الفهرس 
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Abstract
ECT is a widely practiced treatment that is extremely
effective for certain severe or resistant psychiatric conditions
and has a mortality rate comparable to or lower than
universally accepted antidepressant medication.
Despite evidence that electroconvulsive therapy (ECT)
is effective and safe, and leads to shorter and less costly
inpatient treatment, it is rarely used as the first line of
treatment and is generally reserved for older and resistant
cases of depression and other psychiatric disorders. Certain
factors such as social stigma, inadequate undergraduate
training, doubts about its efficacy and safety, ambivalence
among psychiatrists and doubts about its being a costeffective
alternative to antidepressant treatment, might have
limited the use of ECT in the management of depression.
Aim of the study
This study aims to assess the psychological distress,
knowledge and attitude toward electroconvulsive therapy
among family caregivers of mentally ill patients in
Almamoura hospital.
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Research Question
- What are the psychological stress, knowledge and attitude
toward electroconvulsive therapy among family caregivers
of mentally ill patients in Al-Mamoura hospital?
Subjects and Methods
The study portrayed under the four main designs as follows:-
I- Technical design
The technical design included research design,
setting, subjects and tools for data collection.
Research Design:
A descriptive design was utilized in this study.
Setting:
This study was conducted at Almamoura hospital for
mental health in Alexandria governorate.
Subjects:
A sample size included all available family caregivers
of mentally ill patients who subjected to ECT (100).
Inclusion criteria
Exclusion Criteria:
Family care givers who don‟t provide care to their
mentally ill patients.
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Tools of data collection:
I- Interviewing questionnaire sheet including four
parts:-
Part 1: Socio-demographic data: such as (age,
residence, marital status and monthly income).
Part 2: Knowledge of family caregivers toward ECT:
It is designed by the researcher and valid and reliable
questionnaire to assess their level of knowledge about
indications, side effects, mechanism of action about
ECT.
Part 3: Attitude of family caregivers toward ECT: It is
designed by the researcher to identify their thoughts,
beliefs, holistic view toward ECT; it includes positive
and negative statements with five Likert scale ranging
from strongly agree to strongly disagree.
Part 4: Psychosocial stressors of family caregivers
toward ECT: It is designed by the researcher to assess
psychosocial stress toward ECT. It consists of two parts
first part to assess psychological stressors and the
second part is designed to assess social stressors with
five Likert scale ranging from strongly agree to strongly
disagree.
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II- Operational design
It included the preparatory phase, content validity,
reliability, pilot study and field work.
A) The preparatory phase
It included reviewing of related literature and
theoretical knowledge of various aspects of the study using
books, articles, internet periodicals and magazines to
develop tools for data collection.
B) Content validity and Reliability:
The tools used to assess knowledge; attitude and
psychosocial stress toward ECT were valid and reliable tools
and specifically designed to assess them.
C) A Pilot study:
Before performing the actual study, a pilot study was
carried out on 10% of sample size to test clarity, efficiency
and applicability of the tools.
Field work: -
The researcher introduced himself to family caregivers
of mentally ill patients. The purpose of the study and
how-to fill-in the questionnaire was explained to the
caregivers who agreed to participate in the study prior to
any data collection. Approval was obtained orally before
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134
taking socio-demographic data and after explaining purpose
of the study. The family caregivers were assured that
information collected would be treated confidentiality and
it would be used only for the purpose of the research. The
tools of data collection were filled in and completed by the
researcher. The researcher was available 3 days/week
morning shift (Sunday, Tuesday and Thursday) to collect
data and implement this study.
III- Administrative design
An official permission letter to conduct the study was
obtained from the faculty of nursing, Ain Shams University
to the director of Almamoura hospital for mental health in
Alexandria in which the study was conducted.
IV- Statistical design
The collected data was organized, analyzed using
appropriate statistical significant tests.
Ethical considerations
Prior study conduction the ethical approval was
obtained from scientific research, ethical committee of
Faculty of Nursing, Ain-Shams University. An informed
consent was obtained from each study subject. The researcher
clarified the aim of the study to the participants who are
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included in the study. The researcher maintained
confidentiality of participants’ data and gave them the choice
to participate or not and the right to withdraw from the study
at any time.
Result:
The results of the study revealed the following: the
results showed that (75%) of the studied subjects were
males (50%) were in age group (>40 ) yrs., (72%) of the
studied subjects were married, (85%) were employed and
their monthly income not sufficient while (74%) lived in
urban places area,(42%) had a poor knowledge while
(55%) had an average knowledge toward ECT, (60%) of
family caregivers had a negative attitude toward ECT and
(77%) had a high level psychosocial stress. There is a
significant relation between knowledge and education
monthly income and residence. There is a significant
relation between level of attitude and education,
occupation, and residence and there is a significant relation
between knowledge and attitude. There is a significant
relation between level of psychosocial stressors and
education, monthly income and residence.
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Conclusion
It is concluded that the family caregivers whose
patients were subjected to ECT had a poor level of
knowledge, a negative attitude and a high level of
psychosocial stress toward ECT. There is a statistical
significant relation between level of knowledge and their
attitude in which highest knowledge is associated with
positive attitude.
Recommendations
All the medical staff members should answer all the
patients and their relatives question and providing
them with the correct evidence based information to
overcome their misconceptions.
Regular in-service programs to provide nurses and
family caregivers with updated necessary knowledge
and practices about ECT.
Channels of communication for expressing family
caregivers’ feedbacks positive or negative should be
available.
Educational courses should be made for training
instructors to increase the awareness and overcome
misconceptions regard ECT.
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Increase the awareness and benefits of ECT could be
through video films about ECT information
developed by specialists and available through media
to give enough information for patients and their
relatives.
Further studies are recommended to assess family
caregivers’ psychosocial stressors knowledge attitude
and identifying factors affecting them