International Mental Health Nursing Conference 2018 - Abstract Book by National Institute of Mental Health, Sri Lanka

INTERNATIONAL MENTAL HEALTH NURSING CONFERENCE

19th, 20th & 21st JULY 2018

CONFERENCE & ABSTRACTS BOOK

National Institute of Mental Health, Sri Lanka Mulleriyawa New Town

CONFERENCE & ABSTRACTS BOOK

THEME & OBJECTIVES OF THE CONFERENCE THEME: “EDUCATION PRACTICE & RESEARCH DEVELOPMENT IN MENTAL HEALTH NURSING” OBJECTIVES:  To present current research in mental health nursing in Sri Lanka.  To promote a research culture among Nursing Officers working in mental health units in Sri Lanka.  To describe current practice initiatives, nursing care innovations in treatment that reflect state of the art evidence based clinical practice in mental health nursing with populations across the lifespan and across the health-illness continuum.  To discuss educational initiatives that address key issues or strategies for increasing the knowledge and skills of all nurses and nursing students relative to mental health nursing.  To utilize the conference forum as a method for discussion of key issues in mental health nursing, health care policy, advocacy, global health, international collaboration and mental health initiatives for people of all ages.  Provide opportunities for professional networking, mentoring and collaboration.

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development,

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This book contains the abstracts of papers presented at the First International Mental Health Nursing Conference held at The National Institute of Mental Health, Mulleriyawa New Town, Sri Lanka on 19th, 20th & 21st July 2018.

SCIENTIFIC REVIEW COMMITTEE Dr. NFJ Fernando – Consultant Psychiatrist Dr. DBL Samaranayake – Consultant Community Physician Dr. SSP Warnakulasuriya – Senior Lecturer in Nursing

EDITORIAL COMMITTEE Dr. GDVD Wijayabandara Dr. MDA Krishanth Dr. BAO Wijewickrama N/O MGS Malkanthi N/O UGAAN Kumari N/O L Dissanayake

PUBLISHED BY National Institute of Mental Health, Mulleriyawa New Town, Sri Lanka Psychiatric Nurses’ Association, Sri Lanka Tel: +94112578234/7 E-mail: info@nimh.health.gov.lk Website: www.nimh.gov.lk

ISBN 978-955-71540-0-8 Published Date: 12th July 2018

COVER PAGE DESIGNED BY Mr. H. M. Dushyantha Bandara Herath

PRINTED BY Gamma Print Solution, Angoda

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PROJECT CHAIR & CHIEF ADVISOR Dr. HM Kapila Wickramanayake (Director - NIMH)

PROJECT ADVISORS Dr. NFJ Fernando, Dr. M Ganeshan Dr. BAO Wijewickrama, Dr. D Mailewa

CHIEF PROJECT COORDINATOR C/SGNO Ms. JMS Pathmarani

ASSISTANT PROJECT COORDINATORS SGNO Ms. MWSR Ruwangani, SGNO Ms. JDD Gunasekara

PROGRAM COORDINATOR Ms. PC Ekanayake

JUDGES OF ORAL PRESENTATIONS Dr. S Amarasinghe – Consultant Psychiatrist Mrs. S Senevirathne – Senior Lecturer in Nursing (SJP) Mrs. A Abeynayake – Principal PBS, Colombo

JUDGES OF POSTER PRESENTATIONS Dr. K Ranasinghe – Consultant Psychiatrist Mr. Sunil de Silva – Senior Lecturer in Nursing (OUSL) Mrs. R Kulathunga – Principal – NTS (SJP)

CENTRAL ORGANIZING COMMITTEE MEMBERS N/O WLDG Samanthi, N/O MGS Malkanthi, N/O MUS Fernando, N/O JS Biyagama, N/O BGD Erandi, N/O KDCK Migunthanna, N/O PKPR Gunathilake, N/O SHK Samanpiya, N/O BMAG Bandara, N/O GDL Ananda, N/O SV Wickramasinghe, N/O KSC Silva, N/O SKD Lalani

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TABLE OF CONTENT THEME & OBJECTIVES OF THE CONFERENCE ............................................................................. 2 MESSAGE FROM THE CHIEF GUEST ......................................................................................... 8 MESSAGE FROM THE DIRECTOR GENERAL OF HEALTH SERVICES ..................................................... 9 MESSAGE FROM THE DIRECTOR – MENTAL HEALTH .................................................................. 10 MESSAGE FROM THE DIRECTOR - NURSING MEDICAL SERVICES ................................................... 11 MESSAGE FROM THE PROJECT CHAIR .................................................................................... 12 MESSAGE FROM THE PROJECT COORDINATOR ......................................................................... 13 MESSAGE FROM THE PRESIDENT – PSYCHIATRIC NURSES’ ASSOCIATION......................................... 14 PLENARY SESSIONS ........................................................................................................... 15 KEY NOTE ADDRESS ............................................................................................ 16 PLENARY SESSION: 1 – “WORKING AS A MULTI-DISCIPLINARY TEAM FOR BETTERMENT OF THE CLIENT” ........................................................................................................... 19 PLENARY SESSION: 2 – “ROLE OF NURSES IN MENTAL HEALTH REHABILITATION” ............... 20 PLENARY SESSION: 3 – “RESEARCH IN THE FIELD OF PSYCHIATRIC AND MENTAL HEALTH NURSING” ........................................................................................................ 21 PANEL DISCUSSIONS ......................................................................................................... 22 PANEL DISCUSSION: 1 – “MENTAL HEALTH TRAINING FOR NURSES” ............................... 23 PANEL DISCUSSION: 2 – “COMMUNITY MENTAL HEALTH NURSING” ............................... 24 ORAL PRESENTATIONS ....................................................................................................... 25 OP-01 - Influencing Factors for Irregular Psychiatric Clinic Attendance Guardians Perspective.................................................................................... 26 OP-02 - Mothers’ Experiences of Having Child with Thalassemia ..................... 27 OP-03 - KNOWLEDGE, ATTITUDES AND PRACTICES OF FAMILY CAREGIVERS ON CONTINUATION OF CARE FOR PATIENTS ATTENDING MENTAL HEALTH CLINIC AT PROVINCIAL GENERAL HOSPITAL-KALUTARA .......................................................................................... 28 OP -04 - PROBLEMS OF CARE GIVERS OF PERSONS WITH MENTAL ILLNESSES WHO ARE CURRENTLY ADMITTED IN NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA ............... 29 OP-05 - CARE GIVERS' PERCEPTIONS OF COMMUNITY MENTAL HEALTH SERVICES FOR THEIR RELATIVES IN SELECTED GROUP OF PATIENTS FOLLOWED UP IN THE COMMUNITY BY THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA…………………………………………………30 OP-06 - PREVELANCE OF DIFFERENT TYPES OF PATIENT RELATED VIOLENCE EXPERIENCE AMONG NURSING OFFICERS IN TEACHING HOSPITAL KARAPITIYA (THK)............................ 31 OP-07 - THE PREVALENCE OF PHYSICAL VIOLENCE AND ASSOCIATED FACTORS ON NURSES WORKING IN NATIONAL INSTITUTE OF MENTAL HEALTH SRI LANKA ................................ 32 OP-08 - FACTORS AFFECTING EATING PATTERNS AMONG NURSES IN TEACHING HOSPITAL KANDY ............................................................................................................. 33 OP-09 - PERCEIVED CHALLENGES OF NURSES WORKING IN NATIONAL INSTITUTE OF MENTAL HEALTH SRI LANKA ............................................................................................. 34

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CONFERENCE & ABSTRACTS BOOK ORAL PRESENTATIONS (CONT.) ............................................................................................... OP-10 - THE IMPLEMENTATION OF THE MODIFIED DISBURSEMENT LINKED INDICATORS OF THE HEALTH CARE QUALITY AND SAFETY DIRECTORATE OF THE MINISTRY OF HEALTH (DLI 7) AT THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA AND HALF WAY HOME, MULLERIYAWA ...................................................................................................................... 35 OP-11 - NURSES ATTITUDES TOWARDS MENTALLY ILL PEOPLE AT THE NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH) SRI LANKA ..................................................................... 36 OP-12 - PREVALENCE OF GENDER BASED VIOLENCE AT THE WORKPLACE AMONG SELECTED GROUPS OF FEMALE STAFF AT THE NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH), SRI LANKA ............................................................................................................. 37 OP-13 - INTER-PROFESSIONAL COLLABORATION BETWEEN MULTI-DISCIPLINARY TEAM MEMBERS AT THE NATIONAL INSTITUTE OF MENTAL HEALTH , SRI LANKA ......................... 38 OP-14 - PERCEPTION OF THE COMMUNITY PSYCHIATRIC NURSES WHO ARE CURRENTLY IN SERVICE REGARDING THE COMMUNITY PSYCHIATRIC NURSING SERVICE IN SRI LANKA .......... 39 OP-15 - COGNITIVE ABILITY AND PHYSICAL ACTIVITY BEHAVIOR OF ELDERS IN GALLE.......... 40 OP-16 - THE ASSOCIATION BETWEEN NUTRITIONAL STATUS AND COGNITIVE IMPAIRMENT AMONG OLDER PEOPLE IN GALLE DISTRICT SRILANKA .................................................. 41 OP-17 - KNOWLEDGE AND PRACTICES ON ADOLESCENTS WITH DEPRESSION AMONG SECONDARY SCHOOL TEACHERS IN NATIONAL SCHOOLS IN BADDEGAMA EDUCATIONAL DIVISION, GALLE DISTRICT, SRI LANKA ..................................................................... 42 OP-18 - MOTIVATIONAL FACTORS AND COPING STRATEGIES OF PATIENTS PRESENTING TO PSYCHIATRIC UNITS AT COLOMBO SOUTH TEACHING HOSPITAL AND HOMAGAMA BASE HOSPITAL FOLLOWING DELIBERATE SELF-HARM ......................................................... 43 OP-19 - THE PREVALENCE AND FACTORS ASSOCIATED WITH READMISSION OF THE PATIENTS WITH PSYCHIATRIC DISORDERS ............................................................................... 44 OP-20 - G ENERAL P UBLIC VIEWS ON SEXUAL ABUSE OF MALE CHILDREN IN CENTRAL P ROVINCE , SRI L ANKA ........................................................................................ 45 OP-21 - THE IMPACT OF SOCIAL MEDIA TO SELF-ESTEEM AND NARCISSISTIC PERSONALITY AMONG ADOLESCENTS AND YOUTH IN COLOMBO DISTRICT ........................................... 46 OP-22 - EFFECTIVENESS OF PRE-OPERATIVE COUNSELING OF OSTOMY PATIENTS AT SRI JAYEWARDENEPURA GENERAL HOSPITAL .................................................................. 47 POSTER PRESENTATIONS .................................................................................................... 48 PP-01 - THE PREVALENCE OF DEPRESSION AMONG UNDERGRADUATES IN FACULTY OF MEDICAL SCIENCES, UNIVERSITY OF SRI JAYEWARDENEPURA, SRI LANKA ....................................... 49 PP-02 - CHARACTERISTICS OF PATIENTS ATTENDING THE MENTAL HEALTH OUTPATIENT CLINIC IN A DISTRICT GENERAL HOSPITAL IN GAMPAHA DISTRICT ............................................. 50 PP-03 - KNOWLEDGE SKILLS AND ATTITUDES TOWARDS PSYCHOLOGICAL COUNSELLING AMONG NURSING OFFICERS IN PSYCHIATRIC UNITS, SRI LANKA ................................................. 51 PP-04 - ABSCONDING OF PATIENTS FROM THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA; A ROOT CAUSE ANALYSIS ........................................................................... 52

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CONFERENCE & ABSTRACTS BOOK POSTER PRESENTATIONS (CONT.)............................................................................................. PP-05 - THE EFFECTS OF INTERNET ADDICTION ON SOCIAL BEHAVIOR AMONGST YOUTH RESIDING IN COLOMBO DISTRICT, SRI LANKA ............................................................. 53 PP-06 - RESTRAINING OF PATIENTS FOR BEHAVIORAL MANAGEMENT AT THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA, A ROOT CAUSE ANALYSIS ............................. 54 PP-07 - COPING STRATEGIES TOWARDS THE EXAM STRESS AMONG THE YOUTH IN THE INTERNATIONAL INSTITUTE OF HEALTH SCIENCES, SRI LANKA ......................................... 55 PP-08- KNOWLEDGE AND ATTITUDES AMONG HEALTH SUPPORT STAFF ABOUT CARING FOR PATIENTS WITH MENTAL ILLNESS AT THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA ...................................................................................................................... 56 PP-09 - EMPLOYEE SATISFACTION OF SELECTED STAFF AT THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA ............................................................................................ 57 PP-10 - AN AUDIT ON SERVICES PROVIDED BY DENTAL CLINIC OF NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA OVER THREE MONTHS IN 2018 ........................................ 58 PP-11 - AN AUDIT OF THE SERVICES PROVIDED BY THE NAVODAYA PSYCHOLOGICAL TREATMENT SERVICE OF THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA OVER FIVE MONTHS IN 2018 .............................................................................................. 59 PP-12 - AN AUDIT OF THE SERVICES PROVIDED BY ADOLESCENT MENTAL HEALTH UNIT OF THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA OVER FIVE MONTHS IN 2018........... 60 PP-13 - CLINICAL AUDIT ON SERVICES PROVIDED BY PERINATAL PSYCHIATRIC UNIT OF NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA OVER FOUR MONTHS IN 2018 ......... 61 PP-14 - PARTICIPATION OF REHABILITATION ACTIVITIES AMONG PATIENTS REFERRED TO THE FORENSIC PSYCHIATRY UNIT OF NATIONAL INSTITUTE OF MENTAL HEALTH â&#x20AC;&#x201C; A CLINICAL AUDIT ...................................................................................................................... 62 PP-15 - PERCEIVED TRAINING AND EDUCATIONAL NEEDS OF NURSES WORKING IN NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA ............................................................... 63 PP-16 - AN AUDIT OF THE SERVICES PROVIDED BY LEARNING DISABILITY UNIT OF THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA OVER FIVE MONTHS IN 2018........... 64 PP-17 - AN AUDIT OF SERVICES OF THE ELECTRO CONVULSIVE THERAPY UNIT OF NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA OVER FOUR MONTHS IN 2018 ....................... 65 PP-18 - EMPLOYEE SATISFACTION OF SELECTED STAFF AT THE HALF WAY HOME, MULLERIYAWA .................................................................................................. 66 ACKNOWLEDGEMENT ....................................................................................................... 67

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MESSAGE FROM THE CHIEF GUEST Hon. Dr. Rajitha Senarathne Minister of Health, Nutrition and Indigenous Medicine I am pleased to extend my best wishes on the occasion of the Inauguration of the International Mental Health Nursing Conference 2018. Mental Health Services are an integral part in the Healthcare Services spectrum in Sri Lanka. The burden of mental health services is steadily increasing and the related issues are becoming areas of major concern for the country and globally. To cater for this growing need, Mental Health Nursing is developing rapidly around the world. It is important to ensure that the Mental Health Nursing in Sri Lanka to develops on par with other developed countries in a manner suitable to the needs of our people. In the recent past I have witnessed the efforts taken by the Nursing Service to develop its members professionally. Meanwhile, I am happy to note the formation of the Psychiatric Nursesâ&#x20AC;&#x2122; Association of Sri Lanka which I am sure will contribute immensely to the development of Mental Health Nursing in Sri Lanka. I am pleased to note that the National Institute of Mental Health, Sri Lanka which is the leading institute for training and research in Mental Health in the country has brought Mental Health Nursing to the forefront by organizing this conference. Research and sharing of new knowledge contributes immensely to the development of any profession. I am sure that this International Mental Health Nursing Conference will push forward the development of Mental Health Nursing in Sri Lanka. I extend my best wishes to the organizing committee, resource persons and the participants for a successful conference.

