Bernal Dinora, Campos-Serna Javier, Tobias Aurelio, Vargas-Prada Sergio, Benavides Fernando G, Serra Consol
Faculty of Nursing Care, University of Panama, Panama; CiSAL - Center for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, Spain.
CiSAL - Center for Research in Occupational Health, Universitat Pompeu Fabra, Barcelona, Spain; Area of Public Health and Preventive Medicine, University of Alicante, Alicante, Spain; CIBER Epidemiology and Public Health (CIBERESP), Spain.
Int J Nurs Stud. 2015 Feb;52(2):635-48. doi: 10.1016/j.ijnurstu.2014.11.003. Epub 2014 Nov 15.
To estimate the association between psychosocial risk factors in the workplace and musculoskeletal disorders (MSD) in nurses and aides.
Systematic review and meta-analysis.
An electronic search was performed using MEDLINE (Pubmed), Psychinfo, Web of Science, Tripdatabase, Cochrane Central Controlled Trials, NIOSHTIC and Joanna Briggs Institute of Systematic Reviews on Nursing and Midwifery, to identify observational studies assessing the role of psychosocial risk factors on MSD in hospital nurses and nursing aides.
Two reviewers independently assessed eligibility and extracted data. Quality assessment was conducted independently by two reviewers using an adapted version of the Standardized Quality Scale. Random-effects meta-analysis was performed by subsets based on specific anatomical site and the exposure to specific psychosocial risk factors. Heterogeneity for each subset of meta-analysis was assessed and meta-regressions were conducted to examine the source of heterogeneity among studies.
Twenty-four articles were included in the review, seventeen of which were selected for meta-analysis. An association was identified between high psychosocial demands-low job control with prevalent and incident low back pain (OR 1.56; 95% CI 1.22-1.99 and OR 1.52; 95% CI 1.14-2.01, respectively), prevalent shoulder pain (OR 1.89; 95% CI 1.53-2.34), prevalent knee pain (OR 2.21; 95% CI 1.07-4.54), and prevalent pain at any anatomical site (OR 1.38; 95% CI 1.09-1.75). Effort-reward imbalance was associated with prevalent MSD at any anatomical site (OR 6.13; 95% CI 5.32-7.07) and low social support with incident back pain (OR 1.82; 95% CI 1.43-2.32). Heterogeneity was generally low for most subsets of meta-analysis.
This meta-analysis suggests that psychosocial risk factors at the workplace are associated with MSD in hospital nurses and nursing aides. Although most preventive strategies at the workplace are focused on ergonomic risk factors, improving the psychosocial work environment might have an impact on reducing MSDs.
评估工作场所的心理社会风险因素与护士及护理员肌肉骨骼疾病（MSD）之间的关联。
系统评价与荟萃分析。
使用MEDLINE（PubMed）、Psychinfo、科学网、Trip数据库、Cochrane中心对照试验、NIOSHTIC以及乔安娜·布里格斯护理与助产系统评价研究所进行电子检索，以识别评估心理社会风险因素对医院护士和护理员MSD作用的观察性研究。
两名综述员独立评估研究的纳入资格并提取数据。两名综述员使用标准化质量量表的改编版独立进行质量评估。基于特定解剖部位和特定心理社会风险因素暴露情况，对亚组进行随机效应荟萃分析。评估每个荟萃分析亚组的异质性，并进行荟萃回归以检查研究间异质性的来源。
该综述纳入了24篇文章，其中17篇被选入荟萃分析。研究发现，高心理社会需求 - 低工作控制与腰椎疼痛的患病率和发病率相关（OR分别为1.56；95%CI 1.22 - 1.99和OR 1.52；95%CI 1.14 - 2.01）、肩部疼痛患病率（OR 1.89；95%CI 1.53 - 2.34）、膝关节疼痛患病率（OR 2.21；95%CI 1.07 - 4.54）以及任何解剖部位的疼痛患病率（OR 1.38；95%CI 1.09 - 1.75）。付出 - 回报失衡与任何解剖部位的MSD患病率相关（OR 6.13；95%CI 5.32 - 7.07），而低社会支持与腰椎疼痛发病率相关（OR 1.82；95%CI 1.43 - 2.32）。大多数荟萃分析亚组的异质性一般较低。
该荟萃分析表明，工作场所的心理社会风险因素与医院护士和护理员的MSD相关。尽管工作场所的大多数预防策略都集中在工效学风险因素上，但改善心理社会工作环境可能对减少MSD有影响。
