RESEARCH PROPOSAL

ON

ASSESSMENT FOR AWARENESS, KNOWLEDGE AND ATITUDE ON MENTAL HEALTH

AMONG PATIENT AT MBAILZI HOSPITAL, MBEYA REGION

STUDENT NAME: STELLA FRANKEN

CANDIDATE NUMBER: NS0149/028/2005

Purpose: “A RESEARCH PROPOSAL SUBMITTED IN PARTIAL FULFILMENT OF THE

REQUIREMENTS FOR THE ORDINARY DIPLOMA OF NURSING AT MBALIZI
INSTITUTE OF HEALTH SCIENCE

YEAR OF COMPLETION: 2023

i
DECLARATION

I STELLA FRANKEN declare that this research proposal is my own work. It has not been and will not
be presented for any other course of study. I confirm that appropriate credit has been given where
references has been made to the work of others.

Signature_____________________

Date_______________________

ii
CERTIFICATION

The undersigned certifies that she has read and here by recommends for acceptance by Mbalizi institute
of health science. A study topic entitled assessment for awareness, knowledge and attitude on mental
health among patient at Mbalizi hospital in Mbeya region

Supervisor name: Ms. GLORIA MGOGO

signature.......................

date.................................

iii
 ACKNOWLADGEMENT

First i would like to thank God for keeping us healthy and strong from beginning up to now,

Also special thanks to ministry of health community gender elderly and children for giving us this
opportunity of research study as a part of learning program

Secondly i would like to thanks supervisor and coordinator Madam Gloria Mgogo and sir Said Nassoro
and all staff of Mbalizi Institute of Health Science and staff of Mbalizi hospital.

Lastly I would like to thank my parents for their contribution to my work and thanks to all my class
mates and friends.

TABLE OF CONTENTS

iv
DECLARATION.................................................................................................................................................ii
CERTIFICATION................................................................................................................................................iii
ACKNOWLADGEMENT...................................................................................................................................iv
CHAPTER ONE....................................................................................................................................................1
INTRODUCTION.................................................................................................................................................1
1.2 PROBLEM STATEMENT..............................................................................................................................2
1.2.1 NATURE OF PROBLEM............................................................................................................................2
SCOPE OF PROBLEM.........................................................................................................................................3
EFFECT OF PROBLEMS.....................................................................................................................................3
GAPS AND PROPOSED SOLUTION.................................................................................................................5
1.3 RESEARCH OBJECTIVES OF THE STUDY...............................................................................................5
1.3.1 BROAD OBJECTIVE..................................................................................................................................5
1.3.2 THE SPECIFIC OBJECTIVES....................................................................................................................5
1.5 SIGNIFICANT AND PURPOSE OF RESEARCH STUDY.....................................................................6
CHAPTER TWO...................................................................................................................................................8
LITERATURE REVIEW......................................................................................................................................8
2.1 Introduction......................................................................................................................................................8
2.2 Knowledge on mental health...........................................................................................................................8
2.3 Attitudes towards mental health......................................................................................................................9
CHAPTER THREE.............................................................................................................................................12
3.0 RESEARCH METHODOLOGY..................................................................................................................12
3.1 CHAPTER OVERVIEW...............................................................................................................................12
3.2DESCRIPTION OF THE AREA....................................................................................................................13
3.3 RESEARCH DESIGN...................................................................................................................................13
3.4 STUDY POPULATION................................................................................................................................13
3.4.1 INCLUSION CRITERIA..........................................................................................................................13
3.4.2 EXCLUSION CRITERIA..........................................................................................................................13
3.5 SAMPLE SIZE ESTIMATION.....................................................................................................................13
3.6 DATA COLLECTION METHODS AND TOOLS......................................................................................14
3.7 METHODS FOR ENSURING VALIDITY AND RELIABILITY..............................................................14
3.7.1 DATA VALIDITY.....................................................................................................................................15
3.7.DATA RELIABILITY..................................................................................................................................15
3.6 DATA ANALYSIS METHODS...................................................................................................................16
3.7 ETHICAL CONSIDERATIONS...................................................................................................................16
3.8 PLAN FOR DISSEMINATION OF RESEARCH RESULTS.....................................................................16
3.9 LIMITATIONS OF THE STUDY................................................................................................................16
3.10 CHAPTER SUMMARY.............................................................................................................................17

v
REFERENCES....................................................................................................................................................17
APPENDIX IV....................................................................................................................................................20
APPENDIX V PART – I.....................................................................................................................................22
APPENDIX VI PART.........................................................................................................................................23
DODOSO YA NNE.............................................................................................................................................26
DODOSO LA TANO SEHEMU YA KWANZA.........................................................................................27
DODOSO LA SITA............................................................................................................................................28
APPENDIX C: INFORMED CONSENT FORM...............................................................................................31
IMPLEMENTATION PLAN..............................................................................................................................32
Budget and budget justification...........................................................................................................................33

vi
 OPERATIONAL DEFINITION OF TERMS

Awareness

Is the state or ability to perceive, to feel, or to be conscious of events, objects, or sensory patterns. In
this level of consciousness, sense data can be confirmed by an observer without necessarily implying
understanding (Ernelos., 2012).