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MESSAGE FROM THE DIRECTOR GENERAL OF HEALTH SERVICES Dr. Anil Jasinghe Ministry of Health, Nutrition and Indigenous Medicine Mental health is crucial to the well-being of individuals, societies and countries. Mental health is more than the absence of mental disorders. It involves a state of wellbeing whereby individuals recognize their abilities, can cope with the normal stresses of life, work productively and contribute to the community. Provision of Mental Health Services is done best through a multi-disciplinary team and Mental Health Nurses are an integral part of this team. Over the years we have seen the gradual but steady development in the Nursing Services in Sri Lanka including the Mental Health Nursing Services. Mental Health is an important part of basic, undergraduate and post basic training for nurses. Research in the field of Mental Health Nursing is a novel area of development which I’m very pleased to be part of. By Organizing an International Mental Health Nursing Conference, the National Institute of Mental Health, Sri Lanka and the Psychiatric Nurses’ Association have pushed the field of Mental Health Nursing in Sri Lanka to new era. I ‘m especially pleased to see the participation of international faculty as they will bring in new knowledge from the region and the globe which will be extremely useful to our Mental Health Nurses. I’m sure these kinds of forums will contribute immensely to the Professional Development of Mental Health Nurses which in turn will lead to greater improvement in patient care and client services. I congratulate the organizing committee for their dedication and extend my best wishes for a successful International Mental Health Research Conference.

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MESSAGE FROM THE DIRECTOR â&#x20AC;&#x201C; MENTAL HEALTH Dr. Chithramalee de Silva Ministry of Health, Nutrition and Indigenous Medicine I wish to express my sincere gratitude to the National Institute of Mental Health, for organizing the International Mental Health Nursing Conference for the first time in Sri Lanka. Mental health and well-being are fundamental to our collective and individual ability as humans to think, emote, interact with each other, earn a living and enjoy life. Achieving optimum mental health is the responsibility of the entire socio-cultural, economic and political system of the country. The global burden of mental disorders is on the increase, with significant impacts on health and major social and economic consequences. It is estimated that by 2030, the most common global disease will be depression. Ministry of Health is taking a range of measures and policy decisions to improve the mental health of the Sri Lankan population and to encourage the development of psycho-social services to face the future challenges. Improving infrastructure and human resources to provide quality care for the people affected by mental disorders, innovative approaches to promote mental wellbeing, strengthening Information base & surveillance and promoting research are major strategies prioritized by the Government. Development of Community Psychiatry Nursing as an important component in Mental Health is a historical landmark in Mental Health Services in Sri Lanka. As the Director Mental Health of the Ministry of Health Sri Lanka, I appreciate the contributions made by the National Institute of Mental Health in enhancing Psychiatry services and particularly, Mental Health Nursing in Sri Lanka. International forums like this would help to disseminate knowledge and encourage Mental Health professionals and researchers to engage in research in mental health. Such initiatives will help to strengthen further development of mental health services in the country. I would once again like to congratulate the Director and the Academic committee of the National Institute of Mental Health for their commitment and dedication and wish this international conference to be a success.

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MESSAGE FROM THE DIRECTOR - NURSING MEDICAL SERVICES Mrs. M B C Samanmali Ministry of Health, Nutrition and Indigenous Medicine It is my great pleasure to submit a message of felicitation to the International Mental Health Nursing Conference 2018. First, I wish to express my sincere appreciation to the National Institute of Mental Health for organizing this valuable nursing conference in your institution. Mental Health includes our emotional, psychological, and social well-being. It helps us to determine how we handle stress and make choices. It is important at every stage of life, from childhood & adolescence till adulthood. Mental health may include an individual's ability to enjoy life and create a balance between life activities and efforts to achieve psychological resilience. Sri Lanka can proudly lay claim to one of the best health care systems in the world and nursing profession is a significant factor to the consistent levels the health care sector has managed to achieve. Nursing is a profession that requires immense sacrifice and commitment as well as being a kind carrying soul. As trusted health care professionals, nurses have a responsibility to the public to continue to expand their knowledge and understanding of the concepts of mental health and mental illness while delivering competent, safe, ethical, psychosocial, physical, and spiritual care to people with mental illnesses, their caregivers, their families and communities So, this kind of professional base activities are very importance and help to enhance the nursing profession and its carrier path way. I wish the conference the very best.

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MESSAGE FROM THE PROJECT CHAIR Dr. H M Kapila Wickramanayake Director â&#x20AC;&#x201C; National Institute of Mental Health, Sri Lanka Welcome to the Inaugural International Mental Health Nursing Conference 2018. Nursing research in mental health is a growing field in which individuals within the profession can contribute a variety of skills and experiences to the science of mental health nursing care. National Institute of Mental Health, Sri Lanka is the premier center in mental health training and research in Sri Lanka. Nursing Officers working in different mental health units in Sri Lanka participate in various training programs in mental health organizing by NIMH. National Institute of Mental Health, Sri Lanka in collaboration with the Psychiatric Nursesâ&#x20AC;&#x2122; Association and the support of the Ministry of Health and other well-wishers is organizing this International Mental Health Nursing Conference for the first time in Sri Lanka to facilitate the dissemination and application of research findings on mental health nursing care. We see this as a major step forward in the development of Mental Health Nursing research in Sri Lanka. I thank the Hon. Minister, the Ministry of Health officials, the World Health Organization, international faculty and all other sponsors who supported us. I am extremely appreciative of my hard-working organizing committee and staff of NIMH and thank them for their effort. I extend my best wishes to the international and local faculty, resource persons and participants.

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MESSAGE FROM THE PROJECT COORDINATOR Mrs. Sandya Pathmarani Chief Special Grade Nursing Officer, NIMH It is our great pleasure to welcome you to the “International Mental Health Nursing Conference which is to be held from July 19th - 21st, 2018 at National Institute of Mental Health, Sri Lanka”. The conference is mainly focused on Psychiatric and Mental Health Nursing. Mental health nursing is a demanding, but rewarding career choice which will be useful in promoting and supporting a person with mental illness or psychological need’s recovery and enabling them to have more involvement and control over their condition. In a global contest a Mental Health Nurse is the appointed position of a nurse that has specialized in mental health and cares for people of all ages experiencing mental distress, Care of patients with acute and enduring or chronic condition, Care of adults and older people, Care of children and young people with mental health problems. The main aim of this conference is to bring all the nursing officers in field of psychiatry together, and to focus on the current issues related to psychiatric nursing, community psychiatric nursing and training in mental health nursing. Another aspect of this conference is to promote research in psychiatric nursing. This Mental Health Nursing conference 2018 is an extraordinary event designed for nursing professionals to facilitate the dissemination and application of research findings on psychiatric Care. This event is organized by Psychiatric Nurses’ Association and the National Institute of Mental Health, Sri Lanka for the 1st time in Sri Lanka. This is a great opportunity for Nurses in Mental Health Services to meet experts in the field to share their experience in this broad field. This event creates a platform for professionals to share knowledge, network, and gain perspective of Psychiatric and Mental health nursing, unique to the conference destination. It will further provide exposure to the on-going inquiries about in Psychiatry, mental health nursing and Healthcare. I thank all our sponsors and well-wishers who supported us in making this event a success. I extended our warmest greetings to our international faculty, resource persons and participants and wish them the very best.

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MESSAGE FROM THE PRESIDENT – PSYCHIATRIC NURSES’ ASSOCIATION Mr. S H K Samanpiya Nursing Officer, National Institute of Mental Health It is with great pleasure that I write this message on the occasion of the 1st ever International Mental Health Nursing Conference in Sri Lanka. This event will no doubt be a stepping stone to improve nursing standards in mental health care in Sri Lanka. One of the key elements in making this conference a reality was the limitless support we received from the Director of National Institute of Mental Health for which we are very grateful. We are also proud to be a co-organizer of this prestigious conference. The purpose of the Psychiatric Nurses’ Association, Sri Lanka is to develop quality nurses in mental health who are comprehensive in their knowledge, attitudes, and skills. The outcome of this is to have specialized nurses in mental health working around the country. It is with this vision that in August 2017 that this association was formed in NIMH with the able support of the nurses who have completed the 06 months post basic psychiatric nursing training. It should be emphasized that this association seeks only to develop mental health nursing as a profession and not unionization activities. We believe that through this association we would be able to contribute to the benefit of people who are affected by mental health problems in Sri Lanka. We aim to achieve our goals through promoting educational programs for nurses in mental health nursing; holding local, regional, & international mental health research conferences, and improving the media visibility of mental health nursing via newspaper and electronic media. We believe that this will help the public, mental health services, and Sri Lanka as a whole. At a time when mental health nursing is coming to the forefront, the efforts of the National Institute of Mental Health, Sri Lanka is admirable. The effort made by Director, Organizing Committee & Staff is deeply appreciated and respected by Psychiatric Nurses’ Association. While wishing this conference all success, we hope this partnership will continue in the future as well.

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KEY NOTE ADDRESS Dr. S S P Warnakulasuriya [RN, RMN, BscN (Hons.), MNsc, PGDCP, PhD] Senior Lecturer, Department of Clinical Nursing, Faculty of Nursing University of Colombo It is a great honor and a privilege for me to be invited for making the keynote address at this first historical international conference on mental Health Nursing at NIMH. I would like to thank organizing committee for giving me this opportunity. This is a historical event because; I have never seen international nursing conferences had been conducted in a hospital in Sri Lanka in the past. Therefore, organizing this event is a great honor for the 32 thousand nurses in Sri Lanka. Especially, nurses who are working in the field of mental health. NIMH is a very special place for me because of many reasons. I started my career in nursing from NIMH. My first research setting was NIMH and my first BSc nursing degree was completed while I was working here. My research setting for master degree was also NIMH. It was an interesting memory that first qualitative research using phenomenological approach, I conducted among family members of patients with Schizophrenia. As I understood this land is very fertile ground for any mental health professionals to develop in their profession. I have seven yearsâ&#x20AC;&#x2122; experience in this institution with full of good memories. Today I see significant improvements that have been taken place in NIMH in terms of infrastructure, educational resources, and quality of services provided and changes in staff with great motivation. Not only that, as I observed, unlike 20 years before, all categories of health professionals at NIMH have very positive attitudes towards the mentally ill patients, mental health development and improvement of the quality of services.

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They are motivated to seek new knowledge, update and upgrade knowledge and apply the knowledge into practice. Organizing this research conference indicates that positive attitudes of the administration of NIMH to develop nurse’s knowledge in research and expose them to international level knowledge and experience in a scientific forum with eminent professionals in mental health care. If I focus on my topic today “Future of Mental Health Nursing in Asia”, first I will select the key words of the topic. Psychiatric mental health nursing is “a specialized area of nursing which needs more specific knowledge in behavioral theories to use as its science and advanced skills to offer self as an art”. This indicates that mental health nurses should possess good understanding about psychological theories and should equip with specific skills to offer self as an art. Though there is no specialization for psychiatric nursing in Sri Lanka other than giving sixmonth psychiatric training most of the nurses in this field of mental health gain some in-service training from time to time that based on required knowledge and skills in the field. If I focus on south Asian region with regards to mental health and mental health nursing, despite the great diversity in this region, a common thread of a large burden of mental and behavioral disorders, huge treatment gap due to scarcity of available mental health resources, inequities in their distribution, and inefficiencies in their use persist. It has been our guiding principle to trace the common links between these countries mental health issues pertaining to ethical, legal and community psychiatry related issues and to suggest wherever possible ways for further growth and developments. Then we must explore the most effective way of deploying mental health and psychiatric nurses both in the hospital and the community as applied in the well-developed mental health care settings. There is no proper standard strategy to educate the Mental Health nurses in the region, different levels of qualifications exist in different countries. There is ample evidence of the vital role of psychiatric/mental nursing in the hospital and the community.

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Today, many nurses find that the job qualifications for positions they have traditionally held now demand they acquire new skills and knowledge. The hospitals need to be staffed with trained psychiatric nursing personnel. Therefore, they must keep on updating their knowledge in the areas of psychopharmacology, psychological theories, therapeutic techniques in communication, group interventions, and evidence based therapies and disease management. In addition, the nurses in the field of Mental Health care need to begin to recognize new trends and patterns that are emerging in this field. Significant trends that will affect the future of psychiatric/mental health nursing in the South Asia include educational challenges, an aging population and associated health problems such as dementia and depression and other psychological deviations, and increasing cultural diversity, and expanding technology. During my speech I would like to further elaborate following areas that are important to focus on.     

The Changing Trends in Practice: From Hospital to Community and role of the mental health nurse. Need for Preparation of Nurses in Advanced Skills and Knowledge. Need of the nurses to adhere to Technological Changes. Need for Quality Patient Care and Consumer Empowerment. Skills Required for Working with Vulnerable At-Risk Groups.

The quality of mental health services delivered will ultimately depend on the persons equipped to deliver that services. Psychiatric nurses are capable of playing vital roles in specialized areas like community mental health centers, family and marital counseling centers, child and adolescent centers, geriatric and school mental health programs. Though all these facilities have not been established in the field of mental health in all the countries in the region, it is prime important to pay attention to this areas. This is an important time to put the mental health picture of the South Asian region in right perspective to enable us to grow further rapidly.

