Abstract

Inadequate management of gastritis patients can result in delayed patient recovery and the reoccurrence of the disease. However, assessing the nurse’s role in the management of gastritis in the medical, surgical, and outpatient units of the limbe regional hospital from the 19th to the 21st of August 2017 was aimed at evaluating the nurse’s role in the care and management of gastritis patients.

The sample size was 50 nurses (male and female). In order for the research to be realized, a total of 50 questionnaires were administered to the nurses working at the medical, surgical, and pediatric units of the Limbe Regional Hospital in which information collected was analyzed using frequency tables to assess their role on how they can effectively manage gastritis patients. The method used to recruit participants was a convenient sampling technique in which some of the respondents did not comply.

The results indicated that 29.8 (66.6%) were aware of the causes of gastritis. Twenty-six (57.8%) were also aware of the preventive and nursing care measures of gastritis, while 38 (84.4%) of the nurses faced challenges in the management of gastritis.

Most of the nurses could define and understand the causes and predisposing factors of gastritis even though few do not understand and are still lacking on this. Studies show that most nurses are aware of the nursing care measures of gastritis, even though a good number of them are lacking on this. Nurses should organize to sensitize the community on the causes, preventive measures, predisposing factors of gastritis, and also the management of gastritis so as to reduce reoccurrence and create awareness of the disease.

Nurses should also cultivate the habit of attending seminars, clinical meetings, workshops sessions organized in the hospitals which will provide a forum for all nurses irrespective of their qualifications to grasp more knowledge from expertise provision of quality care and modern measures to cancel challenges faced in the management of gastritis.

CHAPTER ONE

GENERAL INTRODUCTION

1.1 Introduction

Gastritis is the inflammation of the stomach lining (Oxford, 2002), another definition is one put forward by Serra et al., 2004, which is an inflammatory condition of the gastric mucosa which displays changes related to etiology and the host response. Gastritis is one the most common stomach disorders and occurs in acute, chronic, and toxic forms.

Gastritis is a common disease affecting people of both developing and developed countries hence very recurrent in society (Turhep et al., 1984). The need for proper management of gastritis is recommended to reduce the disease globally.

Gastritis can be caused by a number of factors including; use of the non-steroidal anti-inflammatory drug (NSAIDs) such as aspirin and ibuprofen, excessive alcohol intake, smoking, infections, use of coffee and other caffeine drinks, anxiety, stress, and infections due to helicobacter pylori (H. pylori) (Mayor, 2005).

The most common cause of gastritis is H. pylori which is a curve gram-negative bacterium that has flagella. The epidemiology of gastritis is 70% in developing countries and its prevalence in Cameroon is 59% to 82% (Turhep et al., 1984). These H. pylori are the main cause of chronic gastritis.

Gastritis can be identified under two broad headings namely: acute gastritis (Sudden) or chronic which can be as a result of substances such as drugs, alcohol, spicy foods, hot or sour foods. The stress causes stimulation of the sympathetic nerves which produces hydrochloric acid (HCL) (Nanda, 2012). Chronic gastritis, which is caused mostly by H. pylori, there is cell desquamation and chronic inflammatory responses that destroy the glands and cause metaplasia.

Metaplasia is the body’s defense mechanism against irritation. At the time of food digestion, the movement of food in the stomach (peristalsis) gives rise to inelastic stiffness of which causes pain. Metaplasia also causes the damage of blood vessels leading to bleeding which is evident by black stools or hematemesis.

1.2 Background Of The Study

The history of gastritis goes far back as it was discovered by “Robin Warren” and “Barry Marshall” in 1983 that a bacteria called campylobacter pylori now called helicobacter pylori (H. pylori) causes gastritis, a tendency of an etiology-oriented denotation began. For this reason, a group of gastro-pathologist prepared a classification in 1990 in Sydney for the first time to classify and rank gastritis.

Within this period, the findings were important as atrophy and metaplasia in Correa’s chart in 1992 were realized and were included in the first classification. However, due to the differences between observers in the rating of especially chronic gastritis and atrophy over time, the Sydney classification was reviewed and a visual analog scale was prepared by preserving the basic principles. Despite all these efforts, inconsistencies especially in the rating of atrophy drew attention.

Thus the team that made the first Sydney classification put forward a metaplastic and non-metaplastic atrophy rating 2002, which is aimed at eradicating the disease. Also, stomach endoscopic biopsies are made to determine the diagnosis of the illness its stage, and follow up after the treatment. Hence a good pathologic and clinic correlation increases the accuracy of the diagnosis hence proper diagnosis will lead to adequate treatment and thus the eradication of gastritis (Serra et al., 2014).

This research also brings about stipulated theories one of such was developed by Hempen, 2009 which states that gastritis is an inflammation of the stomach; acute gastritis is characterized by the following symptoms: excessive burning, gnawing, and striking pain in the epigastria.

Furthermore, the Hart fall theory of 1936 says that gastritis is a typical example of minor ailments, but it is associated with many serious and lethal diseases. While Price’s theory of January 2012, states that gastritis is a disease caused by helicobacter pylori, he continues by saying that gastritis is diagnosed correctly in similarity with other gastric diseases.

According to Gilson (2009), gastritis is not a single disease, but it means inflammation of the stomach lining. Gastritis can be caused by drinking too much alcohol, prolonged use of NSAIDs, or infection with h. pylori. Sometimes, injury, burns, and severe infection can also cause gastritis. The most common signs and symptoms of gastritis include; abdominal pain or upset in the chest, belching, nausea and or vomiting, loss of appetite, hiccups and diarrhea in some cases Gilson (2009), because if not properly handled, it may lead to complications like stomach ulcer and stomach bleeding which might also lead to gastric cancer (Mayo,2011).

The disease has shown a high incidence both in developed and developing countries. In industrialized countries like the United States, 20-50% of the population may be infected with h. pylori. The rate of H. pylori infections is higher in areas with poor sanitation and higher population density. And in developing countries like Cameroon, the infection rate is 59-80% (Shah, 2011).

1.3 Statement Problem

Gastritis is a recurrent pathology amongst people in society. It appears that most people in society consume a lot of spicy foods, beverages that contain caffeine, consume drugs like ibuprofen which are NSAIDs that can predispose them to gastritis. Inadequate management of gastritis can result to delay patient recovery and the reoccurrence of the disease, hence nurse’s role in the management of gastritis, proper clinical assessment, monitoring, and diagnosis of the disease will ensure excellent patient recovery, and reduce the prevalence of the disease.

1.4 Research Questions

1. What are the causes of gastritis?
2. What are the roles of nurses in the management of gastritis?
3. What challenges do nurses face in the management of gastritis?

1.5.1 General Objective

The roles of nurses in the management of gastritis at the Limbe Regional Hospital Mile1.

1.5.2 Specific Objectives

1. To determine the causes of gastritis at the Limbe Regional Hospital
2. To assess the role of nurses in the management, of patients with gastritis at the Limbe Regional Hospital
3. To identify the challenges faced by nurses in the management of gastritis at the LRH