Influence of well-being and quality of work-life on quality of care among healthcare professionals in southwest, Nigeria

The Nigerian healthcare industry is bedevilled with infrastructural dilapidations and a dysfunctional healthcare system. This study investigated the influence of healthcare professionals' well-being and quality of work-life (QoWL) on the quality of care (QoC) of patients in Nigeria. A multicentre cross-sectional study was conducted at four tertiary healthcare institutions in southwest, Nigeria. Participants' demographic information, well-being, quality of life (QoL), QoWL, and QoC were obtained using four standardised questionnaires. Data were summarised using descriptive statistics. Inferential statistics included Chi-square, Pearson's correlation, independent samples t-test, confirmatory factor analyses and structural equation model. Medical practitioners (n = 609) and nurses (n = 570) constituted 74.6% of all the healthcare professionals with physiotherapists, pharmacists, and medical laboratory scientists constituting 25.4%. The mean (SD) participants' well-being = 71.65% (14.65), QoL = 61.8% (21.31), QoWL = 65.73% (10.52) and QoC = 70.14% (12.77). Participants' QoL had a significant negative correlation with QoC while well-being and quality of work-life had a significant positive correlation with QoC. We concluded that healthcare professionals' well-being and QoWL are important factors that influence the QoC rendered to patients. Healthcare policymakers in Nigeria should ensure improved work-related factors and the well-being of healthcare professionals to ensure good QoC for patients.

Preliminary study of perceived cardiovascular disease risk and risk status of adults in small rural and urban locations in Ibadan, Nigeria

<abstract> <p>The burden of cardiovascular disease (CVD) has been on the rise in developing countries like Nigeria recently. Studies on perceived CVD risk and the risk status of adults in Ibadan are not readily available, hence this study. A mixed-method design involving a cross-sectional survey and an exploratory qualitative study was utilized. Convenience sampling was used to recruit 418 participants (209 from rural and 209 from urban) for the cross-sectional survey, while purposive sampling was used to recruit 14 participants for the qualitative aspect. The INTERHEART risk score and the Perception of Risk of Heart Disease Scale were used to investigate participants' CVD risk status and perceived risk, respectively. The data from the cross-sectional survey were summarized by using descriptive statistics, and the data were then analyzed by using the chi-square test of association and a multiple logistic regression model, while content thematic analysis was used to analyze the qualitative data. In the rural and urban areas, respectively, 39.7% and 52.2% had a positive perception of CVD risk. In the rural and urban areas, 44% and 41.6% of individuals respectively had moderate-to-high risk of CVD. Participants with at least secondary school education [2.66 (0.61–11.53)] and participants in the urban area [2.62 (0.78–7.08)] had twice higher odds of positive CVD risk perception. Males [3.91 (1.58–9.68)], adults aged 40 and above [1.59 (0.63–4.00)] and urban dwellers [1.21 (0.33–4.39)] had higher odds of a high CVD risk status. The qualitative aspect of the study corroborated the findings from the survey, as many participants did not perceive themselves as being at risk of CVD. The majority of the participants in this study were found to have a moderate-to-high risk of CVD, and many had a negative perception of their risk. Health education and CVD prevention programs are required to curb the burden of CVD.</p> </abstract>

Perceived occupational prestige of physiotherapy in Nigeria among physiotherapy undergraduates: implication for public and healthcare professionals’ awareness of the role of physiotherapy

Background

The occupational prestige of any occupation is of interest to its members and prospective members. A profession’s occupational prestige influences its desirability, marketability, professional autonomy and social esteem, and career selection among prospective university undergraduates. This study aimed to assess the perception of the occupational prestige of physiotherapy in Nigeria among physiotherapy undergraduates and to explore its determining factors.

Methods

This study employed a mixed method design. The quantitative component involved 280 students from four universities in Nigeria, while the qualitative part involved 35 students. The participants in the survey completed a questionnaire on occupational prestige, and the data obtained were analysed using descriptive and inferential statistics. In addition, the qualitative data was analyzed using content thematic analysis.

