Belief, Knowledge and Perception of Causes of Low Back Pain among Rural and Urban Dwellers in a Nigerian City

Research Article

Phys Med Rehabil Int. 2021; 8(5): 1193.

Belief, Knowledge and Perception of Causes of Low Back Pain among Rural and Urban Dwellers in a Nigerian City

Ojoawo AO* and Ajibade AJ

Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Nigeria

*Corresponding author: Adesola Ojo Ojoawo, Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile Ife, Nigeria

Received: November 26, 2021; Accepted: December 23, 2021; Published: December 30, 2021

Abstract

The study examined the belief, knowledge and perception of causes of low back pain among rural and urban dwellers in Nigeria. One hundred and ninety-two (192) participants (99 from rural and 93 from urban community) were recruited for this study. A modified questionnaire from a previous similar study from India was administered to each of the participants to complete. The completed questionnaire was collected immediately. Data was analyzed using descriptive and inferential statistics, alpha level, was set at 0.05.

Result showed that one hundred and thirty-three (71 urban and 62 rural) participants (133, 69.3%) perceived that pile was very important as a cause of low back pain. Considering the fear avoidance belief, 149 (69 urban and 80 rural) 77.6% agreed that low back pain get progressively worse in life. With regard to the knowledge of participants, 72 (45%) participants were able to answer two or three questions correctly and so were termed partially knowledgeable. Nature of work has significant association with each of the following perception, pile (X²=203.38) and poor mattresses (X²=237.830) as major cause of low back pain.

This study concluded that many residents in Ile-Ife are not adequately knowledgeable about LBP and had negative perception and beliefs regarding low back pain (LBP).

Keywords: Nigeria; Rural; Urban; Low back pain; Knowledge

Introduction

The Health seeking behavior of people who are suffering from musculoskeletal pain varies from one culture to another and cultural factors have been reported to have influence on attitude and perception to illnesses, such as defining what is regarded as “normal” and “abnormal”; determining the cause of the illness, decision making control in healthcare settings and impacting on health setting behavior [1]. The general public, including patients living with LBP, lack knowledge about the causes and contributing factors of LBP [2]. The biopsychosocial model of LBP acknowledges that cognitive, emotional, psychosocial, behavioral physical and social factors interact to perpetuate pain and should be addressed in integrated multimodal interventions [3]. In high-income countries, treatments have targeted the biopsychosocial factors associated with pain persistence and chronic low back pain (CLBP) disability in those contexts [4]. Psychological distress, fear avoidance beliefs, catastrophizing and illness perceptions have been associated with functional disability among LBP patients in such countries [4].

Most patients living with LBP lack knowledge and have negative perceptions regarding causes and contributing factors of LBP [5]. This is despite various treatment guidelines for LBP proposing that besides physical treatment and exercises, advice and health education should be part of the treatment plan [6]. Health education will not only enhance peoples’ knowledge about pain, but might also change their negative attitudes and beliefs regarding their pain, and thereby promote the achievement and the desired clinical outcomes [7]. This in turn may decrease the number of patients living with acute LBP and transitioning to living with chronic LBP [8].

In the rural African contexts where beliefs, culture and common activities such as fetch water, farming and carrying heavy objects prevail, combined with high levels of poverty these may increase the consequences of living with LBP [9]. The choice of management of LBP has been observed to be of broad mainly because of in adequate knowledge about the causes of LBL which has led to some uncertainties [10]. Most patients living with LBP lack knowledge and have negative perceptions regarding causes and contributing factors of LBP [5]. This is despite various treatment guidelines for LBP proposing that besides physical treatment and exercises, advice and health education should be part of the treatment plan [6].

The study was designed to examine the attitude, knowledge and perception of both urban and rural community dwellers in Ile Ife about the causes of low back pain.

Methodology

Respondents

The respondents for this study were recruited among residents in Iyanfoworogi and Odo-Ogbe, Osun State.

Inclusion criteria

The respondents that participated in this study met the following criteria:

• Be a resident of Iyanfoworogi or Odo-Ogbe community

• Respondents must be thirty (30) years old and above.

Exclusion criteria

• Residents with medical challenges e.g. loss of eyesight.

• Residents who did not give their consent.

• Non-literacy in English or Yoruba.

Research design

The study was a cross-sectional survey.

Sampling technique

Respondents were selected using purposive sampling technique.

Sample size determination

The sample size was determined by using the formula for calculating sample size to estimate a proportion at a given precision level posited by Lwamga and Lemeshow [11].

Where,

N=The minimum sample size

Z0=Standard normal deviate of 0 at 95% confidence level (i.e. probability of making a type 1 error)=1.96.

100(1-a)²%=Confidence level

P=Anticipated population proportion.

d=Absolute precision required on either side of the proportion (in percentage points).

Using this proportion;

Anticipated population proportion 10%, Confidence level 95%, Absolute precision (5%).

P=0.50

d=0.05

N=99.8

Hence, 99.8 * 2 = 199.6 [12]

Therefore, a total number of 192 respondents were enrolled in this study (99 respondents in Iyanfoworogi and 93 respondents in Odo-Ogbe.

Site of study

The study was conducted in Iyanfoworogi, and Odo-Ogbe, Osun State.

Instruments

The instrument used for this study was a modified questionnaire (back belief questionnaire by Symonds et al (1996) and Pain Attitude Questionnaire [13] used in a previous study by Tarimo and Diener [14].

The questionnaire was divided into four sections:

Section A: Examined personal information such as age gender occupation; Section B: Assessed information on history of back pain; Section C: Collated information on knowledge beliefs and attitudes towards low back pain; Section D: Evaluated response about expected recovery period following low back pain.

Procedure

Ethical approval was obtained from Health Research and Ethics Committee (HREC) of the Institute of Public Health, Obafemi Awolowo University, Ile-Ife. The purpose and procedures of the research work was explained to each of the respondents before they took part in the research and their consent was obtained prior to data collection. Each participant was given a copy of questionnaire to complete, the copy was collected as soon as it was completed.

Data analysis

Data was analyzed using descriptive statistics of mean, standard deviation, percentage and frequency. Chi Square was used to test the association of the variables.

Result

See Table 1-2c.