Nigerian physiotherapists’ perceptions of their profession’s prestige and implications

AbstractThis study investigated Nigerian physiotherapists’ perceived prestige of their profession relative to 11 selected occupations and how their perception was influenced by selected sociodemographics. A total of 368 copies of a questionnaire adapted from a previous study were sent to registered physiotherapists working in Nigeria as of May 2007. Data were analysed using Chi-square, Kendall’s W, and multidimensional scaling analysis. Two hundred sixty copies of the questionnaire were completed and returned (70.7% response rate). Respondents included 161 men (62%) and 99 women (38%). Most of them (78.5%) were aged between 20 years and 39 years and were bachelor degree holders (67.2%). Physiotherapy was ranked second on level of education, third on usefulness to the society, fifth on level of responsibility, sixth on social standing, and seventh on income. Physiotherapy was rated fifth overall. The only sociodemographic variable that significantly influenced overall perceived occupational prestige of physiotherapy was type of workplace. Physiotherapists in Nigeria perceived their profession as having moderate occupational prestige, placing it in the fifth position below accountant, lawyer, doctor, and engineer. Physiotherapists in Nigeria need to work hard on improving the prestige standing of their profession

Translation, cross-cultural adaptation, and psychometric evaluation of the brief illness perception questionnaire into Yoruba language among persons with chronic low back pain

Background Illness perception may influence the coping behaviors of patients. There is a lack of tools to measure this construct among Yoruba speakers. Therefore, we translate, cross-culturally adapt and determine the reliability and the validity of the Yoruba version of the Brief Illness Perception Questionnaire (BIPQ-Y). Methods The translation and cross-cultural adaptation process was according to Beaton criteria. The psychometric testing of the BIPQ-Y was carried out among 28 consenting patients with low back pain attending a university teaching hospital, while only 10 of them participated in the reliability test. The convergent and discriminant validity of the BIPQ-Y was carried out using the Fear Avoidance Belief Questionnaire and Quadruple Visual Analogue scale. Confirmatory factor analysis was to assess construct validity. Results The mean age of the respondents was 47 ± 15.3 years. The concurrent validity of the BIPQ-Y was excellent (r = 0.996) for the total score of BIPQ-Y while the internal consistency was moderate (α = 0.52). The test–retest of BIPQ-Y yielded excellent results with item intra-class correlation coefficient (ICC) ranging between 0.833 and 0.973 and an overall ICC of 0.889. For the confirmatory analysis of the BIPQ-Y, the factor loading for the eight items ranged from − 0.071 to 0.799 and the composite reliability was good with a score of 0.68. Conclusion The BIPQ-Y demonstrated excellent psychometric properties that are satisfactory with standards, and it is recommended for assessing illness perceptions of patients with chronic low back pain among the Yoruba-speaking populations

Translation, cross-cultural adaptation and psychometric testing of Yoruba Version of the EQ-5D Questionnaire in patients with musculoskeletal disorders

Background: The EuroQol- 5 Dimension (EQ-5D) is a generic self-administered questionnaire used for the measurement and economic valuation of a wide range of health conditions, which necessitates its existence and adaptation in different languages. Currently, the tool does not exist in any Nigerian language. This study was aimed to translate, cross-culturally adapt, and determine the reliability and validity of the Yoruba version of the EQ-5D-5L questionnaire. Methods: The International Quality of Life Assessment (IQOLA) project guidelines, involving forward translation, reconciliation and harmonisation, backward translation, and reconciliation of problematic items was used in the Yoruba translated version of the EQ-5D-5L (EQ-5D-Yor). A total of 113 and 109 persons with musculoskeletal disorders participated in the validity, and seven-day test-retest reliability testing of the EQ-5D-Yor respectively. Convergent and discriminant validity of the EQ-5D-Yor were determined using the Yoruba version of the SF-12 (SF-12-Y) and Visual Analogue Scale (VAS). Data was analysed using descriptive and inferential statistics of Spearman correlation, Intra-Class Correlation, Cronbach alpha and multi trait scaling analysis. Alpha level was set as p < 0.05. Results: The construct validity of the EQ-5D-Yor yielded Spearman rho ranging from 0.438 to 1.000, with the EQ-VAS having the highest co-efficient (r = 1.000; p = 0.001). The convergent validity of the EQ-5D-Yor index with scales and domains of the SF-12-Y yielded no significant correlations (p < 0.05), except the physical functioning scale (r = -0.709, p = 0.001). On the other hand, the divergent validity of the EQ-5D-Yor index with VAS yielded a moderate negative correlation, (r = -0.482; p=0.001). The Intra-class Correlation Coefficient and Cronbach alpha for the test-retest reliability of the EQ-5D-Yor were 1.000 and 0.968. The confirmatory factor analysis showed the factor loadings were poor when including VAS in the model. Conclusion: The EQ-5D-Yor has acceptable validity and reliability and can be used as a valid tool among Yoruba speaking population with musculoskeletal disorder

