CHAPTER ONE

INTRODUCTION

1.1 Background of study

Health is illustrated as physical psychological characteristics of wellbeing. Having the

freedom and strength to avoid any of these elements will keep you healthy. Health is an
invaluable part of a human life, without it, people can become uninspired, de-motivated and
unable to thrive for success. So some individual visit their doctors regularly to make sure they
are in good shape, likewise, there are those who purchase insurance coverage so that they can
receive the best health care in case if there is a need in future, while some others practice self-
prescription/self-medication in other to measure up their health status with others, probably
as a result of lack of money to visit hospitals.

Self-medication refers to the use of medicines or substances to manage self-diagnosed

conditions without professional consultation. Recent studies have reported a rising trend of
self-medication globally, particularly among healthcare students. According to Fekadu et al.
(2022), the prevalence of self-medication among nursing students is significantly high,
largely due to academic stress, easy access to medications, and perceived medical knowledge.
Similarly, Al-Amer et al. (2023) found that nursing students often self-medicate to manage
minor ailments, mental fatigue, or to sustain clinical and academic performance.

In Nigeria, Ogunfowokan and Okunade (2023) reported that the widespread availability of
pharmaceuticals and limited access to affordable healthcare continue to encourage unsafe
self-medication practices. These students often rely on over-the-counter (OTC) drugs,
antibiotics, and analgesics without prescriptions or proper [Link] self-medication
may seem convenient and time-saving, studies have documented its risks. Rahman et al.
(2024) noted that inappropriate self-medication can lead to adverse drug reactions, delayed
diagnoses, antimicrobial resistance, and long-term dependency. Lee & Park (2024)
emphasized that lack of regulatory enforcement and awareness further contribute to the
irrational use of medications in low- and middle-income countries.

The reasons for self-medication vary, including prior experience with symptoms or disease,
perceived medical knowledge, limited financial resources to seek medical assistance, lack of
time to consult a healthcare professional, and personal attitudes toward illness and treatment.
A qualitative study among Iranian nursing students (Janatolmakan et al., 2022) found that
many respondents self-medicated based on previous illness episodes, confidence in their
pharmacology knowledge, limited time, easy medicine access, cost concerns, and trust in
their own judgment rather than consulting a doctor . In a 2023 cross-sectional survey of
female health science students in Saudi Arabia, 77.5% reported “quick relief” as the key
reason, with 76.3% citing time-saving, 71.1% treating minor illnesses, 56.7% showing self-
confidence, and 56.7% admitting to laziness as motivators .
Common factors associated with self-medication include demographic characteristics—such
as female gender, older age groups, and higher academic level—along with lifestyle and
access-related factors like lack of health insurance, and proximity or distance to healthcare
facilities. For instance, a 2023 study involving 319 students in Riyadh observed self-
medication prevalence at 81.6%, with higher rates among females and students with greater
monthly income; the primary sources of self-medication were previous experience (66.5%),
time-saving (50.2%), advice from relatives/friends (62.4%), and pharmacists (48.0%)

The implications of self-medication are far-reaching, underscoring the need to promote

responsible practices in educational settings. Awareness campaigns and curricular
interventions can inform students about the clinical risks and encourage appropriate
consultation. Healthcare educators are pivotal in guiding future professionals to practice safe
medication use. At the same time, policymakers should enforce prescription regulations,
expand access to affordable care, and regulate OTC medicine sales to minimize misuse.

Self-medication remains widely practiced globally, particularly among health-professional

students, with recent studies reporting prevalence rates between 55.9% and over 80% in
nursing, medical, and pharmacy student populations (Ali et al., 2022; Al-Sulami et al., 2023;
El-Sayed et al., 2024). While self-medication may support autonomy, convenience, and cost
savings, it also carries serious hazards including adverse drug reactions, misdiagnosis,
toxicity, treatment delays, and, in extreme cases, hospitalization or death (Janatolmakan et al.,
2022; World Health Organization, 2024).

Studies show that although educational exposure, family or peer influence, societal norms,
and medication accessibility encourage self-medication, they also mask its dangers. In
particular, healthcare students’ confidence in their own medical knowledge—often gained
through limited clinical training—can foster a false sense of security and reinforce unsafe
medication behaviors. The unchecked practice of self-medication may strain public health
resources, contribute to antimicrobial resistance, and degrade the integrity of the healthcare
profession, highlighting the urgent need for structured interventions that reinforce rational
drug use and professional ethics.

