RESUMO
Background: Nigeria's shortage of psychiatrists is exacerbated due to health worker migration. Aim: This study explores migration experiences and tendencies among early-career psychiatrists in Nigeria. Methods: We conducted a cross-sectional survey covering Nigeria's six geopolitical zones, using a 61-item online questionnaire assessing short-term mobility, long-term migration experiences and migration attitudes. Data was analysed using IBM SPSS version 29. Results: Of 228 early-career psychiatrists surveyed, 9.7% had short-term mobility and 8.0% had long-term migration experiences. However, 85.8% had 'ever' considered migration, 69.2% were planning to leave 'now', and 52.9% had taken 'practical migration steps'. Over half (52.7%) said they would be working abroad in 5 years, with 25.2% indicating they would migrate within a year. The top reasons to leave were financial and academic, while personal and cultural factors were the key reasons to stay. Income dissatisfaction (OR = 2.27, 95%, CI = 1.05-4.88) predicted planning to leave 'now', while being in a relationship (OR = 3.46, 95%CI = 1.06-11.30) predicted taking 'practical migration steps'. Attractive job features were good welfare (85.4%) and high salaries (80.3%). Improvements in finances (90.8%) and work conditions (86.8%) were requested. Conclusions: Systemic changes to address psychiatrists' migration from Nigeria are needed.
RESUMO
Studies on psychoactive substance use in Nigeria had focused on prevalence and rarely on treatment implication(s) of large rates reported. Further challenge was to find suitable instruments to monitor change readiness as well as predict treatment outcomes along motivation continuum and according to resilience characteristics. Such ability will not only help to match treatment strategy with stage of change but also come with a more satisfactory outcome. This study therefore provided psychometric properties of one of such measuring scales: Stage of Change Readiness and Treatment Eagerness Scale version 8 (SOCRATES-8) and the accompanying change in resilience among Nigerians using psychoactive substances. Participants were 111 psychoactive substance dependent users in three treatment centers in Northern Nigeria. All respondents filled sociodemographic questionnaire, SOCRATES-8 and 14-item Resilience Scale. The study found overall motivation for change among participants to be medium on the three subscales of SOCRATES-8: ambivalence (median=14.00; range=7-20); recognition (median=31.00; range=7-35); and taking steps (median=35.00; range=12-40). More than half (61.3%) scored moderately on resilience. The Internal reliability of SOCRATES-8's subscales fell into acceptable range (ambivalence=0.54; recognition=0.87; taking steps=0.84). Pearson correlation coefficients of subscales with resilience are positive and in moderate range except for ambivalence with very low coefficient. Hierarchical cluster analysis based on participants' resilience characteristics yields five distinct profiles corresponding to five stages of motivational change. ANOVA of these five profiles based on SOCRATES' 3 subscales was significant. The study demonstrates utility of SOCRATES-8 to assess change readiness and treatment eagerness of psychoactive substance abusers according to stages of change and their resilience characteristics. This will aid treatment planning and can also measure treatment outcome.