Smedley Julia, Trevelyan Fiona, Inskip Hazel, Buckle Peter, Cooper Cyrus, Coggon David
Environmental Epidemiology Unit, Medical Research Council, Community Clinical Sciences, University of Southampton, Southampton, United Kingdom.
Scand J Work Environ Health. 2003 Apr;29(2):117-23. doi: 10.5271/sjweh.713.
This study assessed the impact of ergonomic intervention on rates of low-back pain among hospital nurses.
Altogether 1239 female nurses from two hospitals in southern England completed a baseline postal questionnaire about low-back pain and associated risk factors. Between 18 and 28 months after the baseline survey, major intervention was implemented at one hospital to minimize unassisted patient handling and high-risk nursing tasks. At the other, no intervention was initiated, and efforts to improve patient handling were more limited. Thirty-two months after the baseline survey, a second postal survey was carried out in both hospitals (1,167 respondents) to reassess the prevalence of symptoms and risk factors.
After adjustment for nonoccupational risk factors, prevalent low-back pain at baseline was associated with low job satisfaction and the performance of patient-handling activities without mechanical aids. After the intervention, the prevalence of occupational risk factors was somewhat lower, but similar improvements occurred at the comparison hospital. At the intervention site the prevalence of symptoms increased slightly (from 27% to 30%), whereas at the comparison site there was no change, the prevalence remaining constant at 27%. Calculations based on the association of risk factors with symptoms at baseline and the observed changes in their prevalence indicated that the change in risk factors was insufficient to produce a substantial reduction in back pain.
These findings cast doubt on the means by which many hospitals are attempting to improve the ergonomics of nursing activities. More effective methods of implementing changes in work systems are needed.
本研究评估了人体工程学干预对医院护士腰痛发生率的影响。
来自英格兰南部两家医院的1239名女护士完成了一份关于腰痛及相关风险因素的基线邮寄问卷调查。在基线调查后的18至28个月期间,一家医院实施了主要干预措施,以尽量减少无辅助的患者搬运和高风险护理任务。另一家医院则未启动干预措施,改善患者搬运的努力较为有限。基线调查32个月后,两家医院均进行了第二次邮寄调查(1167名受访者),以重新评估症状和风险因素的患病率。
在对非职业风险因素进行调整后,基线时普遍存在的腰痛与工作满意度低以及无机械辅助设备进行患者搬运活动有关。干预后,职业风险因素的患病率有所降低,但对照医院也出现了类似的改善。在干预地点,症状患病率略有上升(从27%升至30%),而在对照地点则没有变化,患病率保持在27%不变。根据基线时风险因素与症状的关联以及其患病率的观察变化进行的计算表明,风险因素的变化不足以使背痛大幅减少。
这些发现对许多医院试图改善护理活动人体工程学的方式提出了质疑。需要更有效的方法来实施工作系统的变革。