Prevalence and Factors Associated with Fear of Falling in the Elderly Attending a Tertiary Hospital in South-South Nigeria.

BACKGROUND: Fear of falling is a loss of confidence in balance which affects the quality of life of the elderly. Falls in older people can result in disability, death, financial stress on the family, and higher medical expenses. A significant proportion of those who fall are said to be afraid of falling. This study determined the prevalence and the factors associated with the fear of falling in the elderly attending the Rivers State University Teaching Hospital, Port Harcourt. METHODS: This was a cross-sectional study of patients, 60 years and older, attending the Family Medicine clinic in the hospital. A questionnaire was used to collect data on the socio-demographic characteristics, history of chronic illness and lifestyle of the respondents. It also included the Modified Fall Efficacy scale to assess the fear of falling in the respondents and the functional assessment of the respondents was also carried out using the Timed Up and Go Test (TUG). Descriptive analysis and logistic regression were done to determine the factors associated with the fear of falling in the elderly. RESULTS: A total of 292 patients consented to participate, Fear of falling was prevalent in 58 (19.9%) of the participants. The female gender was found to have 50% lower odds of having a fear of falling than their male counterparts (O.R.=0.541, 95% C. I=0.327-0.896) An association was found between reduced frequency of physical activity and fear of falling. (χ2=10.25 P-value=0.006) An association was found between fear of falling and TUG as those with a fear of falling took a longer time to complete the TUG test. CONCLUSION: The study suggests that healthcare professionals should routinely investigate the fear of falling in geriatric care to devise preventive and intervention strategies to combat the fear of falling among the elderly.

CONTEXTE: La peur de tomber est une perte de confiance en l'équilibre qui affecte la qualité de vie des personnes âgées. Les chutes chez les personnes âgées peuvent entraîner une invalidité, la mort, une pression financière sur la famille et des dépenses médicales plus élevées. Une proportion significative de ceux qui tombent est dite avoir peur de tomber. Cette étude a déterminé la prévalence et les facteurs associés à la peur de tomber chez les personnes âgées fréquentant l'Hôpital Universitaire de Rivers State, à Port Harcourt. MÉTHODES: Il s'agissait d'une étude transversale des patients âgés de 60 ans et plus, fréquentant la clinique de médecine familiale de l'hôpital. Un questionnaire a été utilisé pour recueillir des données sur les caractéristiques sociodémographiques, les antécédents de maladies chroniques et le mode de vie des répondants. Il comprenait également l'échelle modifiée d'efficacité des chutes pour évaluer la peur de tomber des répondants et l'évaluation fonctionnelle des répondants a également été réalisée à l'aide du test Timed Up and Go (TUG). Des analyses descriptives et une régression logistique ont été effectuées pour déterminer les facteurs associés à la peur de tomber chez les personnes âgées. RÉSULTATS: Un total de 292 patients ont consenti à participer, la peur de tomber était prévalente chez 58 (19,9 %) des participants. Le sexe féminin avait 50 % moins de chances d'avoir peur de tomber que leurs homologues masculins (O.R.=0,541, 95% C.I=0,327-0,896). Une association a été trouvée entre la réduction de la fréquence de l'activité physique et la peur de tomber (χ2=10,25, P-value=0,006). Une association a été trouvée entre la peur de tomber et le TUG, car ceux qui avaient peur de tomber mettaient plus de temps à terminer le test TUG. CONCLUSION: L'étude suggère que les professionnels de la santé devraient systématiquement enquêter sur la peur de tomber dans les soins gériatriques afin de concevoir des stratégies préventives et interventionnelles pour combattre la peur de tomber chez les personnes âgées. MOTS-CLÉS: Peur de tomber, Personnes âgées, Prévalence des chutes, Test Timed Up and Go, Échelle modifiée d'efficacité des chutes.

FAMILY PLANNING SERVICE UPTAKE IN HOSPITALS IN RIVERS STATE, NIGERIA.

