Article Text
Abstract
Introduction Many people in Nigeria are living with disability due to chronic low back pain (CLBP), with the greatest burden accounted for by people living in rural Nigeria. However, factors associated with disability in rural Nigeria have not yet been established. We investigated the biomechanical and psychosocial predictors of CLBP disability in a rural Nigerian population.
Methods A cross-sectional study of adults with non-specific CLBP recruited from rural communities in Enugu State, South-eastern Nigeria. Measures of self-reported and performance-based disability, pain intensity, anxiety and depression, coping strategies, social support, occupational biomechanical factors, illness perceptions and fear avoidance beliefs were collected by trained community health workers. We used univariate and multivariate analyses.
Results 200 individuals were recruited. Psychosocial factors were the most important factors associated with CLBP disability, and accounted for 62.5% and 49.1% of the variance in self-reported and performance-based disability, respectively. The significant predictors of self-reported disability were: illness perceptions (β=0.289; p<0.0005), pain intensity (β=0.230; p<0.0005), catastrophising (β=0.210; p=0.001), fear avoidance beliefs (β=0.198; p=0.001) and anxiety (β=0.154; p=0.023). The significant predictors of performance-based disability were: illness perceptions (β=0.366; p<0.0005), social support (β=0.290; p<0.0005), fear avoidance beliefs (β=0.189; p<0.01) and female gender (β=0.184; p<0.01). Illness concern was the most salient dimension of illness perceptions predicting self-reported and performance-based disability.
Conclusions These results provide evidence which can be used to inform the development of interventions to reduce CLBP disability in rural Nigeria, and may have relevance in other rural African contexts.
- other diagnostic or tools
- epidemiology
- arthritis
- community-based survey
- cross-sectional survey
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Footnotes
Contributors CNI-C, ELG and IOS conceived and designed the study. CNI-C and CNO collected the data. CNI-C inputed the data into software. CNI-C analysed and interpreted the data, cross-checked by BC and ELG. CNI-C drafted the initial manuscript. All authors contributed to a revised edition of the manuscript. CNI-C prepared the final manuscript.
Funding University of Nigeria/Schlumberger faculty for the future, The Netherlands.
Competing interests None declared.
Ethics approval Research Ethics Committees of King’s College London (Ref: BDM/13/14-99) and University of Nigeria Teaching Hospital (Ref: UNTH/CSA/329/Vol.5).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.