Doctoral Degrees (Physiotherapy)

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Browsing Doctoral Degrees (Physiotherapy) by Author "Nkhata, Loveness A."

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    The effect of a back pain campaign on back beliefs, coping strategies and participant activation for nurses in Lusaka, Zambia
    (Stellenbosch : Stellenbosch University, 2021-03) Nkhata, Loveness A.; Louw, Quinette .A.; Ernstzen, Dawn V.; Brink, Yolandi; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Physiotherapy.
    ENGLISH SUMMARY : Introduction: The prevalence of back pain in nurses globally is high and ranges from 55-84%. In Africa, the prevalence of back pain reported in different studies among nurses ranges from 33%-73.5%. While, in Zambia the reported prevalence for back pain among nurses is 58.3%. Nurses are exposed to labour intensive, repetitive tasks which are often performed in stressful postures. Furthermore, the high occurrence of back pain in nurses is of major concern because it decreases working efficiency and affects the safety of the patients and healthcare outcomes. Aim: The overall aim of this study was to design and assess the effects of a cross-culturally validated back pain campaign on back beliefs, coping strategies and participant activation for nurses in Lusaka, Zambia. Research setting: The research was done in Lusaka at Chawama, Chingwere, Chilenje, Chelstone and Kayama first level hospitals. The hospitals provide various health services and public health programmes at community level. The hospitals were purposefully selected as study sites because of the substantial number of nurses working at the centres and their similarity in operation level and system compared to the other centers. Methodology: Three studies, with different methodologies based on the principle of evidence-based practice (EBP), were carried out as follows: Study 1: A systematic review of self-management education campaigns on back pain, with the aim to retrieve and synthesise the content, mode, and duration of published evidence based on lower back pain (LBP) campaigns, and to describe the outcomes and the effectiveness of the campaigns. Study 2: Cross-cultural validation and formulation of key evidence-based back pain messages for nurses in Zambia. The aim was to ascertain which local contextual factors could influence the understanding, feasibility and uptake of evidence-based messages reported in published campaigns. In addition, it was aimed to design the campaign based on the information obtained in Study 1 and ascertain content validation with experts. Study 3: A pre-post quasi-experimental study to evaluate the effectiveness of a cross-cultural validated back pain campaign for nurses in Lusaka, Zambia, regarding on-participant activation and back beliefs as key outcomes. Results: Articles reviewed (Study 1) had back campaigns conducted in the general population. It was reported that participant activation, awareness, and satisfaction about back pain improved in the general population as an overall effect of the campaigns. Messages delivered during the campaigns were cited as having been helpful in decreasing effects of pain disability and in improving work outcomes by influencing population attitudes and beliefs. Fourteen back pain messages were retrieved, synthesised (Study 1) and cross-culturally validated for implementation among nurses in Zambia (Study 2). All the back pain messages except for one (“back pain is rarely caused by a dangerous illness”) were adapted for use among nurses in Lusaka, Zambia. Effects of the back pain campaign on back beliefs and participant activation for self-management of back pain among nurses in Lusaka, Zambia, showed no significant differences, even though positive trends were observed in many outcomes such as the participant activation measures, where positive trends were recorded in all the 11 items when more people agreed with the statements after the campaign (Study 3). Positive trends were also observed in participants’ coping strategies, use of pain medication, frequency of doctor visits and number of sick-leave days. Conclusion: The back campaign had an influence on the attitudes towards back care goals albeit, not significant, and promoting healthy behaviours. In addition, the campaign demonstrated an effective approach that could decongest the healthcare system and minimise healthcare costs because of the reductions in the number of sick-leave days, frequency of doctor visits and use of pain medication during back pain experiences. Recommendation: The back pain campaign was an effective strategy to advance self-management of back pain in the nursing profession. Their work-setting is also a good arena for implementing practical strategies aimed at promoting health and minimising the effects of back pain experiences.