Becker Annette, Angerer Peter, Müller Andreas
Medical Faculty, Institute for Occupational Medicine, Social Medicine and Environmental Medicine, Düsseldorf University, Universitätsstr. 1, 40225, Düsseldorf, Germany.
Int Arch Occup Environ Health. 2017 May;90(4):357-371. doi: 10.1007/s00420-017-1202-6. Epub 2017 Mar 2.
Research shows that psychosocial factors play a significant role on the emergence of musculoskeletal complaints (MSC). The aim of this study was to determine whether a coaching intervention which was focussed on enabling better strategies for coping with work stressors is superior to physiotherapy alone in the reduction of MSC.
68 nurses were randomized to an intervention group (IG, n = 34) or a control group (CG, n = 34). The IG and CG completed a weekly individual physiotherapy unit (10 weeks). Additionally, the IG passed five coaching sessions (fortnightly), plus one opening and one closing session. The primary outcome was MSC, secondary outcomes were work ability and work-related wellbeing. Outcomes were obtained by physical examinations and questionnaires. Data were analyzed by t-test, Chi-Square test, ANOVA with repeated measurements, and multilevel analyzes.
In respect of MSC, the IG compared to the CG showed a significant improvement in the pain severity of everyday movements, and trends towards an improvement of movement in the vertebral column as well as a reduction of the pain severity due to maximum degree movements. No effects were observed in respect to muscle strengths, and restrictions of everyday activities. The IG exhibited a significant improvement of work ability in reference to the physical working demands, and work-related wellbeing. Analysis indicates that improvements in the IG increased further in the 12 weeks after the intervention.
The results suggest that the coaching, beyond physiotherapy, can support the reduction of MSC, the improvement of work ability and work-related wellbeing.
研究表明，社会心理因素在肌肉骨骼疾病（MSC）的发生中起着重要作用。本研究的目的是确定一种专注于培养更好应对工作压力源策略的辅导干预措施在减少MSC方面是否优于单纯的物理治疗。
68名护士被随机分为干预组（IG，n = 34）或对照组（CG，n = 34）。IG组和CG组每周接受一次个体物理治疗（共10周）。此外，IG组还参加了五次辅导课程（每两周一次），外加一次开场和一次结束课程。主要结局指标是MSC，次要结局指标是工作能力和与工作相关的幸福感。通过体格检查和问卷调查获得结局数据。采用t检验、卡方检验、重复测量方差分析和多水平分析对数据进行分析。
在MSC方面，与CG组相比，IG组在日常活动疼痛严重程度方面有显著改善，在脊柱活动改善以及最大程度活动引起的疼痛严重程度降低方面有改善趋势。在肌肉力量和日常活动受限方面未观察到效果。IG组在体力工作需求和与工作相关的幸福感方面的工作能力有显著改善。分析表明，干预后12周内，IG组的改善进一步增加。
结果表明，除物理治疗外，辅导可以帮助减少MSC，提高工作能力和与工作相关的幸福感。
