CHAPTER ONE
INTRODUCTION
Background to the study
Self-control is the ability of people to control their own behaviour in relative autonomy from external pressures, from their innate or learned automatisms, and physiological impulses (Baumeister and Tierney, 2011; Krug and Carter, 2010; Muraven and Baumeister, 2012). It manifests itself, for instance, in the ability to refrain from unnecessary or harmful responses, in the ability to postpone gratification, in skillful regulation of emotions, as well as in attentive treatment of other people and behavioural adjustment to a social context.
Self-control does not work spontaneously and effortlessly. On the contrary, getting out of the automatic mode of behaviour requires work, understood literally as the consumption of available energy resources (Baumeister, Bratslavsky, Muraven, and Tice, 2010). Therefore, exercising self-control is tiresome, sometimes leading to total exhaustion of resources and unintended falling back into the mode of automatic control of behaviour.
The automatic control mode is not in itself reprehensible or harmful. We entrust many of our everyday activities to our “autopilot”, which uses previously learned patterns of behaviour, habits or reflexes. In this way, we perform many routine actions, sometimes quite complex, but still standard and repetitive.
Peptic ulcer disease (PUD) is one of the most common human ailments, affecting approximately 50% of the world population (Van Der Hulst and Tytgat, 2006). PUD also known as peptic ulcer or stomach ulcer is a break in the lining of the stomach, first part of the small intestine, or occasionally the lower esophagus (Snowden, 2008).
Based on the types, Peptic Ulcers can be broadly classified into Gastric or stomach ulcer and Duodenal Ulcer. Gastric Ulcers occur mainly in the elderly, on the lesser curve. Ulcers elsewhere are often malignant. Duodenal Ulcers are four fold commoner than gastric ulcer. It is identified by the most common symptom i.e. the epigastric pain occurs typically before meals or at night which is relieved by eating or drinking milk (Brown, 2012).
The stomach and the duodenal lining have several mechanisms that prevent ulcers from developing. A coating of mucus protects the stomach lining from the effects of acidic digestive juices. Food and other substances in the stomach neutralize acid. Certain chemicals produced by the stomach protect the cells lining the stomach (Mustafa and Menon, 2013).
For many years, excess acid secretion of HCL from the stomach was believed to be the major cause of ulcer disease. Accordingly treatment emphasis was on neutralizing and inhibiting the secretion of stomach acid. While acid is still considered significant in ulcer formation, the leading cause of ulcer disease is currently believed to be infection of the stomach by a bacterium called “Helicobacter pylorus” (H. pylori) accounting to about 70-90% (Cambel et al., 2015).
According to Prabu and Shivani, (2014) in a study conducted in Jos, most ulcers are caused by an infection and not necessarily spicy food, acid or stress. However, according to Rigas et al., (2015) the etiology of PUD include H.pylori infection, NSAIDS, pepsin, smoking, alcohol, bile-acids, steroids, and stress. While, other causes may include genetic predisposition, and disease factors such as, Zollinger -Ellison syndrome, Crohn disease and liver cirrhosis, stomach cancer, coronary heart disease, and inflammation of the stomach lining or gallbladder (Marshall, 2009).
However, with life style choices such as smoking, alcoholism, dietary habits implicated in the cause of peptic ulcer, it then becomes necessary to ask if self-control can be a means to the management of the disease. Dietary factors such as spice consumption were hypothesized to cause ulcers in a study by Van Der Weyden, (2005), but was shown to be of relative minor importance. Caffeine and coffee, also was thought to cause or exacerbate ulcers, but appear to have little effect while skipping of meals allows gastric acid to directly act on surface mucosa of the stomach causing irritation which ultimately leads to gastric ulcers.
Giving the prevalence of peptic ulcer disease which is relatively drug dependent, self-discipline has been recommended from various studies (Okolo et al., 2012; Blaser et al., 2005; Oputu, 2014) and clinicians as key in improving patient outcomes and preventing crisis. Thus this study is carried out to evaluate self-control in the management of peptic ulcer disease.
Statement of the problem
Peptic ulcer disease is an important cause of morbidity and mortality throughout the world affecting the lives of millions of people in their everyday life. In the United States, approximately four million people have peptic ulcers (duodenal and gastric), and 350,000 and 350, 000 new cases are diagnosed each year. Around 180,000 patients are hospitalized yearly, and about 5000 people die each year as a result of peptic ulcer disease (Cambel et al., 2015).
Peptic ulcer diseases according of the Taylor and Blaser, (2008) Statistics is one of the most common clinical emergencies in Hospitals. In Nigeria, the life time for developing a peptic ulcer is approximately 10% (Okolo et al., 2012). Poor management of the disease resulted in an estimated 30,000 deaths from 2007-2013.
Due to its role in morbidity, role of the drugs, and control requires the individual personal resources. However, no known literature exists on the role of personal resources. This study wish to know the role of resource control as it is a strong determinant to compliance to treatment.
Aim of the study
The aim of this study is to:
- Understand the role of self-control in the management of peptic ulcer
- Establish the relationship between self-control and peptic ulcer disease
Significance of study
This study is significant considering the cost of drugs which in turn depends on patient level of finance; it is thus self-control which includes life style modification will be of immense benefit to patients with peptic ulcer. Self-control is the ability of people to control their own behaviour in relative autonomy from external pressures. Peptic ulcer as a disease has been described as a disease of self-discipline. Thus, this study will help create awareness on how peptic ulcer can be managed by self-control which will help reduce medical cost in the management of the disease.
Research questions
Questions that provide guidelines for this research include:
- What is the role of self-control in the management of peptic ulcer?
- What is the educational attainment in the management of peptic ulcer disease?
Research hypothesis
Hypothesis for the study are:
There is no significant difference between self-control and educational attainment in the management of peptic ulcer disease.
Scope of study
The scope of the study is on self-control and educational attainment of patient with peptic ulcer. It did not consider age, experience, personality, type of ulcer, religion and tribe. The study also focused on patients attending general hospitals.
Operational definition of terms
Self-control: self-control in this study refers to methods in which a disease condition can be managed through self-discipline and adherence to medical prescriptions and advice.
Disclosure: Disclosure in this case study is the act of revealing facts on a particular ailment either in management or prevention.
Management: management in this study refers to a collaborative process that facilitates recommended treatment plans to assure the appropriate medical care is provided to disabled, ill or injured individuals. It refers to the planning and coordination of health care services appropriate to achieve the goal of medical rehabilitation
Peptic ulcer: Peptic Ulcer was defined as a mucosal break at least 3 mm in diameter, with or without a necrotic base in the middle of the lesion, in either the stomach (gastric) or the duodenum (duodenal). In the case of several ulcers/erosions, at least one had to fulfill this definition. In this study PUD is identified by the presence of signs and symptoms through history taking or examinations or from medical records or investigation reports.