This study aims to investigate the knowledge and practices of self-medication among nursing
students in Edo State College of Nursing Sciences, Benin City, Edo State. Nursing students,
as future healthcare professionals, play a critical role in promoting safe and effective
medication use. By exploring the factors that influence self-medication behaviors among
nursing students, we can develop targeted interventions to promote responsible self-
medication practices and reduce the risks associated with this behavior. The study will also
examine the potential implications of self-medication for public health, including the
development of antibiotic resistance and the impact on healthcare systems.
1.2 Statement of the problem

The practice of self-medication among students has become a growing concern globally.
Recent research has demonstrated that self-medication is increasingly prevalent among health
sciences students, including nursing, medical, and pharmacy students—across multiple
countries (Ali et al., 2022; Adeeyo Ayoka et al., 2022; Sultan et al., 2024). Studies have
reported varying prevalence rates: for instance, one Saudi Arabian cross-sectional study
reported 55.9% among health professional students (Ali et al., 2023), while a Nigerian
university study found 54.6% across nursing, medicine, and pharmacy disciplines (Adesina
et al., 2022). Another Nigerian pharmacy student survey revealed a prevalence of 83.8%
(Mgbahurike & Nenwi, 2020), and a recent Karachi nursing student study found 76.9% self-
medicated (Sultan et al., 2024). This trend is worrisome, as self-medication—particularly
when done irresponsibly—can lead to serious health consequences.

Self-medication can lead to several problems, including masked diagnoses, excessive drug
dosage, prolonged duration of use, drug interactions, polypharmacy, and superinfections.
These risks can be attributed to the lack of medical supervision and the potential for incorrect
diagnosis or treatment. Furthermore, non-responsible self-medication can result in
intoxication, adverse reactions, and other serious health consequences . For instance, the
overuse or misuse of antibiotics can lead to antibiotic resistance, making it challenging to
treat infections effectively. Similarly, the use of certain medications without proper medical
supervision can lead to dependence or addiction.

Responsible self-medication involves the use of registered or monographed medicines that

are legally available without a physician's prescription, either on an individual's own initiative
or following advice from a healthcare professional. This type of self-medication requires that
the safety, efficacy, and quality of non-prescription medicines be proven according to the
same principles as prescription medicines. In contrast, non-responsible self-medication
involves the use of drugs without supervision or prescription from a physician, which can
lead to wrong diagnosis, delayed treatment, drug resistance, and other adverse consequences .

For individuals to self-medicate safely and effectively, they must possess adequate
knowledge about medicines, including the ability to recognize symptoms, set therapeutic
objectives, select appropriate medicines, and determine suitable dosages and schedules (Auta
and Abiodun, 2019). This is crucial in preventing adverse reactions, interactions, and other
complications associated with self-medication. Without proper knowledge, individuals may
engage in non-responsible self-medication, which can have serious health consequences. For
instance, individuals may take medications that are not suitable for their condition, or they
may take incorrect dosages, leading to adverse reactions or interactions.

Given the rising concern of self-medication among students, there is a need for targeted
interventions to promote responsible self-medication practices. These interventions should
focus on educating students about the risks and benefits of self-medication, as well as the
importance of seeking medical attention when necessary. By promoting responsible self-
medication practices, we can reduce the risks associated with this behavior and promote
better health outcomes among students. Additionally, healthcare professionals can play a
crucial role in educating patients about safe medication use and promoting responsible self-
medication practices.

Healthcare professionals, including doctors, pharmacists, and nurses, can play a vital role in
promoting responsible self-medication practices. They can educate patients about the safe use
of medications, including the potential risks and benefits, and provide guidance on proper
dosage and administration. By working together, healthcare professionals and patients can
promote safe and effective self-medication practices, reducing the risks associated with this
behavior.

The factors influencing self-medication remain a topic of intense debate in academic

discourse, with various studies highlighting the complexity of this issue (Osemene and
Lamikara, 2020). One of the key factors contributing to self-medication is the availability of
drugs in markets and poor drug regulatory practices (Fadare and Tamuno, 2021). In many
countries, including Nigeria, drugs are often readily available over-the-counter, and
regulatory practices may be inadequate, making it easy for individuals to access and use
medications without proper medical supervision.

Many Nigerians tend to trivialize common ailments such as headaches, fever, cough, throat
infections, common colds, and stomach aches (Emmanuel et al., 2019). This trivialization can
lead to self-medication, as individuals may not consider these ailments serious enough to
warrant medical attention. However, this approach can be problematic, as these ailments can
sometimes be symptoms of underlying conditions that require medical attention.
Furthermore, self-medication can mask symptoms, making it challenging to diagnose and
treat underlying conditions effectively.

