Recherche en médecine familiale et en sciences médicales
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Correlates and Predictors of Low Back Pain Disability and its Impact on Health- Related Quality of Life in a Family Practice Clinic in Calabar, South- South Nigeria

Ita B Okokon, Edidiong E John, Ndifreke E Udonwa, Afiong O Oku, Udeme E Asibong and Udoezuo K Ogbonna

Background: Non-specific low back pain is a common health problem incurring immense health and social costs with concomitant disability, which has assumed significant public health importance in our setting. The impact from this condition is multi-factorial, and includes pain, activity limitations and impairment of quality of life. This study therefore aimed to examine the level of low back pain disability, its correlates and predictors, and the impact on selfperceived quality of life. It also sought to determine the predictors of health-related quality of life among low back pain patients in a Family Practice setting in Calabar, Nigeria.
Method: This was a cross-sectional analytical study involving 350 consecutively selected patients with nonspecific low back pain. Standardized questionnaires were used including: the Oswestry Disability Index (ODI) questionnaire, the 12-item General Health Questionnaire (GHQ-12), the Short-form 36 (SF-36) questionnaire and the Visual Analogue Pain Scale. These were used to assess low back pain disability, psychological distress, healthrelated quality of life and pain intensity respectively.
Result: The mean age of the respondents was 36.16 ± 9.93 years. Majority (70.6%) were females and had chronic pain lasting more than three months. Most of the respondents (88.9%) characterized their pain as severe. The mean health-related quality of life score was 45.82 ± 4.3. Factors associated with severe disability were: psychological distress and pain intensity. Significant correlations were observed between disability, pain intensity and psychological distress using Pearson’s correlation analysis. Independent risk factors for disability were psychological distress and those with chronic pain lasting more than 3 months. Overweight and obese subjects were more likely to have poor health-related quality of life when compared with those with normal body mass index (X2=8.81, P<0.05). The significant predictors of poor health-related quality of life using logistic regression were overweight/obesity and those with severe disability.
Conclusion: This study identified significant correlations between low back pain disability, pain intensity and psychological distress. These correlations could be informative and should guide family physicians in the management of the index problem in our environment. The perception of quality of life in individuals with low back pain should also raise awareness of issues connected to the problem and encourage more research into this area.