Introduction: Family planning refers to a couple's ability to have the number of children they want by spacing out their children appropriately or a person's ability to avoid unintended pregnancies by using various contraceptive methods and infertility treatment. All hospitals in Rivers State, Nigeria, that provide primary care, offer family planning services. Aim: To describe the pattern of family planning service uptake in the hospitals in Rivers State. Methodology: An 8-year retrospective review of data collection from the District Health Information System 2 (DHIS 2) platform in the Health Management Information System in Rivers State was conducted. Data from 387 health facilities were collated and keyed into the DHIS2 platform. Data was analysed using SPSS version 21 and represented as frequencies, percentages and charts. Results: During the period under review, the Family Planning clinics counselled a total of 931,774 individuals, of whom 421,785 (45.3%) accepted family planning services. Condoms (65.3%) were the most widely utilized contraceptive, whereas bilateral tubal ligation (0.1%) was the least utilized. Other methods were injectable, implant, oral contraceptive pills and intrauterine contraceptive devices accounting for 16.1%, 9.4%, 7.8%, and 1.3%, respectively. A significant increase was observed in the trend of use of condoms, injectables and oral contraceptive pills between 2016-2021. Conclusion: The findings were that there was an increasing trend in the yearly utilization of family planning services among women of childbearing age in the State from 2014 - 2021. Condom being the most utilized indicates that it is the most accepted and approved by clients in family planning clinics in Rivers State. The knowledge of contraceptive utilization trends can be used to monitor and appraise the acceptance and approval of each method and family planning program over a period.

FEAR OF FALLING AND ITS RELATIONSHIP WITH QUALITY OF LIFE IN THE ELDERLY ATTENDING A FAMILY MEDICINE CLINIC IN SOUTH-SOUTH NIGERIA.

Introduction: Aging is linked to increased morbidity, higher fear of falling (FOF), and decreased activity, with attendant hampered of quality of life (QOL) in the elderly. Therefore, this study determined the relationship between Fear of falling and Quality of life among the elderly attending a tertiary hospital in Port Harcourt, Rivers State. Method: This was a hospital-based cross-sectional study where 292 participants were recruited by a systematic sampling method and the data was collected using an interviewer-administered questionnaire (which includes age and gender, the Modified Fall Efficacy scale to assess FOL and the 12-item short health survey form [SF-12] to asses QOL). The SPSS version 26.0 was used to perform the data analysis. Results: The mean age of the respondents was 68.5 years ±6.6 years. More of the participants were females and they were more likely than males to be very fearful of falling (37.7% vs 11.1%, respectively). Females aged 60-69 (36.3%) were most likely to express a fear of falling. The PCS-12 correlated with fear of falling as the scores were very low indicating that respondents had some level of loss of physical function. MCS did not correlate with Fear of falling as the scores were fair in both those with a FOF (MFES< 7.99) and those without a FOF (MFES>8). Conclusion: The observed correlation between FOF and QOL domain scores suggests that Fear of falling should be routinely investigated among the elderly irrespective of reason(s) for encounter.

PREVALENCE AND FACTORS ASSOCIATED WITH FEAR OF FALLING IN THE ELDERLY ATTENDING A TERTIARY HOSPITAL IN SOUTH-SOUTH NIGERIA.

