Centre for Ergonomics and Human Factors, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia.
Queensland Ambulance Service, Brisbane, QLD, Australia.
BMC Musculoskelet Disord. 2023 Sep 8;24(1):716. doi: 10.1186/s12891-023-06834-8.
In this paper, we present the protocol for a cluster randomised controlled trial to evaluate the effectiveness and implementation of a participative risk management intervention to address work-related musculoskeletal disorders (WMSDs). The aims of the study include to evaluate the implementation process and the impact of the intervention on work related musculoskeletal pain and discomfort and exposure to physical and psychosocial hazards in paramedics over a 12-month period.
The intervention in this study is to implement A Participative Hazard Identification and Risk Management (APHIRM) toolkit in an ambulance service. Eighteen work groups containing eligible participants (registered paramedics) will be randomised into the intervention or wait-list control arm in one of three rolling recruitment periods. The APHIRM toolkit survey will be offered at baseline and 12 months later, to all current eligible participants in each work group allocated to the trial. The intervention work groups will receive the remainder of the APHIRM toolkit procedures. Identifying data about individual participants will not be collected in the survey, to protect participant privacy and encourage participation. Changes in primary (musculoskeletal pain and discomfort) and secondary (exposure to physical and psychosocial hazards at work) outcomes measured in the survey will be analysed comparing the baseline and follow up response of the cluster. A process evaluation is included to analyse the implementation and associated barriers or facilitators.
This study is important in providing a comprehensive approach which focusses on both physical and psychosocial hazards using worker participation, to address WMSDs, a well-known and significant problem for ambulance services. The effectiveness of the intervention in work groups will be rigorously evaluated. If significant positive results are observed, the intervention may be adopted in ambulance services, both nationally and internationally.
ISRCTN77150219. Registered 21 November 2021.
本文介绍了一项群组随机对照试验的方案，旨在评估一种参与式风险管理干预措施在解决与工作相关的肌肉骨骼疾病（WMSD）方面的有效性和实施情况。本研究的目的包括评估干预措施的实施过程以及在 12 个月内对护理人员与工作相关的肌肉骨骼疼痛和不适以及暴露于物理和心理社会危害的影响。
本研究中的干预措施是在救护服务中实施一种参与式危害识别和风险管理（APHIRM）工具包。18 个工作小组包含符合条件的参与者（注册护理人员），将在三个滚动招募期之一中随机分配到干预组或等待名单对照组。APHIRM 工具包调查将在基线和 12 个月后提供给每个试验分配的工作小组中所有当前符合条件的参与者。干预工作小组将收到 APHIRM 工具包其余程序。为了保护参与者的隐私并鼓励参与，不会在调查中收集参与者个人身份识别数据。将通过分析群组的基线和随访响应来比较主要（肌肉骨骼疼痛和不适）和次要（工作中暴露于物理和心理社会危害）结果的变化。还包括一个过程评估，以分析实施情况以及相关的障碍或促进因素。
这项研究对于提供一种全面的方法非常重要，该方法侧重于使用工人参与来解决 WMSD，这是救护服务中众所周知且重大的问题，同时关注物理和心理社会危害。将严格评估干预措施对工作小组的有效性。如果观察到显著的积极结果，该干预措施可能会在国内外的救护服务中采用。
ISRCTN77150219。于 2021 年 11 月 21 日注册。