Attitude:

This is the feeling, behavior, regard or thinking towards mental health and

patients suffering from mental illnesses. (Sharma Pwan.al 2019)

Knowledge:

This is the familiarity, awareness or understanding of mental health based

on facts, information, descriptions, and treatments. (Mary. Townsend 2019

Mental health

Is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities,
learn well and work well, and contribute to their community ( camilah.,et al 2019)

Mental illnesses

Are health conditions involving changes in emotion, thinking or behavior (or a combination of these).
Mental illnesses can be associated with distress and/or problems functioning in social, work or family
activities. (Mary.C. Townsend, 2014).

Caregivers: Anybody who is involved in taking care of or treating the mentally ill Patients (Chander K
sarin,.2018

vii
1
 CHAPTER ONE

INTRODUCTION

1.1BACKGROUND INFORMATION

Globally, nurses represent the most prevalent professionalgroup working in the mental health
sector; the median rate of nurses in this sector is 5.8 nurses per 100,000populations which are
greater thantherate of all other human resources groups combined (brullein.,2011).

Mental disorders are prevalent in all societies and create a substantial burden for the affected
individuals and their families, and they produce significant economic and social hardships that
affect society as a whole (marcnel.,2008).

Mental health disorders affect hundreds of millions of people worldwide and if left untreated,
create an enormous toll of suffering,disability and economic loss, yet despite the potential to
successfully treat mental disorders only asmall minority of those in need receive even the most
basic treatment (Mukalel.,2007).
In sub-Saharan Africa, with the region having poor mental health services resources. A survey of
university Patient across 21 countries found that one-fifth met the criteria for mental disorders in the
past year. A finding attributed to university studies being emotionally and intellectually demanding,
making Patient prone to mental health challenges.

In Uganda, recent studies reported that one in five medical Patient are depressed, 54.5% of the Patient
experience burnout, and 57.4% of the Patient in medical school are stressed. Following the COVID-19
pandemic, the prevalence of mental illness among Patient increased with over four-fifths of the Patient
having severe symptoms. Patient also reported high suicidal behaviors (i.e., suicidal ideations,
attempts, and plans).

High levels of mental health problems are due to low levels of knowledge, poor attitude, and
perception towards mental health care and mental health in general, which make Patient seek care late
or avoid mental health services. For the present study, perceptions are one’s interpretation of a mental
health challenges, while attitude is how one acts and behaves towards someone with mental health
challenge. (Joseph & Gabriel.,2019)

Studies in some parts of sub-Saharan Africa have found that medical Patient and health workers have
lower levels of knowledge, poor perception, and attitude towards mental illness. This not only

1
predisposes them to mental illness but also hinders the utilization of mental health services available
and the recognition of mental illness in the people they serve.(Chewa.,2009)

The poor perceptions and attitudes on the other hand may bring about the stigmatization of patients
who may run away from treatment as a result. There is a paucity of information on the knowledge,
attitude, and perceptions of medical Patient on mental health in Uganda. Given the high prevalence of
mental illness amongst medical Patient in the country and the scarcity of human resources in the mental
healthcare field, it is important for medical Patient to be knowledgeable and have the right attitude and
perceptions about the subject. Our study sought to determine the student’s knowledge, attitudes and
perspectives towards mental health. (Danken.,2006)

In Tanzania 2010 , comprehensivepublisheddocuments that confirm the prevalence of mental

health disorders in Tanzania remains to be found. What is available as evidence of mental
health problems in Tanzania mental disorders and were limited in types of disorders and also
not representative of the general population of Tanzania these studiesprovided some insight to
the magnitudeof the problem. The phasing out of community outreach has decreased
community awareness on mental health, and limits adequate follow up and all of this
information is not published and only some have been documented (Mbatia et al, 2010)

Limited infrastructure makes patients cared for in a non-therapeutic milieu; non- conducive
working environment for nurses, including high workload, creating more demands from patients
and their significant others, disproportionate nurse/patient ratio that makes one nurse tocare for
more patients than is recommended. (Zakaria et al, 2010),

Internationally one nurse is supposed to take care of one patient in the general ward and two
nurses for a single patient in an acute ward, at MNH one nurse takes care of about 12 patients or
more in the general ward while at Mirembe one nurse takes care of more than 150 patients in
the general ward. (Hudia et al, 2015).

Locally Attitude and perception towards mental illness play a major role in successful treatment and
social reintegration of people with mental health problems. The aim of this study was to determine the
knowledge, attitude and perception of the community towards mental illness in Mbeya Municipality. A
multistage sampling technique was employed to select a sample size of 384 from the study population.

2
1.2 PROBLEM STATEMENT

1.2.1 NATURE OF PROBLEM

Quintanilla (2010) notes that, historically, in the Middle Ages some diseases, especially mental

health disorders were not associated with natural causes but rather with supernatural forces or

malignant spirits, especially when physicians were unable to diagnose or deal with it. In

Tanzania, Barnett (2012) explicates that for centuries witchcraft has explained anything

inexplicable occurring among people in rural villages such as a severely sick child or a strange

illness. With little awareness or no education, many people are more likely to succumb to the

claims of traditional healers and pass down those beliefs to the next generation.

