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患者搬运过程中的身体暴露与背部损伤和下背痛风险:前瞻性队列研究。

Physical exposure during patient transfer and risk of back injury & low-back pain: prospective cohort study.

机构信息

National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, DK, Denmark.

Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.

出版信息

BMC Musculoskelet Disord. 2020 Oct 31;21(1):715. doi: 10.1186/s12891-020-03731-2.

Abstract

BACKGROUND

Work-related musculoskeletal disorders (MSDs) are common among healthcare workers. Because frequent patient transfer has been associated with increased risk of MSDs, we aim to quantify the physical load associated with commonly-used assistive devices and to investigate associations between accumulated physical exposure and risk of MSDs.

METHODS

By applying an exposure matrix based on objective measurements of electromyography and trunk flexion on a large (n = 1285) prospective cohort, intensity of low-back pain (LBP) and odds of back injury at 1-year follow-up were modelled using linear models and logistic regressions, respectively. The cohort was divided into groups according to physical exposure; i.e. low (1st quartile), moderate (2nd and 3rd quartiles) and high (4th quartile) exposure.

RESULTS

Exposure profiles are provided for 9 groups of assistive devices, with ceiling lifts and intelligent beds eliciting the lowest physical exposure. In the fully-adjusted model, we report differences in LBP intensity at follow-up between the low and moderate exposure groups (p = 0.0085). No difference was found between the moderate and high exposure groups (p = 0.2967). Likewise, we find no associations between physical exposure and odds of back injury at 1-year follow-up, with a prevalence of 11, 13 and 11% for the three groups, respectively.

CONCLUSIONS

Low physical exposure during patient transfer was prospectively associated with lower intensity of LBP. Consistent use of assistive devices associated with low physical exposure, namely ceiling-lifts and intelligent beds, may play a role in reducing the incidence of MSDs among healthcare workers.

摘要

背景

与工作相关的肌肉骨骼疾病(MSD)在医护人员中很常见。由于频繁的患者转移与 MSD 风险增加有关,我们旨在量化常见辅助设备相关的体力负荷,并研究体力暴露累积与 MSD 风险之间的关联。

方法

通过应用基于肌电图和躯干弯曲的客观测量的暴露矩阵,对大型(n=1285)前瞻性队列进行分析,使用线性模型和逻辑回归分别对 1 年随访时的下腰痛(LBP)强度和背部损伤的几率进行建模。根据体力暴露将队列分为低(第 1 四分位数)、中(第 2 和第 3 四分位数)和高(第 4 四分位数)暴露组。

结果

为 9 组辅助设备提供了暴露概况,其中天花板升降机和智能床产生的体力暴露最低。在完全调整的模型中,我们报告了随访时低暴露组和中暴露组之间的 LBP 强度差异(p=0.0085)。在中暴露组和高暴露组之间没有发现差异(p=0.2967)。同样,我们发现体力暴露与 1 年随访时背部损伤的几率之间没有关联,三个组的患病率分别为 11%、13%和 11%。

结论

患者转移期间体力暴露较低与 LBP 强度较低呈前瞻性相关。一致使用与低体力暴露相关的辅助设备,即天花板升降机和智能床,可能在降低医护人员 MSD 发病率方面发挥作用。

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