Theses and dissertations (Health Sciences)
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Item The prevalence, knowledge, attitude and practice regarding self-administered over-the-counter analgesic use among patients with chronic musculoskeletal pain attending the Durban University of Technology Chiropractic Day Clinic(2023) Engelbrecht, Donna; Thandar, YasmeenChronic pain is a major concern globally, with the greatest contributor being chronic musculoskeletal pain (CMSP). CMSP decreases quality of life, affects activities of daily living, increases work absenteeism and health care expenses. Recommendations for the management of CMSP include exercise and the use of analgesics, such as non-steroidal anti-inflammatory drugs (NSAIDs), or more potent analgesics, including opioids. Amongst those suffering from CMSP, it is common to self medicate with analgesics. Over-the-counter (OTC) analgesics, in particular, help patients manage their own CMSP symptoms. However, OTC medicine use can be a problem when misused. The common reasons why patients self-medicate with OTC analgesics is the easy access to these medications; previous experience with treating their condition; and financial and economic difficulties, which prevent visiting a primary physician (for more potent analgesics), especially in developing countries. There are many studies that have examined the prevalence of self-medication of OTC analgesics using population-based studies and some among health science students at universities but these do not focus on the prevalence of self-medication among those with CMSP. There appears to be limited research conducted in South Africa with regards to the prevalence of self-administered OTC analgesic use among patients with CMSP, especially within a chiropractic clinic setting, where the treatment of CMSP consumes a large portion of primary care. It has also been noted in the literature that information and research needed to quantify the scale of misuse is currently lacking. Primary care physicians, including chiropractors, who more frequently treat chronic pain, are thus best suited to ascertain this by assessing the attitudes, knowledge and practices regarding self-administered OTC analgesic use amongst patients suffering from CMSP. Method This study is a quantitative, descriptive cross-sectional study, whereby a survey was conducted (using questionnaires) to collect data and make statistical inferences about the Chronic pain is a major concern globally, with the greatest contributor being chronic musculoskeletal pain (CMSP). CMSP decreases quality of life, affects activities of daily living, increases work absenteeism and health care expenses. Recommendations for the management of CMSP include exercise and the use of analgesics, such as non-steroidal anti-inflammatory drugs (NSAIDs), or more potent analgesics, including opioids. Amongst those suffering from CMSP, it is common to self medicate with analgesics. Over-the-counter (OTC) analgesics, in particular, help patients manage their own CMSP symptoms. However, OTC medicine use can be a problem when misused. The common reasons why patients self-medicate with OTC analgesics is the easy access to these medications; previous experience with treating their condition; and financial and economic difficulties, which prevent visiting a primary physician (for more potent analgesics), especially in developing countries. There are many studies that have examined the prevalence of self-medication of OTC analgesics using population-based studies and some among health science students at universities but these do not focus on the prevalence of self-medication among those with CMSP. There appears to be limited research conducted in South Africa with regards to the prevalence of self-administered OTC analgesic use among patients with CMSP, especially within a chiropractic clinic setting, where the treatment of CMSP consumes a large portion of primary care. It has also been noted in the literature that information and research needed to quantify the scale of misuse is currently lacking. Primary care physicians, including chiropractors, who more frequently treat chronic pain, are thus best suited to ascertain this by assessing the attitudes, knowledge and practices regarding self-administered OTC analgesic use amongst patients suffering from CMSP. Method This study is a quantitative, descriptive cross-sectional study, whereby a survey was conducted (using questionnaires) to collect data and make statistical inferences about the indicated that they use their own experience of what helps relieve their pain; a further number (39.3%) indicated that they read the information insert inside the medication box. The percentages do not add up to 100% because the participants had chosen more than one option in the question. Regarding the number of participants who responded to the use of different analgesics, most participants (70.3%) were using NSAIDs; followed by paracetamol only (57.7%); combination analgesics not easily obtainable without a prescription (54.1%); combination analgesics that can be obtained without prescription (41.1%); aspirin (15.3%) and other (0.9%). It was determined that more participants (66.7%) indicated that they did not experience any side effects from the analgesics that they were consuming (p<.001). Gender has shown to have an influence on self-administered analgesic use. It was found that there was a significantly larger number of females (86.2%) who used self-administered analgesics compared to males (69.1%) (p=.001). The age group 35–44 was found to be statistically more likely to use self-administered painkillers (88.9%), followed by those aged 65+ (88%) (p=0.48). A significant number of Black participants (p=0.43) indicated that they did not use self administered OTC analgesics (29.1%) and a significant number of participants who indicated “Other” also did not use self-administered OTC analgesics (44.4%) (p=0.43). Conclusion The findings from this