Henrietta Oluwafunmilola Fawole

To explore Nigerian physiotherapists' (PTs) perspectives on competency-based roles in hospital discharge and the factors that facilitate or constrain their involvement for older adults with mobility limitations. Guided by Interpretive Description, we purposively sampled 26 Nigerian PTs (17 males, 9 females; 5-32 years of experience) from two hospitals with geriatric units. We conducted 45-60-minute semi-structured interviews in person or on Zoom. Interviews were audio-recorded and analyzed using interpretive description with borrowing techniques and multiple coders. A central theme, Competency-based Professional Identity, extends PTs' roles beyond traditional inpatient/outpatient settings. Three subthemes emerged: (a) Experts in Continuous, Integrated, and Iterative Mobility Surveillance and Monitoring; (b) Educators for Patients, Family Members, and Interprofessional Team Members; (c) Real-Time Collaborators to Enhance Continuity of Care. PTs position themselves as mobility experts who collaboratively set discharge mobility goals on admission, hospitalization, and discharge to ensure ongoing mobility monitoring after discharge. Their educator role promotes adherence to prescribed mobility interventions, while their real-time coordinator function is enhanced in Nigeria, where paid, patient-initiated home visits enable more frequent contact and allow PTs to serve as primary informants to the care team regarding progress. Findings support competency-based PT roles in discharge planning.

Background: Motivational interviewing (MI) is a client‐based approach used for strengthening a person's own motivation for change. The use of MI to address health behaviours has begun to gain attention in sub‐Saharan Africa (SSA). Adapting MI to relevant sociocultural settings could improve its accessibility and effectiveness for addressing behavioural change. Therefore, this review aimed to map the evidence on the use and cultural adaptation of MI for health behaviours in SSA. Method: We searched seven databases from inception to July 2024. Studies were eligible if MI was used to improve health behavioural outcomes, reported MI training in adults aged ≥ 18 years, and used any study design. Result: Of the 4586 studies identified, we included 81 studies in this review. More than half (57.1%) of the studies used MI to address substance or alcohol use. Training was described in only 61.7% of the studies, with less than one‐third (30.9%) assessing competence. MI was primarily delivered face to face (92.6%) and combined with other behavioural interventions (55.6%). MI sessions ranged from 1 to 10 sessions, lasting 5 min to 2 h. Only 38.75% of the studies reported cultural adaptation of MI with the use of lay counsellors as the most common adaptation. Conclusion: The application of MI for substance or alcohol use as reported in most studies reflects its original purpose. The number and duration of sessions vary significantly across studies, demonstrating MI's flexibility. However, gaps remain in reporting training, competence assessment and cultural adaptation of MI.

Objectives: To identify non-pharmacological fatigue interventions and determine the effectiveness of these non-pharmacological interventions in reducing fatigue immediately and over time in OA. Methods: A review protocol (CRD42020163730) was developed and registered with the PROSPERO database. Included studies comprised peer-reviewed randomized controlled trials (RCTs) that examined the effects of conservative interventions on fatigue in people with upper and lower limb OA. Cochrane Collaboration’s tool for assessing the risk of bias (ROB-2) was used to assess the quality of evidence of studies. Narrative synthesis was used to summarize the effectiveness of identified fatigue interventions. Results: Out of 2644 citations identified from databases, 32 reports were included after screening for titles, abstracts and full texts. Of these reports, 30 parallel RCTs, one cluster and one cross-over RCT were included. 13 RCTs were of low ROB, 6 had some concerns and 13 had high ROB. The narrative synthesis identified interventions for fatigue including exercise, activity pacing, cognitive behavioural therapy, telerehabilitation and complementary alternative therapies. Exercise interventions showed the most significant beneficial effects on fatigue. Conclusions: Diverse interventions for fatigue management among individuals with upper and lower limb OA were identified. Of these, exercise interventions appear to be the most promising with the majority of these interventions favouring fatigue improvement. While cognitive behavioural therapy has limited evidence of beneficial effects, there is insufficient evidence regarding the effectiveness of other identified interventions, including complementary and alternative therapies, and telerehabilitation.

COVID-19 lockdown, targeted at preventing the spread of coronavirus, had deleterious effects on physical and psychosocial health. This study examined the association between physical activity (PA), sedentary behaviour, health-related quality of life (...

Objective: The aim was systematically to identify and evaluate factors related to fatigue in individuals with hip and/or knee OA.Methods: A systematic literature search was conducted using AMED, CINAHL, MEDLINE, ProQuest and Web of Science Core Collections databases. Inclusion criteria comprised cross-sectional, case–control or longitudinal studies on patients with a diagnosis of hip and/or knee OA that included self-reported fatigue measures. Study quality was assessed using the National Heart, Lung and Blood Institute quality appraisal tool, and factors were synthesized within a bio-behavioural framework. Study designs and quality were combined to determine current evidence levels using best evidence synthesis grading. The full review protocol is available from PROSPERO (PROSPERO 2019: CRD42019138571).Results: Twenty-four studies were included, of which 19 were high, 4 moderate and 1 low quality. There was strong evidence of an association between poor self-reported physical function and high depressive symptoms with higher fatigue. Moderate evidence of an association was found between severe pain, high numbers of co-morbidities and low physical activity levels with higher fatigue. There was moderate or limited evidence of no association between most sociodemographic factors and radiographic OA severity with fatigue.Conclusion: Targets for fatigue management might include improving physical function, reducing depressive symptoms, pain and co-morbidities, and increasing physical activity levels. There is a need for more rigorous longitudinal studies to understand the causal effect of fatigue determinants within the hip and knee OA populations.

Aim: The aim of the study was to identify sociodemographic, disease‐related, physical and mental health‐related determinants of fatigue at 2‐year follow‐up in individuals with symptomatic knee osteoarthritis (OA).Methods: A longitudinal analysis of participants with symptomatic knee OA from the Multicenter Osteoarthritis Study (MOST) was conducted to identify predictors of fatigue at 2‐year follow‐up. Participants self‐reported fatigue at baseline for the first time in the MOST cohort and at follow‐up using a 0‐10 visual analog scale. At baseline, questionnaires on sociodemographics, disease‐related symptoms, physical and mental health factors were completed. Data were analyzed using linear regressions with a backwards elimination approach.Results: Of the 2330 individuals in the MOST cohort at baseline, 576 had symptomatic knee OA and of these, 449 with complete fatigue values at baseline and follow‐up were included in this analysis. Minimally important fatigue change (ie, worsening [≥1.13], no change [2 [2, N = 449] = 9.32, P = .009). The multiple linear regression showed that baseline fatigue (unstandardized coefficient [Β] = 0.435; 95% confidence interval [CI] 0.348‐0.523, P < .001), slow gait speed (Β = −1.124; 95% CI −1.962 to −0.285, P = .009), depressive symptoms (Β = 0.049; 95% CI 0.024‐0.075, P < .001) and higher numbers of comorbidities (Β = 0.242; 95% CI 0.045‐0.439, P = .016) were significant predictors of greater fatigue at follow‐up.Conclusion: Fatigue is strongly associated with physical‐ and mental‐related health factors. Individualized treatments that include combined psychological and physical function rehabilitation might be modalities for fatigue management.