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注册护士中肌肉骨骼疾病的负担:来自泰国护士队列研究的证据。

Burden of musculoskeletal disorders among registered nurses: evidence from the Thai nurse cohort study.

作者信息

Thinkhamrop Wilaiphorn, Sawaengdee Krisada, Tangcharoensathien Viroj, Theerawit Tuangtip, Laohasiriwong Wongsa, Saengsuwan Jiamjit, Hurst Cameron Paul

机构信息

Faculty of Public Health, Khon Kaen University, Khon Kaen, 40002 Thailand.

International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000 Thailand.

出版信息

BMC Nurs. 2017 Nov 21;16:68. doi: 10.1186/s12912-017-0263-x. eCollection 2017.

Abstract

BACKGROUND

Musculoskeletal disorders (MSDs) are a major public health problem among registered nurses (RNs) in Thailand. Information on their burdens at a national level is limited. This study estimated the prevalence of MSDs among RNs using the 2009 Thai Nurse Cohort, a nationally representative sample of RNs in Thailand.

METHODS

This study is part of the first wave survey of the Thai Nurse Cohort Study (TNCS) conducted in 2009. Members of the cohort consisted of 18,756 RNs across Thailand. A 13-page self-administered questionnaire was sent to participants where MSDs were measured by self-reported answers to questions related to experiencing MSDs during a previous year. However, 1070 RNs were excluded from this study since they were unemployed during a previous year, therefore the final sample size was 17,686 RNs. A 12-month prevalence of MSDs and its 95% confidence interval (95% CI) were estimated based on normal approximation to binomial distribution. Chi-square test for trend was used.

RESULTS

Of the 17,686 RNs, 47.8% (95% CI: 47.0-48.5) reported having MSDs during the previous 12 months. The prevalence of MSDs significantly increased with age, body mass index, and working duration (all  < 0.001). Compared to the non-MSD group, RNs with MSDs had a higher proportion who perceived MSDs as a long-term, chronic medical condition (78.1% vs 20.7%;  < 0.001), being currently on medication (49.4% vs 14.7%;  < 0.001), using pain relief medication almost every day (9.0% vs 1.9%;  < 0.001), experiencing sickness absence (15.7% vs 1.1%;  < 0.001), seeking medical specialist consultations (odds ratio, OR 2.2; 95% CI: 2.0-2.3;  < 0.001), and seeking alternative medications (OR 2.5; 95% CI: 2.3-2.7;  < 0.001).

CONCLUSIONS

Musculoskeletal disorders affected almost half of the RNs in Thailand annually. They placed a major healthcare burden and were a major cause of working days lost due to sick leaves, diminished productivity and quality of patient care. More attention should be paid to the prevention and effective management of MSDs in RNs in Thailand. Further study on ergonomics related to MSDs and its prevention are needed.

摘要

背景

肌肉骨骼疾病(MSD)是泰国注册护士(RN)面临的一个主要公共卫生问题。关于其在国家层面负担的信息有限。本研究使用2009年泰国护士队列(这是泰国具有全国代表性的护士样本)估计了RN中MSD的患病率。

方法

本研究是2009年进行的泰国护士队列研究(TNCS)第一波调查的一部分。该队列成员包括泰国各地的18756名RN。向参与者发送了一份13页的自填式问卷,通过对与前一年经历MSD相关问题的自我报告答案来测量MSD。然而,1070名RN被排除在本研究之外,因为他们前一年失业,因此最终样本量为17686名RN。基于二项分布的正态近似估计了MSD的12个月患病率及其95%置信区间(95%CI)。使用了趋势卡方检验。

结果

在17686名RN中,47.8%(95%CI:47.0 - 48.5)报告在前12个月内患有MSD。MSD的患病率随年龄、体重指数和工作时长显著增加(均<0.001)。与无MSD组相比,患有MSD的RN中认为MSD是一种长期慢性疾病的比例更高(78.1%对20.7%;<0.001),目前正在服药的比例更高(49.4%对14.7%;<0.001),几乎每天使用止痛药物的比例更高(9.0%对1.9%;<0.001),经历病假的比例更高(15.7%对1.1%;<0.001),寻求医学专家咨询的比例更高(优势比,OR 2.2;95%CI:2.0 - 2.3;<0.001),以及寻求替代药物的比例更高(OR 2.5;95%CI:2.3 - 2.7;<0.001)。

结论

肌肉骨骼疾病每年影响泰国近一半的RN。它们带来了重大的医疗负担,并且是因病假导致工作日损失、生产力下降和患者护理质量降低的主要原因。应更加关注泰国RN中MSD的预防和有效管理。需要对与MSD及其预防相关的人体工程学进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3ab/5697361/625dda50608f/12912_2017_263_Fig1_HTML.jpg

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