Kwaku Oppong Asante

Correlates of psychological functioning of homeless youth in Accra, Ghana: a cross-sectional study

BackgroundResearch on homeless youth has shown that this population is at high risk for various mental health problems. Previous studies conducted among homeless young adults in Ghana have focused primarily on economic, social and cultural causes of homelessness, their engagement in risky sexual behaviours and the prevalence of STI including HIV/AIDS. We are therefore not fully informed of the prevalence of psychological symptoms and their associated factors. The aim of the study was to determine the association between psychological functioning and social and health risk behaviours among a sample of homeless youth in Ghana.MethodsA cross-sectional survey of a convenience sample of 227 (122 male and 105 female) homeless youth was conducted in Ghana in 2013. An interviewer-administered questionnaire was used to collect data due to low level of literacy among the study population. Pearson-moment correlation coefficient (r) and multiple standard regression models were fitted to analyse the data.ResultsApproximately 87% of the participants in this study exhibited moderate to severe psychosocial symptoms. Specifically, emotional, conduct, hyperactivity and peer relationship problems among the participants were 69%, 74%, 54% and 89% respectively. Overall psychosocial functioning was predicted by stigma (self-stigma and experienced stigma), violent behaviours and suicidal ideation. Substance use and perceived resilience were significantly associated with emotional problems.ConclusionThere is a need for holistic interventions to help improve the psychological and social functioning of homeless youth. Such programmes should strengthen socio-emotional coping strategies in street youth as well as address contextual risk factors such as stigma and discrimination by the public.

Cultural adaptation of the Condom Use Self Efficacy Scale (CUSES) in Ghana

BackgroundAccurate assessment of self-reports of sexual behaviours is vital to the evaluation of HIV prevention and family planning interventions. This investigation was to determine the cross-cultural suitability of the Condom Use Self Efficacy Scale (CUSES) originally developed for American adolescents and young adults by examining the structure and psychometric properties.MethodA self-administered cross-sectional survey of a convenient sample of 511 participants from a private university in Ghana with mean age 21.59 years.ResultA Principal Component Analysis with varimax rotation identified a 14 item scale with four reliable factors labelled Appropriation (Cronbach alpha = .85), Assertive (Cronbach alpha = .90), Pleasure and Intoxicant (Cronbach alpha = .83), and STDs (Cronbach alpha = .81) that altogether explained 73.72% of the total variance. The scale correlated well with a measure of condom use at past sexual encounter (r = .73), indicating evidence of construct and discriminatory validity. The factor loadings were similar to the original CUSES scale but not identical suggesting relevant cultural variations.ConclusionThe 14 item scale (CUSES-G) is a reliable and valid instrument for assessing condom use self efficacy. It is culturally appropriate for use among Ghanaian youth to gauge actual condom use and to evaluate interventions meant to increase condom use. Finally, the study cautioned researchers against the use of the original CUSES without validation in African settings and contexts.

Prevalence and determinants of depressive symptoms among university students in Ghana.

BACKGROUND Over two million Ghanaians suffer from moderate to mild mental disorders but prevalence levels and determinants among university students remains fairly unknown. A better understanding of depression and its determinants is necessary in developing appropriate interventions in this population group. METHOD A convenient sample of 270 students from a public university (132 males and 138 females) were interviewed using a questionnaire to record socio-demographic variables, HIV risk behaviours. Depressive symptoms were measured using Centre for Epidemiological Studies Short Depression Scale (CES-D 10). Multiple logistic regression was used to identify the determinants. RESULTS The mean age was 22 (SD=2.39). Using a cut-off point of 10 of the CES-D10, the overall prevalence of depression was 39.2%; with 31.1% of mild to moderate depression and 8.1% severe depressive symptoms. Significant predictors included lack of social support, religion not having an impact on life, heavy alcohol consumption and traumatic experiences such as being forced to have sex, physically and sexually abused as a child, and beaten by a sex partner. LIMITATIONS Given the cross-sectional nature of the research, the findings are limited highlighting the need for further research. Also, relying on self-report of symptoms could have influenced the outcome. The use of a single university means that there could be regional differences in depression in other universities. CONCLUSION Depression occurs in a significant number of students. An appropriate intervention must be implemented to help reduce the burden of depression, especially to those found to be at risk.

Substance use and risky sexual behaviours among street connected children and youth in Accra, Ghana.