SCOPE OF PROBLEM
Globaly, mental health services provided are still either inadequate or of low quality. Estimates that
154 millions suffer from depression, 25 millions suffer from schizophrenia(Angermeyer.,2006), 91
millions suffer from alcohol use disorder, 15 millions suffer from drug use disorder, 50 millions suffer
from epilepsy, 24 millions suffer from Alzheimer and other dementia, and877,000 die by suicide every
year. Within countries the overall one-year prevalence of mental disorders ranges from4%to26%,
(,Berzins,k.m.,2003). Medical Patient are more susceptible to developing psychological distress and
mental health disorders relative to other Patient in undergraduate training. For example, the prevalence
of depression ( 27.2%), anxiety (33.8%), burnout (12.1%), and suicide (11.1%) among medical Patient
is high. In Uganda, recent studies reported that one in five medical Patient are depressed, 54.5% of the
Patient experience burnout, and 57.4% of the Patient in medical school are stressed.(Gureje, O and
alem, A 2000)

EFFECT OF PROBLEMS

The World Health Organization (2019) ranks depression to have higher burden than other

psychiatric conditions such as Bipolar disorders and schizophrenia. Depression erodes an

individual’s ability to function at home, at work and socially. Further notes that depression

affects individuals’ relationships with family, friends and colleagues, while time off work or

3
 reduced productivity at work affects the financial situation of the organization or push

individuals into debt. The report also notes that in 2010 depression cost the European Union 92

some of the patient noted that they experienced anxiety while at the same time fearing what could
befall them tomorrow.

In Africa generally and Tanzania particularly, workers contend with a lot of challenges but at the

top of the list is the financial crisis as the financial sector has come to a near standstill, hence

leading to food crisis as workers spend over half of their income on basic foodstuff, which had

been hit by a huge inflation recently (Grumiau & Bakvis, 2009)

GAPS AND PROPOSED SOLUTION

Many studies conducted to on the assessment of knowledge, awareness and attitude on mental health
globally but failed to show how in developing countries about knowledge and awareness on mental
health to patient. There for the study seek to assess on the assessment of knowledge, awareness and
attitude on mental health to patients by nurses at Mbalizi Hospital.

1.3 RESEARCH OBJECTIVES OF THE STUDY

1.3.1 BROAD OBJECTIVE

The main objective of the study will be to assess awareness, knowledge and attitude on mental
health among patient at Mbalizi Hospital.

1.3.2 THE SPECIFIC OBJECTIVES

1. To assess awareness on mental health among patient visit at Mbalizi Hospital.

2. To assess level of knowledge toward treatment of mental health among patient who visits at
Mbalizi Hospital
3. To assess attitude on Mental health among patient who visit at Mbalizi hospital

4
5
1 .4 RESEARCH QUESTIONS

1.What is awareness on mental health among patient visit at Mbalizi Hospital

2. What is level of knowledge toward treatment of mental health among patient who visits at Mbalizi
Hospital
3.What is attitude on Mental health among patient who visit at Mbalizi hospital

1.5 SIGNIFICANT AND PURPOSE OF RESEARCH STUDY

The purpose and significant of the study is to increase awareness and knowledge to the
patients about mental health Also, the study will be useful to inform and give alternative
solutions to the government and policy makers regarding the awareness and knowledge of
mental health. Furthermore, the study will be useful for other researchers as they will get
knowledge from the study concerning knowledge, attitude and awareness of mental health.

6
1.6 CONCEPTUAL FRAMEWORK.

The conceptual framework of the study examines the independent and dependent variables .Where in
independent there is awareness (Delay in seeking professional treatment ,Traditional healers),
knowledge(Cultural beliefs,Religious factor and Spiritual factor) and altitude(Age,Gender,Working
experiences).Dependant there is(depression,attention,deficit,aggression,socialwithdrawal,schizophrenia and
bipolar disorder), as shown below.

Independent variable

(Awarness)

Delay in seeking professional

treatment

Traditional healers Dependent variables

Depression
(Knowledge)
Attention-deficity
Cultural beliefs
Aggression
Religious factor
Social withdrawal
Spiritual factor
Schizophrenia

Bipolar disorder

(Attitude)

Age

Gender

Working experiences

CHAPTER SUMMARY

Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their
abilities, learn well and work well, and contribute to their community ( camilah.,et al 2019).Also mental
disorder is among problem affect many people around the world. High levels of mental health problems are
due to low levels of knowledge, poor attitude, and perception towards mental health care and mental health in
general, which make Patient seek care late or avoid mental health services. In Tanzania 2010 , comprehensive
published documents that confirm the prevalence of mental health disorders in Tanzania remains to be
7
found.Hence prevalence of depression ( 27.2%), anxiety (33.8%), burnout (12.1%), and suicide (11.1%)
among medical Patient is high.

8
CHAPTER TWO

LITERATURE REVIEW

2.1 Introduction

This chapter deals with review of literature relevant to study that was obtained from various
sources that include medical and nursing journals, text books and internet and is presented in
relation to the study objectives.

2.2 Knowledge on mental health

Research conducted in Qatar indicates that the level of mental health knowledge and mental
health literacy amongst members of the public is very poor (Bener & Ghuloum, 2011). This
could be attributed to the various myths about mental illnesses among various ethnic groups
indicating why different communities would perceive mental illness differently.

