Lövgren Malin, Gustavsson Petter, Melin Bo, Rudman Ann
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, SE-17177 Stockholm, Sweden; School of Health and Social Studies, Dalarna University, SE-791 88 Falun, Sweden.
Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, SE-17177 Stockholm, Sweden.
Int J Nurs Stud. 2014 Apr;51(4):625-39. doi: 10.1016/j.ijnurstu.2013.08.009. Epub 2013 Aug 31.
Although it is well known that musculoskeletal disorders are common among registered nurses, little longitudinal research has been conducted to examine this problem from nursing education to working life.
The aim was to investigate the prevalence and incidence of neck/shoulder and back pain in nursing students in their final semester, and one and two years after graduation. Furthermore, to identify common trajectories of neck/shoulder and back pain, and explore sociodemographic and lifestyle-related factors, contextual factors and health outcome that might be characteristic of individuals in the various trajectories.
Longitudinal study following nursing students from their final year of studies, with follow-ups one and two years after graduation.
Nursing students who graduated from the 26 universities providing undergraduate nursing education in Sweden 2002 were invited to participate (N=1700). Of those asked, 1153 gave their informed consent.
The participants answered postal surveys at yearly intervals. Descriptive statistics were used to analyze prevalence and incidence of pain, and growth mixture modeling was applied to identify different homogeneous clusters of individuals following similar trajectories in pain development across time.
The prevalence of neck/shoulder and back pain remained constant over time (around 50% for neck/shoulder pain and just over 40% for back pain). Six different development trajectories for each symptom were found, reflecting patterns of stable pain levels or variation in levels over time: one symptom-free group, two decreasing pain groups, two increasing pain groups, and one chronic pain group. With few exceptions, the same factors (sex, children, chronic disease, working overtime, work absence, sickness presence, physical load, depression, self-rated health, sleep quality and muscular tension) were associated with neck/shoulder and back pain trajectories. Different types of physical load characterized new nurses with neck/shoulder pain and back pain respectively.
The high prevalence of pain among nursing students and among new graduate nurses, suggests that it would be effective to implement preventive strategies already during nursing education, but they should also preferably continue after graduation. Many factors associated with pain in the neck/shoulder and back seem to be modifiable, and thereby constitute targets for preventive strategies.
尽管众所周知肌肉骨骼疾病在注册护士中很常见，但很少有纵向研究从护理教育到工作生涯来审视这个问题。
旨在调查护理专业最后一学期的学生、毕业一年和两年后颈部/肩部及背部疼痛的患病率和发病率。此外，确定颈部/肩部及背部疼痛的常见发展轨迹，并探索社会人口学和生活方式相关因素、背景因素以及可能是不同轨迹个体特征的健康结果。
对护理专业学生从最后一年学习开始进行纵向研究，并在毕业后一年和两年进行随访。
邀请了2002年从瑞典26所提供本科护理教育的大学毕业的护理专业学生（N = 1700）。在被邀请者中，1153人给予了知情同意。
参与者每年通过邮寄方式进行调查。使用描述性统计分析疼痛的患病率和发病率，并应用生长混合模型来识别在疼痛发展过程中随时间遵循相似轨迹的不同同质个体群。
颈部/肩部及背部疼痛的患病率随时间保持稳定（颈部/肩部疼痛约为50%，背部疼痛略高于40%）。每种症状发现了六种不同的发展轨迹，反映了疼痛水平稳定或随时间变化的模式：一个无症状组、两个疼痛减轻组、两个疼痛加重组和一个慢性疼痛组。除少数例外，相同的因素（性别、子女、慢性病、加班、缺勤、患病、身体负荷、抑郁、自评健康、睡眠质量和肌肉紧张）与颈部/肩部及背部疼痛轨迹相关。不同类型的身体负荷分别是颈部/肩部疼痛和背部疼痛新护士的特征。
护理专业学生和新毕业护士中疼痛的高患病率表明，在护理教育期间实施预防策略将是有效的，但这些策略在毕业后也最好继续实施。许多与颈部/肩部及背部疼痛相关的因素似乎是可以改变的，因此构成了预防策略的目标。