study reinforce that primary care physicians, including chiropractors, need to take better initiatives in educating, providing better guidelines and promoting safe and effective OTC analgesic use to their CMSP patients. Considering that this study demonstrated a high prevalence of CMSP, and a high prevalence of OTC analgesic use, it is important that chiropractors understand patients with chronic pain and why they may make certain decisions. Seeking additional pain relief options like chiropractic treatment for CMSP earlier may help reduce reliance on OTC analgesic medication.Item The injury profile of musculoskeletal injuries, and the impact thereof, in amateur pole sports athletes in eThekwini municipality(2024) Worth, Kim; Pillay, Julian DavidBackground: Pole sport has gained popularity worldwide, especially in South Africa. Due to the nature of the sport, there is growing evidence of unique musculoskeletal injuries that accompany the sport. Despite this, there is little information regarding the specific musculoskeletal injuries that occur in pole sport athletes and, thus, the sport has been compared to gymnastics and circus arts which include certain similarities. Research in pole sports specifically is essential in order to assist healthcare professionals to manage the injuries specific to the sport appropriately. Aim: The aim of this study was to determine the prevalence, selected risk factors and types of injuries that amateur pole sport athletes experience, as well as the impact of the musculoskeletal injuries and the level of care used. Methodology: A quantitative, descriptive, cross-sectional method was utilised with the distribution of online questionnaires to five pole studios in the eThekwini municipality, KwaZulu-Natal, South Africa. The questionnaire consisted of the following sections: demographics; training history; risk factors; musculoskeletal injuries; consequence of injury on sport and performance, quality of life and the management approaches and impact thereof. The data was analysed using the IBM SPSS version 28. Results: A total of 59 female participants over the age of 18 years old were included in this study. A high prevalence of musculoskeletal injury was found, with a lifetime prevalence of 49.2% (n=29), and period prevalence over 12 months of 40.7% (n=24). The majority of injuries were found to affect the upper limb but injuries to the spine and lower limb were still common. The most commonly reported location of injuries was the shoulder (64.3%, n=18), followed by the hand and wrist (46.4%, n=13), and then the neck (35.7%, n=10) and thoracic back (35.6%, n=10). The most common type of injury was a strain type injury (48.1%, n=14), followed by contusions (11.1%, n=3). Significant risk factors included high skill level (p value of 0.005), increased strength (p value of 0.010), performing warm-ups for longer than 10 minutes (p value of 0.053) and performing static stretching cool-downs (p value of 0.005). The impact of pole sport injuries on the participants’ pole performance demonstrated that despite the athletes’ recovery from injury taking more than six weeks, the majority of the athletes either stopped pole sport and other activities for one week or less or did not stop the activities at all. The impact of pole sports injuries on the participants’ quality of life was significant, especially affecting their ability to perform daily activities, decreasing their ability to sleep and decreasing their mood as a result of injury. Various management approaches, including self-medication, home remedies and complementary healthcare were utilised by participants. Self-medication and home remedies were found to be utilised more commonly compared to seeking help from healthcare professionals. Conclusion: This study demonstrated that musculoskeletal injuries are largely present in pole sport athletes for which various management approaches were utilised. The injuries impacted multiple aspects of the participants’ lives. The uniqueness of this sport provides an interesting platform for new research, especially with regard to musculoskeletal injuries, as shown in this study.Item Prevalence and associated risk factors of musculoskeletal disorders among undergraduate radiography students during work integrated learning at the university of technology, in Kwazulu-Natal(2023-05-31) Siphesihle, Masondo Siyanda; Khoza, Thandokuhle EmmanuelBackground The term musculoskeletal disorders (MSDs) refer to injuries or disorders of the nerves, ligaments, muscles, joints, tendons and supporting structures of the upper and lower limbs, neck and spine which are caused by sudden or accumulative exposures to physical exertion. Musculoskeletal disorders (MSDs) are common among healthcare students including radiography students. Undergraduate radiography students during their study program are being placed in different hospitals for Work-integrated learning (WIL). During this period, they are prone to several risk factors that can trigger the occurrence of MSDs. There is a scarcity in the literature on the prevalence of MSDs in undergraduate radiography students attending WIL in the public and private sectors of South Africa. To date, no study has been performed which determines the risk factors for developing MSDs among Undergraduate radiography students within the eThekwini Municipality. Aim The aim of the study is to determine the prevalence of MSDs and to identify the risk factors associated with MSDs among undergraduate radiography students attending WIL within hospitals in the eThekwini Municipality. Research Methodology The research conducted was a quantitative study with a descriptive design that targeted undergraduate radiography students attending WIL within the hospital of the eThekwini Municipality, KwaZulu Natal. The research questionnaires were administered to undergraduate radiography students at the Durban University of Technology in order to determine the prevalence of MSDs and its associated risk