Browsing by Author "Mwenda, Agnes K."

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    Determinants of relapse in psychiatric patients discharged from Mathari national teaching and referral hospital, Kenya
    (KCA University, 2025) Mwenda, Agnes K.
    This study addressed the critical issue of psychiatric relapse following hospitalization at Mathari National Teaching and Referral Hospital (MNTRH) in Kenya. Despite receiving inpatient treatment and clinical stabilization, a significant proportion of psychiatric patients experienced symptom recurrence after discharge, perpetuating a revolving door phenomenon that disrupted recovery trajectories and strained limited healthcare resources. Regional studies demonstrated concerning relapse patterns, with Ethiopia reporting a 37.78% relapse rate among patients with severe mental illnesses and Botswana documenting a 75.0% relapse prevalence at their main psychiatric unit, while Kenya-specific empirical research on psychiatric relapse determinants remained critically limited. The purpose of this study was to investigate the determinants of relapse among psychiatric patients discharged from Mathari National Teaching and Referral Hospital, Kenya. Specifically, the study aimed to identify patient-related determinants of relapse, determine healthcare-related determinants of relapse, explore socio-economic determinants of relapse, and develop an evidence-based intervention framework to prevent relapse among psychiatric patients at MNTRH. The study was informed by the Stress-Vulnerability Model and the Health Belief Model, which provided analytical lenses for examining the multifaceted nature of psychiatric relapse. An ex post facto research design with a mixed methods approach was employed, involving 301 family caregivers (92.0% response rate) and 12 healthcare providers (75.0% response rate). Data were collected using structured questionnaires and semi-structured interviews, then analysed using SPSS version 28.0 and NVivo 14. Results revealed that 61.1% of patients required readmission after discharge, with patient-related determinants (medication non-adherence, poor illness insight) showing the strongest negative correlation with relapse (r = -.612, p < .001). Healthcare-related factors (inadequate follow-up, limited staffing) and socio-economic determinants (unemployment, unaffordable medications, stigma) also significantly predicted relapse. Regression analysis showed that the four predictor variables collectively explained 55.9% of variance in psychiatric relapse (R² = .559, p < .001). The study concluded that psychiatric relapse at MNTRH results from complex interactions between patient vulnerabilities, healthcare system limitations, and socio-economic pressures. The study recommends establishing dedicated relapse prevention units, implementing mandatory family therapy, creating structured telephone follow-up systems, decentralizing psychiatric services to counties, prioritizing depot medications, and expanding insurance coverage for psychiatric care. Future studies explore determinants of treatment adherence among psychiatric patients as well as determine the effectiveness of different intervention models in preventing relapse.