The proposed scoping review will be conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines(8).
Scoping review frameworkThe proposed framework by Arksey H & O’Malley will be adopted for this scoping review(9). The framework involves (I) identifying the research question, (II) identifying relevant studies, (III) study selection, (IV) charting the data, and (V) collating, summarizing, and reporting the results
I. Identifying the research question
The main research question is: “What is the evidence on the burden of work-related musculoskeletal disorders in Sub-Saharan Africa?
Research sub-questions will be as follows:
- What is the burden of WMSDs among nurses in Sub-Saharan Africa with estimation in relation to prevalence, incidence and mortality?
- What are the risk factors associated with WMSD?
- What are the economic costs associated with WMSD?
Eligibility criteria
Studies will be selected according to the PEO (population, exposure, and outcomes) framework outlined below (Table 1)
Table 1: PEO framework for eligibility of research question
Criteria
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Determinants
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Population and their problem
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Nurses with MSD in Sub Saharan Africa
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Exposure
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Hospital work
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Outcome
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1.Prevalence
|
|
2.Incidence
|
|
3.Mortality
|
|
4.Risk factors
|
|
5.Economic costs
6.Low back ache
|
II. Search strategy
Keyword search will be conducted from various electronic databases without a date limit; PubMed, CINAHL, Google Scholar, nursing academic editions and World Health Organization (WHO) library databases. Furthermore, we will work closely with the University of KwaZulu-Natal library services during the database searching and retrieval to improve the quality of our search strategy of articles. Keywords that will be used to search for these databases are as follows: work related musculoskeletal disorders, nurses, musculoskeletal disorders, low back ache, prevalence, incidence, mortality, economic costs related to MSD and risk factors. During the search, keywords will be separated by Boolean terms (AND, OR). MESH terms will also be used. Furthermore, the reference lists of studies eligible for inclusion will be screened for potential additional articles. Due to under-representation of literature in this area, we will do a global search approach then contextual interpretation for Sub-Saharan Africa. Sub-Saharan African country names and truncated terms such as west Africa, east Africa or southern Africa will be used to retrieve articles indexed using African country specific names or regional terms are retrieved (Appendix I).
III. Study selection
Two independent reviewers will conduct screening, guided by the eligibility criteria for this review. The support from the University of KwaZulu-Natal library services will be sought during database searching and retrieval of articles. The PRISMA (preferred reporting items for systematic reviews and meta-analysis) flow diagram will be used to document the review process (8). Articles with relevant title to the subject of the research will be uploaded to Endnote version X7 X7.7.1. The titles and abstracts that do not meet the study eligibility criteria will be excluded. Discrepancies between reviewers will be resolved through consensus and will involve a third reviewer.
Eligibility criteria
Inclusion criteria
- Study will include nurses with low back ache
- All the study designs with relevant intervention
- Studies that focus on work-related musculoskeletal disorders among nurses; prevalence, incidence, mortality, economic costs and risk factors.
- Only studies conducted in English and in other languages with an English version will be included.
Exclusion criteria
- Studies that do not focus on nurses and low back ache
- Studies that do not focus on work-related musculoskeletal disorders among nurses
- Studies conducted outside Sub-Saharan Africa
- Studies published in languages other than English and do not have an English version will also be excluded.
Study limitation
We have got limitations as far as the language is concerned because we use English in our setting as it is the language that we understand, hence the potential to exclude relevant articles that are published in other languages.
PRISMA flow chart will be used to report the screening results
Table 2 will be used to show the results of the titles searched from different databases.
Table 2 Database search record
Date of search
|
Search engine
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Keyword search
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Number of articles found
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Number articles eligible
|
PRISMA flow chart (Additional file 1: Figure S1) will be used to summarize the inclusion and exclusion criteria.
IV. Charting the data
The relevant data will be drawn out using an extraction form (Appendix 2). In addition to answering the research question a charting form will be developed in such a way that it covers all the needed variables and it will be regularly updated when need arise. The extraction form will continually be updated. Then the form (Table 3) which includes the following: author with date, study title, study design, study setting, population, study aim, intervention, percentages, outcomes of the study, key findings, and comments will be used to chart the data of all the reviewed articles, coded using a coding system. This is purposively done to keep track of the studies included and excluded during the charting process of the scoping review.
Table 3: Data charting form
Author and date
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Study design
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Study setting
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Population
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|
|
Aims
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Intervention
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Outcome
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Key findings
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Conclusions
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Comment
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V. Collating, summarizing, and reporting the results.
The proposed scoping review aims to map the existing evidence on the distribution of work-related musculoskeletal disorders among nurses in Sub-Saharan Africa and to sum up the findings as presented in the relevant articles. All data relating to prevalence of MSD and low back ache, incidence of MSD, mortality of MSD, risk factors of MSD, economic costs related to MSD will be extracted and structured for the purpose of identifying themes. A descriptive report of the findings from literature will be presented through thematic content analysis. The structure of the literature will assume the following estimates; prevalence, incidence, mortality, economic cost and risk factors. The explanation of the findings will be analyzed to see how they relate to the overall study purpose and the implications of these findings for future research, policy, and practice.
Quality assessment
Assessment of the evidence from different studies will be conducted for quality, this will be done in order to ensure appropriateness of the study design to the research objectives and to minimize risk of bias. A quality appraisal tool which focuses on the study methods, the Mixed Method Quality Appraisal Tool (MMAT) Version 2011, will be used (10) . The tool will be used to examine the quality of an article looking at the following aspects: the appropriateness of the aim of the study, adequacy and methodology, study design, participant recruitment, data collection, data analysis, presentation of findings, authors’ discussions, and conclusions.