Introduction: Fear of falling is a loss of confidence in balance which affects the quality of life of the elderly. Falls in older people can result in disability, death, financial stress on the family, and higher medical expenses and a significant proportion of those who fall are said to be afraid of falling. Objective: To determine the prevalence and the factors associated with Fear of falling in the elderly attending the Rivers State University Teaching Hospital, Port Harcourt. Methodology: A cross-sectional study of patients, 60 years and older, attending the Family Medicine clinic. A questionnaire (which included the Modified Fall Efficacy scale) was used to collect data on the socio-demographic characteristics and fear of falling. The functional assessment of the respondents was done using the Timed Up-and-Go test (TUG). Descriptive analysis and logistic regression were done to determine the factors associated with the fear of falling. Results: Of the 292 respondents, fear of falling was prevalent in 58 (19.9%) of them. The female gender was found to have 50% lower odds of having a fear of falling than their male counterparts (O.R.=0.541, 95% C.I=0.327-0.896). An association was found between fear of falling and TUG as those with a fear of falling took a longer time to complete the TUG test. Conclusion: The study suggests that healthcare professionals should routinely investigate the fear of falling in geriatric care to devise preventive and intervention strategies to combat the Fear of falling among the elderly.

Assessment of Healthcare-Seeking Behaviour and Self-Medication among Adult Patients with Gastrointestinal Symptoms at a Rural Clinic in the Niger Delta of Nigeria.

BACKGROUND: Patients' behaviour in making decisions regarding their health is currently changing from a passive role to an active one in which they participate fully in the control of their health as well as take initiatives in self-care. OBJECTIVES: This study evaluated health-seeking behaviour and practice of self-medication among patients with abdominal pain in a rural Primary Health Centre in the Niger Delta. METHODS: This was a cross-sectional study among 400 patients that attended the Primary Health Centre in Oyorokoto, Rivers State, Nigeria. Interviewer-administered questionnaires were used to collect data on participants' demographics, medicines-taking behaviour, and practice of self-medication, Data analysis was done using Statistical Package for Social Science for windows version 20. The p-value of <0.05 at a confidence level of 95% was considered significant. RESULTS: Most of the participants chose to consult formal health care when they experienced health problems (57.3%), and self-medication prevalence was 29.5%. The majority of the respondents (65.8%) took medication based on a health worker's advice while 32.5% depended on past experience with a similar illness. The practice of self-medication was significantly associated with gender, age, and religion. The female gender and older age groups significantly practice self-medication compared to the males and younger age groups(p<0.001). Christians significantly practice self-medication (p = 0.038). CONCLUSION: Increasing public awareness of the rational choice of getting medical assistance is very important. A health education program to increase awareness about the use of medicines among the general public and to enable them make the right decisions relating to their health problems is advocated.

CONTEXTE: Le comportement des patients dans la prise de décisions concernant leur santé est actuellement en train de passer d'un rôle passif à un rôle actif dans lequel ils participent pleinement au contrôle de leur santé et prennent des initiatives en matière de soins personnels. OBJECTIFS: Cette étude a évalué le comportement de recherche de santé et la pratique de l'automédication chez les patients souffrant de douleurs abdominales dans un centre de santé primaire rural du delta du Niger. METHODES: Une étude transversale auprès de 400 patients qui ont fréquenté le centre de santé primaire à Oyorokoto, dans l'État de Rivers, au Nigéria. Des questionnaires administrés par des intervieweurs ont été utilisés pour recueillir des données sur les données démographiques des participants, le comportement des participants prenant des médicaments et la pratique de l'automédication, l'analyse des données a été effectuée à l'aide du package statistique pour les sciences sociales (SPSS) pour Windows version 20. La valeur de p de <0,05 au niveau de confiance de 95 % a été jugée significative. RESULTATS: La plupart des participants ont choisi de consulter des soins de santé formels lorsqu'ils ont éprouvé des problèmes de santé (57,3 %), la prévalence de l'automédication était de 29,5 %. La majorité des répondants (65,8 %) ont pris des médicaments sur les conseils d'un agent de santé, tandis que 32,5 % dépendaient d'expériences antérieures avec une maladie similaire. La pratique de l'automédication était significativement associée au sexe, à l'âge et à la religion.Le sexe féminin et les groupes d'âge plus âgés pratiquent significativement l'automédication par rapport aux hommes et aux groupes d'âge plus jeunes (p<0,001). Les chrétiens pratiquent de manière significative l'automédication (p = 0,038). CONCLUSION: Il est très important de sensibiliser davantage le public au choix rationnel d'obtenir une assistance médicale. Un programme d'éducation sanitaire visant à sensibiliser le grand public à l'utilisation des médicaments et à lui permettre de prendre les bonnes décisions concernant ses problèmes de santé est préconisé. Mots-clés: Symptômes gastro-intestinaux, Comportement de recherche de soins de santé, Automédication, Rural.