Professional practice profile, treatment preferences, and the bases for clinical, educational, and research among Nigerian physiotherapists

Background Physiotherapy education and practice have country-specific peculiarities which may limit globalization in health care. This study aimed to characterize physiotherapy practice and treatment preferences, educational qualifications, and research in Nigeria, with a view of providing vital information for transnational integration and collaboration. Methods A cross-sectional survey of 104 Nigerian physiotherapists was conducted. The Physical Therapy Practice Questionnaire and a self-developed proforma were used as survey tools. Results The mean age of respondents was 33.5 ± 9.4 years. About two-fifth of all respondents (39.4%) had an MSc and mostly practice as clinicians (51.0%) in teaching hospitals (34.6%). The respondents were mostly involved in general practice (50.0%), with a caseload of 1–10 patients per day (67.3%). Soft tissue mobilization (83%), proprioceptive neuromuscular facilitation (76%), breathing exercises (77%), and transcutaneous electrical neuromuscular stimulation (83%) were commonly used. Respondents were familiar databases and evidence-based resources (81.2%) and mostly utilize PubMed (73.3%). Regular case conferences with professional colleagues (47.6%) and treatment planning of between 11 and 30 min (40.6%) were common. Educators spend 1–3 h planning educational work (91.8%). Clinical decision-making is mostly based on professional experience, while journals are the primary resource for educational information. Conclusion Physiotherapy practice in Nigeria is degree based and requires registration board’s licensure. Practitioners deal with a high caseload and utilize a wide range of techniques and modalities and have tendencies to utilize personal experience and research in making clinical decisions. The parity in education and practice with advanced climes inadvertently gives physiotherapy practice in Nigeria a global purview

Sobrecarga e qualidade de vida de cuidadores informais de crianças com paralisia cerebral

Objective: to analyze the caregiver burden and the quality of life of informal caregivers of children with cerebral palsy. Methods: the cross-sectional survey involved 109 caregivers of children with cerebral palsy recruited from physiotherapy clinic at a tertiary hospital. The quality of life and caregiver burden were assessed using the Personal Wellbeing Index Scale and the Modified Caregivers’ Strain Index, respectively. Data were analysed using descriptive and inferential statistics. Results: the mean strain index and quality of life scores of the participants were 11.85 ± 5.72 and 64.68 ± 8.03 respectively. The majority (67.9%) of the caregivers had fair personal well-being, while about one-third (33.0%) had high caregiver’s strain. Child’s age (B=2.454; p<0.005) and caregivers’ occupation (B= -2.547; p=0.001) were predictors of caregiver strain. Conclusion: caring for children with cerebral palsy imposed a substantial burden on the caregivers and child’s age and caregivers’ occupation were predictor variables.Objetivo: analisar a sobrecarga e qualidade de vida de cuidadores informais de crianças com paralisia cerebral. Métodos: o estudo transversal envolveu 109 cuidadores recrutados em uma clínica de fisioterapia em um hospital terciário. A qualidade de vida e a sobrecarga foram avaliadas por meio do Personal Wellbeing Index e do Modified Caregivers’ Strain Index, respectivamente. Os dados foram analisados de forma descritiva e inferencial. Resultados: as médias do índice de sobrecarga e dos escores de qualidade de vida foram 11,85 ± 5,72 e 64,68 ± 8,03, respectivamente. A maioria (67,9%) dos cuidadores apresentou bem-estar pessoal razoável, enquanto cerca de um terço (33,0%) apresentou alta sobrecarga. Idade da criança (B=2,454; p<0,005) e ocupação dos cuidadores (B= -2,547; p=0,001) foram preditores de tensão do cuidador. Conclusão: cuidar de crianças com paralisia cerebral impôs uma sobrecarga substancial aos cuidadores e a idade da criança e a ocupação dos cuidadores foram variáveis preditoras

Therapeutic itinerary of patients with chronic low-back pain attending outpatient physiotherapy clinic

