Chronic pain in the community: A survey in a township in Mthatha, Eastern Cape, South Africa

Background: Comprehensive information is needed on the epidemiology and burden of chronic pain in the population for the development of appropriate health interventions. This study aimed to determine the prevalence, severity, risk indicators and responses of chronic pain among adults in Ngangelizwe, Mthatha, South Africa. Method: A cross-sectional survey utilising structured interviews of a sample of adult residents was used. Interviews elicited information on socio-demographic characteristics, general health status, and the prevalence, duration, frequency, severity, activity limitation and impact of chronic pain. Results: More than 95% (n = 473) of the sampled adults participated in the study. Of these, 182 [38.5%, 95% confidence interval (CI): 36.3-42.5%] reported chronic pain in at least one anatomical site. The most common pain sites were the back and head. The median pain score was 5 on a scale of 0 to 10 [interquartile range (IQR) = 4-7] and the median number of sites of pain was 1 (IQR = 1-2). Female gender [odds ratio (OR) = 2.6, 95% CI: 1.7-3.9] and being older than 50 years of age (OR = 3.5, 95% CI: 2.6-4.1) were identified as risk indicators for chronic pain in the sample. Over 65% of respondents reported that they self-treated; 92.1% had consulted with a doctor or nurse, 13.6% consulted a traditional healer, and 34.5% consulted a pharmacist because of their pain. Despite this, over 50% reported that relief of their pain was transient. Conclusion: Chronic pain is a common general complaint in this community, but there is a need for focused attention on women and the elderly.Department of HE and Training approved lis

Pain as a reason for primary care visits: cross-sectional survey in a rural and periurban health clinic in the Eastern Cape, South Africa

Background: The burden of pain in primary care has not been described for South Africa. This study aimed to determine the prevalence of pain in primary care and to characterise pain among adult patients attending a rural and a periurban clinic in the Eastern Cape (EC) Province. Method: cross-sectional descriptive survey was conducted among adult patients attending a rural and periurban clinic over four days. Consecutive patients were asked whether they were in the clinic because of pain and whether the pain was the major reason for their visit. Pain was characterised using an adaptation of the Brief Pain Inventory and the Pain Disability Index. The prevalence percentage and the 95% confidence interval (CI) of pain were estimated, and the relationship with demographic variables was determined at a significance level of P < 0.05. Results: Seven hundred and ninety-six adult patients were interviewed, representing a response rate of 97.4%. Almost three-quarters (74.6%; 95% CI: 63.2-81.4%) reported visiting the clinic because of pain. Pain was the primary reason for 393 (49.4%; 95% CI: 32.1-61.0%) visits and was secondary in 201 (25.3%; 95% CI: 12.8-33.7%) visits. The common sites of pain were the head, back and chest. The median pain score was eight on a scale of 0-10 (interquartile range: 6-8). Respondents experienced limitations in a number of activities of daily living as a result of pain. Conclusion: Pain is a central problem in public primary care settings in the EC Province and must therefore be a priority area for primary care research. Strategies are needed to develop to improve pain management at primary care level in the province.Department of HE and Training approved lis

Pain as a reason for primary care visits: Cross-sectional survey in a rural and periurban health clinic in the Eastern Cape, South Africa

Background: The burden of pain in primary care has not been described for South Africa. This study aimed to determine the prevalence of pain in primary care and to characterise pain among adult patients attending a rural and a periurban clinic in the Eastern Cape (EC) Province.Method: A cross-sectional descriptive survey was conducted among adult patients attending a rural and periurban clinic over four days. Consecutive patients were asked whether they were in the clinic because of pain and whether the pain was the major reason for their visit. Pain was characterised using an adaptation of the Brief Pain Inventory and the Pain Disability Index. The prevalence percentage and the 95% confidence interval (CI) of pain were estimated, and the relationship with demographic variables was determined at a significance level of P &lt; 0.05.Results: Seven hundred and ninety-six adult patients were interviewed, representing a response rate of 97.4%. Almost three-quarters (74.6%; 95% CI: 63.2-81.4%) reported visiting the clinic because of pain. Pain was the primary reason for 393 (49.4%; 95% CI: 32.1-61.0%) visits and was secondary in 201 (25.3%; 95% CI: 12.8-33.7%) visits. The commonsites of pain were the head, back and chest. The median pain score was eight on a scale of 0-10 (interquartile range: 6-8). Respondents experienced limitations in a number of activities of daily living as a result of pain.Conclusion: Pain is a central problem in public primary care settings in the EC Province and must therefore be a priority area for primary care research. Strategies are needed to develop to improve pain management at primary care level in the province

Chronic pain in the community: a survey in a township in Mthatha, Eastern Cape, South Africa

Background: Comprehensive information is needed on the epidemiology and burden of chronic pain in the population for the development of appropriate health interventions. This study aimed to determine the prevalence, severity, risk indicators and responses of chronic pain among adults in Ngangelizwe, Mthatha, South Africa.Method: A cross-sectional survey utilising structured interviews of a sample of adult residents was used. Interviews elicited information on socio-demographic characteristics, general health status, and the prevalence, duration, frequency, severity, activity limitation and impact of chronic pain.Results: More than 95% (n = 473) of the sampled adults participated in the study. Of these, 182 [38.5%, 95% confidence interval (CI): 36.3-42.5%] reported chronic pain in at least one anatomical site. The most common pain sites were the back and head. The median pain score was 5 on a scale of 0 to 10 [interquartile range (IQR) = 4-7] and the median number of sites of pain was 1 (IQR = 1-2). Female gender [odds ratio (OR) = 2.6, 95% CI: 1.7-3.9] and being older than 50 years of age (OR = 3.5, 95% CI: 2.6-4.1) were identified as risk indicators for chronic pain in the sample. Over 65% of respondents reported that they self-treated; 92.1% had consulted with a doctor or nurse, 13.6% consulted a traditional healer, and 34.5% consulted a pharmacist because of their pain. Despite this, over 50% reported that relief of their pain was transient.Conclusion: Chronic pain is a common general complaint in this community, but there is a need for focused attention on women and the elderly.Keywords: chronic pain, community-based survey, epidemiology, Mthatha, Eastern Cape, South Afric

Sherwood Anderson and the Art of American Autobiography

This paper will consider autobiography from these various perspectives in search of a means of evaluation of autobiography in terms of the restrictions and potentials of the genre. The intention, the truth, the theme, or the formal value--alone-- are insufficient for a valid conception of the genre. Their interaction is what makes some autobiographies more than historical curiosities--what make them successful and enduring works of art. This study of American autobiography will focus on Sherwood Anderson\u27s autobiography and autobiographical novel, A Storyteller\u27s Story and Tar. Anderson deals with the familiar themes of American literature and American autobiography : the individual self and the American experience, freedom and determination, growth and success

Sherwood Anderson and the Art of American Autobiography

This paper will consider autobiography from these various perspectives in search of a means of evaluation of autobiography in terms of the restrictions and potentials of the genre. The intention, the truth, the theme, or the formal value--alone-- are insufficient for a valid conception of the genre. Their interaction is what makes some autobiographies more than historical curiosities--what make them successful and enduring works of art. This study of American autobiography will focus on Sherwood Anderson\u27s autobiography and autobiographical novel, A Storyteller\u27s Story and Tar. Anderson deals with the familiar themes of American literature and American autobiography : the individual self and the American experience, freedom and determination, growth and success