Results

The perception of occupational prestige obtained from the cross-sectional survey showed that 12.1% of the participants perceived it as low, 49.3% as intermediate, and 38.6% as high. Overall, 49.3% of the participants ranked physiotherapy fourth, following medicine, engineering and law. The qualitative component corroborated these findings and further explained that the perceived status resulted from public perception of the profession in relation to other jobs, especially within the health care team.

Conclusion

Physiotherapy is ranked intermediate occupational prestige by most physiotherapy undergraduates. The significant determinants of this ranking are poor knowledge and awareness of physiotherapy among other health care professionals and the general public. To enhance the occupational prestige of physiotherapy, there is a need for public awareness of physiotherapy and its role and inter-professional education among health care professionals.

Pattern and perception of wellbeing, quality of work life and quality of care of health professionals in Southwest Nigeria

BACKGROUND

Personal wellbeing (PW) including quality of life and work life is a very complex concept that influences health professionals' commitment and productivity. Improving PW may result in positive outcomes and good quality of care. Therefore, this study aimed to assess the pattern and perception of wellbeing, quality of work life (QoWL) and quality of care (QoC) of health professionals (HPs) in southwest Nigeria.  METHODS: The study was a convergent parallel mixed method design comprising a cross-sectional survey (1580 conveniently selected participants) and a focus group interview (40 purposively selected participants). Participants' PW, quality of life (QoL), QoWL, and QoC were assessed using the PW Index Scale, 5-item World Health Organization Well-Being Index, QoWL questionnaire, and Clinician QoC scale, respectively. The pattern of wellbeing, QoWL and quality of care of HPs were evaluated using t-test and ANOVA tests. Binary regression analysis was used to assess factors that could classify participants as having good or poor wellbeing, QoWL, and quality of care of HPs. The qualitative findings were thematically analyzed following two independent transcriptions. An inductive approach to naming themes was used. Codes were assigned to the data and common codes were grouped into categories, leading to themes and subthemes.

RESULTS

Of 1600 administered questionnaires, 1580 were returned, giving a 98.75% response rate. Only 45.3%, 43.9%, 39.8% and 38.4% of HP reported good PW, QoL, QoC and QoWL, respectively; while 54.7%, 56.1%, 60.2% and 61.6% were poor. There were significant gender differences in PW and QoC in favor of females. With an increase in age and years of practice, there was a significant increase in PW, QoWL and QoC. As the work volume increased, there was significant decrease in QoWL. Participants with master's or Ph.D. degrees reported improved QoWL while those with diploma reported better QoC. PWI and QoC were significantly different along the type of appointment, with those who held part-time appointments having the least values. The regression models showed that participant's characteristics such as age, gender, designation, and work volume significantly classified health professionals who had good or poor QoC, QoWL, PW and QoL. The focus group interview revealed four themes and 16 sub-themes. The four themes were the definitions of QoC, QoWL, and PW, and dimensions of QoC.

CONCLUSION

More than half of health professionals reported poor quality of work life, quality of life and personal wellbeing which were influenced by personal and work-related factors. All these may have influenced the poor quality of care reported, despite the finding of a good knowledge of what quality of care entails.

Towards cardiovascular disease prevention in Nigeria: A mixed method study of how adolescents and young adults in a university setting perceive cardiovascular disease and risk factors

BACKGROUND

Cardiovascular disease (CVD) is a global problem but its increasing prevalence in the working age group in developing countries like Nigeria is concerning and needs urgent attention.

METHODS

The study was a mixed method design: quantitative phase with 402 participants and qualitative phase with 16 participants in two focus groups. The participants in the quantitative survey phase completed two questionnaires on the knowledge and perception of CVD and its risk factors. Data from the quantitative cross-sectional survey were analysed using descriptive and inferential statistics. The qualitative data were analysed using content thematic analysis.

