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医护人员腰背损伤的物理和心理社会工作环境风险因素:前瞻性队列研究。

Physical and Psychosocial Work Environmental Risk Factors for Back Injury among Healthcare Workers: Prospective Cohort Study.

机构信息

National Research Centre for the Working Environment, DK-2100 Copenhagen, Denmark.

出版信息

Int J Environ Res Public Health. 2019 Nov 15;16(22):4528. doi: 10.3390/ijerph16224528.

Abstract

The incidence of occupational back injury in the healthcare sector remains high despite decades of efforts to reduce such injuries. This prospective cohort study investigated the risk factors for back injury during patient transfer. Healthcare workers ( = 2080) from 314 departments at 17 hospitals in Denmark replied to repeated questionnaires sent every 14 days for one year. Using repeated-measures binomial logistic regression, controlling for education, work, lifestyle, and health, the odds for back injury (i.e., sudden onset episodes) were modeled. On the basis of 482 back injury events, a higher number of patient transfers was an important risk factor, with odds ratio (OR) 3.58 (95% confidence interval (CI) 2.51-5.10) for 1-4 transfers per day, OR 7.60 (5.14-11.22) for 5-8 transfers per day, and OR 8.03 (5.26-12.27) for 9 or more transfers per day (reference: less than 1 per day). The lack of necessary assistive devices was a common phenomenon during back injury events, with the top four lacking devices being sliding sheets (30%), intelligent beds (19%), walking aids (18%), and ceiling lifts (13%). For the psychosocial factors, poor collaboration between and support from colleagues increased the risk for back injury, with OR 3.16 (1.85-5.39). In conclusion, reducing the physical burden in terms of number of daily patient transfers, providing the necessary assistive devices, and cultivating good collaboration between colleagues are important factors in preventing occupational back injuries among healthcare workers.

摘要

尽管数十年来一直致力于减少医疗保健领域的职业性背部损伤,但该领域的背部损伤发生率仍然居高不下。本前瞻性队列研究调查了患者转移过程中背部损伤的危险因素。丹麦 17 家医院 314 个科室的 2080 名医护人员回复了为期一年、每 14 天重复发送一次的问卷。使用重复测量二项逻辑回归,在控制教育、工作、生活方式和健康因素的情况下,对背部损伤(即突发性发作)的几率进行建模。基于 482 例背部损伤事件,更多的患者转移是一个重要的危险因素,每天 1-4 次转移的比值比(OR)为 3.58(95%置信区间(CI)为 2.51-5.10),每天 5-8 次转移的 OR 为 7.60(5.14-11.22),每天 9 次或更多转移的 OR 为 8.03(5.26-12.27)(参考值:每天少于 1 次)。在背部损伤事件中,缺乏必要的辅助设备是一种常见现象,排名前四的缺乏设备分别是滑动垫(30%)、智能床(19%)、助行器(18%)和天花板吊具(13%)。对于心理社会因素,同事之间缺乏协作和支持会增加背部损伤的风险,OR 为 3.16(1.85-5.39)。总之,减少每天患者转移的数量、提供必要的辅助设备以及培养医护人员之间良好的协作关系,是预防医护人员职业性背部损伤的重要因素。

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