Adebayo O. Adejumo

Role of socio-psychological factors in perceived quality of care rendered by traditional medical practitioners in Ibadan, Nigeria.

Background: It was the aim of the current research to investigate perceived service quality rendered by traditional medical practitioners and the role of socio-psychological factors in the perception. Methods: The first part, a quantitative cross-sectional survey utilized a 93-item questionnaire to examine the influence of quality of life, general health perception, socio-economic status and personality factors on perceived service quality. The second part, a qualitative study utilized 5 FGDs and 2 KIIs to explore consumers’ evaluation of perceived service quality. Five research questions were raised. The 336 purposively-selected participants were attendees of traditional-health clinics/centers in Ibadan with a mean age of X̄=30.60±9.97. Findings: The FGD respondents opined that the scope of orthodox-medicine does not cover certain illnesses. 77.8% of the participants attested to the affordability and promptness of services in traditional hospitals; acknowledging that its perceived efficacy (i.e. 56.8%) motivate patronage of traditional-health service. The 2x2x3 ANOVA revealed significant main effect of quality of life (F[1,270]=41.05, p<.001) and socio-economic status (F[2,270]=36.34; p<.001); as well as interaction effect of quality of life, general health and socio-economic status (F[1,270]=9.624, p<.002); while the regression analysis showed independent influence of extraversion (β=0.31; p<.001), agreeableness (β=0.303; p<.001) and openness to experience (β=0.166; p<.01). Conclusion: This sample acknowledged that traditional health care met quality standards. The role of socio-psychological factors in the quality appraisal was established. The need for better regulation and validation of traditional health care in assuring evidence based care was suggested.

Augmenting conventional treatment of non-specific low back pain with progressive goal attainment programme

Background: Prospective studies on the effects of progressive goal attainment programme (PGAP) on treatment outcomes and specifically psychosocial variables in individuals with non-specific low back pain (NSLBP) are scarce. The study was aimed at investigating the effects of a 10-week PGAP adjunct therapy on selected pain and psychosocial characteristics in patients with NSLBP. Methods: The quasi-experimental study involved consecutive 70 (42 females; 28 males) patients with NSLBP. Participants were alternately assigned into experimental and control groups. Both groups received conventional treatment of back education, soft tissue mobilisation, transcutaneous electrical nerve stimulation, flexibility, coordination and isometric trunk muscle strengthening exercises thrice a week for 10 weeks but the experimental group had PGAP in addition. Participants’ pain intensity, pain catastrophising, kinesiophobia, perceived disability and self-efficacy were assessed at baseline, end of 5th and 10th week of intervention and 22nd week (follow-up) using Visual Analogue Scale, Pain Catastrophising Scale, Tampa Scale for Kinesiophobia, Revised Oswestry Disability Questionnaire and Self-Efficacy for Rehabilitation Outcome Scale, respectively. Results: Between-group comparison at the end of intervention did not reveal significant difference (p > 0.05) between experimental and control groups in all five measures. There were significant reductions (p < 0.05) in pain intensity, pain catastrophising, kinesiophobia, perceived disability and increase in self-efficacy scores for both groups from baseline to 10th week. At follow-up (22nd week), experimental group had significantly lower scores of pain intensity (p = 0.031), pain catastrophising (p = 0.050), kinesiophobia (p < 0.001), perceived disability (p = 0.001) and higher self-efficacy (p = 0.016) than the controls. Conclusion: Addition of PGAP to conventional treatment is effective for achieving sustained improvement in pain and psychosocial characteristics of patients with NSLBP having psychosocial overlay.

Predictors of health expectation and health anxiety among post-salpingectomy patients in Ibadan Nigeria

Abstract Objective: Salpingectomy is the surgical removal of a fallopian tube, often as a result of tubal pregnancy. Little is known about the role of self-efficacy, health consciousness and health locus of control in health expectation and health anxiety among post-salpingectomy patients. Background: An ectopic pregnancy and subsequent salpingectomy could present significant life crises for any woman with far-reaching implications. Methods: Sixty purposively selected post-salpingectomy women (gravida 0–6; parity 0–4; mean age 34 ± 4.05 years) were included in the cross-sectional survey. A 49-item questionnaire made up of the perceived self-efficacy scale, as well as health consciousness, health orientation, health anxiety and health expectation subscales of Snell’s Health Orientation Scale, was used for data collection. Descriptive (means; SD; and %) and inferential (multiple regression; t-test; and Zero-Order correlation) statistics were employed in analysis, with two hypotheses tested at p < 0.05. Results: Health consciousness, health locus of control and self-efficacy jointly predicted health expectation and health anxiety with differences in independent prediction of health expectation and health anxiety. Participants with a low level of health consciousness reported a higher level of health expectation and health anxiety. A low level of self-efficacy yielded a higher level of health expectation. Participants with external health locus of control reported significantly higher levels of health anxiety. Conclusion: These psychological factors are pertinent in forecasting health expectation and health anxiety among post-salpingectomy patients. Attention to these psychological factors in the management of patients with reproductive and surgical challenges would enhance a patient-centred approach to care.