RESULTS

We report that 39.1% of the participants had high knowledge whilst 61.9% had low and average knowledge of CVD and its risk factors. Of the participants, 78.1% had a wrong perception of CVD and its risk factors. Participants from faculties of veterinary medicine and basic medical sciences had better knowledge than others who were not medically inclined (F = 16.11; p 0.001). Only participants from the faculty of veterinary medicine had the right perception of CVD and its risk factors. There was no significant difference in knowledge and perception scores between male and female participants. The qualitative study buttressed the results from the cross-sectional survey, where adolescents and young adults highlighted academic stress and poverty as major risk factors for CVD.

CONCLUSION

Adolescents and young adults in this study did not have good knowledge of CVD and its risk factors. They also had a wrong perception about CVD and its risk factors.

Effects of a four-week aerobic exercise programme on depression, anxiety and general self-efficacy in people living with HIV on highly active anti-retroviral therapy

The Human Immunodeficiency Virus (HIV) remains a major public health concern. Depression, anxiety and reduced self-efficacy are common psychological problems experienced by people living with HIV. We investigated the effects of a four-week, supervised aerobic exercise programme on depression, anxiety and self-efficacy of people living with HIV on HAART in Ibadan, Nigeria. A quasi-experimental design was used. Fifty-three eligible participants completed the study and only their data were analysed. The experimental subjects received aerobic exercise training for thirty minutes, three times per week for four weeks, alongside HAART, while control subjects were only on HAART. Depression, anxiety and self-efficacy scores were assessed at baseline and after the fourth week. Descriptive statistics of mean and standard deviation were used to summarise data, and inferential statistics of independent t-test was used to compare data between groups. At the end of the aerobic exercise programme, there was significant improvement in depression (p < 0.001), anxiety (p < 0.001) and self-efficacy scores (p = 0.042) in the experimental group, compared to the control group. More attention should be given to the prevention and management of psychological problems in people living with HIV through the use of aerobic exercise.

Psychometric testing of Ibadan low back pain disability questionnaire

Background

The Ibadan Low Back Pain Disability Questionnaire (ILBPDQ) was developed to meet the need for a LBP treatment outcome measure that was appropriate for the Nigerian culture and environment. The objective of this study was to determine the psychometric properties of ILBPDQ.

Methods

This study used the validation design. One hundred and forty-two participants with LBP (LBPPs) and 142 age and sex-matched participants without LBP (NLBPPs) were included. The LBPPs were recruited consecutively from Physiotherapy clinics of selected tertiary hospitals in the six geopolitical zones of Nigeria. Both LBPPs and NLBPPs completed the ILBPDQ - the LBPPs completed the Numerical Pain Rating Scale (NPRS). The ILBPDQ was completed by 113 LBPPs two days after initial assessment. Sixty-four of the LBPPs received physiotherapy for 5-weeks, after which they were reassessed using ILBPDQ and NPRS.

Results

ILBPDQ score of LBPPs was significantly higher than that of NLBPPs (construct validity) and LBPPs NPRS score correlated significantly with their ILBPDQ score (r = 0.50) at baseline and post intervention (r =0.35) (divergent validity). ILBPDQ scores at baseline and 48 hours later for LBPPs correlated significantly (Intra Class Correlation =0.80) (test re -test reliability). Cronbach's α for ILBPDQ was 0.84 (internal consistency). The postintervention ILBPDQ and NPRS scores for LBPPs were significantly lower than their pre-intervention ILBPDQ scores (responsiveness) and NPRS scores. The changes in ILBPDQ and NPRS scores of the LBPPs correlated significantly (r =0.62) (responsiveness).

Conclusion

The ILBPDQ demonstrated evidence of validity, reliability and responsiveness.

Funding

University of Ibadan Senate Research Grant.

Development and structural validity of a Nigerian culture- and environment-friendly low back pain outcome measure: Ibadan Low Back Pain Disability Questionnaire

Background

Low Back Pain (LBP) is the leading cause of disability globally. Standardized outcome measures for measuring LBP disability exist but none was developed with consideration for the Nigerian culture and environment.