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PLENARY SESSION: 1 WORKING AS A MULTI-DISCIPLINARY TEAM FOR BETTERMENT OF THE CLIENT Dr. Bino Thomas (BA, MA, MPhil, PhD) Asst. Professor of Psychiatric Social Work and Consultant, Child and Adolescent Psychiatry Services, National Institute of Mental Health and Neuro Sciences, India Mental health issues are understood better in etiological and interventional aspects compared to the past. Our understanding about mental illness has moved from an evil spirited version to a contribution of combination of biological, psychological and psychosocial factors. Diverse predisposing, precipitating and perpetuating factors are usually associated with mental ill health. Bio-psycho-social models of understanding mental illness have contributed largely in providing bio-psychosocially oriented interventions. The origin of multidisciplinary approach in mental health practice has evolved from this very understanding. The core team consists of psychiatrists, psychologists, psychiatric social workers, and psychiatric nurses. All the professionals holistically contribute to the welfare of the individuals and families according to their special areas of training. When a psychiatrist manages the medical and physical aspects of the patient, a psychologist handles the cognitive and emotional issues of the patient and the psychiatric social worker deals with the familial/marital issues, welfare and after care programs. Psychiatric nurses join hands in the inpatient care activities significantly. Multidisciplinary approaches have greater benefits. Maintaining and respecting the professional boundaries are challenges to deal with in everyday mental health practices.

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PLENARY SESSION: 2 ROLE OF NURSES IN MENTAL HEALTH REHABILITATION Dr. Bino Thomas (BA, MA, MPhil, PhD) Asst. Professor of Psychiatric Social Work and Consultant, Child and Adolescent Psychiatry Services, National Institute of Mental Health and Neuro Sciences, India

Psychiatric nurses are trained nursing professionals in the field of psychiatry. Professional involvement of the nurses has great impacts on the lives of the mentally ill and their family members. The role of the nurses in mental health practices has wide range of recognition. They supervise the medication compliance and facilitate the investigations for the patients. They collaborate with the vocational instructors and family members in training vocational skills. They have a greater role in organizing recreational activities for the patients, and group based programs such as education, yoga, art, craft and life skills training. In addition to the patient focused activities, administrative responsibilities include supervision of vocational instructors, collecting feedbacks and making appropriate changes, developing vocational care programs. Training nurses in psychiatric rehabilitation and organizing continuing nursing education are excellent opportunities for professional development.

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PLENARY SESSION: 3 RESEARCH IN THE FIELD OF PSYCHIATRIC AND MENTAL HEALTH NURSING PROF.ATHULA SUMATHIPALA[MBBS, DFM, MD (Family Medicine), MRCPsych (UK), CCST, PhD, FSLCGP] Professor of Psychiatry, Director, Internationalization Research Institute for Primary Care & Health Sciences, Faculty of Medicine & Health Sciences Keele University, Staffordshire, ST5 5BG, United Kingdom

The main objective of this session will be to stimulate research among nursing professionals. Therefore, this workshop will be to introduce; what is research? and how to learn to do research. The most important step in this direction is to develop the skill, how to develop a research question? After that, how to proceed: sharing practical tips. You donâ&#x20AC;&#x2122;t need to have to any past experience in doing research. However, if you have past experience bring you research and there will be opportunity for discussion.

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PANEL DISCUSSION: 1 MENTAL HEALTH TRAINING FOR NURSES 

CHAIRPERSON: DR. SUNIL DE ALWIS Additional Secretary - Medical Services, Ministry of Health

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CO-CHAIRPERSON: DR. DILANTHA DHARMAGUNAWARDENE Director - Training, Ministry of Health

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PANELISTS: 1) Mr. S H K Samanpiya - NOIC (Training Unit – NIMH) “CURRENT MENTAL HEALTH NURSING TRAINING AT THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA” 2) Mrs. R Wallipuranathan - Director – Nursing (Education) “MENTAL HEALTH TRAINING IN THE CONTEXT OF GENERAL NURSING TRAINING IN THE NURSING TRAINING SCHOOLS AND POST BASIC TRAINING” 3) Mrs. M B C Samanmali - Director - Nursing (Medical Services) “IMPORTANCE OF MENTAL HEALTH TRAINING IN THE GENERAL NURSING PRACTICE AND THE ROLE OF TRAINED PSYCHIATRIC NURSES IN GENERAL, BASE AND PRIMARY LEVEL HOSPITALS” 4) Dr. Pushpa Ranasinghe - Consultant Psychiatrist – NIMH “FUTURE OF MENTAL HEALTH TRAINING IN SRI LANKA; WHAT SHOULD WE AIM FOR?”

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COORDINATOR: MRS. M W S R RUWANGANI Special Grade Nursing Officer NIMH

IMHNC 2018

CONFERENCE & ABSTRACTS BOOK

PANEL DISCUSSION: 2 COMMUNITY MENTAL HEALTH NURSING 

CHAIRPERSON: DR. NEIL FERNANDO Consultant Psychiatrist Senior Lecturer in Psychological Medicine, Kothalawela Defense University

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CO-CHAIRPERSON: DR. CHITHRAMALEE DE SILVA Director – Mental Health Ministry of Health

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PANELISTS: 1) Mrs. Deepa S Neththikumara - Community Psychiatric Nurse – General Hospital, Mathara “EXPERIENCES FROM THE PERIPHERY IN COMMUNITY PSYCHIATRIC NURSING” 2) Mrs. W L D G Samanthi - Community Psychiatric Nurse – NIMH “EXPERIENCES FROM A TRAINING CENTRE IN COMMUNITY PSYCHIATRIC NURSING” 3) Dr. Nirupa Hettige - Medical Officer – Mental Health (Focal point),Colombo “PERSPECTIVE OF MEDICAL OFFICERS - MENTAL HEALTH ABOUT COMMUNITY MENTAL HEALTH NURSING” 4) Ms. P. D. Kusumalatha – Senior Special Grade Nursing Tutor (Public Health), National Institute of Health Sciences, Kaluthara “FUTURE OF COMMUNITY MENTAL HEALTH NURSING”

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COORDINATOR: MRS. W L D G SAMANTHI Community Psychiatric Nurse NIMH

IMHNC 2018

CONFERENCE & ABSTRACTS BOOK

IMHNC 2018

OP-01

CONFERENCE & ABSTRACTS BOOK

INFLUENCING FACTORS FOR IRREGULAR PSYCHIATRIC CLINIC ATTENDANCE - GUARDIANS PERSPECTIVE Pathmini NMAT1#, Priyadarshani LPD1, Srimali AHKE1, Lianage N1 1

Department of Nursing, Faculty of Health Science, The Open University of Sri Lanka # tecla79nur2001@gmail.com

Introduction: According to the definition of World Health Organization (WHO) mental and behavioral disorders are understood as clinically significant condition characterized by alteration of thinking, emotions or behavior associated with personal distress and or impaired functioning. Non-attendance at the Out patientsâ&#x20AC;&#x2122; follow-up clinic is a serious problem and loss to follow up with psychiatric treatment is associated with increased clinical, social, and economic cost and closely related with relapses, rehospitalization and poor outcome among patients with psychiatric illness. The clinic follow-up is very poor among registered patients in the psychiatric clinic at District General Hospital, Hambantota. Objective: Main purpose of the study is to identify the influencing factors for the irregular psychiatric clinic attendance.

IMHNC 2018

Method: A descriptive cross-sectional study was employed using a selfadministered and are searcher administered questionnaire. We used convenient sample of 180 guardians of clinic patients. Result: Out of 180, 92.7% responded. Majority were Sinhalese (56%), 45% were Buddhists. Most participants were females (52%).the identified reasons for erratic clinic attendance were lack of insight towards treatment (77%) poor compliance (72%), poor understanding about medication (70%), lack of awareness on medication side effect (72%), engage with other activities (67%), family problems(54%), social activities (55%) and social stigma (53%). Conclusion: Multiple factors were identified as influencing for erratic clinic attendance, which needs to be studied in detail and addressed accordingly in future to improve current pattern of clinic attendance at the psychiatric clinic at Hambanthota.

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OP-02

MOTHERS’ EXPERIENCES OF HAVING CHILD WITH THALASSEMIA Waduge NMK1#, Guruge NDS1, Senevirathne PLW1, Sanjeewani HGN1, Siriwardana IM1 1

Department of Nursing, Faculty of Health Science, The Open University of Sri Lanka # nilu20120815@gmail.com

Introduction: Thalassemia is the most common hereditary gene disorder in the world, which is a challenge for children, parents and health care system, impairing the physical and psycho-social well-being of the whole family. Method: This qualitative study aimed to explore live experiences of mother’s in regard to the care of their children having thalassemia, in thalassemia unit at Teaching Hospital Anuradhapura (THA). Specific objectives were to describe physical, psychological and socio- economic experiences of mothers’ having child with thalassemia. Semi structured interview guide used to collect data. Data was analyzed by using content analysis. Result: The analysis comprises one theme “let’s strive ourselves to regain the balance of the imbalance” and three main categories and nine sub categories which illustrating mothers’ experiences of their child being diagnosed as thalassemia.

IMHNC 2018

According to the findings mothers had different experiences of handling of their thalassemia children. Most of them had been stressful and undergone lot of suffering. Findings show mothers have lot of physical experiences like back pain, joint pain, leg swelling and pain, sleeplessness, abdominal discomfort and loss of their appetite. The most prevalent psychological experiences were hopelessness, frustration, worry about future, stress, suicidal ideas and emotional disorganization. All mothers expected governmental financial support for bone marrow transplantation for their children. Findings stated that mothers and their families need special support from peers, society, medical team and government. Conclusion: Thalassemia requires lifelong regular treatment and followup care. Study revealed mothers of child having thalassemia face significant physical, psychological and socio-economic burden. Identified experiences need to be addressed appropriately in long-term.

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OP-03

KNOWLEDGE, ATTITUDES AND PRACTICES OF FAMILY CAREGIVERS ON CONTINUATION OF CARE FOR PATIENTS ATTENDING MENTAL HEALTH CLINIC AT PROVINCIAL GENERAL HOSPITAL-KALUTARA Kumarathunga NPSC1#, Herath HMJP1, Sasanka PADN1, Tennakoon TMML1, Abhayasinghe MPKW1, Fernando NFJ2 1

Faculty of Allied Health Sciences, Genaral Sir John Kotelawala Defense University, Sri Lanka 2 Faculty of Medicine, Genaral Sir John Kotelawala Defense University, Sri Lanka # suwimalikumarathunga@gmail.com

Introduction: Continuation of care is one of the priority concerns of global mental health. Family members play major role in continuation of care of the mentally ill. Care giving practices depend on the knowledge and attitudes of family caregivers. It was observed a lack of regular clinic attendance in mental health clinic once the patient is discharged from acute mental health setting. Main aim of this study was to assess knowledge, attitudes and practices of family caregivers on continuation of care for mentally ill person. Method: A descriptive cross-sectional study was conducted using an interviewer administered questionnaire. Target study population was the family caregivers of patients attending Mental Health Clinic at Provincial General HospitalKaluthara (n=384). Simple descriptive analysis and content analysis method for open ended questions was used in data analysis.

IMHNC 2018

Result: Response rate was 99.8%. Majority of the caregivers were females (70.4%), 22.5% of the caregivers were over the age of sixty. Results revealed that there is a mismatch between the knowledge and practices of caregivers in relation to continuation of care. 97.9% caregivers knew the importance of regular clinic attendance but only 78% were regularly attending the clinic. 98.4% caregivers knew mentally ill patients need long term adherence to the medication, less than 1% were adhered to medical advice at home. Almost half (49%) of the participant perceived home based care for mentally ill as a challenge. Negative attitudes observed towards perceived stigma, treatment methods and prognosis of the illness was observed among the study participants. Conclusion: Overall knowledge on continuation of care among family caregiver was at a high level. Care practices are associated with cultural and religious beliefs of the family caregivers, irrespective of the level of knowledge towards continuation of care.

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OP-04

PROBLEMS OF CARE GIVERS OF PERSONS WITH MENTAL ILLNESSES WHO ARE CURRENTLY ADMITTED IN NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA Harshani TT1#, Kumari UGAAN1 1

National Institute of Mental Health, Sri Lanka # harshi88122@gmail.com

Introduction: The Care-givers of patients with mental illnesses suffer from significant stresses, experience moderately high levels of burden, and often receive inadequate assistance from mental health professionals. National Institute of Mental Health communicates with patients, their care-givers, general public and scientists about the science of mental illnesses based on the latest research. Objective: To assess the problems of care givers of persons with mental illnesses who are currently admitted to the National Institute of Mental Health (NIMH), Sri Lanka. Method: A descriptive cross-sectional study was conducted from April to June 2018 among 146 care givers of patients with mental illnesses who are receiving treatment from NIMH. Caregivers who are older than 18 years and living with a relative who had been suffering from mental illnesses for more than six months were selected. A self-administered questionnaire was administered.

IMHNC 2018

Result: Fifty-five percent of respondents were female and 64% of caregivers were older than 41 years. Sixty-nine percent of respondents were living in the same house with mentally ill persons and out of them 73% are employed. Eighty-six percent take a break on and off from providing care with the extended support of friends, family members and paid care persons. Seventy-three percent of respondents had difficulties in earning monthly income. Ninety-two percent were complaining difficulties while caring, 44% were facing those difficulties constantly and majority at home (93%). Sixty-four percent had disruption on routine household activities, 40% had disruption of family functions, risk of being injured / killed, psychological distress and stigma discrimination. Although, 57% of care givers have reasonable knowledge about psychiatric illnesses, 71% had little knowledge about medications and its side-effects. Conclusion: Further in-depth studies are required about the burden on care givers of patients with mental illnesses and Care Giver education and psycho-social support for care givers need to be further strengthen at NIMH. Key Words: Mental Illness, Care Giver, NIMH

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OP-05

CARE GIVERS' PERCEPTIONS OF COMMUNITY MENTAL HEALTH SERVICES FOR THEIR RELATIVES IN SELECTED GROUP OF PATIENTS FOLLOWED UP IN THE COMMUNITY BY THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA 1#

Samanthi WLDG , Migunthenna KDCK , Fernando NFJ , Mendis J , Ranasinghe PK1, Wijewickrama BAO3, Uthistan V1, Hettige N4 1

The National Institute of Mental Health, Sri Lanka Faculty of Medicine, Genaral Sir John Kotelawala Defense University, Sri Lanka 3 Ministry of Health, Sri Lanka 4 RDHS Office, Colombo # samanthiwijethunga71@gmail.com

Introduction: National Institute of Mental Health (NIMH) has a welldeveloped Community Mental Health Service. Multi-disciplinary teams including Medical Officers in Mental Health, Community Psychiatric Nurses and Psychiatric Social Workers visit patients in the community from house to house to review patients and provide treatment. Objective: To describe the Care Givers' perceptions of community mental health Services for their relatives in selected group of patients followed up in the Community by the National Institute of Mental Health, Sri Lanka. Method: A descriptive cross-sectional study was conducted in the community, followed up by the Community Mental Health Team (CMHT) of General Psychiatry Units six and five of NIMH. A tri-lingual selfadministered questionnaire was given to the primary care givers of patients by an independent research assistant. Result: Total of 100 care givers were interviewed. Majority of participants were Sinhalese (76%). Out of all 72% of Care Givers were females and 61% of their patients were Males.