BackgroundResearch on street children and youth has shown that this population is at high risk for substance use. Though risky sexual behaviours have been investigated and widely reported among street youth in resource constrained-settings, few studies have explored the relationship between substance use and other risk behaviours. This study was therefore conducted to examine the association between substance use and risky sexual behaviours among homeless youth in Ghana.MethodA cross-sectional survey of a convenient sample of 227 (122 male and 105 female) street connected children and youth was conducted in Ghana in 2012. Using self-report measures, the relationship between substance use and risky sexual behaviours was examined using logistic regression.ResultsSubstance use was relatively high as 12% and 16.2% reported daily use of alcohol and marijuana respectively. There were age and sex differences in substance use among the sample. As compared to males, more females had smoked cigarettes, used alcohol and marijuana. While alcohol use decrease with age, marijuana use on the other hand increases with age. Results from multivariate analysis revealed that having ever drunk alcohol and alcohol use in the past one month were independently associated with all the four indices of risky sexual behaviour (ever had sex, non-condom use, multiple sexual partners and survival sex). Both marijuana use and smoking of cigarettes were associated with having ever had sex, multiple sexual partners and survival sex. Other drug use was independently associated with non-condom use.ConclusionSubstance use seems to serve as a possible risk factor for sexual risk behaviours among homeless youth. Harm reduction interventions are needed to prevent street children and youth from engaging in substance use and risky sexual behaviours. Such programmes should pay special attention to females and younger children who are highly susceptible to the adverse conditions on the street.

Psychology in Ghana

This article presents a brief overview of the emergence, education and practice of psychology as a profession and academic discipline in Ghana. We begin with a short history about psychology education in Ghana, which could be traced to the offering of courses in counseling and educational psychology in departments of education at the colleges of education. Because the classroom has been used mainly to train psychologists in Ghana, we provide relevant information about how and where to get psychology education in that country. We also highlight the practice of psychology as a formal discipline in Ghana, including specific challenges that are encountered. Psychology has the potential to be more relevant to Ghanaian people if we demonstrate the importance of the application of its principles in their everyday life.

The prevalence and correlates of suicidal behaviours (ideation, plan and attempt) among adolescents in senior high schools in Ghana

Suicide is recognised as the third leading cause of death among adolescents globally. There is however limited data on the prevalence and factors associated with suicide particularly in Ghana. To explore the prevalence and risk and protective factors associated with suicide in Ghana, a nationwide Global School-based Student Health Survey data collected among senior high school adolescents in Ghana was used. The prevalence of suicidal behaviours was 18.2%, 22.5% and 22.2% for suicidal ideation, suicidal plan and suicidal attempt respectively. In the final analysis, anxiety increases the odds of suicidal behaviour, even after controlling for other variables. Loneliness increases the odds of suicidal behaviour but after adjusting for other factors the odds remained for only suicidal plan. Being bullied, physically attacked, involved in a physical fight and food insecurity remained risk factors for suicidal behaviour (i.e. ideation, plan and attempt) after adjusting for other factors. Truancy was found as a risk factor for both suicidal ideation and plans but such effect diminished for suicidal plan after adjusting for other variables. Increasing number of close friends remained a risk factor for both suicidal plan and attempt but such effect diminished for suicidal ideation after adjusting for other variables. Parental understanding of adolescents’ problems and worries remained a significant protective factor for all the indices of suicidal behaviour after adjusting for other variables. Parental respect for privacy was protective of suicidal attempt but was not significant after adjusting for other variables. Early identification and intervention for at-risk adolescents in senior high schools, for example those experiencing different forms of physical abuse, drug and substance use and hunger can potentially reduce the prevalence of suicide among this population in Ghana.

The lived experiences of street children in Durban, South Africa: Violence, substance use, and resilience