Objective

This study was aimed to develop a Nigerian culture- and environment-friendly LBP scale, the Ibadan Low Back Pain Disability Questionnaire (ILBPDQ).

Methods

Items on ILBPDQ were devised from literature review, interview of patients (231 consecutively-sampled patients with chronic non-specific LBP) and 12 professionals experienced in LBP management and were contentvalidated. The first draft of the questionnaire underwent pretesting twice among individuals with chronic non-specific LBP (n=35 and 114 respectively), factor analysis and experts' reviews to produce the final version.

Results

The final scale comprised 18 items with a two-factor structure (common Activity of Daily Living [ADL] and culture-specific ADL). It has eigen value ≥ 1 and explained 60% of variance. Items on ILBPDQ covered important constructs relevant to an average Nigerian patient with LBP.

Conclusion

A scale for assessing disability in LBP is made available for use in Nigeria and similar populations.

Funding

None declared

Factors influencing the use of outcome measures in knee osteoarthritis: A mixed method study of physiotherapists in Nigeria

Background: Osteoarthritis (OA) of the knee constitutes a significant proportion of musculoskeletal disorders managed in physiotherapy clinics worldwide. Best practice guidelines in the management of OA ensure the use of outcome measures. Aim: This study explored the factors influencing the use of outcome measures in management of patients with knee OA among physiotherapists in southwestern Nigeria. Methods: Mixed method design was used that involved a cross-sectional survey of 77 purposively selected physiotherapists and a focus group discussion with another 6 physiotherapists. Results: Participants (48 males, 29 females) were aged 35.3 ± 7.3 years. Fifty-two (67.5%) participants reported the use of outcome measures in the treatment of the patients with knee OA. The perceived barriers reported were lack of time/heavy workload (55.9%); lack of standardization of outcome measures (45%); lack of motivation (36.4%); and nonavailability of outcome measures in the clinic (36.4%). Reported perceived facilitators include interest/need to track patient's progress and ethical practice (87.1%); familiarity with outcome measures (87.0%); and understanding of the benefits of using outcome measures (87.0%). Conclusion: There is a need to establish good organizational structure focusing on the use of outcome measures in practice and development of a concessional toolkit of short and easily applicable instruments with user description.

Cross-cultural adaptation, content validation, and reliability of the Nigerian Composite Lifestyle CVD Risk Factors Questionnaire for adolescents among Yoruba rural adolescents in Nigeria

BACKGROUND

Assessment of lifestyle risk factors must be culturally- and contextually relevant and available in local languages. This paper reports on a study which aimed to cross culturally adapt a composite lifestyle cardiovascular disease (CVD) risk factors questionnaire into an African language (Yoruba) and testing some of its psychometric properties such as content validity and test retest reliability in comparison to the original English version.

METHODS

This study utilized a cross sectional design. Translation of the English version of the questionnaire into Yoruba was undertaken using the guideline by Beaton et al. The translated instrument was presented to 21 rural adolescents to assess comprehensibility and clarity using a sample of convenience. A test retest reliability was conducted among 150 rural adolescents using a purposive sampling. Data was analyzed using intraclass correlation (ICC ) model 3, Cohen kappa statistics and prevalence rates.

RESULTS

ICC ranged between 0.4-0.8. The Yoruba version was completed 15-20 minutes and was reported to be culturally appropriate and acceptable for rural Nigerian adolescents.

CONCLUSIONS

The Yoruba translation of the Nigerian composite lifestyle risk factors questionnaire performs at least as well as the original English version in terms of content validity and reliability. It took a shorter time to complete therefore may be more relevant to rural adolescents.

Nigerian (Yoruba) version of Disabilities of the Arm, Shoulder and Hand questionnaire (DASH-Y): Cross-cultural adaptation and initial validation

Introduction

The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a widely used upper extremity outcome measure. However, it is yet to be translated into any of the major languages in Nigeria, thus limiting its utility in the Nigerian clinical setting. The aim of this study was to cross-culturally adapt the DASH questionnaire into Yoruba, a major Nigerian language and investigate its initial validation.