IMHNC 2018

Majority of them were in low-income families (53% was <Rs.15,000). Majority (59%) was on long-term treatment and under CMHT services (67% more than 5 years). Majority expressed the need (86%) and happiness (77%) to have CMHT services and 74% had positive responses from the neighborhood. However, 23% of families stated that CMHT visits are uncomfortable to them. Majority had no issue CMHT visiting in named hospital vehicle (67%) and as a team (83%). But, 64% of care givers preferred the CPNN visiting their houses in a civil dress. 88% said CMHT visits fulfill their requirements and beneficial (91%) due to reasons of inability to take patient to hospital (47%), reduces admissions (83%), reduces aggression (76%), easier to discuss problems families (73%). Conclusion: Significant majority primary care givers of patients receiving community mental health services have a very positive perception about the services they receive.

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OP-06

PREVELANCE OF DIFFERENT TYPES OF PATIENT RELATED VIOLENCE EXPERIENCE AMONG NURSING OFFICERS IN TEACHING HOSPITAL KARAPITIYA (THK) Godawita SMRG2#, Punchihewa GD1, Fonseka NHDP2 1

Department of Psychiatry, Faculty of Medicine, University of Ruhuna Nursing Degree Program, Faculty of Medicine, University of Ruhuna # rivindig@gmail.com

Introduction: The rising rate of violence and abuse in health care centers has become a major problem for nurses. It affects staff and organizations adversely. There are four types of violence; physical assault, verbal abuse, verbal threat and sexual harassment. Many studies have shown that nurses are exposed mainly to physical violence and verbal violence. Objective: To determine the prevalence of different types of patient related violence experienced by nursing officers in THK and to identify the commonest types of violence. Method: Using systematic random sampling method 136 nurses were selected from all the units in THK. Data were collected using interviewer administered questionnaire, which was based on Single-Click and Barakat’s (2004) questionnaire and this was modified following a focus group discussion which included a Consultant Psychiatrist. Before data collection, the necessary approval was obtained from the Ethical Review Committee of the Faculty of Medicine at University of Ruhuna.

IMHNC 2018

Result: Majority of participants 90.4% were females. Of the 136 of respondents 88 (64.7%) have exposed to violence with 25% to physical assault, 56.6% to verbal abuse, 8.8% to verbal threat, and 9.6% to sexual harassment. Some of the most common types of physical violence were being "kicked", "slapped". "pushed", or "repelled" as experienced by 43.8% of the respondents. Among participants who had experience verbal abuse stated that 76% had experienced "being yelled at or shouted at". Majority of verbal threat was in the form of ‘killing’ (33.3%) and majority who experienced sexual harassment were by ‘showing someone’s body sexually’ (76.9%). However, Majority (91.2% and 90.4%) had not experienced any verbal threat or any sexual harassment. Conclusion: The commonest type of violence experienced by nurses in THK was verbal abuse. There was a dire need for regular program for training in violent patient management and reporting procedure to provide a safer working environment for the nurses

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OP-07

THE PREVALENCE OF PHYSICAL VIOLENCE AND ASSOCIATED FACTORS ON NURSES WORKING IN NATIONAL INSTITUTE OF MENTAL HEALTH SRI LANKA Herath HMD1#, Ahangama AKGC1, Adikari AMC1, Meegoda MKDL2 1

National Institute of Mental Health, Sri Lanka Department of Allied Health, Faculty of Medical Sciences, UOSJ # herathdil2@gmail.com

Introduction: Violence in the Workplace is a universal phenomenon. However, in the area of mental health, nurses are exposed to a higher risk due to many reasons. This can be categorized broadly into physical violence (assault, aggressive behavior) or psychological violence (verbal abuse, talking, and sexual harassment). This study analyzed physical violence against nursing professionals of Mental Health Services in National Institute of Mental Health, Mulleriyawa New Town (NIMH) and associated factors for physical violence.

Result: Total number of 325 nurses consented for the study. Of the sample (n=325), the incidents of the physical violence in the workplace was reported in 67. 3%. Female nurses faced more physical violence than male nurses. Out of the reported physical violence, 36% had been assaulted, 27% had been scratched, 17% had been kicked, 10% had been battened, 7% pushed, 2% had been pinched, 1% had been slapped. Nurses working in evening shift experience significantly more violence than nurses working in morning shift. Method: A descriptive, cross-sectional Nursesâ&#x20AC;&#x2122; age, work experience, sex, experience (violence study was carried out among nurses training management), place of the incident and working in NIMH using a selftime of the incident were identified as administered questionnaire. associated factors for physical violence. Conclusion: Physical violence in the workplace is prevalent within NIMH setting. Being assaulted was dominant among physical violence. Significant association was found between time of the shift and physical violence in the workplace.

IMHNC 2018

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OP-08

FACTORS AFFECTING EATING PATTERNS AMONG NURSES IN TEACHING HOSPITAL KANDY Sumathipala SDSI1#, Hemachandra KC1, Kandangama JPK1, Wathsala HDR1, Shriyani KA1 1

Department of Nursing, Faculty of Health Science, The Open University of Sri Lanka # shakilairoshini@gmail.com

Introduction: Eating patterns refers to why and how people eat, which food people eat, with whom and the ways people obtain, store, use and discard food. Method: A quantitative descriptive study was conducted among 290 (Grade I, II, III) registered nurses doing shift duty at Teaching Hospital Kandy. A self-administered questionnaire was used which included questions on socio- demographic data, eating patterns, psychological factors and work related factors. Convenience sampling method was used. Data collection was done from 23rd March 2018 to 23rd May 2018. Result: Obese (20.69%), Underweight (13.1%), Overweight (28.97%) and Normal weight (37.24%). According to the eating patterns occasionally eat fast food (42.07%), fatty food (35.17%), snacks between meals (34.48%). Rarely eat frying food (34.48%), canteen (33.10%), salty food (34.48%), and canned food (40%). Often eat spicy food (37.24%), sweets (42.07%), more vegetables (46.90%), dairy foods (31.03%), breakfast purposefully (42.07%), three meals everyday (48.28%), meat contain all food elements (46.21%).

IMHNC 2018

According to the psychological factors strongly disagree eat because of feeling lonely (28.97%) Disagree (44.83%), strongly disagree feel completely out of control when it comes to Food (26.21%) disagree (52.41%), strongly disagree eat so much until stomach hurts (34.48%) Disagree (47.59%), strongly disagree eat because of feeling upset or nervous (33.10%) disagree (47.59%), strongly disagree eat because of feeling bored (36.55%) disagree (35.17%), strongly agree eat because of feeling happy (3.45%) agree (21.38%) strongly disagree (26.21%) disagree (13.75%). According to work related factors 8-10 night shifts per month (67.59%), rice and curry is the choice of food during shifts (74.48%), Appetite is reason for food (48.28%), get meal from home (66.90%), skip any meal (71.72%), skip breakfast (20%), skip meal due to unbearable workload (35.17%) and working long hours (36.55%), adequate time to have meal (64.14%) and inadequate (35.86%). Conclusion: Most of nurses in THK perform healthy eating patterns. They have good knowledge about nutrition and gave high priority for balanced diet. Majority feeling tired by working and very busy with their job caused to miss the balanced diet.

OP-09

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PERCEIVED CHALLENGES OF NURSES WORKING IN NATIONAL INSTITUTE OF MENTAL HEALTH SRI LANKA Gunawardena N1#, Biyagama LJS1, Kumari RAS1, Rajapaksha WPM1 1

Department of Nursing, Faculty of Health Science, The Open University of Sri Lanka # ngnimesha@gmail.com

Introduction: Nurse is a trained personal in a hospital setting who provide care for the sick or infirm. Nurse will have to deal with various obvious or commonly believed competitive situations which could be defined as perceived challenges. At National Institute of Mental Health (NIMH) setting, the nurses deal with variety of situations with regard to patients, care-takers, general public and scientists in their working routines. Objective: The objective of this study was to identify perceived challenges of nurses working in NIMH. Method: A Quantitative descriptive study was conducted among two hundred and forty-seven nurses with using non-probability convenience sampling method who works in all wards and special units in National Institute of Mental Health Sri Lanka. A self administered questionnaire was used as the data collection tool. Descriptive statistics were used for data analysis.

IMHNC 2018

Result: Majority of respondents were female (87%). Mostly perceived challenges were lack of resources (90%), inadequacy of allocated staff (85%), increased number of patients (85%), night shifts (83%), and increased number of working hours (81%), Work lord (81%), and patientsâ&#x20AC;&#x2122; behavior; disturbed, violence, threatening and being assaulted (80%). Other perceived challenges are lack of skills in handling violent patients (79%),Stigma (78%), taking leaves (78%), lack of education and training in psychiatric field (76%) and lack of support from administrative officers, medical officers, clerical staff, supportive staff members(above 75%). Conclusion: Majority of nurses have perceived challenges while working in National Institute of Mental Health Sri Lanka. It would be recommended to engage in further research in areas to minimize these perceived challenges of nurses as some of them were related to illness of clients they are handling with.

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OP-10

THE IMPLEMENTATION OF THE MODIFIED DISBURSEMENT LINKED INDICATORS OF THE HEALTH CARE QUALITY AND SAFETY DIRECTORATE OF THE MINISTRY OF HEALTH (DLI 7) AT THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA AND HALF WAY HOME, MULLERIYAWA 1#

Erandi BGD , Gunasekara CTKS , Wijewickrama BAO , Krishanth MDA2, Ruwangani MWSR1, Jayasekera HKDN1 1

National Institute of Mental Health, Sri Lanka 2 Minstry of Health, Sri Lanka # duneesha.e@gmail.com

Introduction: Quality and safety not only improve patient care but, reduce the work load of employees. Circular Number 02-189/2012 dated 17.12.2012 issued by the Ministry of Health has assigned 20 basic indicators to be implemented through the Quality Management Unit of all health institutions in Sri Lanka. National Institute of Mental Health (NIMH) has been implementing these since 2010. Indicators were modified and adopted to the hospital set up. Objective: To describe the current status of implementation of the Modified Disbursement Linked Indicators of the Healthcare Quality and Safety Directorate of the Ministry of Health (DLI 7) at the in-patient units of NIMH and Half-Way Home, Mulleriyawa (HWH) and to describe the perception of unit in-Charges regarding the Implementation. Method: A check list was used to measure the current status of implementation of the said indicators at NIMH and HWH including all inpatient care units. A self-administered questionnaire was used to assess the perception of unit and ward in charges. Result: All study participants were nursing officers.

IMHNC 2018

Half of them have the work experience for more than 20 years and 61% of them were 46-55 years old. Fifty-eight percent units at NIMH have implemented 65-84% of these indicators and 15% have more than 85% implementation. However, majority (58%) of HWH wards have less than 49% implementation of these indicators and 17% implemented more than 85%. Majority responded positively about quality management program in improving patient care (81% (NIMH) and 88% (HWH)). Forty-seven percent NIMH and 59% HWH study participants responded positively about leadership style improving the patient care. Thirty-five percent in HWH and 48% at NIMH responded negatively about use of human resource in improving patient care. Forty-one percent of NIMH and 57% of HWH express that it is important to use client data in improving patient care. Conclusion: The in-patient units are in the process of implementation of these indicators and unit in-charges had different opinion on contribution of quality management programs, leadership, human resource and client information on patient care. The barriers for implementing them need to be studied in detail in future.

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OP-11

NURSES ATTITUDES TOWARDS MENTALLY ILL PEOPLE AT THE NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH) SRI LANKA Senarathne HS1#, Fernando MUS2, Dissanayake DMC2 1

School of Nursing, Kurunegala National Institute of Mental Health, Sri Lanka # Shereensenarathne@gmail.com

Introduction: The attitudes of nurses and quality of care depend on their education and mental health nursing experience. Those who lack such training express fear and avoid mentally ill patients. According to the evidence, less education or training in mental health displayed more negative attitudes towards mentally ill and poor-quality care. To date there is limited knowledge on nurses' attitudes towards mental illness in Sri Lanka. Objective: To describe attitudes of nurses towards mentally ill people in National Institute of Mental Health (NIMH), Sri Lanka. Method: A descriptive cross-sectional study was conducted among the nurses at NIMH in Sri Lanka. Convenient sampling method was used and 160 participants were assessed using a validated selfadministered questionnaire - Attitude Scale for Mental Illness (ASMI) with 34 items, a modified version of the Likert scale type questionnaire (Ng and Chan, 2000). Appropriate statistic tests were used for analysis.

