Tawa N.1,2, Diener I.2, Rhoda A.3
1Jomo Kenyatta University of Agriculture & Technology, Rehabilitative Sciences, Juja, Kenya, 2Stellenbosch University, Faculty of Medicine & Health Sciences, Physiotherapy, Cape Town, South Africa, 3University of the Western Cape, Physiotherapy, Cape Town, South Africa
Background: Neuropathic lumbar spinal pain occurs in 23-57% of patients with low back pain. Distinguishing neuropathic pain from nociceptive pain is very imperative for the purpose of establishing etiology, prognosis, and specific therapeutic strategies. Several diagnostic neuropathic pain screening questionnaires have been developed in the recent past and the need for use of validated tools is highly recommended in practice.
Purpose: S-LANSS is a valid and reliable too widely used across the world but has not been used in Sub-Sahara Africa. We therefore aimed at validating S-LANSS among native African pain patients in the Kenyan clinical setting.
Methods: We utilised both quantitative and qualitative research methodologies. A purposive sample of 60 lumbar spinal pain patients were randomly recruited from six selected physiotherapy departments in Kenya. Step 1 involved un-aided completion of the tool by all participating patients, in step 2, we used a researcher-developed data sheet to capture patients perceptions regarding interpretation of the terms in the Kenyan context and in step 3, we conducted structured focus group discussions at each of the study centres regarding appropriateness and applicability of the tool among native Kenyan patients.
Results: 60 patients (21 males and 39 females) participated in the validation study. The patient self-reported pain intensity according to the VAS-INT ranged from moderate (52%) to severe (45%), and 53% of the patients were diagnosed as having pain of predominantly neuropathic origin (POPNO) while the remaining 47% had somatic pain type according to the S-LANSS score. There was over 78% (n=64) positive response regarding the appropriateness of the terminologies and words used in the original S-LANSS tool and the applicability of the tool among native Kenyan patients. Minimal linguistic adaptations were made to the original tool.
Conclusion(s): The minimally adapted version of the S-LANSS score is valid for use among native Kenyan patients, both in research and clinical practice. This is clinically relevant because of the fact that the S-LANSS scale is a rapid, low-risk and cost-effective but accurate screening tool which could be used in primary health care settings for early identification of patients with neuropathic pain, and considering that Kenya is one of the resource-poor countries in sub- Sahara Africa.
Implications: The minimally adapted version of the S-LANSS scale is a valid neuropathic pain diagnostic tool suitable for use among native Kenyans in resource-poor primary care settings of Kenya.
Funding acknowledgements: Directorate of research production and extension, Jomo Kenyatta University of Agriculture & Technology
Topic: Pain & pain management
Ethics approval: Senate higher degrees research ethics, University of the Western Cape
All authors, affiliations and abstracts have been published as submitted.
