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基层医疗保健护士的工作相关肌肉骨骼疾病

Work related musculoskeletal disorders in primary health care nurses.

作者信息

Ribeiro Tânia, Serranheira Florentino, Loureiro Helena

机构信息

Community Nurse Specialist, Unidade de Cuidados de Saúde Primários - Penha de França, 1170-201 Lisbon, Portugal.

Ergonomist, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; CISP, Avenida Padre Cruz, 1600-560 Lisbon, Portugal.

出版信息

Appl Nurs Res. 2017 Feb;33:72-77. doi: 10.1016/j.apnr.2016.09.003. Epub 2016 Sep 14.

Abstract

BACKGROUND

Work related musculoskeletal disorders (WRMSDs) constitute a serious occupational health problem among registered nurses (RN) all around the world. Its prevalence is mainly associated with nurses' high physical demands that still remain poorly studied in primary health care (PHC).

PURPOSE

To describe nurses' self-reported symptoms of WRMSDs (mainly discomfort and pain) in PHC, featuring the main work tasks that may have risk factors for its development.

METHODS

A cross-sectional study was developed to identify self-reported WRMSD symptoms by nurses that worked on PHC in Portugal. Nurses answered an online Portuguese version of the Nordic Musculoskeletal Questionnaire (NMQ) (surveymonkey platform). Data was analyzed using the Statistical Package for the Social Science (SPSS17) program. Statistical analysis was based on descriptive statistics and associations with the χ test, Cramér's V, Mann-Whitney and Kruskal-Wallis test, with a significance level of 5%.

RESULTS

A sample (n=409), mostly female (84.0%), showed a high prevalence of WRMSDs symptoms in the last 12months (89.0%). The lower back was the most affected body region (63.1%), followed by cervical, dorsal, shoulders and the wrist/hand. In the same period, absenteeism related to these complaints was high (51.4%) and strongly connected with standing work (48.8%), bending the trunk (42.3%), rotating the trunk (40.6%), applying force with hands or fingers (37.3%), sitting work (36.6%) and repetitive arm movement (34.3%). This study showed associations between the prevalence of WRMSDs symptoms in different body regions and some individual characteristics such as: gender, age, BMI, presence of other pathologies and regular physical exercise.

CONCLUSIONS

This study indicates that, as in other areas of nursing practice, in PHC nurses are also exposed to risk factors that are linked with a high prevalence of WRMSDs symptoms. "Inadequate" and extreme postures sustained for prolonged periods and their repetitiveness will contribute to this occurrence. This shows the need to develop occupational prevention programs to curb this occupational health issue among PHC nurses.

摘要

背景

工作相关肌肉骨骼疾病(WRMSDs)是全球注册护士(RN)面临的一个严重职业健康问题。其患病率主要与护士较高的体力需求有关,而在初级卫生保健(PHC)中,这方面的研究仍很匮乏。

目的

描述初级卫生保健中护士自我报告的工作相关肌肉骨骼疾病症状(主要是不适和疼痛),并找出可能存在发病风险因素的主要工作任务。

方法

开展一项横断面研究,以确定在葡萄牙初级卫生保健机构工作的护士自我报告的工作相关肌肉骨骼疾病症状。护士们通过在线葡萄牙语版的北欧肌肉骨骼问卷(NMQ)(SurveyMonkey平台)进行回答。使用社会科学统计软件包(SPSS17)程序对数据进行分析。统计分析基于描述性统计以及χ检验、克莱默V系数、曼-惠特尼检验和克鲁斯卡尔-沃利斯检验,显著性水平为5%。

结果

一个样本(n = 409),大多数为女性(84.0%),显示在过去12个月中工作相关肌肉骨骼疾病症状的患病率很高(89.0%)。下背部是受影响最严重的身体部位(63.1%),其次是颈部、背部、肩部和手腕/手部。同期,因这些不适导致的缺勤率很高(51.4%),且与站立工作(48.8%)、躯干弯曲(42.3%)、躯干旋转(40.6%)、用手或手指施力(37.3%)、坐着工作(36.6%)和重复性手臂运动(34.3%)密切相关。本研究显示了不同身体部位工作相关肌肉骨骼疾病症状的患病率与一些个体特征之间的关联,如性别、年龄、体重指数、是否存在其他疾病以及是否经常进行体育锻炼。

结论

本研究表明,与护理实践的其他领域一样,在初级卫生保健中,护士也面临与工作相关肌肉骨骼疾病症状高患病率相关的风险因素。长时间保持“不适当”和极端姿势及其重复性会导致这种情况的发生。这表明有必要制定职业预防计划,以遏制初级卫生保健护士中的这一职业健康问题。

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