IMHNC 2018

Result: Response rate was 84.37% (n=135). Of the sample majority (81%, n=109) were female. 44.4% (n=60) were in 30-39 years age group. All the participants passed G.C.E. A/L. But majority (89%) did not have the nursing degree (n=120). However, 21% (n=29) had six-month training on mental health nursing. Majority (62.9%) had less than four-year experience as a mental health nurse. The overall mean score on nurseâ&#x20AC;&#x2122;s attitude was 2.02 and mean score on separatism was 3.02. There was no significant relationship in six-month training on mental health nursing and attitudes of nurses. (p= 0.275) Conclusion: Nurses had satisfactory positive attitudes towards mentally ill people. But there were negative attitudes on separatism. Educational sessions on separatism should be provided for nurses to change their attitudes as well as to protect human rights of the mentally ill. Key Words: Nurses, Attitudes, Mental illness

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OP-12

PREVALENCE OF GENDER BASED VIOLENCE AT THE WORKPLACE AMONG SELECTED GROUPS OF FEMALE STAFF AT THE NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH), SRI LANKA Malkanthi MGS1#, Ranasinghe PK1, Wijayabandara GDVD2, Wijewickrama BAO3, Wickramanayake HMK1 1

The National Institute of Mental Health, Sri Lanka 2 Base Hospital, Mawanella 3 The Ministry of Health, Sri Lanka # sakunthalam2@gmail.com

Introduction: The gender based violence (GBV) at workplace is neither novel nor rare, yet it is unreported and unspoken oftentimes. Numerous forms of GBV at work, including: Physical, Sexual, Psychological, and financial abuse are identified and all forms remain under-researched in and outside of the world of work. Sexual harassment is widespread and pervasive harassment is negatively associated with job related outcome, psychological health and physical health conditions. Objective: The purpose of this study is to identify the prevalence of genderbased violence during work among selected groups of female staff while raising awareness, identifying training needs and gaps for a better working environment. Method: A descriptive cross-sectional study was conducted with a selfadministered questionnaire during June- July 2018, among 360 Female staff (Doctors, Nurses, and Officers of Professions Supplementary to Medicine, Social Workers, Clerical Staff and Health Support Staff) who has been working at NIMH for minimum of 6 months duration.

IMHNC 2018

Result: out of the 505 total female staff, 360 (71%) consented. 70% of respondents were aware of the policy against sexual harassment in NIMH and 44% were aware of the complaining procedure. 106 (29%) claimed to have experienced some form of GBV themselves and 31% have witnessed during last 6 months duration. 41% were either subjective or observed victims of some form of GBV while 21% victims in both forms. 21% have experienced themselves and 24% have witnessed incidents of sexual harassment while 31% have experienced either. 9% experienced emotional violence and 7% witnessed. 13% were victims of physical forms of GBV at work place. 19% have experienced both sexual and emotional violence during work place. A significant variation of prevalence rates noted among different subcategories of staff. Conclusion: There is an immediate need to develop a friendly working environment with raising awareness and arranging training programs to empower female workers to eliminate Gender Based Violence at workplace. It is also necessary to plan for followup study to look into details of the risk factors and determinants in detail.

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OP-13

INTER-PROFESSIONAL COLLABORATION BETWEEN MULTI-DISCIPLINARY TEAM MEMBERS AT THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA 1#

Ekanayake PC , Mailewa DMDB , Wijewickrama BAO , Wickramanayake HMK , 1 1 3 1 1 Ranasinghe PK , Panadurage DU , Gabadage Y ,Pathmarani S , Perusinghe YM 1

The National Institute of Mental Health, Sri Lanka 2 The Ministry of Health, Sri Lanka 3 Divisional Hospital, Wethara # piyumineth@yahoo.com

Introduction: Inter-professional collaboration is defined as "when multiple health workers from different professional backgrounds work together with patients, families, carers and communities to deliver the highest quality of care". It is based on the concept that, when providers consider each other's perspective, including that of the patient, they can deliver better care. Mental Health is a field where the patients are looked after through a multi-disciplinary Care Team. Objective: To describe the interprofessional collaboration between Doctors, Nurses and Allied Health Professionals (AHP) at the National Institute of Mental Health. Method: An Employee Survey was conducted among Doctors (i.e. Consultants, Medical Officers, Dental Surgeons), Nurses (i.e. Nursing Sisters, Nursing Officers) and Allied Health Professionals (i.e. Occupational Therapists, Physiotherapists, Radiographers, Pharmacists, Medical Laboratory Technologists, Psychiatric Social Workers). Inter-professional Collaboration Scale Developed by the National Centre for Inter Professional collaboration and Education, Canada was used as a Self-Administered Questionnaire.

IMHNC 2018

Communication, Accommodation and Isolation were thematic aspects that were considered. Result: Response Rate for Doctors 47.5 % (n=19); Nurses 99% (n=99); AHP 50% (n=20). Marks were given and analyzed to get a percentage score on each theme. Doctors about Nurses; Communication 70.2%, Accommodation 65.3%, Isolation 54.2%. Doctors about AHP; Communication 65.1%, Accommodation 65.3%, Isolation 59.9%. Nurses about Doctors; Communication 71.7%, Accommodation 62.9%, Isolation 70.4%. Nurses about AHP; Communication 67.9%, Accommodation 58.3%, Isolation 58%. AHP about Doctors; Communication 62.5%, Accommodation 60%, Isolation 69.2%. AHP about Nurses; Communication 60.6%, Accommodation 57.9%, Isolation 74.2%. Conclusion: Nurses and Allied health professionals have indicated high scores in Isolation which indicates they feel their views are not taken into consideration in the decision-making process adequately. This is a preliminary screening. Further in-depth research is recommended in this regard.

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OP-14

PERCEPTION OF THE COMMUNITY PSYCHIATRIC NURSES WHO ARE CURRENTLY IN SERVICE REGARDING THE COMMUNITY PSYCHIATRIC NURSING SERVICE IN SRI LANKA Migunthenna KDCK#1, Samanthi WLDG1, Fernando NFJ2, Wijewickrama BAO3, Wickramanayake HMK1, De Silva C3 1

The National Institute of Mental Health, Sri Lanka Genaral Sir John Kotelawala Defense University, Sri Lanka 3 The Ministry of Health, Sri Lanka # Chaminimigunthanna@gmail.com

Introduction: Community Psychiatric Nurses who are an integral part of the community mental health services were introduced in Sri Lanka in 2010. As a pilot activity the National Institute of Mental Health, Sri Lanka selected and trained a group of 46 Nurses as Community Psychiatric Nurses. They were deployed to various psychiatric Units around the country. This study was to describe the perception of the Community Psychiatric Nurses who are currently in service regarding the Community Psychiatric Nursing Service in Sri Lanka. Method: An Employee Survey was conducted among the Community Psychiatric Nurses (CPN) who are currently in service within Sri Lanka. Following training in 2010 forty-six CPNs were deployed to various units across the country. A selfadministered semi structured questionnaire was administered to them upon receiving written informed consent. Of the data gathered repetitive similar words were listed out on the descending frequency order and most commonly given three answers with height repetitive frequency have been selected.

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Result: Of the 46 trained CPN, two have deceased and another two have retired at the time of this study and one is employing overseas. Only 24 remained in service as CPNN and 17 of them consented to participate in this research. Two most common answers for selecting CPN career were desire for community work and happiness in community work. Highlighted positive aspects of the CPN service were Increase compliance of patients to treatment, increase access to patientsâ&#x20AC;&#x2122; information and Increase ease in reintegrating patient to the society. Few negative aspects of CPN service such as; negativity from the administration, stigma attached to mental illness and reduced safety at field were highlighted. Difficulties in Transport, absence of specific Allowances and absence of promotion pathway were indicated as short comings of the CPN career. Conclusion: Nursing officers have chosen CPN career due to desire and happiness in community work. There are positive and negative aspects which need further evaluation and study.

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OP-15

COGNITIVE ABILITY AND PHYSICAL ACTIVITY BEHAVIOR OF ELDERS IN GALLE Wickramarachchi BI1#, Gamage MWK1, Perera R2, Perera B3 1

Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Galle 2 Department of Psychiatry, Faculty of Medical Sciences, UOSJ, Nugegoda 3 Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle # mkgamage@yahoo.com

Introduction: Psychological health of the elderly will become a vital health issue in Sri Lanka in the near future as a result of rapid population aging in the country. Physical inactivity has been identified as one of the major modifiable risk factors of psychological health. Hence, we aimed to investigate the association between cognitive ability and physical activity in a sample of elders in Galle. Method: A community survey was conducted using a sample of 104 elders (aged ≥ 60 years). International Physical Activity Questionnaire – Elderly (IPAQ-E) was validated and used to measure physical activity behavior. Mini Mental State Examination (MMSE) scale was used to measure cognitive ability. Result: The original English version of IPAQ-E was translated into Sinhala following standardized translation procedures and its face validity was

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assessed by research experts. The IPAQ-E demonstrated a good testretest reliability (intra-class correlation coefficient = 0.84). A fair correlation coefficient was found between IPAQ-E score and the total score of the Quality of Life measure (rs = 0.29, p = 0.015). Twenty five elders (24%) obtained a value of MMSE on or less than 23 that indicates a possible cognitive impairment. The mean value of IPAQE was 4925.5 MET – minutes- per week, which is higher compared to such scores obtained in elders in other countries. The correlation between MMSE score and IPAQ-E score was 0.32 (p<0.05). Conclusion: IPAQ-E seems to be a reliable and valid tool to measure Physical Activity behavior in the elderly. The majority (75%) of subjects was both physically active and has a good cognitive ability.

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OP-16

THE ASSOCIATION BETWEEN NUTRITIONAL STATUS AND COGNITIVE IMPAIRMENT AMONG OLDER PEOPLE IN GALLE DISTRICT SRILANKA De Silva KKPMK1#, Liyanage C2, Wijesinghe CJ2, Perera B2 1 2

Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna Department of Community Medicine, Faculty of Medicine, University of Ruhuna # manojadsilva@gmail.com

Introduction: Aging is a global public health issue. It has been shown that, malnutrition and cognitive impairments are associated with aging process. This study aimed to examine the association between nutritional status and cognitive impairments among older people living in Galle, Sri Lanka. Method: A community â&#x20AC;&#x201C; based cross sectional study was conducted in 2016 using a sample of 396 older people (aged 60 years and above). Mini Nutritional Assessment (MNA) was used to assess nutritional status and Mini Mental State Examination (MMSE) was used to assess cognitive impairments. Ethical clearance was obtained from the Ethical Review Committee of the Faculty of Medicine, Galle, Sri Lanka.

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Result: Mean age of the participants was 69 years (SD=7.2 years) and 67.7% (n=268) were women. Of the total 30.8% (n=122) were found to be at risk of being malnourished. In this study, results revealed that, 7.8% (n=31) of the elderly people had mild cognitive impairment and 2.3% (n=9) with moderate cognitive impairment. There was a weak positive correlation between MNA score and the MMSE score of the study participants (r=0.230, p=0.01) suggesting that, those participants with poor nutritional status seems to be at higher risk of developing cognitive impairment. Conclusion: Nutrition seems to play a major role in psychological well-being of the elderly in this target population and geriatric nursing care services in the country should consider these issues in their health promotion activities.

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OP-17

KNOWLEDGE AND PRACTICES ON ADOLESCENTS WITH DEPRESSION AMONG SECONDARY SCHOOL TEACHERS IN NATIONAL SCHOOLS IN BADDEGAMA EDUCATIONAL DIVISION, GALLE DISTRICT, SRI LANKA Wijerathna TPGSA1# 1

Colombo South Teaching Hospital, Kalubowila # sajeenimmi35@gmail.com

Introduction: Teachers are a valuable resource for early identification and referral of adolescent with depressive disorders, but teachers must be skilled at recognizing depression in adolescent. Depression in children and adolescents is a serious problem which only recently has begun to receive the attention in the world. Objectives: To identify knowledge and practices of teachers regarding adolescents with depression. Specific objectives are to describe some factors associated with the level of knowledge regarding adolescents with depression and the practices that teachers utilize once they perceive depression in adolescents. Method: A cross-sectional descriptive study was conducted using selfadministered questionnaires on a convenient sample of 100 secondary school teachers who teach adolescent children (grade 5 to grade 13) at national schools in Baddegama educational division, Galle district, Sri Lanka. The data collection was carried out over a period of one month. Descriptive statistical analysis methods were used to analyze the data.

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Result: The study found that teacherâ&#x20AC;&#x2122;s source of knowledge on depression increase the level of ability to identifying depression in adolescents. There was a statistically significant relationship among source of knowledge among teachers and knowledge mean score (p<0.001). There was no significant relationship between the knowledge score and educational level or work experience. The older age category (40 years and above) obtained a significantly higher mean practice score than the younger age category (p = 0.013). Teachersâ&#x20AC;&#x2122; source of knowledge also showed a significant association with the practice score (p = 0.004). Work experience more than 10 years was also associated with a significantly higher practice score (p=0.001). None of the other variable showed significant associations with the practice score. Conclusion: One reason for teachers under identification of the depressed children may be lack of knowledge about depression. The majority of teachers did not have adequate knowledge about childhood depression. The present findings of practices suggest that teachers are particularly skilled at interventions of depression in adolescent.

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MOTIVATIONAL FACTORS AND COPING STRATEGIES OF PATIENTS PRESENTING TO PSYCHIATRIC UNITS AT COLOMBO SOUTH TEACHING HOSPITAL AND HOMAGAMA BASE HOSPITAL FOLLOWING DELIBERATE SELF-HARM Jayathilake PKUP1#, De Silva J2, Vidanapathirana M3 1

Department of allied health sciences, Faculty of Medical Sciences, UOSJ, Sri Lanka 2 Department of Psychiatry, Faculty of Medical Sciences, UOSJ, Sri Lanka 3 Department of Forensic Medicine, Faculty of Medical Sciences, UOSJ, Sri Lanka # kavindi@gmail.com

Introduction: Deliberate self-harm DSH is one of the leading psychiatric conditions referred to mental health units in Sri Lanka. This study was conducted to describe the risk factors for DSH in patients presenting to psychiatric units at Colombo South Teaching Hospital and Homagama Base Hospital. Method: A descriptive cross-sectional study was carried out on patients aged above 18 years presenting to psychiatric clinics of above hospitals following a DSH attempt, using an interviewer-administered questionnaire over 3 months period from December 2017. Result: Out of 121 patients, 89 were included with a Response rate of 74%. Female preponderance (71%) was noted and 73% were in 18-29 age groups with a Mean age of 19.4. Majority were unmarried (60%). Pharmaceutical overdose (82%) was the most common method. There was a history of previous DSH attempts in 24% and 66% were unplanned acts.

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Financial problems (25%), interruption of education and separation of either parent were common stressful life events they had during childhood. The common reasons for DSH were to escape from unbearable thoughts (78%), Interpersonal conflicts (58.4%), disappointment/ frustration through love affairs (35%). Sadness (23%) was the commonly associated feeling. while 67% believed that they committed DSH due to weakness in their personality and 53% due to madness. Main coping strategies were becoming aggressive (71%), solving problems by themselves (65%) upon stressful life event. 40% trusted on religion while 76% claimed that they were uncontrollable upon stressful incident. There was no significant difference in coping strategies between two sexes, but compared to males, females significantly (P-0.0414) engaged more in religious activities. Conclusion: Youth who didnâ&#x20AC;&#x2122;t have favorable integration with domestic society and friendly interpersonal relationships are vulnerable. Sadness, inability to face stresses, weak personalities and poor coping abilities were identified as motivational factors.