Van der Ham, et al, (2011), in an explorative study conducted in Vietnam, found that the p
articipants in the study were unable to identify and name the different mental illness. Some of
the participants in the study conducted by Ganesh, (2011) amongst the general public in South
India could mention a few mentally ill disorders. This is because knowledge, attitudes and
perceptions can be influenced by factors such as ethnicity, religion, age, gender, working
experience and culture (Chaudhury & Minas, 2011).

However, the knowledge pertaining to the causes of mental illness was poor and many of the
participants alluded mental illness to punishment from God (Barke, et al.,2010). Cultural beliefs
often influence people’s general knowledge of mental illness (NCCAH,2009).Research by
Crabb,et al, (2012) revealed that most people in Sub-Saharan Africa associate mental illnesses
to cultural beliefs. In contrast,a research conducted in America to determine knowledge,
attitudes and perceptions of various groups of people towards mental illness and mentally ill
patients,demonstrate that the general public attribute mental illness to stress, family related
matters and biological factors such as trauma to the brain, illicit drug use (Gateshill et al, 2010).

9
Despite the knowledge people have on mental illnesses, cultural beliefs often outweigh the
mental health literacy as society tend to hold on to cultural beliefs more ( Bener & Ghuloum,
2011).Historically in Tanzania, mental health care has been provided by a traditional healing
system based on the commonly believed association between mental illness and religious and
spiritual factors. Furthermore, traditional healing is more accessible than Western medicine for
many people seeking mental health care especially for those in rural areas due to a lack of
available and accessible mental health care professionals, poor transportation and acceptance of
spiritual and/or supernatural causes for health problems (Kutcher, et al, 2016).

Studies that identified similar gaps recommended programs of enlightenment in which mental health
literacy promotion and training should be established. (Kapungwe, et al., 2011). Pande, et al, (2012)
support the view that higher literacy levels are associated with more positive attitudes towards mental
illness.2010).Cultural beliefs often influence people’s general knowledge of mental illness
(Ayonrinde,2004).Research by Crabb, et al, (2012) revealed that most people in Sub-Saharan Africa
associate mental illnesses to cultural beliefs.

Despite the knowledge people have on mental illnesses, cultural beliefs often outweigh the
mental health literacy as society tend to hold on to cultural beliefs more ( Bener & Ghuloum,
2011).Historically in Tanzania, mental health care has been provided by a traditional healing
system based on the commonly believed association between mental illness and religious and
spiritual factors. Furthermore, traditional healing is more accessible than Western medicine for
many people seeking mental health care especially for those in rural areas due to a lack of
available and accessible mental health care professionals, poor transportation and acceptance of
spiritual and/or supernatural causes for health problems (Kutcher, et al, 2016).

Studies that identified similar gaps recommended programs of enlightenment in which mental
health literacy promotion and training should be established. (Kapungwe, et al., 2011). Pande,
et al, (2012) support the view that higher literacy levels are associated with more positive
attitudes towards mental illness.

2.3 Attitudes towards mental health

10
 Mental Health report of the (Centre of Disease Control, 2012) indicate that the attitude and
beliefs about mental illness are shaped by an individual’s knowledge about mental illness,
interaction with mentally ill people, cultural stereotyping and various other factors.

Quinn, et al, (2009) revealed that older people had more favorable perceptions towards mental
illness. Adewuya and Oguntade, (2007) investigating social distance found that the age groups
of the participants were significantly associated with social distance, which implies that there is
a relationship between the age of the participants and the variables that tested social distance.
Yamawaki, et al, (2011) supported the fact that women generally have more favorable and less
stigmatizing attitudes towards mentally ill patients.

Chikaodiri, (2009) states that in Nigeria, non-mental health care workers fear mental health
users so much that they expressed fears about treating mentally ill patients in a general teaching
hospital.Participants in this research study expressed fear and negative attitudes towards
mentally ill patients and often viewed mental ill patients as dirty, worthless, dangerous etc. and
from time to time they also associated mental illness with witchcraft and the works of evil
machines (Ewhrudjakpor,2009). Ghanaians expressed their unwillingness to marry people with
mental illnesses (Barke,et al, 2011).A study conducted by Li, et al, (2014) supports the fact that
Asian people have high levels of stigmatization towards mental illness. (McDaid, 2011).

A national survey conducted in France that explored knowledge, attitudes and perceptions
towards schizophrenia, bipolar mood disorder and autism revealed prejudice as well as
stigmatization; participants also viewed mentally ill people as dangerous and labeling of
mentally ill patients was also prevalent in this study (Durand-Zaleski, et al, 2012). Adewuya ,
(2007) also proved, in their study that the participants in the study regarded mentally ill patients
as dangerous, unpredictable, and aggressive; and that mentally ill patients have a poor prognosis
2.4 Awareness towards mentally health

Globally, more than 70% of people with mental illness receive no not aware of mental health
treatment. According to the Centre of Disease Control (CDC, 2012), a person’s awareness and
attitude towards mental illness influences how to treat, support and interact with mentally ill
people. Cultural beliefs have a great impact on mental health care, treatment and mentally ill
patients. This phenomenon is more prominent in African communities especially in Sub
Saharan Africa (Manda, et al, 2017).
Mentally ill people are often blamed as victims of unfortunate fate, religious and moral
transgression, or even witchcraft. This may lead to denial by both sufferers and their families,
11
with subsequent delays in seeking professional treatment. The belief that a disturbed mental
state is a result of an “evil eye” or black magic leads the majority of patients to seek traditional
healers first and only present to a psychiatrist once the disturbance is severe or unmanageable at
home, often quite late in the illness (Manda, et al, 2017).