Methods

The English version of DASH was adapted into Yoruba through forward–back translations, experts’ committee meetings, pretesting and cognitive debriefing interview in accordance with the guidelines recommended by the developers of DASH. Fifty-two purposively selected patients with upper extremity musculoskeletal disorders participated in a cross-sectional survey. Factor analysis was performed to ensure structural validity of Yoruba version, and construct validity was investigated with Spearman rank correlation coefficient.

Results

The Yoruba version of DASH has semantic, idiomatic, linguistic and conceptual equivalence with the English DASH. Thirty linear components were identified within the data set. Principal factor analysis of the Yoruba DASH revealed a seven factor scale, having fulfilled all the necessary conditions. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.61, and Barlett’s test of Sphericity was adequate and significant (χ2 (1066) = 435, p = 0.001). Significant correlation (r = 0.994, p = 0.001) exists between scores obtained on English and Yoruba versions of DASH.

Conclusion

A cross-culturally adapted, valid Yoruba version of DASH is available for use in in south western Nigeria and other similar populations.

Are lifestyle cardiovascular disease risk factors associated with pre-hypertension in 15-18 years rural Nigerian youth? A cross sectional study

BACKGROUND

Cardiovascular disease (CVD) is a public health concern worldwide. Hypertensive heart disease is predominant in Nigeria. To effectively reduce CVD in Nigeria, the prevalence of, and factors associated with, pre-hypertension in Nigerian youth first need to be established.

METHODS

A locally-validated CVD risk factor survey was completed by 15-18 year olds in a rural setting in south-west Nigeria. Body Mass Index (BMI), waist-hip ratio and systolic and diastolic blood pressure was measured. Putative risk factors were tested in gender-specific hypothesized causal pathways for overweight/obesity, and for pre-hypertension.

RESULTS

Of 1079 participants, prevalence of systolic pre-hypertension was 33.2 %, diastolic pre-hypertension prevalence approximated 5 %, and hypertension occurred in less than 10 % sample. There were no gender differences in prevalence of pre- hypertension, and significant predictors of systolic pre-hypertension (high BMI and older age) were identified. Considering high BMI, older age was a risk for both genders, whilst fried food preference was female-only risk, and low breakfast cereal intake was a male-only risk.

CONCLUSION

Rural Nigerian adolescents are at-risk of future CVD because of lifestyle factors, and high prevalence of systolic pre-hypertension. Relevant interventions can now be proposed to reduce BMI and thus ameliorate future rural adult Nigerian CVD.

High prevalence and clustering of modifiable CVD risk factors among rural adolescents in southwest Nigeria: implication for grass root prevention

Background

Cardiovascular disease (CVD) is an immense global problem with serious economic and social consequences. Modifiable risk factors for CVD have been identified internationally in adolescents where early intervention programs have the potential to reduce CVD risk on individual and population levels. In developing countries such as Nigeria, little is known about the prevalence of modifiable CVD risk factors among adolescents especially in the rural areas.

Methods

This paper reports on a cross-sectional survey of modifiable CVD risk factors among rural adolescents in South-West Nigeria. All 15–18 years old adolescents in all the schools at Ibarapa central local government were approached and all those who assented and consented to participate in the study were involved. A total of 1500 adolescents participated in the study. Measurements of CVD risks factors taken were; smoking, physical activity, alcohol, dietary pattern using a questionnaire developed by authors. Other CVD risk factors such as waist hip ratio and BMI were taken using standardized instruments. Data were analyzed using STATA version 12.

Results

Data from 1079 adolescents (56.5 % males and 53.5 % females) were analyzed. Mean age of males was 16.4 ± 1.14 years and mean age for females was 16.29 ± 1.13 years. Adolescents showed clustering of CVD risk factors with about 72 % having between two and four risk factors. A total of 102 clustering patterns were reported. The most common clustering pattern (19.6 %) included high animal lipid and salt diet.