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THE PREVALENCE AND FACTORS ASSOCIATED WITH READMISSION OF THE PATIENTS WITH PSYCHIATRIC DISORDERS Abesekara GRRL1#, Bamunusinghe BAAC1, Herath HMWS1, Nettasinghe NAR2, Jayamaha AR1 1

Department of Nursing, KIU, Sri Lanka Faculty of Nursing, University of Colombo # lasaniabesekara1987@gmail.com

Introduction: Readmission of the patients with psychiatric disorders, within a short period of time following discharge is undoubtedly an undesirable event. It increases the cost of the health care system and workload of the mental health care workers. Readmission is a painful experience for the patients and their families. It is estimated that repeat admissions may be responsible for up to 60% of hospital expenditure. Objective: To assess the prevalence and factors associated with readmission as explained by the relatives of patients in National Institute of Mental Health (NIMH), Sri Lanka. Method: Descriptive cross-sectional study was conducted among randomly selected 200 relatives of patients with psychiatric disorders using interviewer-administered structured questionnaire.Ethical approval was obtained from the ethics review committees of KIU and NIMH. Result: Prevalence rate of psychiatric readmissions during first three months of 2018 was74.14%. Among readmitted patients 64% were males and 2.5% were in 5 – 18 years of age group, 36% were in 19 – 29 years age group, 38% were in 30 – 45 years age

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group, 33% were in 46 – 60 years age group and 17% were over 60 years age group. Readmission rates were high among Schizophrenia patients (40%), bipolar affective disorder (36%) and other disease conditions were mania, depression, psychosis, postpartum psychosis, intellectual disabilities and disorders due to drug abuse. Common causes for the readmission were poor drug compliance (79%), poor community support (80.5%), lack of permanent care giver (84%), lack of awareness related to the proper patient management (56%) and other factors include medical co-morbidities, unplanned discharge, and substance abuse. Among readmissions 84% of patients have not attended the regular follow up clinics. Conclusion: Relatively high prevalence rate of psychiatric readmissions were observed and factors related to readmission as explained by the relatives of the patients were lack of permanent care giver, poor drug compliance, poor community support, lack of awareness related to the proper patient management of the relatives, co-morbidities, unplanned discharge and substance abuse.

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OP-20

GENERAL PUBLIC VIEWS ON SEXUAL ABUSE OF MALE CHILDREN IN CENTRAL PROVINCE, SRI LANKA Samarasinghe HKNB1#, Kaluarachchi DAS1, Rajapaksha MDS1, Shanaka WFB1, Perera MHT1, Gamlath GRHH2, Lakmal PS1, Weerasekara KA1, Jayakody DS1 1

International Institute of Health Sciences (IIHS), Welisara Sri Lanka # nethme_2007@yahoo.com

Introduction: Sexual abuse is a crime where deliberately forcing another person to engage in unwanted sexual act. Sexually abused Boys may experience the same effects as female survivors or adult males or may face more unique challenges. Objective: This study was conducted to identify and assess the knowledge of the public in Central Province about the prevalence of male sexual abuse. Method: This was a descriptive crosssectional study carried out among a convenience sample of 199 public between the age group of 16 â&#x20AC;&#x201C; 35 years in the central province using a self-administered structured questionnaire. Result: Among the respondents 51% were males; 31% were in age group of 21-25 years. 84% supposed that male children were abused in Sri Lanka.

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33% stated that sexual orientation of the perpetrators was the reason for sexual abuse against boys. Lack of attention paid on children by responsible parents is concerned to be a main factor for sexual abuse among male children; 13% expressed that the latter action does not impose substantial consequences on the victims. 42.7% of the participants suggested that the community should be much aware on misbehaviors which can lead to male sexual abuse. Conclusion: Many were aware that male children are abused in Sri Lanka, but they lack the knowledge on actions to be taken to avoid it. Therefore, educating the public, raising the awareness and reinforcing the reporting system are recommended.

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OP-21

THE IMPACT OF SOCIAL MEDIA TO SELF-ESTEEM AND NARCISSISTIC PERSONALITY AMONG ADOLESCENTS AND YOUTH IN COLOMBO DISTRICT Silva ERD1#, Nawarathna NMNW1 2

International Institute of Health Sciences, Welisara, Sri Lanka # romeni2009@hotmail.com

Introduction: According to the American Psychiatric Association (DSM-5), there are several traits associated with Narcissistic Personality Disorder. These include a grandiose view on oneself, problems with empathy, a sense of entitlement and a need for an admiration or attention. Recently, the social media has multiplied the possibilities of selfpromotion and it provides a means for narcissistic social status and attention. Due to this reason, majority of the narcissistic traits can be induced by the usage of social media. Objective: To assess the impact of social media to self-esteem and narcissistic personality among adolescents and youth in Sri Lanka. Method: Descriptive cross-sectional study was done on 202 participants using an online quantitative research questionnaire from the Colombo District.

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Result: Among the 202 participants, majority was males, 56.4% (n=144). 68% (n=137) from all participants use social media for more than three hours. 51% (n=102) feels both empowered when posting a selfie on social media and feel like removing the selfie if they did not t get enough ‘Likes.’ 49.5% (n=100) got aggressive and annoyed when someone ignores their messages and when their mistakes were corrected in social media. 52% (n=104) says that they get more respect from social media and they believed that they should get more respect from others the people who are not connected to them through social media. The reason why 49% (n=98) of males posts selfies on social media is to get appreciation, more ‘Likes’ and comments. 30% (n=60) believe they do not get admiration, respect, attention and entitlement from anyone like the way they get from social media Conclusion: It was revealed that unknowingly most of the social media frequent users (adolescents and youth), mainly men, were showing signs and symptoms of narcissistic behavior and excessive self-esteem.

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EFFECTIVENESS OF PRE-OPERATIVE COUNSELING OF OSTOMY PATIENTS AT SRI JAYEWARDENEPURA GENERAL HOSPITAL Samaraweera HMGA1#, Samarkoon SMSRB1 Sri Jayawardhanapura General Hospital, Sri Lanka # sgeethani@gmail.com

Introduction: A stoma is an artificial communication between organs or viscera and the external environment, for feeding, drainage and elimination. The making of an ostomy is a medicalsurgical procedure. Because of this surgery, it is necessary to use fecal collecting equipment. Patients with colostomy are likely to face complex problems such as changes in the physical, mental, and emotional status. It will have an impact on other aspects of life of the patient's such as physical, psychological, social, and spiritual. The main challenge of ostomy patient is the ability to maintain self-care on his/her own and manage psychological response to changes in the patient's self-image or body image that will affect the patient's mental, emotional and sexual status. Objective: To describe the effectiveness of pre-operative counseling of patients who have undergone stoma surgery in adapting to changing body image and the knowledge and skills regarding stoma care and assess the skills regarding pouch application.

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Method: A cross sectional descriptive study was conducted among stoma patients who attended to the surgical units of Sri Jayewardenepura General Hospital. Data was collected by using a self-administered questionnaire. Result: Questionnaire was administered to 27 of stoma patients and 24 of stoma patients of all were participated in the study. Sixty-five percent of participants had opportunity to participate preoperative counseling. These participants have had opportunity to enhance their knowledge regarding stoma care and to live with stoma. Sixty percent of counselled participants have adjusted to ostomy within a week. Seventy percent of educated participants improved their social contacts. Of uncounseled participants (35%) only 12% have improved their social contacts. Fifty percent of the educated participants have positive attitudes and adjusted to living with stoma. Conclusion: The results showed that pre-operative counseling of ostomy patients has better impact on adjusting to their new body image and keeping social contact over their counterpart.

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THE PREVALENCE OF DEPRESSION AMONG UNDERGRADUATES IN FACULTY OF MEDICAL SCIENCES, UNIVERSITY OF SRI JAYEWARDENEPURA, SRI LANKA Kodagoda ASK1#, Meegoda MKDL1 1

Department of Allied Health Sciences, Faculty of Medical Sciences, UOSJ, Sri Lanka # ashanikodagoda93@gmail.com

Introduction: Depression is a common mental disorder which can lead to major problems such as suicidal attempts. It is well known that the demands and pressure of undergraduates in medical faculties create tremendous challenges which result in an extensive range of psychological ailments like depression. The objective of this study was to determine the prevalence of depression among undergraduates in Faculty of Medical Sciences, University of Sri Jayewardenepura. Method: A descriptive cross sectional study was conducted using convenient sampling technique among students in faculty of Medical Sciences (FMS), University of Sri Jayewardenepura (USJP). Ethical approval was granted by the Ethics Review Committee of the FMS, USJP. Depression scale (DASS 21) was used to assess depressive symptoms of the respondents.

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Result: Mean age of the sample (n=397) was 24.1 years (SDÂą2.5). The mean score for depression was 10.5 (SD Âą8.3). Only 38.5% of the respondents had a normal level of depressive symptoms while 7.1% and 4.0% of the respondents presented severe and extremely severe symptoms, respectively. Age (p= 0.011) and academic year (p = 0.001) showed a significant association with the depression. Conclusion: The study demonstrates a considerable existence of different levels of depressive symptoms among undergraduates in the Faculty of Medical Sciences. As many students showed different levels of depressive symptoms, it is greatly beneficial to reduce depressive symptoms by early identification. Studies to identify causes and interventional studies will contribute to take measures to see an improvement in identification and reduce the prevalence of depression among undergraduates.

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CHARACTERISTICS OF PATIENTS ATTENDING THE MENTAL HEALTH OUTPATIENT CLINIC IN A DISTRICT GENERAL HOSPITAL IN GAMPAHA DISTRICT Perera KANS1# 1

District General Hospital, Negombo, Sri Lanka # shereenperera2@gmail.com

Introduction: A large number of patients attend the Mental Health clinics in the Gampaha District and therefore, a study was conducted with the objective of describing the demographic and socio-economic characteristics of these patients. Method: A descriptive cross-sectional study was carried out at District General Hospital, Negombo and a random sample of 50 patients (over 18years of age) and their bystanders were selected as the study sample. An interviewer administered questionnaire was used, with two trained nurses as data collectors. Result: Mean age of the patients was 42.2 years (19 to77 years) and 82% were females. Of them, 52% had a family history of mental illnesses and 36% had other illnesses as well. Also, 16% had passed the G.C.E. (O/L) examination and 31% were employed, with 57% earning a monthly salary of over Rs.10,000/=. About 61% were from rural areas and 65% had a spiritual background as well.

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Of this sample, 47% attended the clinic on their own, while 86% cited adequacy in family support. Even though 55% had been on the current treatment for over 10 years, 96% were not aware of the names of their drugs. However, 98% were aware of the frequency of medication and 84% administered their own treatment, while 77% were aware of the side effects of their drugs. Mean age of bystanders was 50 years (17 to 73 years) and 94% were patientâ&#x20AC;&#x2122;s relations. Conclusion: Majority of the patient at the mental health clinic at Negombo hospital were middle aged, less educated females, who had an adequate knowledge and experience of their treatment. A family history of mental illness was present in nearly half of them. It was noted that most of them had good family support, with a majority of bystanders being related to the patient.

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KNOWLEDGE SKILLS AND ATTITUDES TOWARDS PSYCHOLOGICAL COUNSELLING AMONG NURSING OFFICERS IN PSYCHIATRIC UNITS, SRI LANKA Thalagala TRJ1# 1

School of Nursing, Kaluthara royeljayanthathalagala@gmail.com

Introduction: Professional counselling is a skilled activity that involves assisting others in managing and resolving psychological, emotional, behavioral development, relational, vocational and other personal challenges. Nurses who are working in psychiatric units have major responsibility regarding psychological counselling. This study was designed to assess the knowledge skills and attitudes towards psychological counselling of nursing officers in selected psychiatric unitsâ&#x20AC;&#x2122; Sri Lanka. Method: This is a descriptive crosssectional study and the data collection was done through a self-administered questionnaire which was distributed among 173 nurses who are working in psychiatric units in 14 government hospitals in Sri Lanka. Result: Out of 173 participants, majority (%) were married females. About 65% (n=) had more than 10 years of work experience and 40% had worked more than five years in a psychiatric ward. 43% were satisfied with their knowledge on psychiatric counselling. 92 (%) nurses did not believe that everyone is capable of counselling.

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Only 7% were strongly confident on identifying people who require counselling. More than half of the population (53%) strongly believed that psychiatric counselling workshops are essential for every nurse. But, 71 were not satisfied with the knowledge on psychiatry received during nurses training period. Sixty five percent of the population stated that they have active listening skills. Majority (%) had the knowledge on managing a proper counselling session and paraphrasing patientâ&#x20AC;&#x2122;s information. But, 42 (%) nurses were not confident on conducting a counselling session though they have knowledge. 73% (n=) of population were confident of counselling patients who had suicidal attempts and 10% (n=) could counsel both depressive and schizophrenic patients. 42 participants did not conduct counselling due to lack of knowledge. Conclusion: Although many nurses have more than 10 years of work experience in nursing field, they have lack of knowledge and experience on psychological counselling. Many participants have not received adequate training during nurses training period to build up the confidence on counselling.

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ABSCONDING OF PATIENTS FROM THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA; A ROOT CAUSE ANALYSIS Ruwangani MWSR1#, Wijewickrama BAO2, Wickramanayake HMK1 1

The National Institute of Mental Health, Sri Lanka 2 The Ministry of Health, Sri Lanka # ruwanganimwsr@gmail.com

Introduction: The National Institute of Mental Health, Mulleriyawa, the foremost center of clinical care for Adult and Forensic Psychiatry in Sri Lanka has a significant number of patients absconding from the hospital. Objectives: To conduct a Root Cause Analysis of the issues related to absconding of Patients from the National Institute of Mental Health, Sri Lanka with the view of finding areas that need urgent attention. Method: This project team received extensive training in Root Cause Analysis as tool for Healthcare Quality Improvement in Singapore arranged by the Ministry of Health in February 2017. The project team conducted a training program in Root Cause Analysis to different categories of staff involved in this process and developed a TOT group (Training of Trainers) that can train others working with them regarding the relevant subjects.

