老年护理中护理人员的背部疾病和腰部负荷：家庭护理和养老院的比较。
Back disorders and lumbar load in nursing staff in geriatric care: a comparison of home-based care and nursing homes.
机构信息
Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services, Pappellallee 35/37, 22089 Hamburg, Germany.
出版信息
J Occup Med Toxicol. 2009 Dec 10;4:33. doi: 10.1186/1745-6673-4-33.
BACKGROUND
Back pain is one of the most frequent complaints in the nursing profession. Thus, the 12-month prevalence of pain in the lumbar spine in nursing staff is as high as 76%. Only a few representative studies have assessed the prevalence rates of back pain and its risk factors among nursing staff in nursing homes in comparison to staff in home-based care facilities. The present study accordingly investigates the prevalence in the lumbar and cervical spine and determines the physical workload to lifting and caring in geriatric care.
METHODS
1390 health care workers in nursing homes and home care participated in this cross sectional survey. The nursing staff members were examined by occupational physicians according to the principals of the multistep diagnosis of musculoskeletal disorders. Occupational exposure to daily care activities with patient transfers was measured by a standardised questionnaire. The lumbar load was calculated with the Mainz-Dortmund dose model. Information on ergonomic conditions were recorded from the management of the nursing homes. Comparisons of all outcome variables were made between both care settings.
RESULTS
Complete documentation, including the findings from the occupational physicians and the questionnaire, was available for 41%. Staff in nursing homes had more often positive orthopaedic findings than staff in home care. At the same time the values calculated for lumbar load were found to be significant higher in staff in nursing homes than in home-based care: 45% vs. 6% were above the reference value. Nursing homes were well equipped with technical lifting aids, though their provision with assistive advices is unsatisfactory. Situation in home care seems worse, especially as the staff often has to get by without assistance.
CONCLUSIONS
Future interventions should focus on counteracting work-related lumbar load among staff in nursing homes. Equipment and training in handling of assistive devices should be improved especially for staff working in home care.
背景
背痛是护理行业最常见的投诉之一。因此，护理人员腰椎疼痛的 12 个月患病率高达 76%。只有少数有代表性的研究评估了养老院护理人员与家庭护理设施护理人员背痛及其危险因素的患病率。因此，本研究调查了腰椎和颈椎的患病率，并确定了老年护理中与举升和护理相关的体力工作负荷。
方法
1390 名养老院和家庭护理的医护人员参与了这项横断面调查。护理人员由职业医生根据肌肉骨骼疾病多步骤诊断的原则进行检查。通过标准化问卷测量日常护理活动中与患者转移相关的职业暴露。使用美因茨-多特蒙德剂量模型计算腰椎负荷。从养老院管理层记录有关人体工程学条件的信息。比较了两种护理环境下所有结果变量。
结果
包括职业医生和问卷结果在内的完整记录，可用于 41%的人员。养老院的工作人员比家庭护理的工作人员更常出现骨科发现。与此同时，养老院工作人员的腰椎负荷计算值明显高于家庭护理人员：45%的人高于参考值，而家庭护理人员中只有 6%的人高于参考值。养老院配备了良好的技术提升辅助设备，尽管其提供的辅助建议并不令人满意。家庭护理的情况似乎更糟，尤其是因为工作人员经常在没有帮助的情况下工作。
结论
未来的干预措施应侧重于减轻养老院工作人员与工作相关的腰椎负荷。应特别改善处理辅助设备的设备和培训，尤其是为在家中护理的工作人员。
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