Historically people with mental illness were burned, hanged, mutilated, abandoned and
restrained with chains, all in the bid to save their souls, or bring redemption to their families and
curb the inequities causing mental illness within the families (Okpalauwaekwe, et al, 2017).
Despite the fact that mental illness and mental health care awareness programs being extended
extensively over the past few decades, mentally challenged patients are still being mocked,
ostracized, labeled, ill-treated and misunderstood by the greater community, family and
sometimes health care personnel (Ukpong & Abasiugbong, 2010).

A national survey and systematic review in Australia different mental illnesses with regards to
treatment, the participants indicated that they’ll seek help from a general practitioner,
psychologists, family and friends. Participants also viewed relaxation and physical activity as
well as medication as treatment options. Despite this, non-medical personnel are still reluctant
to help mentally ill patients who are in crises (Gates, et al, 2011).
In light of the above studies, we can conclude that despite the fact that a significant number of
studies conducted in Africa indicated that some people firmly believe that sangoma’s and
traditional healers can heal mental illness, the results in the present study dismiss the
assumption that sangoma’s can heal mental illness (Chikaodiri, 2009).

CHAPTER SUMMARY

Level of mental health knowledge and mental health literacy amongst members of the public is
very poor (Bener & Ghuloum, 2011. Cultural beliefs have a great impact on mental health care,
treatment and mentally ill patients. This phenomenon is more prominent in African
communities especially in Sub Saharan Africa (Manda, et al, 2017). The participants in the
study were unable to identify and name the different mental illness, . According to the Centre of
Disease Control (Gray A J, 2001), a person’s awareness and attitude towards mental illness
influences how to treat, support and interact with mentally ill people.

12
CHAPTER THREE
3.0 RESEARCH METHODOLOGY

3.1 CHAPTER OVERVIEW

This chapter includes description of the research design, description of the study area, targeted
population of the study area, sample size estimation, sampling and recruitment procedures, study
protocols or procedures, data collection methods, data tools and instruments, methods for ensuring
validity and reliability, data analysis methods, ethical considerations, operational definitions, plan for
dissemination of research results, limitations and delimitations of the study, and chapter summary.

3.2DESCRIPTION OF THE AREA

The study will be conducted at The Mbalizi Hospital in s situated 20km east of Mbeya, one of the
largest cities in Tanzania, in southwestern highlands. It was opened as a mission hospital from the
Mbalizi Evangelistic Church (MEC) beginning of 2007 because the previous smaller hospital was
always overcrowded. Mbeya Region is one of Tanzania's 31 administrative regions. The region covers
an area of 35,954 km2 (13,882 sq mi) and 33 26 59.99 E latitude 8 53 59 99 E. The region is
comparable in size to the combined land area of the nation state of Guinea Bissau. Mbeya Region is
bordered to the east by Singida Region, Iringa Region and Njombe Region. The region is bordered to
the south by Malawi and Lake Nyasa.To the north the region borders southern Tabora Region.

3.3 RESEARCH DESIGN

Cross-sectional research design will be used in assessment for awareness, knowledge and attitude on
mental health among patient at mbailzi hospital, mbeya region using a quantitative approach, where by
a structured questionnaire will be used for data collection from the sample of the study population. This
design will be appropriate to this study, because it will involve collection of information about the state
of a problem in a particular point in time to give a picture or results of the existing healthcondition.

3.4 STUDY POPULATION

The study population will comprise all patient who attended at OPD at Mbalizi hospital during the
study period.
3.4.1 INCLUSION CRITERIA

All patient who will be willing and able to give an informed consent to participate in this study.
3.4.2 EXCLUSION CRITERIA

Patient who will be too sick to give consent and critically ill to withstand the interviewing process will
13
 be excluded from the study
3.5 SAMPLE SIZE ESTIMATION

For this study, the sample size is calculated by using the following formula

2
n=Z P(1−P)
2
e

Where as

N= number of population

Z= value for level of confidence

P= expected population or prevalence of participant

e= the marginal error

Inputs to the formula

In this study, the value of 95% will be used such as z will be 95% = 1.96 whereas this is the most used

The marginal error will be 5% which is equals to 0.05

N = 1.962x0.95(1-0.95)

0.052

Therefore, N is equal to 72, then Add 10% of this value to take care for possible non respondent
72 + (10/100x72)
Now the exactly population size is 79 participants.