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A Root Cause Analysis of absconding of patients was carried out through focused group discussions by a representative team of hospital staff which included Doctors, Nurses and Paramedical staff who received above training. Feasible solutions for Prevention of Absconding of Patients were discussed by the group. Result: Equal emphasis was given for three factors: Patient Factor – Illness of the Patient, for which the suggestion was for urgent and focused treatment; Environmental Factor – Less Patient Friendly Environment in the ward, for which the suggestion was to make the ward environment more client friendly; Staff Factor – Poor Communication Skills, for which the suggestion was for better training in Effective Communication. Conclusions: Root Cause Analysis carried out by the staff involved in the day to day care of patients at NIMH has identified illness of patient, less patient friendly ward environment and poor communication by staff as major contributing factors for absconding of patients from NIMH.

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THE EFFECTS OF INTERNET ADDICTION ON SOCIAL BEHAVIOR AMONGST YOUTH RESIDING IN COLOMBO DISTRICT, SRI LANKA Rajapaksha MDS1#, Weerakoon N1 1

Department of nursing, International Institute of Health Sciences (IIHS), Welisara Sri Lanka # mdsamrajapaksha@gmail.com

Introduction: Internet usage in Sri Lanka has increased significantly. Compared with other districts in Sri Lanka, Colombo is the most prominent area where internet is being used, due to majority of infrastructure facilities have clustered around there. Along with this unexpected growth, as other developing and developed countries, Sri Lankan too has had to encounter to an emerging issue is called Internet addiction. Objective: To assess the Effects of Internet Addiction on Social Behavior amongst Youth Residing in Colombo District, Sri Lanka. Method: A descriptive cross sectional quantitative study was done on 100 participants (age above fourteen) using convenient sampling and data collection was done using a selfadministered questionnaire (Internet addiction tool). Result: Among 100 participants, 69 were female. 55 have completed their advanced Level Examination.

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Even though majority of people were average online users (33%), 22% said that their school works suffer frequently. 30% of respondents stated that their job performances suffer because of internet usage and 23% claimed that they failed often even though they tried to cut down the amount of time that they are on online. 26% accepted that they feel depressed frequently when offline but it goes away once come back. 39% of participants claimed that they lose sleep due to late night logins and 25% of people stated that they frequently use internet for excitement to intimacy with the partner. Conclusion: Internet has become a source which influences on majority of respondents. Participants have had to encounter number of negative consequences and through that productivity and the man power have severely impacted. Further in depth studies are recommended. Key Words: Internet addiction, Social behavior

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RESTRAINING OF PATIENTS FOR BEHAVIORAL MANAGEMENT AT THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA, A ROOT CAUSE ANALYSIS Ruwangani MWSR1#, Wijewickrama BAO2, Wickramanayake HMK1 1

The National Institute of Mental Health, Sri Lanka 2 The Ministry of Health, Sri Lanka # ruwanganimwsr@gmail.com

Problem: Restraining is still in practice in management of behavioral symptoms at The National Institute of Mental Health (NIMH), Mulleriyawa.

Feasible solutions for reduction of restraining of Patients were identified in focused group discussions using Fish – bone chart and Pareto charts.

Objectives: To conduct a Root Cause Analysis of the issues related to restraining of Patients for behavioral management at the National Institute of Mental Health, Sri Lanka with the view of finding areas that need urgent attention. Method: This project team received extensive training in Root Cause Analysis as tool for Healthcare Quality Improvement in Singapore arranged by the Ministry of Health in February 2017. The project team conducted a training program in Root Cause Analysis to different categories of staff involved in this process and developed a TOT group (Training of Trainers) that can train others working with them regarding the relevant subjects, including Doctors, Nurses and Paramedical staff.

Result: Equal emphasis was given for two factors: Factor 1 - Severely aggressive patients require restrain to prevent them from harming others and themselves and the solution suggested was for optimized medical sedation to reduce the need for physical restraining. Factor 2 – Significant proportion of restrains are for fall prevention of elderly and memory impaired patients and the suggestion was that safer innovative immobilization methods need to be introduced to reduce the need for standard restraining.

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Conclusion: Root Cause Analysis by staff involved in the day to day patients’ care at NIMH has identified severe aggression of patients who are medically managed inadequately and mitigating high fall risk of elderly and memory impaired patients as major causes for restraining patients for behavioral management at NIMH.

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COPING STRATEGIES TOWARDS THE EXAM STRESS AMONG THE YOUTH IN THE INTERNATIONAL INSTITUTE OF HEALTH SCIENCES, SRI LANKA Wijesinghe WGSP1#, Dissanayake DPDS1 1

Department of Nursing, International Institute of Health Sciences, Welisara, Sri Lanka # senuri.wijesinghe99@gmail.com

Introduction: Exam stress has affected youth so much to an extend that they are incapable of handling it and resulting themselves as patients of stress involved disorders, especially chronic stress can affect the developing brain and alter the responses in adult life. This research will be discussing on the strategies youth cope with during an examination. Objective: Assess the perception of exam stress amongst healthcare students in International Institute of Health Sciences and their coping strategies. Method: Descriptive cross-sectional study done on 150 youth from the International Institute of Health Sciences, Sri Lanka selected using convenient sampling using a selfadministered online questionnaire.

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Result: Among the 150 participants the most prevalent gender were females (70%) and the age were between 20-25 (59%). All the participants were undergraduates. 88.6% of them believed that they feel stressed during exams. 48.6% believed that exams tend to directly affect their health. 34.7% gave up trying to reach their goal. 42% got angry with their parents, relatives and friends. 52% turned to other activities to take their mind off the exams, e.g. shopping, social media. 40% agreed that they take additional actions to get rid of the stress, but 71% of them strongly felt stressed out during an exam. Conclusion: It was revealed that most of the youths are stressed because of exams and shows signs and symptoms of stress involved disorders. Key Words: Stress, Students, International Institute of Health Sciences, Coping strategies, Exams

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KNOWLEDGE AND ATTITUDES AMONG HEALTH SUPPORT STAFF ABOUT CARING FOR PATIENTS WITH MENTAL ILLNESS AT THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA Rathnayake RMSA1#, Wijewickrama BAO2, Ruwangani MWSR1, Wickramanayake HMK1, Weerawardene S1, Lalani SKD1, Gunathilake PKPR1 1

The National Institute of Mental Health, Sri Lanka 2 The Ministry of Health, Sri Lanka # ruwanganimwsr@gmail.com

Introduction: Health Support Staff is an important staff category who plays a major role in caring for the patients. Objectives: To describe Knowledge and Attitudes among Health Support Staff about caring for patients with mental illness at the National Institute of Mental Health, Sri Lanka. Method: An employee survey was carried out among the Health Support staff of NIMH through a selfadministered questionnaire prepared in English, Sinhala and Tamil, which contained 13 questions on knowledge and 12 statements on attitudes. Knowledge was assessed with marks given out of 100 and attitudes were reviewed as whether positive or negative. Result: Out of all support staff (n=470), 224 (47.65%) participated in this survey. Out of the respondents, majority was males (56.25%) with long service of more than ten years (46%).

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Among the male respondents, 76.98% of respondents scored marks over 75 out 100 in knowledge area and among females, 86.73% respondents had marks over 75. Overall, over 70% of males and females showed positive attitudes caring for patients when considering areas such as care, respect, duty, timeliness, following orders. Seventyeight present males and 95% females highlighted the need for training. Among the female respondents, 33.68% still believe that restraining as a main method of management for disturbed patients. 57.14% male respondents and 45.92% of female respondents believed that administration of support staff should only be done via overseers and Administrative Officer. Conclusion: Knowledge levels among most of support staff at NIMH are high and majority show positive attitudes in caring for patients with mental illnesses.

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EMPLOYEE SATISFACTION OF SELECTED STAFF AT THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA Jayarathne DCART1#, Meththananda MKUP1, Wijewickrama BAO2, Krishanth MDA2, Ranasinghe PK1, Gunasekara CTKS1, Alahakoon D1, Pathmarani S1, Erandi BGD1 1

The National Institute of Mental Health, Sri Lanka 2 The Ministry of Health, Sri Lanka # thilinij1984@gmail.com

Introduction: Mental health work is acknowledged to be more stressful than that of other medical fields. The National Institute of Mental Health provides exclusively mental health services and satisfaction of the employees is an important aspect to measure as attitudes and beliefs of staff have been linked to variables including productivity, absenteeism and turnover. Keeping employees happy helps to strengthen institution in many ways, as well as them to behave in positive way. Objectives: To describe the Employee Satisfaction of selected staff at the National Institute of Mental Health, Sri Lanka. Method: An Employee Survey was conducted among the Doctors, Nurses, Officers of Professions Supplementary to Medicine (PSM), Other Paramedical staff, Social Workers (PSW), Clerical Staff (PMA), Drivers and Health Support Staff currently working at the National Institute of Mental Health, Sri Lanka.

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A Self-Administered Questionnaire developed based on the Spectorâ&#x20AC;&#x2122;s Job Satisfaction Survey Questionnaire, modified for the local context of the institution and was administered to the participants. Result: Response Rate for Doctors 65% (n= 34); Nurses 76.7% (n= 115); PSM 76% (n= 19); other paramedical 100% (n = 8); PSW 38.3% (n= 5); Clerical staff 40% (n= 22), Drivers 83.3% (n= 10); Support Staff 61.7% (n = 150). Overall Positive Job Satisfaction of for Doctors were 81.8%; for Nurses 79.7%, for PSM 90.3%; for Other Paramedical 73.8%; for PSW 81.3 %; for PMA 73.8%; for Drivers 97% and for Support staff 81.9%. While the overall satisfaction rates were above 70% negative comments were mainly concerning facilities available for staff at the National Institute of Mental Health. Conclusion: Although Job satisfaction level of staff at NIMH remains high, it needs continuous monitoring and more in-depth studies as satisfaction may change over the time and depend on the facilities available for the staff.

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AN AUDIT ON SERVICES PROVIDED BY DENTAL CLINIC OF NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA OVER THREE MONTHS IN 2018 Kumari HS1#, Pushpakanthi KA1, Jayakodi J1 1

The National Institute of Mental Health, Sri Lanka # jesmin.jayatilake@gmail.com

Introduction: Dental unit of the hospital was established in 1970â&#x20AC;&#x2122;s. The clinic is functioning six days for a week. It provides Dental care services for both inward patients of the National Institute of Mental Health and out patients coming from the community. Objective: To audit the services provided by the Dental clinic of National Institute of Mental Health. Method: This is a closed loop audit of services from March 2018 to May 2018. Statistics were worked out from the routinely entered data available at the clinic. Data were audited based on preset criteria. Result: Total number of 425 outpatients and 218 inpatients received dental care In March 2018. These numbers for the April 2018 were 473 and 177, and for May those were 456 and 209 respectively.

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The most prevalent dental procedure for the outpatients was temporary filling during this period (80.98 %) rest being inpatients. LCC and Amalgam fillings (80.74%), GIC Filling (75.07%) and Dental Extractions (74.22%) followed. However, these dental procedures were least prevalent among inpatients. The most prevalent procedure for inpatients was scaling amounting to 90.54% the rest being outpatients. A wide variation was noted among the number of referrals from different wards at NIMH. Conclusion: Patients were offered a wide variety of dental procedures through the dental clinic. Dental procedure seeking pattern of outpatients are different from the seeking pattern of inpatients.

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AN AUDIT OF THE SERVICES PROVIDED BY THE NAVODAYA PSYCHOLOGICAL TREATMENT SERVICE OF THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA OVER FIVE MONTHS IN 2018 Bandara BMAG1#, Sanjeewa A1, Jayakody DSJ1, Weerasekara SS1, Rajapaksha I1, Weerawardhana S1 1

The National Institute of Mental Health, Sri Lanka # bmagbandara@gmail.com

Introduction: This unit was opened in October 2012 as a day treatment centre. The unit facilitates psychotherapy, day rehabilitation activities, alcohol prevention programs, community mental health awareness programs and an information desk. The unit was renamed as “Navodaya” Psychological Treatment Service in October 2017. Objective: To audit services provided by “Navodaya” Method: Routine data collected and recorded were reviewed and analysed to audit the services based on the set guidelines. Result: Service provided to 615 clients during the period of January to May in 2018 as psychotherapy, alcohol prevention programs, community awareness programs, day rehabilitation and information desk. 114 new clients for psychotherapy and 13 new clients for day rehabilitation attended registered during this period. Information desk – 220 clients contacted the desk for information. Of the 220, 151 received advised over the phone and 69 visited the centre. There were 268 revisits during the staid period.

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Among those who received, Psychotherapy the diagnosis was as follows; (F0_F9) organic, including symptomatic, mental disorders 03, (F10_F19) mental and behavioral disturbances due to psychoactive substance use 15, (F20_F29) schizophrenia, schizotypal and delusional disorders 3, (F30_F39) mood (affective disorders) disorders 32, (F40_48) neurotic, stress related and somatoform disorders 34, (F60_F69) disorders of adult personality and behaviour02, (F99) unspecified mental disorders 25. Among the total client population; Psychological treatment was offered for organic, including symptomatic, mental disorders 2.63%, mental and behavioral disturbances due to psychoactive substance use 13.15%, schizophrenia, schizotypal and delusional disorders 2.63%, mood (affective disorders) disorders 28.07%, neurotic, stress related and somatoform disorders 29.82%, disorders of adult personality and behavior 1.75%, unspecified mental disorders 21.95%. Conclusion: Navodaya Centre provides a wide range of services to the clients, which can be expanded further in future.

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AN AUDIT OF THE SERVICES PROVIDED BY ADOLESCENT MENTAL HEALTH UNIT OF THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA OVER FIVE MONTHS IN 2018 Wijawardhana HATAK1#, Ruwangani MWSR1, Wijewickrama BAO2, Hettiarachchi LV1 1

The National Institute of Mental Health, Sri Lanka 2 The Ministry of Health, Sri Lanka # ruwanganimwsr@gmail.com

Introduction: The Adolescent Mental Health Unit (AMHU) of the National Institute of Mental Health, Sri Lanka was declared open in December 2014. It is a unique ward designed to admit and treat adolescent clients who are suspected of having mental illnesses. The Unit has six rooms with bedding facility for 12 patients at a given time. Objective: To audit service provided by the Adolescent Mental Health Unit over five months. Method: This is a closed loop audit. Routine data collected and recorded was reviewed and analysed to audit the services based on set guideline. Data from January to May 2018 were taken into consideration.