Conclusion

There is high level and clustering of CVD risk factors among rural adolescents in Southwest Nigeria. The most common clustering pattern was biased towards dietary factors. The high prevalence of CVD risk factors among rural adolescents in Southwest Nigeria suggests that urgent primary prevention programs are required to prevent the next generation of Nigerians from suffering of CVD.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-2028-3) contains supplementary material, which is available to authorized users.

Development, initial content validation and reliability of Nigerian composite lifestyle CVD risk factors questionnaire for adolescents

BACKGROUND

Cardiovascular disease risk (CVD) factors affect every age category including adolescents in developing nations. Prevention strategies are effective only when there are epidemiological data for the targeted populations. The collection of such data is only made easy with composite lifestyle CVD risk factors measures that are culturally sensitive and acceptable among the target populations.

OBJECTIVE

The objective of the study was to develop a culturally sensitive and friendly composite lifestyle CVD risk factors questionnaire for adolescents in Nigeria.

METHODS

A systematic review was conducted to identify existing, published questionnaires from which items could be selected. Content and face validation were conducted using an expert panel and a sub-sample of the target population. Data was analyzed qualitatively and reliability was assessed using intra-class correlation and Kappa statistic.

RESULTS

Based on the comments received from experts, the questions were restructured, simplified, clarified, formatted, some questions were added and expert reached a consensus. Kappa showed fair to moderate agreement in 65% of the questions and perfect agreement in one question.

CONCLUSION

The CVD risk factors questionnaire has acceptable content validity and reliability and should be used to assess CVD risk factors among adolescents in Nigeria.

Ergonomic suitability of educational furniture and possible health implications in a university setting

Ergonomically unsuitable school furniture is frequently considered one of the major causes of severe posture problems in adulthood. This study was designed to determine the ergonomic suitability of educational furniture in the lecture theaters at the University of Ibadan to serve as a case study. Sample of convenience was used to select participants for this study. The lecture theaters were selected based on their capacity, design, and dimension. A total of 240 students (120 males and 120 females) participated in this study. The ergonomic suitability of lecture theaters was determined by analyzing the mismatches between student anthropometric dimensions and furniture dimensions, and also by analyzing the design and orientation of the lecture theaters. The data were analyzed using descriptive statistics of mean, standard deviation, range, and median. The results showed that there was a significant difference in height between males and females but no significant difference between other anthropometric variables measured. About 20% of the participants had a fitting seat height, while seat height was unsuitable for the remaining 80.4%. On the other hand, 23.3% had a fitting seat depth, while it was unsuitable for 76.7% of the participants, and 99.6% of the participants had fitting desk clearance but 0.4% found it unsuitable. A total of 25.8% of the participants had a fitting desk height, while 74.2% of the students found it unsuitable. It was concluded that the furniture in the lecture theaters at the university studied was not ergonomically suitable for the students. Hence it is recommended that further studies, including more universities across a wide spectrum of society, should be performed to determine the effect of furniture on student health, and the need to adopt the use of adjustable furniture in lecture theaters to prevent health hazards that may occur secondary to the use of unsuitable furniture.

Sexual dysfunction in Nigerian stroke survivors

BACKGROUND

Over three-quarters of stroke survivors experience disruption of sexual functioning. Studies reporting poststroke sexual function of Nigerian patients are few.

OBJECTIVES

This survey reports sexual dysfunction in Nigerian stroke survivors, and determines the influence of sociodemographic, clinical and psychological factors on the dysfunction.

METHODS

Participants were 77 stroke survivors (60 males; 17 females) recruited consecutively from a teaching hospital. Participants completed the Beck Depression Inventory, Stroke Specific Quality of Life Scale and post-stroke sexual function questionnaire. Participants' motor ability was rated on the Modified Motor Assessment Scale. Data were analysed using Chi square test and Mann-Whitney U test (alpha level set at 0.05).

