Central poststroke pain : its profile among stroke survivors in Kano, Nigeria

Background. Central poststroke pain (CPSP) caused by sensory dysfunction of central origin is a disabling condition that significantly affects the quality of life of stroke patients. Aim. The aim of this study is to determine the clinical profiles and pattern of CPSP among stroke patients in Kano, Nigeria. Methods. The study was a cross-sectional design involving stroke survivors who were >= 18 years old and with no significant cognitive impairment approved by the Research Ethics Committee of Aminu Kano Teaching Hospital. Participants were assessed using diagnostic criteria form, the douleur neuropathique 4 questions (DN4 questionnaire), and Leeds assessment of neuropathic symptoms and signs (LANNS). Results. A total of 120 stroke patients participated in the study, in which 6 (5%) were diagnosed with CPSP occurring within the first 3 months in 50% of the participants. The pain characteristics were mainly moderate (83.3%), burning (62.5%), and continuously experienced (66.7%). The frequently affected parts were extremities or occurring as hemisyndrome. Conclusion. Prevalence of CPSP following stroke is low. The clinical features are variable and can occur at a varied time and different intensities and locations. However, it majorly occurs within the first few months post stroke

Views and experiences of discharged COVID-19 patients in Kano, Nigeria : a qualitative study

Introduction: COVID-19 has spread globally, thereby contributing to substantial hospitalisation rates and morbidity. However, little or no information is available on the experiences of patients with COVID-19 in an African-setting. The study aimed to explore the experiences of patients with COVID-19. Methods: semi-structured interviews were conducted via telephone with eleven individuals who were managed and discharged due to COVID-19. A descriptive phenomenological approach to qualitative research was employed and participants were mainly asked about their experiences before, during and after hospitalisation for COVID-19. Data were analysed using thematic analysis. Results: patients' viewpoints were suggestive of community and secondary transmission of COIVD-19 in the study area. A few participants experienced severe symptoms. Most participants tend to resign their condition to fate; while some displayed unfounded conspiracy theories. Nevertheless, precautionary measures to prevent infection were largely observed. COVID-19 also negatively affected activities of daily living of the participants. Furthermore, the participants were generally satisfied with quality of care provided. However, areas of patients' education, isolation centre set-up and caregiver-patient interaction needed further improvements. Lastly, experience of fear and stigma during post-hospitalisation were common. Conclusion: COVID-19 impacted negatively on the lives of the studied population. However, their experience during hospitalisation was generally positive

Development of culturally sensitive pain neuroscience education materials for Hausa-speaking patients with chronic spinal pain : a modified Delphi study

This study aimed to develop culturally sensitive pain neuroscience education (PNE) materials for Hausa speaking patients with chronic spinal pain (CSP). PNE is a program of teaching patients about pain that has gained considerable attention in research and is increasingly used during physical therapy for patients with chronic pain. It helps in decreasing pain, disability, fear-avoidance, pain catastrophization, movement restriction, and health care utilization among patients with chronic pain. However, existing PNE materials and their application are limited to few languages and cultural inclinations. Due to the variations in pain perceptions, beliefs, and related outcomes among different population groups, culture-sensitive PNE materials addressing these outcomes are warranted. A focus-group discussion comprising 4 experts was used to adapt and develop preliminary PNE materials. Thereafter, an internet-based 3-round modified Delphi-study involving 22 experts ensued. Experts’ consensus/recommendations concerning the content were used in modifying the PNE materials. Consensus was predefined as ≥75% level of (dis)agreement. Eighteen experts completed the Delphi rounds. Nineteen, 18 and 18 experts participated in rounds 1, 2 and 3 respectively, representing 86%, 94% and 100% participation rate respectively. Consensus agreement was reached in every round and content of the materials, including drawings, examples, figures and metaphors were adapted following the experts’ suggestions. We therefore concluded that, culture-sensitive PNE materials for Hausa speaking patients with CSP were successfully produced. The present study also provides a direction for further research whereby the effects of culturally-sensitive PNE materials can be piloted among Hausa speaking patients with CSP

Cross-cultural adaptation and validation of the Hausa version of the Oswestry Disability Index 2.1a for patients with low back pain

