A.Y Oyeyemi1, R.B Usman2 and A.L Oyeyemi1,3
- Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
- Department of Physiotherapy, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
- Physical Activity, Sport and Recreation Research Center, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
Background: A general presumption is that any advice from physicians would likely be taken seriously by patients, and patients are more likely to see their doctors in the event of any health complaints than any other health professionals. The perceptions and practice of Nigerian physicians on their role in physical activity promotion are not well known. This study aimed to determine the knowledge of physical activity message, confidence, role perceptions, barriers and feasibility of physical activity promotion among physicians in two tertiary health institutions in North-Eastern Nigeria.
Methods: A total of 153 (84.5% response) physicians at the University of Maiduguri Teaching Hospital and Federal Medical Center Yola completed a previously developed questionnaire that elicited information on their knowledge, barrier, feasibility, role and confidence in physical activity promotion.
Results: Physicians in this study reported fairly good knowledge (mean score=14.7±2.2/20), minimal or little barrier to physical activity promotion (mean score=24.4±3.5/30), perceived physical activity promotion as their role (mean score=12.9±1.6/15), were confident in their ability to discuss and recommend exercises for physical activity promotion (mean score=7.9±1.3/ 10) and believed promoting physical activity was feasible for them (mean score=15.0±2.5/20). The physicians had good disposition to physical activity promotion (Mean score=78.5±6.7/100), but male physicians showed better disposition than their female counterparts.
Conclusions: Overall these cohorts of physicians are somewhat knowledgeable on physical activity promotion and are positively disposed to promoting physical activity among their patients. These findings can be leveraged upon to optimize outcome of campaigns or interventions to change physical activity behaviour in Nigerian populace.
Keywords: Physical activity, Exercise promotion, Medical doctors, Disposition, Active lifestyle
Dr. A.Y. Oyeyemi
Department of Medical Rehabilitation,
College of Medical Sciences,
University of Maiduguri,
Physical activity is defined as any bodily movement that is produced by skeletal muscles requiring energy expenditure.1 The term connotes movements that enhance health and is mostly used interchangeably with exercise which is a subset of physical activity that is planned, structured and repetitive with a long or short term objective of improving or maintaining physical fitness.2 Physical activity can be occupational, sports, or activities of daily living functions and others activities which are often done with little regard to physical fitness but which confers health benefits just as exercise. Physical inactivity has been identified as the fourth leading risk factor for global mortality and global estimate shows that physical inactivity causes 6% of the burden of disease from coronary heart disease, 7% of type-2 diabetes, 10% of breast cancer, 10% of colon cancer and 9% of premature mortality.3 An estimate of 0.68 years of life expectancy increase for the world population has been projected if physical inactivity is eliminated.3
Promotion of physical activity is important because there is ample scientific evidence on its benefits in the prevention, treatment, and rehabilitation of major public health diseases.4–8 Traditionally, physicians are the gatekeepers to health care and are more likely to be seen by their patients regularly than other health professional.9–11 Furthermore, a general presumption is that advice from physicians would likely be taken seriously by patients.11 Despite the benefits of physical activity and presumable advice by physicians and health professionals, adherence to it among populations is still low.12 Consequently, engaging the physicians and other health care providers in physical activity promotion has been advocated as a promising strategy to improve populations physical activity and health promotion in some developed countries.13
Previous reports exist on the belief of physicians about the importance of physical activity,14–18 and some of these show that doctors more often than not do not discuss physical activity with more than half of their patients.14,17 Physicians in the United Kingdom have good knowledge of the benefits of regular physical activity and the required level for good health, they identified lack of time as possible barriers to promoting physical activity, and they also believed that physical activity was not pertinent to patients’ complaint and is not a cogent reason for consultation and that patients would not adhere to their advice on physical activity.17 However, Australian physicians reported promoting physical activity is important and would be enacted as part of the patient’s plan of management.19
Physicians in Switzerland reported that counseling will be provided if other cardiovascular risk factors were present,20 and overwhelming majority of Canadians physicians reported asking their patients about physical activity and counseling them on physical activity.18 Conversely, less than half (43%) of US physicians counseled more than half of their patients about physical activity and only 14% prescribed exercise for more than half of their patients, and cited lack of time and effective counseling skills as barriers to effective promotion of physical activity.16 Presently there is paucity of published data on physical activity promotion and prescription by physicians and other health professional groups in sub-Sahara Africa including Nigeria, and it is unclear whether physicians in Nigeria give their patients the necessary advice on exercises and physical activity or not.
The disposition of physicians to promote and recommend physical activity and exercises to their clients is an indication of their awareness of the menace of non-communicable diseases and solution to mitigating the menace. Initiating a positive behavioural change or influencing the level of adherence to exercise and physical activity, it can be argued, hinges on the disposition of physicians and other health experts to promoting and recommending physical activity to patients and clients. The aims of the study were to determine the knowledge of physical activity message, confidence, role perceptions, barriers and feasibility of physical activity promotion among physicians at two tertiary hospitals in North Eastern Nigeria. It was also to identify any socio-demographic variables that could influence the knowledge of physical activity message, confidence, role perceptions, barriers and feasibility of physical activity promotion among physicians in the two hospitals.