RESULTS

Participants were aged 55.2 ± 10.8 (28-79) years. Most (94.8%) participants reported a dysfunction in sexual function. Decline in libido and coital frequency were reported by >70% and in erection, ejaculation and orgasm by >60% of participants. Participants' with erectile dysfunction were significantly older than those without (U=267.0; p=0.02). Depression, quality of life, willingness to have sex, general attitude to sex and ability to express sexual feelings had significant influence on sexual dysfunction reported by participants (p<0.05).

CONCLUSION

Our findings suggest that sexual dysfunction is common among Nigerian stroke survivors and it is mostly associated with psychological factors.

Attitude and practices of obstetricians and gynecologists towards involvement of physiotherapists in management of obstetric and gynecologic conditions

Background:

The role of physiotherapists in obstetrics and gynecology is pivotal. However, utilization of their capabilities depends on the cooperation of other health professionals in discharging their services to patients, who are the focus of the team. This study was designed to assess the attitude of obstetricians and gynecologists in south-western Nigeria towards involving physiotherapists in the management of patients with obstetric and gynecologic conditions.

Methods:

This was a descriptive survey of obstetricians and gynecologists from seven hospitals in south-western Nigeria. Sixty-seven participants, including 41 senior registrars and 26 consultants, participated in the study. More consultants (73.1%) than senior registrars (46.3%) had a good knowledge of the role of physiotherapists in obstetric and gynecological practice. All participants had general knowledge of the role of physiotherapists in obstetrics and gynecology, but a limited knowledge of specific conditions amenable to treatment by physiotherapists. More senior registrars had a better attitude (73.2%) than consultants (53.8%) towards involvement of physiotherapists in their practice, and 94.0% of the obstetricians and gynecologists utilized the services of physiotherapists, with referral of patients (56.7%) mainly to physiotherapists working in general/state hospitals.

Conclusion:

There is a need for better interaction and communication between physiotherapists and obstetricians and gynecologists, which could be achieved through clinical meetings, seminars, and workshops.

Physical activity levels of senior secondary school students in Ibadan, western Nigeria

BACKGROUND

Inactivity and low levels of physical activity are predisposing factors to many chronic diseases such as heart disease which are showing an increase in prevalence in Sub-Saharan Africa generally and Nigeria in particular. Physical activity levels have been found to be decreasing among young people in many countries around the world resulting in a state where young people are not found to be sufficiently active in order to safeguard their present and future health and well-being.

OBJECTIVE

This study was designed to assess the physical activity levels of students in government-owned senior secondary schools located in the South-east Municipality, Ibadan, Western Nigeria, and its association with their physical characteristics and level of study.

SUBJECTS AND METHOD

Multi-stage sampling was used to select participants from senior secondary schools. A modified version of the self-reported physical activity questionnaire for adolescents (PAQ-A) validated for Nigerian adolescents was used for data collection. One thousand and two questionnaires were distributed to the respondents. The questionnaire was designed to collect the respondents' demographic data and assess their physical activity levels. One thousand (1000) questionnaires were completed. Two of the 1002 questionnaires were not properly completed and were therefore discarded. The data were analysed using descriptive statistics of mean, standard deviation and cumulative percentage. A table was used to present the results. The chi-square test was used to determine the association between physical activity levels and the physical characteristics of the participants. Independent t-test was used to determine the difference in the physical activity levels of the participants.

RESULTS

The results indicated that 38% of the participants engaged in low activity levels, 58.8% in moderate activity levels and 3.2% in high activity levels. Furthermore, physical activity levels (PAL) had significant positive associations with the physical characteristics of the participants and males appeared to be significantly more active than females.

CONCLUSION

Adolescents are not involved in adequate physical activities that could safeguard their present and future health and well-being. Therefore, it is recommended that there should be educational programmes in place which emphasize the benefits of exercise, primordial prevention of future chronic and cardiovascular diseases and also the incorporation of physical education in the secondary school curriculum.