Demographic factors, such as age, sex, and socioeconomic status, have been found to
influence self-medication practices (Osemene and Lamikara, 2020). For instance, younger
individuals may be more likely to engage in self-medication due to their perceived
invincibility and lack of health concerns. Older adults, on the other hand, may be more likely
to self-medicate due to chronic health conditions and limited mobility. Additionally,
individuals from lower socioeconomic backgrounds may be more likely to self-medicate due
to limited access to healthcare services.

Education and awareness can also play a significant role in shaping self-medication practices.
Individuals with higher levels of education may be more likely to engage in responsible self-
medication practices, as they are more aware of the potential risks and benefits of
medications. Conversely, individuals with limited education or health literacy may be more
likely to engage in non-responsible self-medication practices, which can have serious health
[Link] the complexity of factors influencing self-medication, there is a need for
targeted interventions to promote responsible self-medication practices. These interventions
should focus on educating individuals about the risks and benefits of self-medication, as well
as the importance of seeking medical attention when necessary. Additionally, policymakers
can play a crucial role in regulating the availability of medications and promoting safe
medication use practices.

Objectives of the Study

This study aims to investigate the perceived impact of self-medication among nursing student
in Edo State College of Nursing Sciences. The specific objectives are:

1. Find out the level of knowledge of self-medication among nursing students in Edo state
college of nursing science.
2. Assess the impact of self-medication among nursing students in Edo state college of
nursing sciences
3. Determine the causes of self-medication among student nurses in Edo state college of
nursing sciences
4. Identify the common drugs used for self-medication among nursing student in Edo state
college of nursing sciences
Research Questions

The study will address the following research questions:

1. What is the level of knowledge do students have about self-medication among nursing
students in Edo state college of nursing science?
2. What is the impact of self-medication among nursing students at Edo State College of
Nursing Sciences?
3. What are the cause of self-medication among nursing students in Edo state college of
nursing science?
4. What are the common drugs used for self-medication among nursing students in Edo state
college of nursing science?

Significance of the Study

This study has significant implications for society, the nursing profession, and healthcare. By
exploring the impact of self-medication among nursing students, the study can:

1. Protect patient care and promote a healthier nursing workforce

2. Advance healthcare quality and maintain the integrity and excellence of the nursing
profession
3. Identify factors contributing to self-medication, such as stress, burnout, or coping
mechanisms
4. Inform initiatives promoting responsible medication use, substance abuse prevention, and
mental health support among nursing students and the broader community
5. Influence social norms and cultural values, discouraging self-medication and promoting
healthy coping mechanisms
6. Inform policy initiatives and regulations addressing substance abuse, mental health, and
healthcare workforce development

The study's findings can:

 Inform nursing education, emphasizing stress management, mental health, and

responsible medication use
 Guide the development of support systems and resources for nursing students struggling
with self-medication or substance abuse
 Inform initiatives and policies addressing substance abuse and wellness within
professional nursing organizations
 Promote a positive image of the nursing profession, emphasizing caring, compassion, and
responsibility

Scope of Study
The scope of this study will focus on the perceived impact of self-medication among nursing
students at Edo State College of Nursing Sciences, Benin City, Edo State. Geographically, the
study will be carried out within the premises of Edo State College of Nursing [Link]
study will specifically target student nurses across various academic levels within the
institution. It will examine the prevalence of self-medication, explore the underlying reasons
for this behavior, and assess its perceived consequences on health, academic performance,
and future professional conduct. The study will also identify commonly used substances and
potential sources of influence such as peer pressure, stress, and accessibility to
[Link] research will be limited to full-time student nurses who are currently
enrolled in the college during the 2025 academic year, ensuring participants have adequate
exposure to academic and clinical settings relevant to the study objectives

Operational Definition of Terms

To ensure clarity and consistency, the following operational definitions were used in this
study:

1. Impact: The effect or influence of a particular action, event, or circumstance on an

individual, group, or situation.
2. Perceived: Subjectively experienced or interpreted by an individual. In research or
assessment, perceived refers to the personal viewpoint, feeling, or interpretation of a
phenomenon, situation, or experience.
3. Self-medication: The use of substances, medications, or remedies by an individual to
manage or alleviate their own health issues or symptoms without professional guidance or
supervision.
4. Nursing students: Individuals who are enrolled in a nursing education program and are
preparing to become registered nurses (RNs).