Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Unicare Helsefort Rehabilitation Centre, Rissa, Norway.
BMC Health Serv Res. 2024 May 9;24(1):565. doi: 10.1186/s12913-024-10897-1.
Prolonged standing at work may contribute to increased risk of musculoskeletal pain in home care workers. Patients' activities of daily living (ADL) score may be a proxy for home care workers' standing time at work. The objective of the present study was to investigate the association between patients' ADL self-care score, and workers standing time.
This cross-sectional study measured time spent standing, sitting and in physical activity for seven days using thigh-worn accelerometers, among 14 home care workers. Patients' ADL self-care scores are routinely adjusted by home care nurses, and time intervals of home care visits are stored in home care services electronic patient journal. We collected ADL self-care scores and start and end time points of visits, and categorized ADL self-care scores as low (ADL ≤ 2.0), medium (ADL > 2.0 to 3.0) or high (ADL > 3.0). Physical behavior data were transformed to isometric log-ratios and a mixed-effect model was used to investigate differences in physical behavior between the three ADL self-care score categories.
We analyzed 931 patient visits and found that high ADL self-care scores were associated with longer standing times relative to sitting and physical activity, compared to low ADL score (0.457, p = 0.001). However, no significant differences in time spent standing were found between high and medium ADL patient visits (0.259, p = 0.260), nor medium and low (0.204, p = 0.288). High ADL score patients made up 33.4% of the total care time, despite only making up 7.8% of the number of patients.
Our findings suggest that caring for patients with high ADL self-care score requires workers to stand for longer durations and that this group of patients constitute a significant proportion of home care workers' total work time. The findings of this study can inform interventions to improve musculoskeletal health among home care workers by appropriate planning of patient visits.
长时间站立工作可能会增加家庭护理人员肌肉骨骼疼痛的风险。患者的日常生活活动（ADL）评分可能是家庭护理人员工作站立时间的替代指标。本研究的目的是调查患者 ADL 自理评分与工人站立时间之间的关系。
本横断面研究使用大腿佩戴的加速度计测量了 14 名家庭护理工人 7 天的站立、坐着和体力活动时间。家庭护理护士会定期调整患者的 ADL 自理评分，并且家庭护理服务电子病历会记录家庭护理访问的开始和结束时间点。我们收集了 ADL 自理评分以及访问的开始和结束时间点，并将 ADL 自理评分分为低（ADL≤2.0）、中（ADL>2.0 至 3.0）或高（ADL>3.0）。身体行为数据被转换为等距对数比，并使用混合效应模型来研究这三个 ADL 自理评分类别之间的身体行为差异。
我们分析了 931 次患者访问，发现与低 ADL 评分相比，高 ADL 自理评分与站立时间较长有关，而与坐和体力活动时间较短有关（0.457，p=0.001）。然而，高和中 ADL 患者访问之间的站立时间没有显著差异（0.259，p=0.260），中 ADL 和低 ADL 之间也没有显著差异（0.204，p=0.288）。高 ADL 评分患者占总护理时间的 33.4%，尽管仅占患者总数的 7.8%。
我们的研究结果表明，照顾 ADL 自理评分高的患者需要工人站立更长时间，而这组患者构成了家庭护理工人总工作时间的重要部分。这项研究的结果可以为通过适当规划患者访问来改善家庭护理工人的肌肉骨骼健康提供信息。