3.5 SAMPLING METHOD

Random sampling technique will be used by selecting randomly to patients attending at Mbalizi hospital in
Mbeya region for data collection. In random sampling every patient had equal chance of being
selected.Sampling technique of study is simple random sampling techniques used

14
3.6 DATA COLLECTION METHODS AND TOOLS

Structured questionnaire as a primary data collection method will employ in data

collection, questionnaires will be used because a lot of information’s will be collected
within a short period of time with minimal resources.
3.7 METHODS FOR ENSURING VALIDITY AND RELIABILITY

Pretesting of the research instruments will be done at Mbalizi Hospital to ensure clarity,
validity and reliability involving 16 respondents which is 10% of the total sample size.
This will be done to ensure proper adjustments and standardization of the research
instruments which will be performed before the actual data collection exercise. This will
be done one week before starting data collection.
3.7.1 DATA VALIDITY

To ensure validity of the collected data, we will cross check the data collection tool with
our supervisor, research expert, mental specialists, and staff nurses work in OPD unit. A
standardized questionnaire will be used as data collection instrument which will be
designed to meet the stated objectives of the study, some of the questions in the
questionnaire will be asked more than once so as to assure if there will be consistency in
their responses also.
3.7.DATA RELIABILITY

The questionnaires were given to 16 Patient at Mbalizi Hospital who will meet the
inclusion criteria and that patient who will not part of the study participants. The same
questionnaires will be re-administered again to the same 10 patients to assess for the
stability and consistency of the questionnaires which will be a test retest reliability
measure. A pre-test of data collection tools will be done for the purpose of avoiding
information bias, checking whether questions will be clear and well understood,
estimating the time to be used to administer one questionnaire and to ensure that data
collection tools will be reliable.

15
3.6 DATA ANALYSIS METHODS

The data collected will be analyzed, coded and entered in the statistical package for social
science SPSS. The SPSS package version 28 will be employed in this study. Through this
frequency, mean and proportion of variables will be computed and tested for significant
difference or association between independent variables and dependent variables using
Chi-square test where appropriate, and 95% confidence interval. P value < 0.05 will be
considered significant.the data will be presented by using frequency tables, pie chart, and
graphs, also descriptive statistics will be used to determine percentages so as to present a
summary of the dataobtained.
3.7 ETHICAL CONSIDERATIONS

Ethical clearance to conduct the study will be obtained from Mbalizi Institute of health
publication committee. Each of the responden ts will be explainedto on the purpose of the
study, benefits of the study and that there will be no any risk during participation.

Respondents will be informed their right to voluntary participation. Informed consent will
be signed from each respondent by the written signature or thumb print on voluntary basis
with an assurance of confidentiality.

Patient who will be below the age of 18 years signed or used thumb print on the
assent form before proceeding to participate in the study. Participants’ names will not be
included on the questionnaire for confidentiality purposes with only letters being used for
accountability and the data collected will be shared with only authorized people. Also, the
participants will be allowed to ask questions for more clarifications.
3.8 PLAN FOR DISSEMINATION OF RESEARCH RESULTS

The findings of this study will be first disseminated to our supervisor at Mbalizi Institute
of health science research administration, thereafter the results will be disseminated in
Mbalizi Hospitals at Mbeya region where the study will be conducted. Also, people will
get information about the research finding through books, journal article, and copy of
research report will remain at MBIHS library for MBIHS community.

3.9 LIMITATIONS OF THE STUDY

The following will be the limitations of this study, misunderstanding with the respondents
due to the lack of knowledge about the study, language barrier, disagree to participate in
answering question and low level of education.

16
3.10 CHAPTER SUMMARY

This chapter in general discussed the whole process that will be done in collections of data
and preparing well elaborated data in manner that will be well understood, disseminated
and provided channel for writing a well composed research.

17
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mental illness among Nigerian Psychiatric patients and their relatives. African Journal
of Medicine and Medical Science, 28, (1-2), 35- 41.

 Al- Adawi, S., Dovlo,A.S., Al –Ismaily, S.S., Al-Ghafry,D.A., Al-Noobi, B.Z.,Al-

SalmiA.,Burrke,D.T.,Shah,M.K.,Ghassany.H.,Chand
,S.P.(2002) Perception of and attitude towards mental illness in Oman. International
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 Angermeyer, M.C. & Dietrich, S. (2006) Public beliefs about and attitudes towards
people with mental illness: a review of population studies. Acta Psychiatrica
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 Angermeyer, M.C. & Matschinger, H. (2004) Public attitudes to people with

depression: - Have there been any changes over the last decade? Journal of Affective
Disorder, 83,177-182.

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bridging tradition and modernization. British Journal of Psychiatry, 184, 536–538.

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 Crisp All, Gelder MG, Rix Setal. Stigmatization of People with Mental illness. The
British Journal of Psychiatry 2000; 177: 4 –7.

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Health Religion Culture 2001;4:71

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19
 APPENDIX IV
PART–I DEMOGRAPHIC DATA
INSTRUCTIONS TO PATIENT/
CLIENT:

Read carefully, and give appropriate response in each column.

