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老年人护理医护人员长期病假的肌肉骨骼风险因素的前瞻性队列研究。

A prospective cohort study on musculoskeletal risk factors for long-term sickness absence among healthcare workers in eldercare.

机构信息

National Research Centre for the Working Environment, Lersø Parkalle 105, 2100, Copenhagen, Denmark.

出版信息

Int Arch Occup Environ Health. 2012 Aug;85(6):615-22. doi: 10.1007/s00420-011-0709-5. Epub 2011 Oct 11.

Abstract

PURPOSE

The socioeconomic burden of sickness absence from musculoskeletal disorders is considerable. However, knowledge about the risk of sickness absence from pain in different body regions among specific job groups is needed to more efficiently target preventative strategies. This study estimates the risk of long-term sickness absence (LTSA) from pain in different body regions among healthcare workers.

METHODS

Prospective cohort study among 8,952 Danish healthcare workers responding to a questionnaire in 2004-2005 and followed for 1 year in a national register of social transfer payments (DREAM). Using Cox regression hazard ratio (HR) analysis controlled for age, gender, BMI, smoking, seniority, leisure physical activity and psychosocial working conditions, we modeled risk estimates of sub-chronic (1-30 days last year) and chronic pain (>30 days last year) in the low back, neck/shoulder and knees for onset of LTSA (receiving sickness absence compensation for at least eight consecutive weeks) during one-year follow-up.

RESULTS

At baseline, the prevalence of chronic pain was 23% (low back), 28% (neck/shoulder) and 12% (knees). During follow-up, the 12-month prevalence of LTSA was 6.3%. Chronic pains in the low back (HR 1.47 [95% CI 1.17-1.85]), neck/shoulder (HR 1.60 [95% CI 1.27-2.02]) and knees (HR 1.92 [95% CI 1.52-2.42]) were significant risk factors for LTSA. However, only chronic neck/shoulder (HR 1.41 [95% CI 1.09-1.82]) and knee pain (HR 1.69 [95% CI 1.32-2.16]) remained significant with mutual adjustment for all three musculoskeletal pain regions.

CONCLUSION

Musculoskeletal pain is a risk factor for LTSA among healthcare workers. Future research among healthcare workers in eldercare should include the management of neck/shoulder and knee pain in addition to the management of back pain.

摘要

目的

肌肉骨骼疾病缺勤造成的社会经济负担相当大。然而,需要了解特定职业群体不同身体部位疼痛导致缺勤的风险,以便更有效地针对预防策略。本研究估计医疗保健工作者不同身体部位疼痛导致长期缺勤(LTSA)的风险。

方法

对 8952 名丹麦医疗保健工作者进行前瞻性队列研究,他们于 2004-2005 年对问卷做出回应,并在全国社会转移支付登记处(DREAM)中进行为期 1 年的随访。使用 Cox 回归风险比(HR)分析,控制年龄、性别、BMI、吸烟、资历、休闲体育活动和心理社会工作条件,我们对亚慢性疼痛(去年 1-30 天)和慢性疼痛(去年>30 天)进行建模,分析低背、颈肩和膝盖疼痛的风险估计值,这些疼痛是一年随访期间 LTSA(至少连续 8 周领取病假补偿)发病的预测因素。

结果

基线时,慢性疼痛的患病率为 23%(低背)、28%(颈肩)和 12%(膝盖)。随访期间,12 个月 LTSA 的患病率为 6.3%。低背(HR 1.47[95%CI 1.17-1.85])、颈肩(HR 1.60[95%CI 1.27-2.02])和膝盖(HR 1.92[95%CI 1.52-2.42])慢性疼痛是 LTSA 的显著危险因素。然而,只有慢性颈肩疼痛(HR 1.41[95%CI 1.09-1.82])和膝盖疼痛(HR 1.69[95%CI 1.32-2.16])在调整所有三个肌肉骨骼疼痛部位后仍然具有统计学意义。

结论

肌肉骨骼疼痛是医疗保健工作者 LTSA 的一个危险因素。在老年护理医护人员中进行的未来研究应包括颈肩和膝盖疼痛的管理,除了背部疼痛的管理。

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