Vinstrup Jonas, Jakobsen Markus D, Andersen Lars L
National Research Centre for the Working Environment, DK-2100 Copenhagen, Denmark.
Int J Environ Res Public Health. 2020 Feb 5;17(3):996. doi: 10.3390/ijerph17030996.
This study aimed to investigate the association between poor sleep and risk of low-back pain (LBP) in healthcare workers. Using a prospective cohort design with 1-year follow-up, a total of 1955 healthcare workers (60% nurses) from 389 departments at 19 hospitals responded to questionnaires containing items related to lifestyle, health, and working environment. Associations between sleep scores (0-100) at baseline and LBP intensity (0-10) at follow-up were modelled using cumulative logistic regression accounting for clustering at the department level and adjusted for lifestyle and psychosocial confounders. In the full population of healthcare workers, 43.9% and 24.4% experienced moderate and poor sleep, respectively. In the fully adjusted model with good sleep as reference, moderate, and poor sleep increased the risk of LBP at follow-up, with odds ratios (OR's) of 1.66 (95% confidence interval (CI) 1.35-2.04) and 2.05 (95% CI 1.57-2.69), respectively. Three sensitivity analyses including healthcare workers free from LBP, nurses, and nurses free from LBP at baseline, respectively, yielded similar results. In conclusion, poor sleep constitutes a potent risk factor for LBP among healthcare workers. The presented results provide strong incentives to evaluate and weigh current prevention policies against an updated biopsychosocial framework.
本研究旨在调查医护人员睡眠质量差与腰痛(LBP)风险之间的关联。采用前瞻性队列设计并进行1年随访,来自19家医院389个科室的1955名医护人员(60%为护士)回答了包含生活方式、健康和工作环境相关问题的问卷。使用累积逻辑回归模型,对基线时的睡眠评分(0 - 100)与随访时的LBP强度(0 - 10)之间的关联进行建模,该模型考虑了科室层面的聚类情况,并对生活方式和社会心理混杂因素进行了调整。在全体医护人员中,分别有43.9%和24.4%的人睡眠质量中等和较差。在以良好睡眠为参照的完全调整模型中,中等和较差的睡眠会增加随访时患LBP的风险,优势比(OR)分别为1.66(95%置信区间(CI)1.35 - 2.04)和2.05(95% CI 1.57 - 2.69)。三项敏感性分析分别包括基线时无LBP的医护人员、护士以及基线时无LBP的护士,结果相似。总之,睡眠质量差是医护人员患LBP的一个重要风险因素。研究结果强烈促使人们根据更新后的生物心理社会框架评估和权衡当前的预防政策。