Patient satisfaction with postoperative spine rehabilitation at the National Orthopaedic Hospital Dala Kano, Nigeria: A Cross-Sectional Study

Background: Postoperative rehabilitation is essential for optimal recovery after spine surgery, yet rehabilitation services in Nigerian tertiary hospitals face significant resource constraints. This study aimed to assess patient satisfaction with postoperative spine rehabilitation services and identify factors influencing satisfaction at the National Orthopaedic Hospital Dala, Kano, Nigeria.
Methods: A cross-sectional study was conducted at the Physiotherapy Department of the National Orthopaedic Hospital Dala, Kano, between January and March 2025. Consecutive adult patients who had undergone spine surgery and were attending postoperative rehabilitation were recruited. Data were collected using an interviewer-administered questionnaire capturing sociodemographic characteristics, rehabilitation parameters (waiting time, session duration, number of sessions), and satisfaction measured using a 5-point Likert scale across five domains: access, facility/equipment, therapist-patient interaction, information provision, and overall satisfaction. The department operates with 5 trained physiotherapists and few assistants seeing approximately 100 patients daily over 8 hours, with patients attending once weekly for 10-minute sessions. The department is ill-equipped with no in-house or external training opportunities. Multivariate logistic regression identified independent predictors of overall satisfaction.
Results: A total of 342 patients participated (response rate 91.2%). Mean age was 52.4 ± 13.8 years; 56.1% were male. Majority (68.4%) had undergone lumbar surgery. Median waiting time was 45 minutes (IQR: 30–75), while median session duration was 10 minutes (IQR: 8–12). Patients attended a median of 8 sessions (IQR: 4–12). Overall satisfaction rate was 42.1% (144/342). Domain-specific satisfaction was highest for therapist interpersonal aspects (58.2%) and lowest for facility/equipment (18.7%) and access (31.3%). Factors independently associated with lower satisfaction included: waiting time >60 minutes (OR: 0.38; 95% CI: 0.24–0.60; p<0.001), session duration <10 minutes (OR: 0.45; 95% CI: 0.29–0.70; p<0.001), perceived inadequate equipment (OR: 0.21; 95% CI: 0.13–0.34; p<0.001), and lack of explanation about exercises (OR: 0.36; 95% CI: 0.23–0.56; p<0.001). Higher satisfaction was associated with perceived therapist competence (OR: 3.12; 95% CI: 2.01–4.84; p<0.001) and receiving a home exercise programme (OR: 2.48; 95% CI: 1.62–3.80; p<0.001). Major reasons for dissatisfaction were: inadequate equipment/facilities (78.8%), short session duration (67.2%), long waiting time (58.6%), and insufficient explanation (45.5%).
Conclusion: Patient satisfaction with postoperative spine rehabilitation at the National Orthopaedic Hospital Dala is low, with fewer than half of patients reporting satisfaction. Severe resource constraints—inadequate staffing (5 therapists for 100 patients daily), extremely brief sessions (10 minutes weekly), ill-equipped facilities, and lack of staff training opportunities—are the primary drivers of dissatisfaction. Urgent system-level interventions including increased staffing, equipment provision, extended session duration, and staff development programmes are needed to improve rehabilitation quality and patient experience.