Objective: to assess therapeutic itinerary of patients with chronic low-back pain. Methods: qualitative study involving the use of an in-depth semi structured interviews were used to collect data on therapeutic itinerary among ten patients with chronic low-back pain who from physiotherapy clinic of a tertiary hospital. Data was analysed using thematic content analysis. Results: emerging themes were as follows: onset of low-back pain, symptoms that initiated the journey for care, steps taken to find pain relief, respondent’s perception on care received, interference of chronic low-back pain with normal life, family and relations, multiple practices in which chronic low-back pain patients are involved, perception of effectiveness of the multiple practices, and hurdles to seeking care. Conclusion: patients with chronic low-back pain take different routes in search of care. Chronic low-back pain markedly altered patients’ life and made them prone to practicing medical pluralism

Qualitative exploration into therapeutic itinerary of children with physical disabilities in Nigeria using thematic content analysis (Exploração qualitativa do itinerário terapêutico de crianças com deficiência física na Nigéria usando análise de conteúdo temática)

Objective: To explore the therapeutic itinerary for seeking care for children with physical disabilities by caregivers. Methods: A descriptive qualitative design recruiting nine consenting caregivers of children with physical disabilities attending a Nigerian Teaching Hospital. A semi-structured interview guide was used to collect data on therapeutic itinerary which was defined as the paths taken by individuals to address their health problem. Interviews were audio-recorded and transcribed verbatim. Data was analyzed using thematic content analysis. Results: Emerging themes revealed that caregivers commenced therapeutic itinerary for their children upon observation of any impairments that go beyond casual illnesses. Lack of capacity in private hospitals, which serves as initial point of entry into care seeking, encourage vacillation into public hospitals, spiritual homes, and traditional clinics. Entry into physiotherapy was dependent on self-referrals, referrals by relatives, and physicians. Caring for children with physical disability significantly affected caregiver’s social life, finances, work; and unmet expectations for a child to get well as soon as possible encouraged continuous pluralism. Conclusion and implications for the practice: Having children presenting with impairments and delayed milestones led to complex multiple health care seeking practices among caregivers. Thus, these caregivers become medical pluralists and covertly non-adherent to hospital treatment prescriptions

Therapeutic itinerary of stroke survivors in a Nigerian tertiary hospital

Objective: to analyze the therapeutic itinerary of stroke survivors from stroke occurrence to rehabilitation. Methods: therapeutic itinerary - route taken by individuals to solve their health problems, of 12 stroke survivors was explored using in-depth interviews and was thematically analyzed. Results: stroke survivors’ routes were influenced by type of stroke and the state of the patient at onset of stroke. Lack of capacity facilitates vacillation from private to the public hospital settings. Entry into physiotherapy was dependent on self-referrals and referrals from physicians who often serve as gatekeeper of patients. Stroke significantly affected social life of stroke survivors, and the extent of stroke impairment and unmet expectations promotes medical pluralism among the survivors. Conclusion: stroke survivors are involved in intricate and lengthy therapeutic itineraries that are characterized by multiple care seeking practice

Itinerário terapêutico de sobreviventes de acidente vascular cerebral em um hospital terciário nigeriano

Objective: to analyze the therapeutic itinerary of stroke survivors from stroke occurrence to rehabilitation. Methods: therapeutic itinerary - route taken by individuals to solve their health problems, of 12 stroke survivors was explored using in-depth interviews and was thematically analyzed. Results: stroke survivors’ routes were influenced by type of stroke and the state of the patient at onset of stroke. Lack of capacity facilitates vacillation from private to the public hospital settings. Entry into physiotherapy was dependent on self-referrals and referrals from physicians who often serve as gatekeeper of patients. Stroke significantly affected social life of stroke survivors, and the extent of stroke impairment and unmet expectations promotes medical pluralism among the survivors. Conclusion: stroke survivors are involved in intricate and lengthy therapeutic itineraries that are characterized by multiple care seeking practice.Objetivo: analisar o itinerário terapêutico de sobreviventes de acidente vascular cerebral, desde sua ocorrência até a reabilitação. Métodos: itinerário terapêutico percorrido por 12 sobreviventes de acidente vascular cerebral para resolver seus problemas de saúde foi explorado usando entrevistas em profundidade e análise temática. Resultados: as rotas dos sobreviventes foram influenciadas pelo tipo e estado do paciente no início do acidente vascular cerebral. A falta de capacidade contribuiu para indecisão entre buscar atendimento em hospitais privados ou públicos. A entrada na fisioterapia dependeu da demanda espontânea e de encaminhamentos realizados por médicos que atuam como sentinelas dos pacientes. O acidente vascular cerebral afetou significativamente a vida social dos sobreviventes. A extensão do comprometimento do acidente vascular cerebral e expectativas não atendidas promovem o pluralismo médico entre os sobreviventes. Conclusão: sobreviventes de acidente vascular cerebral estão envolvidos em itinerários terapêuticos complexos e extensos, caracterizados pela prática de busca de múltiplos cuidados