South African studies have suggested that street children are resilient but also suicidal, engage in unprotected sex and other high risk sexual behaviour as a means of survival, have high rates of substance abuse and are physically abused and stigmatized due to their state of homelessness. However, few studies have explored in a more holistic manner the lived experiences of street children in South Africa. The main purpose of this study was to explore qualitatively the lived experiences of street children living on the street of Durban, in the province of KwaZulu-Natal, South Africa. Adolescents (six males and four females) between the ages of 14 and 18 years (average age=16) were purposively selected and in-depth semi-structured interviews were conducted. An interpretative phenomenological analysis of the transcribed data revealed that incidence of violence and drug and alcohol use were common experiences of street life. Yet despite these challenges survival was made possible through personal and emotional strength, cultural values, religious beliefs, supportive peer relationships, and participation in sports activities. These protective, resilience resources should be strengthened in health promotion interventions with a focus on mental health, the prevention of violence, substance use, and daily physical activities that seems to provide meaning and hope.South African studies have suggested that street children are resilient but also suicidal, engage in unprotected sex and other high risk sexual behaviour as a means of survival, have high rates of substance abuse and are physically abused and stigmatized due to their state of homelessness. However, few studies have explored in a more holistic manner the lived experiences of street children in South Africa. The main purpose of this study was to explore qualitatively the lived experiences of street children living on the street of Durban, in the province of KwaZulu-Natal, South Africa. Adolescents (six males and four females) between the ages of 14 and 18 years (average age=16) were purposively selected and in-depth semi-structured interviews were conducted. An interpretative phenomenological analysis of the transcribed data revealed that incidence of violence and drug and alcohol use were common experiences of street life. Yet despite these challenges survival was made possible through personal and emotional strength, cultural values, religious beliefs, supportive peer relationships, and participation in sports activities. These protective, resilience resources should be strengthened in health promotion interventions with a focus on mental health, the prevention of violence, substance use, and daily physical activities that seems to provide meaning and hope.

Psychological functioning among vertically infected HIV-positive children and their primary caregivers

ABSTRACT The current study sought to explore the association between primary caregiver depressive symptoms and the psychological functioning in children vertically infected with human immunodeficiency virus (HIV) living in Eastern Cape, South Africa. A cross-sectional data were collected using the Beck Depression Inventory and Strength and Difficulties Questionnaire in a sample of 152 caregiver/child dyads. The results revealed that poorer psychological functioning in children was significantly associated with depressive symptoms in caregivers. This relationship existed whether or not the child was raised by a biological or non-biological caregiver as well as for both genders. Younger childrens psychological functioning was more negatively influenced than that of older children raised by a caregiver with depressive symptoms. In the context of a large treatment gap for common mental disorders in South Africa, there is a need for interventions to address maternal mental health in families infected and affected by the HIV/AIDS pandemic as a mental health promotion strategy given that HIV-infected children are a particularly vulnerable population for poor mental and behavioural health outcomes.

An exploratory study of the socio-cultural risk influences for cigarette smoking among Southern Nigerian youth

BackgroundThe increase in smoking prevalence in developing countries including Nigeria has been mainly blamed on the aggressive marketing strategies of big tobacco companies. There is a paucity of research on other socio-cultural risk factors for smoking among the youth. The main objective of this study is to explore and describe socio-cultural risk factors influencing cigarette smoking among the youth in Southern Nigeria.MethodsA total of 27 respondents (5 community leaders, 4 political analysts and 18 young cigarette smokers) were interviewed using a semi-structured interview guide. Interpretative Phenomenological Analysis (IPA) was used to analyse the data.ResultsSocial-cultural practices fuelling early usage and exposure of children to cigarettes and the promotional activities of tobacco companies were identified as possible factors influencing youth’s smoking behaviour in Southern Nigeria.ConclusionTobacco control policies should include cultural interventions to modify current traditional practices and social norms which fuel the use of tobacco in the society. Such interventions must target specific groups, subpopulations and subcultures more exposed to the cultural risk influences for smoking.

Illness perception, diabetes knowledge and self-care practices among type-2 diabetes patients: a cross-sectional study

BackgroundSelf-care practices among persons living with type-2 diabetes are very crucial in diabetes manages as poor self-care results in complications. However, little research exists within the Ghanaian context. This study examined whether type-2 diabetes patients’ illness perception and diabetes knowledge significantly predict diabetes self-care practices.MethodsA cross-sectional survey design was employed and a total of 160 participants (45 males and 115 females) were sampled from a general hospital in Accra. A self-administered questionnaire measuring illness perception, diabetes knowledge and diabetes self-care practices as well as demographic checklist were used collect data.ResultsResults showed that illness perception and diabetes knowledge significantly predicted overall diabetes self-care practices. Analysis of domain specific self-care practices showed that patients’ diet was significantly predicted by illness perception and diabetes knowledge. Exercise was significantly predicted by only illness perception while blood sugar testing and diabetes foot-care were significantly predicted by diabetes knowledge.ConclusionCognitive and emotional representation of diabetes and diabetes knowledge are key determinants of patients’ diabetes self-care practices. It is therefore important that appropriate psychosocial interventions are developed to help patients’ adherence to recommended self-care practices.