Profile and predictor of health-related quality of life among hypertensive patients in south-western Nigeria

Background

The health-related quality of life (HRQOL) of hypertensives may be influenced by blood pressure, adverse effects of drugs used to treat hypertension, or other factors, such as the labelling effect, or beliefs and attitudes about illness and treatment. There is paucity of information on the determinants of HRQOL among black hypertensives especially in the developing countries such as Nigeria. This study describes the HRQOL and its determinants among black patients diagnosed and treated for Hypertension in Nigeria.

Methods

The study was a cross sectional in design that involved 265 hypertensive patients receiving treatment at the medical outpatient unit of the Federal Medical Centre Abeokuta, Nigeria. They were all consecutive patients that presented at the hospital during the period of the study who meet the inclusion criteria and consented to participate in the study. Demographic data, disease characteristics such as symptoms and signs and recent drug history were obtained from the patients and their hospital records as documented by the physician. The SF-36 questionnaire was administered once by interview to the participants to measure their HRQOL. Descriptive statistics was used in summarizing the demographic data and hypertension related histories of the participants. Multiple linear regression was used to model for the influence of socio demographic and clinical variables of the hypertensives on their HRQOL.

Results

Physical functioning domain mean score was far below average (33.53 ± 29.65). Role physical and role emotional domains were a little above average (54.7 ± 40.4, 51.1 ± 40.6 respectively). Role Physical (p = 0.043), Role Emotional (p = 0.003), Vitality (p = 0.014) and Mental Health (p = 0.034) domain mean scores for patients with controlled BP were significantly higher than patients with uncontrolled BP. The overall HRQOL was significantly better in the group of hypertensives with controlled blood pressure (p = 0.014). Increasing blood pressure (p = 0.005) and symptom count (p < 0.001), the presence of stroke (p = 0.008) and visual impairment (p = 0.015) were significant negative predictors of the overall HRQOL.

Conclusion

This study provides evidence for a model that links patients' status with regard to biology (blood pressure), symptoms, and functionality (HRQOL) and may prove useful in guiding follow-up of patients who receive treatment for hypertension. Identification of patient's symptoms, blood pressure, complication/comorbidity and changes in functioning may help clinicians increase their effectiveness in helping patients maintain adherent behaviour with drug and non drug interventions in chronic diseases such as hypertension.

Prevalence of low back pain among peasant farmers in a rural community in South West Nigeria

This study is a survey conducted in Iju-Odo rural community of Ondo State in South West Nigeria to determine the prevalence and risk factors for low back pain amongst peasant farmers. Five hundred peasant farmers were selected using a multi-stage sampling technique. A questionnaire was administered which sought information on demographic characteristics, presence of low back pain in the last 12 months prior to the time of the study and the duration, severity of low back pain and its effect on farming activity. The five hundred peasant farmers that participated in this study were 276 men (55.2%) and 224 women (44.8%). Three hundred and sixty two peasant farmers (72.4% of the population) had low back pain in the last 12 months prior to the time of this study, of which two hundred and three (73.5%) were males and one hundred and fifty nine (71.0%) were females peasant farmers having low back pain. The nature of onset of low back pain was that of gradual onset in 57.5%. One hundred and eighty-eight (51.9%) respondents indicated that low back pain reduced their farming workload, while one hundred and twenty four (34.3%) respondents were prevented from going to farm because they could not walk, resulting in 675 work days being lost by one hundred and twenty one (24.2%) peasant farmers in the last one-year with a mean of 5.6 days lost. This study concluded that low back pain prevalence is high among peasant farmers, with higher prevalence in males compared with females (P<0.05). The prevalence also increased with age (P<0.05). Years of farming was found to have a significant influence on the prevalence of low back pain (P<0.05) with prevalence of low back pain increasing as years of farming increases. Low back pain was found to be a cause of work absenteeism in this working population.