A Qualitative Investigation of the Psychosocial Impact of Chronic Low Back Pain in Ghana

Overview

Journal BMJ Open

Specialty General Medicine

Date 2023 Jul 20

PMID 37474173

Authors

Josephine Ahenkorah Ampiah

Fiona Moffatt

Claire Diver

Paapa Kwesi Ampiah

Affiliations

Soon will be listed here.

Abstract

Introduction: Chronic low back pain (CLBP) is a global health concern associated with multidimensional/biopsychosocial levels of affectation in developed countries, with holistic management requiring consideration of these factors. There has been minimal research exploring the psychosocial impact of CLBP, and the factors influencing it, in African contexts, with none in Ghana.

Objectives: To explore the psychosocial impact of CLBP among patients with CLBP in Ghana.

Design: Qualitative study using individual semistructured face-to-face interviews, underpinned by Straussian grounded theory principles and critical realist philosophy.

Participants: Thirty patients with CLBP attending physiotherapy at two hospitals in Ghana.

Results: Five categories: loss of self and roles, emotional distress, fear, stigmatisation and marginalisation, financial burden, and social support and three mechanisms: acquired biomedical/mechanical beliefs from healthcare professionals (HCPs), sociocultural beliefs and the socioeconomic impact of CLBP were derived.

Conclusion: CLBP adversely affects multidimensional/biopsychosocial aspects of individuals experiencing CLBP in Ghana. This delineates the need for a biopsychosocial approach to care. There is the need for HCPs in Ghana to reassess current CLBP management strategies to address the influence of adverse HCPs biomedical inclinations on patients' psychosocial consequences. Population-based education strategies and consideration of formal support systems for persons with disabling CLBP may also be beneficial.

References

McKillop A, Carroll L, Jones C, Battie M . The relation of social support and depression in patients with chronic low back pain. Disabil Rehabil. 2016; 39(15):1482-1488. DOI: 10.1080/09638288.2016.1202335. View

Pope C, Ziebland S, Mays N . Qualitative research in health care. Analysing qualitative data. BMJ. 2000; 320(7227):114-6. PMC: 1117368. DOI: 10.1136/bmj.320.7227.114. View

Ramond A, Bouton C, Richard I, Roquelaure Y, Baufreton C, Legrand E . Psychosocial risk factors for chronic low back pain in primary care--a systematic review. Fam Pract. 2010; 28(1):12-21. DOI: 10.1093/fampra/cmq072. View

Igwesi-Chidobe C, Coker B, Onwasigwe C, Sorinola I, Godfrey E . Biopsychosocial factors associated with chronic low back pain disability in rural Nigeria: a population-based cross-sectional study. BMJ Glob Health. 2017; 2(3):e000284. PMC: 5717944. DOI: 10.1136/bmjgh-2017-000284. View

Hill J, Fritz J . Psychosocial influences on low back pain, disability, and response to treatment. Phys Ther. 2011; 91(5):712-21. DOI: 10.2522/ptj.20100280. View

Dagenais S, Caro J, Haldeman S . A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J. 2008; 8(1):8-20. DOI: 10.1016/j.spinee.2007.10.005. View

OSullivan P, Caneiro J, OKeeffe M, OSullivan K . Unraveling the Complexity of Low Back Pain. J Orthop Sports Phys Ther. 2016; 46(11):932-937. DOI: 10.2519/jospt.2016.0609. View

Tavafian S, Gregory D, Montazeri A . The experience of low back pain in Iranian women: a focus group study. Health Care Women Int. 2008; 29(4):339-48. DOI: 10.1080/07399330701876356. View

Balague F, Mannion A, Pellise F, Cedraschi C . Non-specific low back pain. Lancet. 2011; 379(9814):482-91. DOI: 10.1016/S0140-6736(11)60610-7. View

10.

Kahere M, Hlongwa M, Ginindza T . A Scoping Review on the Epidemiology of Chronic Low Back Pain among Adults in Sub-Saharan Africa. Int J Environ Res Public Health. 2022; 19(5). PMC: 8910337. DOI: 10.3390/ijerph19052964. View

11.

Kamper S, Apeldoorn A, Chiarotto A, Smeets R, Ostelo R, Guzman J . Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ. 2015; 350:h444. PMC: 4353283. DOI: 10.1136/bmj.h444. View

12.

Chala M, Donnelly C, Ghahari S, Wondie Y, Abebe A, Miller J . An Interpretative Phenomenological Analysis of Living with Chronic Low Back Pain in Ethiopia. J Pain Res. 2022; 15:4031-4045. PMC: 9790163. DOI: 10.2147/JPR.S389827. View

13.

Nijs J, Roussel N, van Wilgen C, Koke A, Smeets R . Thinking beyond muscles and joints: therapists' and patients' attitudes and beliefs regarding chronic musculoskeletal pain are key to applying effective treatment. Man Ther. 2013; 18(2):96-102. DOI: 10.1016/j.math.2012.11.001. View

14.

Lin I, Wiles L, Waller R, Goucke R, Nagree Y, Gibberd M . What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med. 2019; 54(2):79-86. DOI: 10.1136/bjsports-2018-099878. View

15.

Omoke N, Amaraegbulam P . Low back pain as seen in orthopedic clinics of a Nigerian Teaching Hospital. Niger J Clin Pract. 2016; 19(2):212-7. DOI: 10.4103/1119-3077.175964. View

16.

Bunzli S, Watkins R, Smith A, Schutze R, OSullivan P . Lives on hold: a qualitative synthesis exploring the experience of chronic low-back pain. Clin J Pain. 2013; 29(10):907-16. DOI: 10.1097/AJP.0b013e31827a6dd8. View

17.

Osborn M, Rodham K . Insights into Pain: A Review of Qualitative Research. Rev Pain. 2015; 4(1):2-7. PMC: 4590060. DOI: 10.1177/204946371000400102. View

18.

Ampiah J, Moffatt F, Diver C, Ampiah P . Understanding how patients' pain beliefs influence chronic low back pain management in Ghana: a grounded theory approach. BMJ Open. 2022; 12(12):e061062. PMC: 9806037. DOI: 10.1136/bmjopen-2022-061062. View

19.

OSullivan P, Caneiro J, OKeeffe M, Smith A, Dankaerts W, Fersum K . Cognitive Functional Therapy: An Integrated Behavioral Approach for the Targeted Management of Disabling Low Back Pain. Phys Ther. 2018; 98(5):408-423. PMC: 6037069. DOI: 10.1093/ptj/pzy022. View

20.

Snelgrove S, Liossi C . Living with chronic low back pain: a metasynthesis of qualitative research. Chronic Illn. 2013; 9(4):283-301. DOI: 10.1177/1742395313476901. View