Study Design: Validation of a translated, culturally adapted questionnaire. Objective: To translate the Oswestry Disability Index (ODI) version 2.1a into Hausa Language and to validate its use in a cohort of patients with low back pain (LBP). Summary of Background Data: The ODI is one of the most commonly used condition-specific questionnaires for assessing functional disability in patients with LBP, yet, no formal cross-culturally adapted and validated Hausa version exists. Methods: The Hausa version of the ODI 2.1a (ODI-H) was developed according to established guidelines. Validation was performed among 200 patients with LBP recruited from both rural and urban Nigeria. Reliability was assessed using internal consistency (Cronbach alpha), test-retest reliability by computing intraclass correlation coefficient, standard error of measurement, and minimal detectable change. Convergent validity was assessed by correlating the ODI-H with Visual Analogue Scale for pain, Fear-Avoidance Beliefs Questionnaire, and finger-floor distance test. Divergent validity was assessed by correlating the ODI-H with age, educational level, and occupational status. Exploratory factor analysis (EFA) and confirmatory factor analysis were also performed. Confirmatory factor analysis was performed with three models: 1) one-factor theory-driven model, 2) two-factor theory-driven model (dynamic and static factors), and 3) a model based on our EFA. Results: The ODI-H had high internal consistency (Cronbach alpha = 0.87) and excellent test-retest reliability (intraclass correlation coefficient = 0.937) with standard error of measurement and minimal detectable change being 3.69 and 10.2 respectively. The construct validity (convergent and divergent validity) is supported as all (6:6, 100%) the a priori hypotheses were confirmed. The EFA yielded a two-factor model explaining 54.3% of the total variance but demonstrated poor fit. The one-factor and two-factor theory-driven model had acceptable fit but the one-factor theory-driven model was better. Conclusion: The ODI-H version 2.1a was transculturally equivalent, reliable, and valid tool for assessing functional disability among Hausa-speaking patients with LBP. The use of this tool can be recommended for future clinical and research purposes

Development of culturally sensitive pain neuroscience education materials for Hausa-speaking patients with chronic spinal pain : a modified Delphi study

This study aimed to develop culturally sensitive pain neuroscience education (PNE) materials for Hausa speaking patients with chronic spinal pain (CSP). PNE is a program of teaching patients about pain that has gained considerable attention in research and is increasingly used during physical therapy for patients with chronic pain. It helps in decreasing pain, disability, fear-avoidance, pain catastrophization, movement restriction, and health care utilization among patients with chronic pain. However, existing PNE materials and their application are limited to few languages and cultural inclinations. Due to the variations in pain perceptions, beliefs, and related outcomes among different population groups, culture-sensitive PNE materials addressing these outcomes are warranted. A focus-group discussion comprising 4 experts was used to adapt and develop preliminary PNE materials. Thereafter, an internet-based 3-round modified Delphi-study involving 22 experts ensued. Experts' consensus/recommendations concerning the content were used in modifying the PNE materials. Consensus was predefined as >= 75% level of (dis)agreement. Eighteen experts completed the Delphi rounds. Nineteen, 18 and 18 experts participated in rounds 1, 2 and 3 respectively, representing 86%, 94% and 100% participation rate respectively. Consensus agreement was reached in every round and content of the materials, including drawings, examples, figures and metaphors were adapted following the experts' suggestions. We therefore concluded that, culture-sensitive PNE materials for Hausa speaking patients with CSP were successfully produced. The present study also provides a direction for further research whereby the effects of culturally-sensitive PNE materials can be piloted among Hausa speaking patients with CSP

Are pain beliefs, cognitions, and behaviors influenced by race, ethnicity, and culture in patients with chronic musculoskeletal pain : a systematic review

Background: Chronic pain has been considered as a biopsychosocial condition in which cognitive and emotional factors as well as biological factors significantly affect perception of pain. Race, ethnicity and culture have a crucial impact on illness beliefs, health care preferences, help-seeking behaviors, and acceptance of medical interventions. Objectives: The aim of the present study was to systematically review the current evidence regarding the racial, ethnic and cultural alterations and differences in pain beliefs, cognitions, and behaviors in patients with chronic musculoskeletal pain (MSKP). Study Design: Systematic review. Methods: This systematic review was conducted and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines (PRISMA). PubMed and Web of Science were searched. A first screening was conducted based on title and abstract of the articles. In the second screening, full-texts of the remaining articles were evaluated for the fulfilment of the inclusion criteria. The risk of bias was assessed with the modified Newcastle-Ottawa Scale. Results: A total of 11 articles were included. The methodological quality of the included studies ranged from low to moderate. There is moderate evidence that African-Americans use more praying, hoping, and emotion-focused coping strategies than Caucasians. There is also preliminary evidence regarding the differences in some coping strategies such as distraction, catastrophizing, and problem-focused solving between African-Americans and Caucasians. Preliminary evidence exists regarding the differences in pain coping strategies between the US and Portugal; the US and Singapore; and among 4 French-speaking countries. It is found that Spanish patients with fibromyalgia (FM) have more negative illness perceptions than Dutch patients. There is preliminary evidence that Caucasians have higher self-efficacy than African-Americans. There is also preliminary evidence that New Zealanders have more internal health expectancies than patients from the US. Preliminary evidence is demonstrated that Caucasians with rheumatoid arthritis (RA) have more positive control beliefs than African-Americans. Lastly, there is preliminary evidence that patients from the US believe that they are more disabled, while Singaporeans interpret the pain more by a traditional biomedical perspective. Limitations: Only 11 articles were included. The small number of articles, wide range of assessment methods, and substantial risk of bias in the included studies led the investigator to draw conclusions cautiously. Conclusion: Preliminary to moderate evidence shows the differences in coping strategies, illness perceptions, self-efficacy, fear avoidance beliefs, locus of control, and pain attitudes in different populations. Further prospective and longitudinal studies using standard definitions for race, ethnicity or culture and valid questionnaires for each population are warranted to explore the racial, ethnic and cultural discrepancies in pain beliefs, cognitions, and behaviours