Result: Adolescent Mental Health Unit Bed occupancy rate was 46.6%. During last five Months in AMHU Male admissions - 20 (52.63%), Female admissions -18 (47.37%). Twentyeight patients (77.7%) were brought by family (Temporary admissions) eight Patients (22.3%) were admitted by Care Homes. The medical diagnoses of the admissions were 14% ADHD and Conduct disorders; 14% Schizophrenia; 11% Bipolar Affective Disorder; 22% Borderline personality disorders; 2.8% Depression; 5.5 % Dissociative disorders; 2.8% Asperger syndrome; 8.3% Obsessive Compulsive Disorder; 2.8% Non-Specific Psychosis; 2.8% Substance Abuse and 13.9% None diagnosed patients. Conclusion: AMHU provides services to a wide variety of cases and a wellequipped ward and well-trained staff are needed to handle the disease burden.

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CLINICAL AUDIT ON SERVICES PROVIDED BY PERINATAL PSYCHIATRIC UNIT OF NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA OVER FOUR MONTHS IN 2018 Jayaweera TWHP1#, Somasiri DGP1, Ruwangani MWSR1, Ranasinghe PK1 1

The National Institute of Mental Health, Sri Lanka # Subakaran.sk@gmail.com

Introduction: The perinatal psychiatric unit is the first ever in south east and Asia, was established in 2007. The unit has eight separate rooms for clients with a baby room for the babies who are separated from mothers due to behavioral changes. An audit was planned to assess the services provided by the Perinatal Psychiatry unit of the National Institute of Mental Health. Objective: To audit the services provided by the Perinatal Psychiatry Unit of the National Institute of Mental Health, Sri Lanka. Method: The audit was conducted from February to May 2018 and the data was gathered from past records of admissions and other statistics of perinatal psychiatric unit. The findings were reviewed and analyzed based on the specific objectives of the audit. Result: Forty-one mothers were admitted during the study time and bed occupancy rate was 99%. Average admission rate was ten per month and majority of mothers were admitted with their babies (80%) and 87% of babies were infants. Majority of mothers who admitted to the perinatal psychiatric unit belong to the age group of 26-35 years.

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Admissions by diseases show that seven mothers had schizophrenia, ten mothers had post-partum psychosis, 04 mothers had Depression, seven mothers were bipolar affective disorder; five mothers were borderline personality disorder, three mothers were learning disability and three mothers were admitted to get psychological assessment and two mothers were admitted for acute stress reaction. Majority of mothers presented to the unit as postpartum psychosis. Analysis of admission by types reviled; one voluntarily, 17 involuntarily, two from magistrate courts and 21 transfers from other hospitals. Most reason for transferring most of mothers to the unit was “further psychiatric management for mother “when mother’s behavior had changed soon after the delivery. Treatment wise three, four and six mothers underwent electroconvulsive therapy in February, March and April 2018 respectively. Conclusion: The perinatal Psychiatry Unit continues to provide significant service with high bed occupancy rate.

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PARTICIPATION OF REHABILITATION ACTIVITIES AMONG PATIENTS REFERRED TO THE FORENSIC PSYCHIATRY UNIT OF NATIONAL INSTITUTE OF MENTAL HEALTH â&#x20AC;&#x201C; A CLINICAL AUDIT Biyagama, LJS1#, Hettiarachchi LV1, Fernando CTK1, Gunarathne GPC1, Kumari MV1, Wimalathunga WMP1, Bamunusinghe BAAC1 1

Forensic Psychiatry Service, The National Institute of Mental Health, Sri Lanka # gpcguna@live.com

Introduction: Forensic Psychiatry Service is the largest specialized unit of NIMH. It consists of two wards (male and female), a rehabilitation unit, a horticulture area and a set of outreach clinics. The wards 21 and 25 house male and female patients with bed strengths of 103 and 24 respectively. Forensic Psychiatry Rehabilitation Unit (FPRU), opened in 2010 to provide rehabilitative care for the persons admitted in the male forensic ward. The FPRU provides a structured rehabilitation program for the patients referred to the unit. Activities include personal care, creative therapies, cookery, sports, cognitive games, education activities and recreation. Literature shows strong evidence of positive outcomes of these activities to improve communication, interpersonal interactions, reduced recidivism and reduced aggressive behaviors. Method: This clinical audit aimed to assess the statistical impact of forensic rehabilitation on the patients admitted in the forensic psychiatry male ward.

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The average number of patients attended to the each program was assessed against the average number of patients admitted in the male forensic ward in the first six month of year 2018. Audit was conducted as a closed loop audit. Raw data were analyzed statistically to obtain the average numbers and percentages. Result: Average number of patients admitted in ward 21 was 98.77. An average of 25.26 patients (25.57%) have attended to the rehabilitation activities on daily basis. FRU had been open for 175 (96.68%) days for 181 days. Each activity considered for the audit had conducted for 26 sessions. Average attendance for the activities are; art therapy 27.07, music therapy 31.65, drama therapy 20.53, cookery 30.11, open school 24.46 and sports 22.61. Conclusion: The forensic psychiatry rehabilitation had been available for patientsâ&#x20AC;&#x2122; use for 96.68% days of the first half of the year which is a good outcome. Still the percentage of patients referred or attended for rehabilitation activities remains around 25% which may have the capacity to increase with proper staff allocation and security.

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PERCEIVED TRAINING AND EDUCATIONAL NEEDS OF NURSES WORKING IN NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA Vidanapathirana DE1#, Mendis ASP1, Jagodaarachchi AI1, Warnakulasooriya SSP2 1

Kaatsu International University, Koswattha, Battharamulla Department of Clinical Nursing Faculty of Nursing, University of Colombo # era.vidana@gmail.com

Introduction: Psychiatric nursing is a specialized area of nursing practice, employing theories of human behavior as its science and purposeful use of self as its arts, in diagnosis and treatment of human responses to actual or potential mental health problems. Nurses working in this area are expected to have specialized training as they need to deals with psychologically affected people with various cognitive and behavioral impairments. Generally Nurses get 5 weeks of Psychiatric training with clinical practice during the three year basic Diploma in Nursing course. Majority of Nurses working in NIMH has no special training in psychiatric nursing. Nurses in the field of psychiatric care face various problems, challenges that they require various skills and knowledge to overcome those problems. Therefore, it would be better to investigate nurses perceived educational and training needs in order to plan and upgrade nursesâ&#x20AC;&#x2122; education in psychiatric nursing, ultimately contributing to improvement in quality of care. Method: The data were collected by self-administered questionnaire, during March and June 2017.

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Total number of nurses in NIMH was selected as the sample. Data were analyzed using SPSS software 16version. Result: This research demonstrates that mental health nurses want the opportunity to receive specific training programs. The participants expressed that the most important areas that nurses in mental health setting need training in, are assessment skills, risk patient management, communication skills, medication management, violent and aggression, and policy issues and legal aspect. The most popular type of delivery are teaching seminars, practical teaching session, short courses, longer intense courses, academic courses, distance learning, and one-to-one support from nurse specialist. Majority wants to have special psychiatric training. Very few had special training in psychiatric nursing. Conclusion: Majority wanted a special training for improving the practice and believed that basic psychiatric training is not sufficient to work in NIMH. Very few had special nursing training in other specialized psychiatric fields

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AN AUDIT OF THE SERVICES PROVIDED BY LEARNING DISABILITY UNIT OF THE NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA OVER FIVE MONTHS IN 2018 Shanika TAN1#, Rupika EAS1, Ruwangani MWSR1, Wijewickrama BAO2, Wickramanayake HMK1 1

The National Institute Mental Health, Sri Lanka 2 The Ministry of Health, Sri Lanka # nipunadk@gmail.com

Introduction: The Learning Disability Unit (LDU) was established in 2008. In the unit there are six rooms to accommodate clients individually. The unit encourages a care giver to stay with the client. Method: A closed loop audit on the services provided by the LDU in National Institute of Mental Health, Sri Lanka was conducted from January to May2018. The data was gathered from past records of the admission and other statistics of LDU. Result: Total of 33 patients were admitted during the said five months. Bed Occupancy Rate was 29%. Majority were male (90.9%) in adolescence (48.8%).

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Based on the disease condition, only 12 clients were having Learning Disability (36.76%).Also there were clients with Schizophrenia (18.18%), epilepsy (8%), Asperger Syndrome (8%) and Depression (8%) and OCD (7%). 19 out of 33 were new admissions (57.58%), and rest was re-admissions. Regarding Occupational Therapy (OT) referrals, 15 clients out of 33 were sent to OT (45.45%). Conclusion: LDU continues to provide a valuable service for clients with Learning Disability; however other diagnoses were also noted. More extensive detailed research especially about low bed occupancy rate need to be carried out in developing service setting in future.

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AN AUDIT OF SERVICES OF THE ELECTRO CONVULSIVE THERAPY UNIT OF NATIONAL INSTITUTE OF MENTAL HEALTH, SRI LANKA OVER FOUR MONTHS IN 2018 Perera MNL1#, Jayasundara JMCB1, Ruwangani MWSR1, Wijayabadara GDVD2, Weerawardena S1, Sanjeewani VGT1 1

The National Institute Mental Health, Sri Lanka 2 BH Mawanella # nirmalaperera84@yahoo.com

Introduction: Electro convulsive Therapy (ECT) was introduced in 1940 to National Institute of Mental Health, Sri Lanka (NIMH) and an out-patient unit was added to this as an expansion. The unit plays a major role in management of patients up to now. Method: A closed loop audit of Service provided to clients in ECT Unit of NIMH from February to May 2018 was carried out from the unit admission books. Result: An average of 745 ECTs is performed each month and 30 per each day, during February-May 2018. Majority were for male (63%) patients.

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An average of 25 out-patients underwent ECT each month during this period. Indication for ECT was various. Majority (46%) was for poor response to treatment, followed by depression, violence and schizophrenia. When considered the post-ECT complications, only 1 case of post-ECT head injury and one patient absconded after ECT. Conclusion: The ECT unit plays an important management role in patient care which needs to be researched in depth in future.

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EMPLOYEE SATISFACTION OF SELECTED STAFF AT THE HALF WAY HOME, MULLERIYAWA Lionel IHSH1#, Sheriff MR2, Wijewickrama BAO3, Weeragalla J1, Wickramanayake HMK2, Poddalgoda L3 Siriwardena CTKS2, Gunasekera D2, Basnayake SIK1 1

Half Way Home, Mulleriyawa New Town The National Institute of Mental Health, Sri Lanka 3 Ministry of Health, Sri Lanka # rikaz.sheriff@gmail.com

Introduction: It is recognized that work in mental health is more stressful than that other medical fields. Therefore, it is important to have a validated measure regarding an employee and his or her level of job satisfaction. The Halfway Home Mulleriyawa provides long term mental health services for women and evaluating the satisfaction of the employees is an important. Objectives: To describe the Employee Satisfaction of selected staff at the Halfway Home Mulleriyawa, Sri Lanka. Method: An Employee Survey was conducted among the Doctors, Nurses, and Health Support Staff currently working at the Half Way Home, Mulleriyawa.

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The instrument used was a SelfAdministered Questionnaire which was developed based on the focal group discussion done with representatives of target population by the investigators. Result: Response Rate for Doctors 40% (n= 5); Nurses 78.18 (n= 55); All Support Staff 52.05% (n = 73). Overall Positive Job Satisfaction for Doctors was 81.3%; for Nurses 74.4%, for All Support staff 83.5%. While the overall satisfaction rates were above 70% the top concerns for staff were facilities available and staff safety. Conclusion: While Job satisfaction levels of staff at Halfway Home Mulleriyawa can be considered satisfactory more in-depth studies are required about how best to improve on facilities and safety available for staff.

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ACKNOWLEDGEMENT THE ORGANIZING COMMITTEE WOULD LIKE

TO SINCERELY THANK AND APPRECIATE THE FOLLOWING FOR SUPPORT EXTENDED IN MAKING THIS CONFERENCE A SUCCESS.

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HONORABLE DR. RAJITHA SENARATHNE, MINISTER OF HEALTH, NUTRITION AND INDIGENOUS MEDICINE OF THE DEMOCRATIC SOCIALIST REPUBLIC OF SRI LANKA

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DR. RAZIA PENDSE, COUNTRY REPRESENTATIVE OF THE WORLD HEALTH ORGANIZATION IN SRI LANKA

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THE SECRETARY, ADDITIONAL SECRETARIES, DIRECTOR GENERAL OF HEALTH SERVICES, DEPUTY DIRECTOR GENERALS OF HEALTH SERVICES AND ALL DIRECTORS WHO SUPPORTED US OF THE MINISTRY OF HEALTH, SRI LANKA

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THE INTERNATIONAL FACULTY FOR THIS CONFERENCE, PROFESSOR ATHULA SUMATHIPALA FROM THE KEELE UNIVERSITY, UK AND DR. BINO THOMAS FROM NIMHANS, INDIA

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EDUCATION, TRAINING AND RESEARCH UNIT OF THE MINISTRY OF HEALTH, SRI LANKA

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MENTAL HEALTH DIRECTORATE OF THE MINISTRY OF HEALTH, SRI LANKA

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EXTERNAL SPONSORS; WORLD HEALTH ORGANIZATION, KAATSU INTERNATIONAL UNIVERSITY, INTERNATIONAL INSTITUTE OF HEALTH SCIENCES, SUNPHARMA, SIGNTECH, ATLAS

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OUR SCIENTIFIC PANEL, JUDGES AND RESOURCE PERSONS WHO EXTENDED THEIR SUPPORT TO US

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ALL CONSULTANTS AND MEDICAL STAFF FROM NIMH AND INVITED HOSPITALS AND UNIVERSITIES WHO SUPPORTED US

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ALL THE SPECIAL GRADE NURSING OFFICERS, NURSING SISTERS, WARD MASTERS, IN CHARGE NURSING OFFICERS AND NURSING STAFF OF NIMH, OTHER HOSPITALS AND NURSING SCHOOLS WHO SUPPORTED US

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2ND BATCH OF CPNN TRAINEES WHO SUPPORTED US

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ALL THE OTHER CATEGORIES OF STAFF INCLUDING SUPPORT STAFF OF NIMH FOR THE SUPPORT EXTENDED



THE ENERGETIC COMMITTEE MEMBERS WHO WORKED TIRELESSLY TO MAKE THIS EVENT A SUCCESS

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"Nursing research is a powerful tool for generating new knowledge and evidence to underpin nursing practice. Nursing has an obligation to society to provide care that is continually researched and evaluated. Nurses working singly or in multidisciplinary research teams can offer new insights and unique perspectives to the research process"

International Council of Nurses

The Journey Continues â&#x20AC;Ś

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