factors. The questionnaire included demographic information, work routine during WIL, symptoms and impacts of MSDs on participants. Data was captured by the researcher and sent to a statistician for statistical analysis. Results In total, 144 questionnaires were utilised for statistical analysis, giving a response rate of 84.2%. The results showed a significantly high prevalence of the musculoskeletal disorder among the students (92.4%). The most common areas of pain reported by the participants were the lower back (79.7%), neck (72.2%) and upper back (54.1%). The statistically significant risk factors for musculoskeletal disorder among radiography students were bending, stress and depression. The Chi-square test showed that participants who are more often involved in bending experience significantly higher lower back pain. Multiple regression analysis shown found depression and stress during work-integrated learning (WIL) as independent risks factor for musculoskeletal disorders among radiography students Conclusion and Recommendations The study showed that the prevalence of musculoskeletal disorder is high (92.4%) among undergraduate radiography students during WIL. Further research is needed in this population and South Africa in order to address the high incidence of MSDs and their impacts on healthcare students. In addition, to prevent the recurrence of MSDs among students, it is recommended that the faculty of health sciences and the radiography department design and implement suitable interventions, such as an education program/training on ergonomics practice. Also, it would be beneficial for the students to become more aware of MSDs and take corrective measures to better equip themselves to mitigate MSDs and seek treatment when necessary.Item Prevalence and risk factors of occupational injuries among emergency care providers(2020-11-30) Chule, Ntuthuko Gift; Govender, Kevin; Sobuwa, SimpiweIntroduction: Occupational injuries and diseases affect approximately 260 million people worldwide and kill nearly 2.3 million people per year. While paramedics and other healthcare workers (HCWs) are responsible for ensuring the health of others, their working environment is also considered to be one of the most hazardous environments. Purpose: To describe the prevalence and risk factors associated with occupational injuries, as well as perceptions of both the mitigation and prevention of occupational injuries among paramedics working for KwaZulu-Natal (KZN) Emergency Medical Rescue Services (EMRS). Methodology: The study adopted a quantitative, descriptive, cross-sectional approach. The study population comprised operational paramedics working for the KZN EMRS with a sample of 334 paramedics being drawn from a total of 2378 KZN EMRS paramedics. The study was conducted in five of the eleven districts in KZN. The data collection methods used included a closed ended questionnaire and a document review. The data which had been collected was analysed using Stata version 15. The Pearson chi-squared test was used to test for associations between any two categorical variables and, in instances, where Pearson chi-squared test was invalid Fisher’s exact test was used. A p-value of less than 0.05 was considered to be statistically significant. Results: Two of the five districts provided the required information for reviewing the records. A total of 36 injuries were reported in the two districts between 2011 and 2018. The reported injuries included injuries from motor vehicle accidents (61%), musculoskeletal injuries (16.7%), needle-stick injuries (13.9%), accidental surgical blade cuts (5.6%) and assault injuries (2.8%). A total of 152 survey questionnaires were completed and returned – a 45% response rate. The findings from the selfadministered questionnaire revealed 25 (16.5%) unreported injuries which included musculoskeletal injuries (48%, n = 12), needle-stick injuries (48%, n = 12), and one (1) (4%) assault-related injuries. A further 49 (32.2%) injuries which had resulted in medical attention being sought included musculoskeletal injuries (55.1%, n = 27), injuries due to motor vehicle accidents (44.9%, n = 22), needle-stick injuries (26.5%, n = 13) and assault-related injuries (8.2%, n = 4). Overall, 59 (38.8%) paramedics had experienced occupational injuries (both reported and unreported). The paramedics’ perceived risk factors for occupational injuries included high speed driving (87.5%, n = 133), violent members of society (87.5%, n = 133), heavy objects and patient lifting (86.2%, n = 131), physical exhaustion (78.3%, n = 119), hazardous material (77%, n = 117), and temperature extremes (73%, n = 111). In addition, the paramedics’ perceptions regarding occupational injury prevention revealed the following precautions, namely, avoiding high speed driving (79.6%, n = 121), specific positioning during equipment and patient lifting (63.8%, n = 97), avoiding chaotic scenes (61.8%, n = 94) and avoiding working longer hours (49.3%, n = 75). Conclusion: While it may be anticipated that information regarding occupational injuries suffered by paramedics would not be public knowledge, access to this information for purposes of research that aim to establish mitigation and prevention strategies, should be subjected to fewer challenges. From the data that was available, paramedics from KZN EMRS experienced multiple types of occupational injuries from a variety of injury sources. These injuries could be a result of both, the nature of the work and environment in which paramedics operate. However, further research is necessary to identify and validate these findings, as well as presented strategies required to minimise the rates of occupational injury among paramedics working for KZN EMRS.Item Risks, prevalence and management of carpal tunnel syndrome amidst Somatologists within the Western Cape(2020-11-30) Kistoor, Charne; Brooks, N.; Rammanhor, K.Carpal Tunnel Syndrome (CTS) has been recognised for many decades across various