Simon Michael, Tackenberg Peter, Nienhaus Albert, Estryn-Behar Madeleine, Conway Paul Maurice, Hasselhorn H-M
Department of Safety Engineering, Section of Occupational Safety & Ergonomics, University of Wuppertal, Germany.
Int J Nurs Stud. 2008 Jan;45(1):24-34. doi: 10.1016/j.ijnurstu.2006.11.003. Epub 2007 Jan 10.
Musculoskeletal disorders are a widespread affliction in the nursing profession. Back or neck-pain-related disability of nursing staff is mainly attributed to physical and psychosocial risk factors.
To investigate which-and to what extent-physical and psychosocial risk factors are associated with neck/back-pain-related disability in nursing, and to assess the role of the type of health care institution (hospitals, nursing homes and home care institutions) within different countries in this problem.
Cross-sectional secondary analysis of multinational data of nurses and auxiliary staff in hospitals (n=16,770), nursing homes (n=2140) and home care institutions (n=2606) in seven countries from the European NEXT-Study.
Multinomial logistic regression analysis with raw models for each factor and mutually adjusted with all analysed variables.
Analysis of the pooled data revealed effort-reward imbalance as the predominant risk factor for disability in all settings (odds ratios for high disability by effort-reward ratio: hospital 5.05 [4.30-5.93]; nursing home 6.52 [4.04-10.52] and home care 6.4 [3.83-10.70] [after mutual adjustment of psychosocial and physical risk factors]). In contrast, physical exposure to lifting and bending showed only limited associations with odds ratios below 1.6; the availability and use of lifting aids was-after mutual adjustment-not or only marginally associated with disability. These findings were basically confirmed in separate analyses for all seven countries and types of institutions.
The findings show a pronounced association between psychosocial factors and back or neck-pain-related disability. Further research should consider psychosocial factors and should take the setting where nurses work into account.
肌肉骨骼疾病在护理行业中是一种普遍存在的折磨。护理人员与背部或颈部疼痛相关的残疾主要归因于身体和心理社会风险因素。
调查哪些身体和心理社会风险因素与护理中与颈部/背部疼痛相关的残疾有关，以及在何种程度上有关，并评估不同国家的医疗保健机构类型（医院、疗养院和家庭护理机构）在这个问题中所起的作用。
对来自欧洲NEXT研究的七个国家的医院（n = 16,770）、疗养院（n = 2140）和家庭护理机构（n = 2606）的护士和辅助人员的多国数据进行横断面二次分析。
对每个因素采用原始模型进行多项逻辑回归分析，并对所有分析变量进行相互调整。
对汇总数据的分析表明，努力-回报失衡是所有环境中残疾的主要风险因素（按努力-回报比计算的高残疾比值比：医院5.05 [4.30 - 5.93]；疗养院6.52 [4.04 - 10.52]；家庭护理6.4 [3.83 - 10.70] [在对心理社会和身体风险因素进行相互调整之后]）。相比之下，搬运和弯腰的身体暴露与比值比低于1.6的关联有限；在相互调整之后，搬运辅助工具的可用性和使用与残疾没有关联或仅有微弱关联。所有七个国家和机构类型的单独分析基本证实了这些发现。
研究结果表明心理社会因素与背部或颈部疼痛相关的残疾之间存在显著关联。进一步的研究应考虑心理社会因素，并应考虑护士工作的环境。