3 Age
a. 15- 18 years [ ]
b. 19-30 years [ ]
c. 31-40 years [ ]
d. 40 years and above [ ]
2. Gender
a.Male [ ]

b. Female [ ]
3. Religion
a.Hindu [ ]

b. Muslim [ ]
c. Christian [ ]
d. Others [ ]
4. Maritalstatus
a. Single [ ]

b. Married [ ]
c. Divorced [ ]
d. Widow [ ]

[ ]
[ ]
5. Locality [ ]
a. Rural [ ]

b. Urban

[ ]
[ ]
6.Do you have any previous exposure with mentally illpatient
20
 Yes / No
7.Do you have any family member suffering with mentalillness
Yes / No

21
 APPENDIX V
PART – I

Read the following statements carefully. If you feel the statement is correct put a tic mark.
If you feel the statements are incorrect put an (x) mark in the bracket.

S.NO. KNOWLEDGE QUESTIONNAIRE YES NO

1. Mental health and physical health are like two of the coin sides.

2. Mental illness is hereditary.

3.
Anybody under stress can become mentally ill.

4. Only poor people suffer from mental illness.

5. It is safe to keep mentally ill persons inside the mental hospital

6 A treated mentally ill person can work with responsibility

7. In addition to drugs, mental patients need love and courage

8. Once the drugs are prescribed patients need not consult again.

9 Alcohol and drug abuse also treatable in psychiatric unit.

10 Beating and locking the patient in a room is violation

against human rights.

22
 APPENDIX VI PART

On the following pages you will find a number of statements about mental
health problems. I want to know how much you agree or disagree with
each statements. To the right of each statement you will find a scale.

Disagree Agree
1 2 3 4 5

The points along the scale (1, 2, 3, 4 and 5) can be interpreted as follows.

• Completely or stronglydisagree

• Disagree

• Cannot say or do notknow.

• Agree

• Completely or stronglyagree

If you agree completely with a statement, then circle the number ‘5’ that is there
on the right of the statement (but not completely disagree). Then place the circle around the
number ‘2’ in the scale. In this way you can indicate whether you agree or disagree with each
of the statement on the following pages.

Lik e everyone else, you will probably feel that you cannot give an answer to some of
the statement. When that occurs make the guess that you can.

23
 Orientation scale Strongly No
Disagree Agree Disagree
S.No. Disagree Opinion
2 4 5
1 3
1 After an attack of mental illness, these
individual become very antisocial.
2 Practice of yoga prevents mental
illness.
3 After an attack of a mental illness the
patients loss a lot of weight.
4 Mentally ill individual are not at all
trust worthy.
5 To treat mental patient effectively, it
costs too much money.
6 Taking mentally ill to holy places
cures them.
7 Unmarried persons are less likely to
develop mental illness than married
persons.
8 Mental patients commit lot of crimes.
9 Those that have lost the parents during
childhood have a greater risk of
developing mental illness.
10 People look much older after they
recover from mental illness.
11 Mentally ill persons are dangerous to
those around them.
12 Fasting cures mental illness.

24
13 patients with mental illness are no
longer really human.
14 Religious ceremonies help the patients to
come out of mental illness.
15 To treat a mental patient, the most
important thing is to teach him how to
control his emotions.
16 Mental illness is due to damaged or
diseased brain.
17 People become mentally ill whenthey
come under the influence of evilstars.
Mental illness is caused by the
18 influence of the moon.
19 Brain operation alone can cure mental
illness.
20 If a person is dominated by others, he
is likely to develop mental illness.

25
 DODOSO YA NNE

1.Miaka
a.Miaka 15- 18 [ ]
b. Miaka 19-30 y [ ]
c. Miaka 31-40 y [ ]
d.Miaka 40 na zaidi [ ]
2.Jinsia
a.wakiume [ ]

c. Wakike [ ]
3.Dini
a.kiindu [ ]
b. Muisla mu [ ]
c. Mkristu [ ]
d. Nyinginezo [ ]
4. Maisha kiujumla
a. Hajaolewa [ ]
b. A meolewa [ ]
c. A natalaka [ ]
d. Mjane [ ]

[ ]
[ ]
5 Makazi [ ]
d. Kijijini [ ]

e. Mjini

[ ]
[ ]
6.Je ulishawahi ugua ugonjwa wa akili kabla
Ndio / Hapa na
7.Je katika fa milia yako kuna mtu alishawahi ugua ugonjwa wa akili
Ndio/ Hapana

26
DODOSO LA TANO SEHEMU YA KWANZA

Soma maelezo yafuatayo kama jibu ni ndio weka alama ya vem kama hapana weka alama
ya kosa

S.NO. MASWALI YA UFAHAMU NDIO HAPA

NA
1. Afya ya akili na mwili ni kama shilingi yenye sehemu kuu mbili.

2. Ugonjwa wa akili ni wa kurithi

3.
Mtu yeyote mwenye mawazo anaweza ugua ugonjwa wa akili

4. Watu masikini tu ndio wanao ugua ugonjwa wa akili

5. Nisalama kuwatunza wagonjwa wa akili katika hospitali

6 Mgonjwa wa akili aliye tibiwa anaweza kuendelea na majukumu

yake
7. Kwa msaada zaidi wa kimatibabu mgonjwa wa akilianaitaji
kupendwa na kutiwa moyo
8. Dawa za mgonjwa zikiishwa andaliwa hatakiwi kujulishwa tena

