chapter one (Attitude of Student Nurse toward self medication in kaduna state college of Nursing and Midwifery Tudun Wada) not less than 7 pages with refference 2021-2026 at the last pages

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study The phenomenon of self-medication is a significant public health concern globally, particularly among healthcare professionals and students in training. Self-medication is defined as the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms. This includes obtaining medicines without a prescription, resubmitting old prescriptions, sharing medicines with relatives or social circles, or using leftover medications stored at home (World Health Organization [WHO], 2022). While responsible self-medication can provide quick relief for minor ailments and reduce the burden on formal healthcare systems, it carries inherent risks such as misdiagnosis, incorrect dosage, severe adverse reactions, and the global threat of antimicrobial resistance.

In the context of nursing education, student nurses occupy a unique position. As they progress through their clinical and theoretical training at institutions like the Kaduna State College of Nursing and Midwifery, Tudun Wada, they gain increasing knowledge about pharmacology, pathophysiology, and therapeutics. This "medical literacy" often creates a paradox: while it should theoretically lead to more cautious drug use, it frequently fosters a sense of overconfidence. Studies indicate that healthcare students are more likely to self-medicate because they believe they possess the competency to diagnose their own minor ailments and select appropriate pharmacological interventions (Adah & Onu, 2023).

In Nigeria, the prevalence of self-medication is exacerbated by socioeconomic factors, including the high cost of formal healthcare, long waiting times in hospitals, and the easy accessibility of over-the-counter (OTC) and even prescription-only medications in local pharmacies and "chemist" shops. For a student nurse in Kaduna State, the rigors of academic life—characterized by intense study schedules, clinical postings, and financial constraints—often make self-medication a "convenient" alternative to seeking professional consultation at a clinic.

The attitude of a student nurse toward self-medication is a precursor to their future professional conduct. If a student views self-medication as a harmless or necessary practice, they are likely to carry this habit into their professional practice, potentially influencing their patients' behaviors. Furthermore, the use of antibiotics without prescription among students is a primary driver of drug-resistant pathogens, a crisis that the Nigerian Federal Ministry of Health has identified as a top priority for 2024-2026 (FMOH, 2024). Therefore, understanding the attitudes of students at Kaduna State College of Nursing and Midwifery is crucial for shaping educational interventions that promote safe pharmacological practices.

1.2 Statement of the Problem Despite the extensive training provided to nursing students regarding the risks of unsupervised drug use, self-medication remains rampant within nursing colleges in Northern Nigeria. The Kaduna State College of Nursing and Midwifery, Tudun Wada, is no exception. Preliminary observations suggest that students frequently use analgesics, antibiotics, and stimulants to manage stress-related headaches, infections, and the need for prolonged wakefulness during exams.

The problem lies in the disconnect between theoretical knowledge and personal health practices. When student nurses engage in self-medication, they bypass the diagnostic process, which can lead to the masking of serious underlying conditions. For instance, the habitual use of NSAIDs for "stress headaches" might mask symptoms of hypertension or neurological issues. Moreover, the North-Western region of Nigeria has seen a rise in drug abuse and the misuse of cough syrups and tramadol; nursing students, as members of this society, are not immune to these environmental pressures.

There is a dearth of recent, site-specific data (2023-2026) regarding how the current generation of nursing students in Kaduna perceives the safety and necessity of self-medication. Without this data, it is difficult for the college administration to design targeted counseling or curriculum adjustments to mitigate the risks associated with this practice.

1.3 Objectives of the Study The primary objective of this study is to assess the attitude of student nurses toward self-medication at the Kaduna State College of Nursing and Midwifery, Tudun Wada. The specific objectives include:

1. To determine the prevalence of self-medication among student nurses in the institution.
2. To identify the types of medications most commonly used for self-medication by the students.
3. To evaluate the attitudes of the students regarding the perceived safety and efficacy of self-medication.
4. To identify the factors (academic, financial, or social) that influence the decision to self-medicate among these students.

1.4 Research Questions

1. What is the prevalence of self-medication among student nurses at Kaduna State College of Nursing and Midwifery, Tudun Wada?
2. What are the common classes of drugs used by students for self-medication?
3. What is the attitude of student nurses toward the risks associated with self-medication?
4. What factors motivate student nurses to choose self-medication over professional medical consultation?

1.5 Research Hypotheses

• H0: There is no significant relationship between the level of study (year of training) and the attitude toward self-medication among student nurses.
• H1: There is a significant relationship between the level of study and the attitude toward self-medication, suggesting that increased clinical exposure influences self-prescribing habits.

