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Theses and dissertations (Health Sciences)

Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/12

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    Identification and management of yellow flags in chronic low back pain by Chiropractic Master's students at a University of Technology teaching clinic
    (2023-05-31) Egumbo, Shameez; Ghuman, Shanaz
    Chronic low back pain (CLBP) is one of the leading causes of disability worldwide, preventing many people from performing day to day tasks. Low back pain is the third most common reason for visits to the doctors, right after skin disorders and osteoarthritis. Even though doctors of chiropractic treat more than just back pain, many patients initially visit a chiropractor looking for relief from this persuasive condition. Yellow flags are psychosocial issues that can be indicative of long-term chronicity in low back pain. It is therefore appropriate for chiropractors to know how to manage yellow flags in patients with low back pain, since the two are related. The aim of this study, therefore, is to investigate the identification, knowledge, and the management of yellow flags at teaching clinic by chiropractic master’s students. AIM AND OBJECTIVES OF THE STUDY The aim of the study was to explore and describe the identification and management of yellow flags in chronic low back pain by chiropractic master’s students at a university of technology teaching clinic. METHODOLOGY A qualitative, exploratory, descriptive study was conducted. Master’s degree chiropractic students, who had been clinically active for five months and treated a minimum of five low back pain patients were interviewed to establish their identification and management of yellow flags in CLBP. Semi-structured interviews were conducted in English, which were then transcribed to a Microsoft Word document. The transcripts were analysed using Tsech’s eight steps of thematic analysis to establish the themes, categories and codes. RESULTS AND DISCUSSION This qualitative, descriptive study explored 10 chiropractic master’s students’ identification and management of yellow flags in their chronic low back pain patients. It was found that the chiropractic master’s students had limited understanding of psychosocial factors. Their lack of information and clinical expertise lead to uncertainty pertaining to the identification, assessment and management of yellow flags. The participants acknowledged their shortcomings and suggested numerous limitations to the integration of psychosocial assessments as part of routine practice. The lack of formal education in the theory, assessment and management was the most frequently cited barrier among those raised by the participants. The review of the chiropractic curricula was outside the purview of this study. Nevertheless, considering the comparable findings reported in the literature further supported this, it may suggest a need for chiropractic education of yellow flag assessment and management to be reviewed and strengthened. CONCLUSIONS This is the first South African study that had been conducted on registered master’s degree chiropractic students’ identification and management of yellow flags in chronic low back pain. This study will add to the existing literature and enable other registered master’s degree students and new graduate chiropractors to have a better understanding of the of the management of yellow flag patients.
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    The role of psychosocial risk factors on the prevalence of low back pain amongst Grade 12 learners in public schools in the greater Durban area
    (2010) Seethal, Verusha J.; Van Niekerk, L.; Wilson, Laura Maie
    Background: Low back pain (LBP) is the most prevalent musculoskeletal condition experienced by human beings and the most common cause of disability in developed nations. Psychosocial factors, involving aspects of social and psychological behaviour, have previously been documented as potential risk factors in the development of adult LBP. However, more research is required to fully understand the role of psychosocial risk factors on the prevalence of LBP amongst adolescents. Objective: To determine the prevalence of LBP and to identify selected psychosocial risk factors associated with LBP amongst Grade 12 learners in the Greater Durban area. Methods: A population-based study was conducted amongst a stratified random sample of 20 public secondary schools in all three educational districts in the Greater Durban area. Data was collected by means of a structured questionnaire administered to the sample population consisting of Grade 12 learners. Using an exploratory research design, the individuals reported on demographics as well as prevalence, severity, frequency and chronicity of LBP. In addition, data was obtained regarding various psychosocial risk factors including depression, exam stress and anxiety, socio-economic status, family history of LBP, smoking, alcohol and drug abuse amongst the respondents. Results: The prevalence of LBP was 57.42% with a median frequency of 8 times a month. About a third (33.9%) of the respondents experienced difficulty bending whilst 35% reported that their LBP spread down to the legs below their knees. The daily activity most affected by LBP was having a good night‟s sleep (50.6%), followed closely by playing sports (47.4%) and concentrating in class (46.6%). The majority of the respondents that suffered from LBP had taken pain relief medication (47.1%) whilst only 21% of the respondents had missed school because of LBP. With regards to the psychosocial risk factors under investigation, three of the risk factors did not show any association to LBP. They included socio-economic status, smoking and recreational drug use. In contrast, five psychosocial risk factors showed an 6 association to LBP. They included alcohol abuse, family history, exam stress, anxiety and depression. Finally, after adjusting for all other risk factors for adolescent LBP, depression and high exam stress showed the strongest correlation with the occurrence of LBP amongst Grade 12 learners in the Greater Durban area. Conclusion: LBP amongst adolescents is a common problem that increases with age, representing a risk for LBP in adulthood. The researcher is of the opinion, that this illustrates the need for further investigations with more profound studies on the risk factors so that more light can be shed on how to manage this ever-growing problem.