Garg A, Owen B, Beller D, Banaag J
Department of Industrial and Systems Engineering, University of Wisconsin, Milwaukee 53201.
Ergonomics. 1991 Apr;34(4):407-19. doi: 10.1080/00140139108967325.
A laboratory study was conducted to evaluate five different manual techniques (two-person manual lifting; rocking and pulling the patient using a gait belt with two persons; walking belt with one and two persons) and three different mechanical hoists (Hoyer lift, Trans-Aid and Ambulift) for transferring patients from wheelchair to shower chair and shower chair to wheelchair. Six female nursing students with prior patient transfer experience served both as nurses and as passive patients. Static biomechanical evaluation showed that the mean trunk flexion moments, erector spinae muscle forces and compressive and shear forces at the L5S1 disc for the four pulling methods ranged from 92 to 125 Nm, 1845 to 2507 N, 1973 to 2641 N and 442 to 580 N, respectively, as compared to about 213 Nm, 4260 N, 5050 N and 926 N for two-person manual lifting. Perceived stress ratings for the shoulder, upper back, lower back and whole body were significantly lower for pulling methods than those for lifting the patient (p less than or equal to 0.01). Patients found pulling techniques, except the gait belt, to be more comfortable and secure than the lifting method (p less than or equal to 0.01). However, most of the nurses believed that Medesign and the one-person walking belt would not work on those patients who cannot bear weight and those who are heavy, contracted or combative. A two-person walking belt was the most preferred method. Two out of three hoists (Hoyer lift and Trans-Aid) were perceived by the nurses to be more stressful than one- and two-person walking belts. The patients found these two hoists to be more uncomfortable and less secure than with three of the five manual methods (one- and two-person walking belts and Medesign). Pulling techniques and hoists took significantly longer amounts of time to make the transfer than manually lifting the patient (p less than or equal to 0.01). The two-person walking belt, using a gentle rocking motion to utilize momentum and a pulling technique, and Ambulift are recommended for transferring patients from wheelchair to shower chair and shower chair to wheelchair.
进行了一项实验室研究，以评估五种不同的人工技术（两人手动搬运；两人使用步态带摇晃并拉动患者；一人和两人使用行走带）和三种不同的机械升降机（霍耶升降机、转运辅助器和救护车升降机），用于将患者从轮椅转移到淋浴椅以及从淋浴椅转移到轮椅。六名有患者转移经验的女护生既充当护士，也充当被动患者。静态生物力学评估表明，四种拉动方法在L5S1椎间盘处的平均躯干屈曲力矩、竖脊肌力量以及压缩力和剪切力分别为92至125牛米、1845至2507牛、1973至2641牛和442至580牛，而两人手动搬运时分别约为213牛米、4260牛、5050牛和926牛。与搬运患者相比，拉动方法在肩部\、上背部\、下背部和全身的感知压力评分显著更低（p小于或等于0.01）。患者发现，除了步态带外，拉动技术比搬运方法更舒适、更安全（p小于或等于0.01）。然而，大多数护士认为，Medesign和单人行走带对那些无法承重以及体重较重\、身体僵硬或好斗的患者不起作用。两人行走带是最受欢迎的方法。护士们认为，三种升降机中的两种（霍耶升降机和转运辅助器）比一人和两人行走带更有压力。患者发现，这两种升降机比五种人工方法中的三种（一人和两人行走带以及Medesign）更不舒服、更不安全。与手动搬运患者相比，拉动技术和升降机进行转移所需的时间明显更长（p小于或等于0.01）。建议使用两人行走带，采用轻柔的摇晃动作利用动量并结合拉动技术，以及使用救护车升降机，用于将患者从轮椅转移到淋浴椅以及从淋浴椅转移到轮椅。