Prevalence of low back pain among peasant farmers in a rural community in South South Nigeria.

INTRODUCTION: This study was undertaken to assess the prevalence and predominant causes of low back pain (LBP) among peasant farmers in Ebubu community in South-south Nigeria. METHODS: This was a community based cross-sectional study of 310 consenting, adult, full-time farmers, recruited using a two-stage cluster sampling scheme developed by WHO. Specially trained community health extension workers interviewed participants using a pre-tested questionnaire designed by the authors to solicit information on defined LBP. Socio-demographic characteristics were also obtained. A clinical history was recorded, including: duration of LBP and mode of onset, pain severity, knowledge of LBP causes and care-seeking practices. Participants' BMI were calculated. Data were entered into Microsoft Excel and analyzed using the Statistical Package for Social Sciences v15 (www.spss.com). RESULTS: Of the 310 apparently healthy farmers (age range 18-58 years [mean 36.71±8.98]; 132 males) sampled, 208 had LBP (67.10%). Low back pain was more prevalent in the 31-40 years age group (49.04%), females (50.96%), those who were non-obese (68.95%) or tall (73.2%) and those who had practiced farming for a long duration. Severe LBP was significantly (p<0.05) linked to aging (51-60 years group), low BMI and those above average height (1.60 m). CONCLUSION: This study indicates that LBP is a prevalent health problem among rural peasant farmers. It was more prevalent in the middle-aged groups, and among females, the non-obese and tall individuals, and those who had been farming for a long duration. Severe LBP was linked to aging, high BMI and those above average height.

Sources of healthcare financing among surgical patients in a rural Niger Delta practice in Nigeria.

INTRODUCTION: The environmental degradation following crude oil exploration in the Niger Delta has resulted in poverty for local rural dwellers. For those who are ill, if herbal treatments and/or self-medication with orthodox drugs are unsuccessful, the only alternative is expensive medical treatment in clinics. Surgical patients in a rural clinic may have to stay beyond than the normal 7 days if they are unable to pay their hospital bill; because this limits bed availability, there is an impacts on the hospital's economic management. This study aimed to determine the pattern of hospital bill payment among rural surgical patients in a rural Nigerian community, including the sources of finance for bill payment, in order to determine ways to resolve this issue. METHOD: This cross-sectional study was conducted in a rural community in the Niger Delta area (Bethesda Clinic Ngo) over 5 years (2005-2009). RESULTS: In the 5 year study period, 3712 patients were seen, of which 229 were surgical patients who consented to the study. Their ages ranged from 4 to 97 years (mean 45.6 ± 13.5 years) and most were fish farmers (79.91%), secondary-school leavers (56.33%) and of the Christian religion (86.03%). The association of these characteristics with a greater than 7 day hospital stay was statistically significant (p < 0.05). The most prevalent surgical procedure was herniorrhaphy but the longest staying patients were those who had an ectopic pregnancy (23.32 ± 7.52 days), cesarean section (19.51 ± 6.73 days), appendectomy (18.46 ± 6.82 days) and exploratory laparotomy (17.33 ± 8.32 days). The hospital bill ranged from US$33.3 to $500, with a mean of $105.7 ± 0.043. Their sources of finance for the hospital bill were multiple but mainly personal savings (71.18%). Few (3.06%) had knowledge of the National Health Insurance Scheme, but when informed about it 84.28% were willing to enroll. CONCLUSION: The sources of finance for payment of hospital bills were multiple but the most common were personal savings and family members.