Tong Henry C, Haig Andrew J, Nelson Virginia S, Yamakawa Karen S-J, Kandala Geeta, Shin Ki Y
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48108, USA.
Arch Pediatr Adolesc Med. 2003 Nov;157(11):1128-33. doi: 10.1001/archpedi.157.11.1128.
Low back pain (LBP) in occupational settings has been studied extensively. There are fewer studies on LBP in domestic settings, especially in an informal caregiving setting.
To compare the prevalence of LBP in adult female primary caregivers of children with physical disabilities who need assistance with transfers (eg, moving from a bed to a wheelchair) with the prevalence of LBP in adult female primary caregivers of children with nondisabling medical illnesses and to evaluate the factors associated with LBP.
A 15-minute, self-administered, cross-sectional survey.
University-based clinics. Subjects Ninety consecutive adult female caregivers of children presenting to a pediatric physical medicine and rehabilitation clinic and 23 consecutive adult female caregivers of children presenting to a pediatric endocrine clinic were studied. General exclusionary criteria included the following: male sex, a history of back surgery or fracture, the caregiver was younger than 18 years old at the time of the completion of the questionnaire, or the caregiver was caring for any child younger than 2 years old. Caregivers visiting the pediatric endocrine clinic were excluded if they were caring for 1 or more children needing assistance with transfers.
The dependent variable was the presence of LBP. The independent variables were mood, work status, amount of lifting at work, physical functioning of the child, demographic variables of the caregiver, and demographic variables of the child.
The prevalence of having LBP (71.1%) in the physical medicine and rehabilitation group is higher than the prevalence (43.5%) in the endocrine clinic group (odds ratio, 3.2; 95% confidence interval, 1.25-8.21). The prevalence of having LBP (80.3%) when the child required physical assistance with transfers was significantly higher than the prevalence (40.5%) when the child did not require physical assistance with transfers (odds ratio, 2.56; 95% confidence interval, 2.56-14.0). Forward multiple logistic regression showed that the factors related to LBP in the caregiver were the transferability of the child, mood of the caregiver, and a history of LBP in the caregiver.
The prevalence of LBP is higher in caregivers of children needing assistance with transfers. This increased prevalence is associated with the transferability of the child and mood of the caregiver. Results of this study suggest that physical and psychological factors both contribute to the presence of nonoccupational LBP.
职业环境中的腰痛(LBP)已得到广泛研究。而针对家庭环境中,尤其是非正式照料环境下的腰痛研究较少。
比较需要转移协助(如从床转移至轮椅)的残疾儿童成年女性主要照料者中LBP的患病率与非残疾疾病儿童成年女性主要照料者中LBP的患病率,并评估与LBP相关的因素。
一项15分钟的自填式横断面调查。
大学附属医院门诊。研究对象为连续就诊于儿科物理医学与康复门诊的90名儿童成年女性照料者以及连续就诊于儿科内分泌门诊的23名儿童成年女性照料者。一般排除标准包括:男性、有背部手术或骨折史、问卷完成时照料者年龄小于18岁,或照料2岁以下儿童。若照料者照料1名或多名需要转移协助的儿童,则排除在儿科内分泌门诊就诊的照料者。
因变量为是否存在LBP。自变量包括情绪、工作状态、工作中搬运量、儿童身体功能、照料者人口统计学变量以及儿童人口统计学变量。
物理医学与康复组中LBP的患病率(71.1%)高于内分泌门诊组(43.5%)(优势比,3.2;95%置信区间,1.25 - 8.21)。当儿童需要身体转移协助时LBP的患病率(80.3%)显著高于儿童不需要身体转移协助时的患病率(40.5%)(优势比,2.56;95%置信区间,2.56 - 14.0)。向前多因素逻辑回归显示,与照料者LBP相关的因素为儿童的可转移性、照料者的情绪以及照料者既往LBP史。
需要转移协助的儿童照料者中LBP的患病率更高。这种患病率的增加与儿童的可转移性及照料者的情绪有关。本研究结果表明,生理和心理因素均与非职业性LBP的发生有关。