Prevalence of mental distress
The prevalence of mental distress in the current study was 53.1% with (95% CI, 48%-58%), 52.6% in medical ward and 53.7% in surgical ward. This finding was relatively comparable with study reported from Korea among surgical inpatients, South Africa hospitals and elsewhere in Ethiopia in hospitalized inpatient care givers were 48%, 49.7%, 54.6% and56.7% respectively(12–15).
The prevalence of this study was relatively lower than from the studies conducted in Pakistan, Harari Regional State, Debre Markos and Felege Hiwot hospitals and Gondar University hospitals, Ethiopia were 87.9%, 59.7%, 61% and 58.6% respectively(16–19). This variation might be resulted from making mental health as global prioritizing problems, change in improving policy, service development and management protocol on mental health related problems(20,21) and life style modification of patients, change in patient safety with in and after discharge the hospitals, relatively increase mental and psychological counseling and even change in methodological approach might be also the possible difference.
The prevalence of this study was relatively higher than the studies reported from Saudi Arabia, Iran, India, United Kingdome, Northeast Brazil, South Brazil, Uganda and Nigeria hospitalized patients were 25.5%, 34.8%, 44.1%, 8.1%, 27.1%, 33.7%, 22.5% and 22% respectively (22–29) and similarly higher than the studies reported from Vietnam, Jazan Province of Saudi Arabia, Southern Taiwan, Hawassa, Ethiopia, Amanuel mental health hospital, Ethiopia, Menlike II hospital, Ethiopia were 5.4%, 20.6%,38%, 22.1%, 27.1% and 23.2% respectively (5,30–34). This variation might be resulted from change in methodological difference, study population; which were data taken from chronic medical surgical and trauma inpatients including intensive care unit inpatients, difference in screening and diagnostic questionnaire tool used; some researchers used like Kessler scale, Burden Assessment Scale, Hospital Depression, Anxiety and Stress Scale to measure mental distress and other sociodemographic and environmental factors may increase the prevalence of mental distress on this study.
Factors associated with mental distress in hospitalized inpatient
In this study marital status of being married was an important factor; which was statistically associated with mental distress with almost2.7 times more positively associated with distress than being unmarried. This result of the study was similarly consistent to the study reported from Korea, Gondar University hospital, Ethiopia respectively (10,31). The reason that being married marital status more likely to develop mental distress were might be due to holding more responsibility to their home, family and child care, imbalance of demand and supply of resources to their family during being paired and poor communication and socialization relationship with in the family and other socioeconomically factors might be the possible difference.
Inpatients living in rural area have been two times significantly associated with mental distress than living in urban but, in other studies living in rural residence have not been significantly associated with mental distress. This might be resulted from patients living in rural district might have low perception on life style modification, relaxation, recreation and other luxuries for the management of distress and low seeking behavior to get psychological and mental health counselor or consultation.
In this study being private employee were more than 2 times positively associated with mental distress compared to being a governmental employee and this association was also similarly in line with the study revealed from Vietnam (5); this also might be resulted from poor life style enjoyment and devote their time in the working place and work load, payment payed to them, poor administration and management system and relatively having low awareness. Being daily laborer were the highest statistically associated variable; which was almost five times more highly associated with mental distress compared to being governmental employee; which might be resulted from having low income to fulfill their daily allowance, live alone and far from their family, sometimes lack of work and work load at a point of time could be the possible reason.
Inpatients who drink alcohol had near to 1.7 times more likely associated with mental distress than those who were not drink alcohol. This result was extended to the study done in Australia, Gondar University hospital, Ethiopia(10,35). The reason might be resulted from people with alcohol abuse are responsible for neuropsychiatric disorders, domestic violence, child abuse and neglecting and productivity loss and also meets the diagnostic criteria for majority of mental disorders and sometimes they may develop distress in their life after a time(36).
Participants who had previous history of psychiatry illness were highly increase the venerability of mental distress. Previous history of psychiatric illness had been 3.4 times more highly associated with mental distress than those who had no previous history of illness. This might be due to patients who had history of psychiatric illness were not fully recover and well healthy from their illness; some negative and positive psychiatric symptoms may present and may include the screening tool diagnostic criteria and positively associated with mental distress.
Respondents with co-morbid disorder had been twice significantly associated with mental distress than those who had no comorbid disorder. This result was similar with the studies reported from Jeddah of Saudi Arabia, Jazan province of Saudi Arabia, India, South Africa, Menlike II hospital, Hawassa and Harari Regional State hospitals of Ethiopia respectively (13,17,22,24,30,32,34). This outcome might be resulted from inpatients with two or more chronic comorbid disorder might have different physical illness and the self-reporting questionnaire diagnostic tool also included some symptoms of physical illness and patients with comorbid disorder were limited from their daily physical activities; which might result to high report of mental distress(11).