9 Utumiaji wa pombe na madawa ya kulevya waweza tibika soba

10 Kumpiga na kumfungua mgonjwa wa wakili ni unyanyasaji na

kumyima haki zake

27
 DODOSO LA SITA

MASWALI YA UFAHAMU Kataa Hajaping

Kataa 2 kubali Kataa
Namba kwa a
4 5
nguvu 1 3
1 Baada ya kuwashambulia wagonjwa wa
akili wanabadilika na kuwa washiriki
wazuri katika jamii
2 Kufanya mazoezi kunazuia kutopatwa
ugonjwa wa akili
3 Baada ya kushambuliwa na ugonjwa wa akili
mgojwa anapungua uzito
4 Wagonjwa wa wa akili sio wa kuwa amini
kabisa
5 Kuwatibu wagonjwa wa akili kunatumia
kiasi kikubwa sana cha pesa
6 Kuwa peleka wagonjwa wa akili
kuombewa sehemu takataifu kunawaponya
7 Mtu ambaye hajaolewa anaweza ugua
ugonjwa wa akili haraka kuliko
ambaye yuko kwenye ndoa
8 Wagonjwa wa akili wanasababisha uhaifu
sana katika jamii
9 Wale amabao wamepoteza wazazi wao
wakiwa wadogo wako katika hatari
kubwa ya k u u g u augonjwa wa akili
10 Watu wanaonekana wazee sana baada ya
kupona ugonjwa wa akili
11 Wagonjwa wa akili ni hatari sana kwa watu
wanao wazunguka
12 Ugonjwa wa akili napona haraka
13

28
13 Wagonjwa wa akili sio binadamu tena

14 Mikutano ya kidini inasaidia sana kuwa

ponya wagonjwa wa akili
15 Kuwatibu wagonjwa wa akili moja ya
muhimu ni kuwafundisha jinsi ya kuwa
makini na hisia zao
16 Ugonjwa wa akili kunasababishwa na
kuharibika kwau bongo
17 Watu wanaugua ugonjwa wa akili
kutokana na kujihusisha na mambo ya
kishetani
Ugonjwa wa akili unasababishwa na
18 kuchomoza kwa mwezi
19 Upasuaji wa ubongo unasaidia kuponya
ugonjwa wa akili
20 Kama mtu akitengwa inampelekea
kuugua ugonjwa wa akili

29
PERMISSION LETTER FROM MBALIZI INSTITUTE OF HEALTH SCIENCES

STELLA FRANKEN,
P.O.BOX 6117,
MBEYA,
24. NOVEMBER.2022
DR INCHARGE,
MBALIZI HOSPITAL,
P.O.BOX 6117,
MBEYA
U.F.S
PRINCIPAL,
MBALIZI SCHOOL OF NURSING,
P.O BOX .6117
MBEYA
Dear, Madam

REF: APPLICATION FOR PERMISION TO CONDUCT RESEARCH AT MBALIZIHOSPITAL

The heading above is concerned, I here by applying for permission to conduct resear
ch at Mbalizi hospital about Assesssment of knowelege,awareness and attitude of mental health at Mbalizi
hospital.I am a student who taking diploma in nurses and midwifery course at Mbalizi institute of health
science, for fulfillment of my studies, I need to conduct a research and submit the report before completing the
course. I request for your permission to conduct research study in your hospital.

I hope my application will be considered

Yours Faithful.

………………………………

STELLA FRANKEN

30
 APPENDIX C: INFORMED CONSENT FORM

MBALIZI INSTITUTE OF HEALTH SCIENCE

P.O. BOX 6117 MBEYA

TANZANIA
The purpose of this study is to investigate awareness,knowledge and attitude on mental health among patient
at Mbalizi hospital.You will be asked a few questions which will take thirty to forty five
minutes.Participation in this study is voluntarily and you are allowed to withdraw at any time. There are
benefits to you as an individual from this study. However this knowledge will help researchers, nurses who are
participating in this field.

I have read and understood and volunteer to participate in this study

Participant signature……………………

Date……………………………

31
IMPLEMENTATION PLAN

COVERAGE ACTIVITIES TO BE IMPLEMENTED

28 November 2022– 30 November 2022 Preparation of title and objectives

1 December 2022_ 3 December 2022 Writing research proposal

4 December 2022– 10January 2023 Submission of research proposal

15January 2023 Presentation of research proposal

16 January 2023_18 January 2023 Data collection

19 January 2023– 20 January 2023 Data processing and analysis

22January 2023– 25January 2023 Report writing

30 January 2023 Submission of research report

Presentation of research report

32
Budget and budget justification

S/ CATEGORY No. of UNIT RATE IN AMOUNT TOTAL

N0 unit COST TSH COSTS
1 ALLOWANCES
-Researcher meals 1 7days 2000 2000 x7 x1 14,000
Transport 1 7 10,00 1,000x7 x1 7,000
2 EQIPMENTS AND
STATIONERIES
- photocopying Papers 1 Ream 15000 15000x 1 15000
-Ball Pens 6 pcs 500 500 x 6 3,000
-Envelops A4 size 10 pcs 250 250 x 10 2,500
-Pencil 2 pcs 500 500 x 2 1,000
files 2 pcs 2500 2500 x 2 5,000
Bindings and 5 pcs 10000 10000 x 5 50,000
lamination
TOTAL 97,500

33
1