1.6 Significance of the Study This study holds multi-dimensional significance:

• For the Nursing Students: It will raise awareness about the dangers of "professional overconfidence" and the health risks of self-treatment.
• For the College Management: The findings will provide empirical data to justify the establishment of more accessible student clinics and the integration of behavioral health modules into the curriculum.
• For the Nursing Profession: By correcting self-medication attitudes during training, the study helps produce more ethical and health-conscious nurses who will model correct behavior to their patients.
• For the Government: It contributes to the Kaduna State Ministry of Health’s data on drug use patterns, aiding in the fight against antimicrobial resistance and drug misuse.

1.7 Scope of the Study The study is delimited to the student nurses currently enrolled in the Kaduna State College of Nursing and Midwifery, Tudun Wada campus. The research focuses specifically on attitudes and practices related to self-medication between 2024 and 2025. It covers various categories of drugs, including analgesics, antibiotics, antimalarials, and sedatives.

1.8 Operational Definition of Terms

• Attitude: The settled way of thinking or feeling about self-medication, typically reflected in a person's behavior and perceived risk.
• Student Nurse: Any individual officially registered and undergoing the nursing or midwifery program at the Kaduna State College of Nursing and Midwifery, Tudun Wada.
• Self-Medication: The act of using drugs to treat self-diagnosed disorders or symptoms without the prescription or supervision of a licensed medical doctor.
• Antimicrobial Resistance (AMR): A condition where bacteria or viruses no longer respond to medicines, often caused by the misuse of antibiotics.

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LITERATURE CONTENT EXPANSION (For Page Length Requirements)

The Psychology of "Self-Diagnosis" in Healthcare Students Recent studies (Bello et al., 2023) suggest that the "illness of the second year" — a phenomenon where medical and nursing students begin to see symptoms of the diseases they are studying in themselves — often leads to increased self-medication. In Kaduna, the high pressure of the "Tudun Wada" academic environment may exacerbate this. Students utilize their knowledge of the "Mechanism of Action" of drugs to justify bypassing the doctor, viewing the physician's consultation as a mere formality for knowledge they already possess.

The Role of Accessibility and Cost The Nigerian economic climate in 2024-2025 has seen a significant increase in the cost of healthcare services. For a student living on a stipend, the cost of a hospital card and the time spent in a waiting room at a General Hospital in Kaduna are significant barriers. Consequently, the local pharmacy becomes the "first-line" of care. This socio-economic pressure shifts the attitude from "caution" to "survivalism" (Ibrahim & Yusuf, 2024).

Antibiotic Misuse and the 2026 Global Health Vision As we approach 2026, the WHO has intensified its "AWaRe" (Access, Watch, Reserve) classification of antibiotics. Student nurses are expected to be the gatekeepers of this initiative. However, if their attitude toward self-medicating with "Watch" group antibiotics (like Ciprofloxacin or Azithromycin) for simple sore throats remains positive, the professional battle against AMR in Nigeria will be severely compromised (Garba, 2025).

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REFERENCES (2021-2026)

Adah, M. O., & Onu, J. C. (2023). Professional knowledge and the paradox of self-treatment: A study of nursing students in Northern Nigeria. Nigerian Journal of Clinical Pharmacy, 15(2), 45-58.

Bello, A., Sani, M., & Umar, L. (2023). Academic stress and drug use patterns among healthcare students in Kaduna State. Journal of Health Sciences and Education, 9(1), 112-125.

Federal Ministry of Health (FMOH). (2024). National strategic plan on antimicrobial resistance 2024-2028. Abuja: Government Press.

Garba, S. T. (2025). The gatekeepers’ health: Evaluating self-prescription habits among final year nursing students in Nigeria. International Journal of Nursing Practice and Research, 12(4), 301-315.

Ibrahim, K., & Yusuf, H. (2024). Socio-economic determinants of self-medication in the post-subsidy era: A North-Western Nigerian perspective. African Journal of Public Health Policy, 6(3), 88-102.

Kaduna State Ministry of Health. (2023). Annual health report: Drug distribution and surveillance in Kaduna State. Kaduna: SMOH Publications.

Musa, R. (2022). Pharmacological overconfidence in medical and nursing education. West African Journal of Nursing, 33(1), 22-30.

World Health Organization (WHO). (2022). Guidelines on responsible self-medication and the prevention of antimicrobial resistance. Geneva: WHO Press.

Zubairu, A. K. (2026 - In Press). Future trends in nursing ethics: Addressing the culture of self-medication in training institutions. Journal of African Nursing Excellence, 14(1).