industries and researched extensively in these domains. The practice of Somatology has greatly evolved from the beauty therapy industry of past years that simply focussed on aesthetic techniques of beautifying clients. The new techniques and general physical demands of the somatologist profession, however, raise concerns for the health and wellness of the somatologist. This research was motivated by the lack of data available on musculoskeletal disorders generally, and specifically, the prevalence among somatologists in the Western Cape of carpal tunnel syndrome. The study objectives were to determine the general prevalence of CTS among qualified somatologists in the Western Cape, to identify risk factors that contribute to the development of CTS in somatologists, and to determine current preventative measures and management of CTS among somatologists. A quantitative research approach was used to evaluate the objectives by collecting the data, using a questionnaire as the research tool. Various beauty schools and businesses within the field were contacted to determine the prevalence rate of qualified somatologists being diagnosed with CTS. A sample group of somatologists who had worked or were working in the Western Cape was recruited to the study and the questionnaire included openended questions to elicit more detailed responses beyond the statistical data. The results of the study indicated CTS is generally prevalent in the beauty therapy industry and has debilitating long-term consequences for the health and career longevity of somatologists, many of whom have to prematurely leave their chosen career paths due to their development of CTS, or to divert income to treatment costs in an industry where earnings are typically low. The study highlighted several issues that require further and wider study, such as compensation for injury, access to medical aid or employer subsidies, inherent health risks in the nature of some treatments and the need for more education and possible adjustments to training to prevent or alleviate the onset of CTS. Such future studies should provide insight for companies within the industry to aid their revision of policies and procedures to better facilitate and support somatologists suffering from CTS.Item The epidemiology of musculoskeletal injuries in competitive lifesavers in KwaZulu-Natal(2020-11-30) Billson, Carmel Beth; O'Connor, Laura; Clifton, Stuart RonaldLifesaving is a multidimensional sport which can lead to injury and a high likelihood of overuse-related injuries. The environment within which lifesaving occurs is unique, with the soft beach sand and unpredictable nature of the ocean. It is difficult to assess the effects that injuries may have on the training and competitive performance of lifesavers as the incidence and severity of these injuries have not previously been studied in South Africa. Thus, this study investigated the epidemiology of lifesaving induced musculoskeletal (MSK) injuries in competitive lifesavers in KwaZulu-Natal. Lifesavers are under-investigated, yet the growth and development of the sport requires that athletes are assessed for injury. This study could aid in educating federations, coaches and athletes regarding MSK injuries sustained by lifesavers, thereby assisting athletes to be more competitive at national and international competition levels. Method: A quantitative, descriptive, cross-sectional epidemiological survey was used to collect data from 100 competitive lifesavers in KwaZulu-Natal. The questionnaire was pre-validated and hand delivered to the lifesaving clubs that agreed to participate, where the lifesavers selfselected to participate. Informed consent was obtained. The survey contained questions related to demographics, activity participation, psychosocial factors and the occurrence of lifesaving related musculoskeletal pain. Results: The respondents were male (65%, n=65) and had a mean age of 28.6 years (±SD 14, range 16-73). The lifetime prevalence of MSK injury from lifesaving was 72% (n=72), with a total of 177 injuries being reported with shoulder pain being the most prevalent (38%). The 12- month prevalence showed 133 injuries were sustained whereas for current prevalence there were 86 injuries. Lower back pain was most frequently reported over these periods (26% and 22% respectively). The board race was the most popular event participated in at 76% (n=76), followed by surf ski 69% (n=69) and thirdly surf swim 67% (n=67). Seventy-four percent (74%) of board paddlers, 68% of surf ski paddlers and 67% of beach sprint and flags participants had experienced MSK pain related to lifesaving. Of the 72 competitors that experienced lifesaving MSK injuries more than half reported that it negatively affected them psychologically either in training, competition or overall. Injuries cause athletes to miss training sessions, which result in loss of fitness and falling behind the other athletes, this could cause a lack of confidence, lack of self-belief and lack of motivation to continue training and competing. The worst injury that the respondents had sustained occur mostly due to running (44%), was overuse related (43%), occurring in season (70%) and was described as a sharp, shooting severe pain with a constant and recurrent nature. It affected the athlete’s participation in the sport (75%) and required them to seek medical attention (89%). The only factor found to be related to MSK injuries was the number of rest days, which was significantly lower in those who suffered injuries (p=0.04). All other demographic, health, lifestyle and lifesaving activity participation factors were not associated with MSK lifesaving injuries (p < 0.05). Conclusion: This is the first study to document MSK injuries in lifesaving athletes in South Africa. The high prevalence of injuries necessitates that mechanisms are put in place to prevent injury. In addition, the mechanics of running on sand requires further investigation to understand its impact on injury