnerable children.

Word Count: 499