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跨专业团队评估手术住院医师的肌肉骨骼疼痛和工效学

An Interprofessional Approach to Assessing Musculoskeletal Pain and Ergonomics in Surgery Residents.

机构信息

Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.

Department of Occupational Therapy, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.

出版信息

J Surg Res. 2024 Nov;303:513-518. doi: 10.1016/j.jss.2024.09.069. Epub 2024 Oct 18.

Abstract

INTRODUCTION

Work-related musculoskeletal injuries are common in general surgeons, causing chronic pain and lost work. However, formal ergonomic curriculums in residency programs are rare. We aimed to assess the feasibility of an interprofessional educational approach to ergonomics in general surgery residents, in collaboration with occupational therapy (OT) students.

METHODS

General surgery residents completed a survey regarding musculoskeletal pain and ergonomics. OT students captured photos of trainees performing open and laparoscopic abdominal surgery over a 4-wk period. Rapid entire body assessment (REBA) and the rapid upper limb assessment were used to assess ergonomic efficiency and postural risk. Higher scores represent unfavorable posture and correlate with the need for ergonomic change.

RESULTS

There were 37/44 (84%) responses. Everyone reported some degree of pain related to surgery, most commonly neck pain (75%), shoulder (61%), and foot pain (53%). Most residents (66%) felt the pressure to perform surgery regardless of the pain. Ergonomic breaks directed by faculty were reported by less than 11% of residents. A total of 11 intraoperative observations were made by OT students of surgical trainees, with a mean rapid upper limb assessment score of 6.1 and a mean rapid entire body assessment score of 7.3. These scores demonstrated suboptimal posture with recommendations for prompt change.

CONCLUSIONS

This study conveys a successful interprofessional educational approach to assessing surgical ergonomics in general surgery residents. Musculoskeletal symptoms and intraoperative ergonomic dysfunctions are prevalent among general surgery residents, without workplace measures for management or prevention. This needs assessment will be used to create an ergonomics initiative for the surgery residency.

摘要

简介

与工作相关的肌肉骨骼损伤在普通外科医生中很常见,导致慢性疼痛和工作损失。然而,住院医师培训计划中很少有正式的人体工程学课程。我们旨在评估与职业治疗(OT)学生合作,在普通外科住院医师中采用跨专业教育方法进行人体工程学的可行性。

方法

普通外科住院医师完成了一份关于肌肉骨骼疼痛和人体工程学的调查。OT 学生在 4 周的时间内拍摄了受训者进行开放和腹腔镜腹部手术的照片。使用快速全身评估(REBA)和快速上肢评估来评估人体工程学效率和姿势风险。较高的分数表示不利的姿势,并与人体工程学改变的需求相关。

结果

共有 37/44(84%)人做出了回应。每个人都报告了与手术相关的某种程度的疼痛,最常见的是颈部疼痛(75%)、肩部(61%)和脚部疼痛(53%)。大多数住院医师(66%)感到无论疼痛如何都有进行手术的压力。不到 11%的住院医师报告了由教师指导的人体工程学休息。OT 学生共对 11 名外科受训者进行了术中观察,上肢快速评估的平均得分为 6.1,全身快速评估的平均得分为 7.3。这些分数显示出姿势不佳,建议立即进行改变。

结论

这项研究传达了一种成功的跨专业教育方法,用于评估普通外科住院医师的手术人体工程学。肌肉骨骼症状和术中人体工程学功能障碍在普通外科住院医师中很常见,但没有针对管理或预防的工作场所措施。这项需求评估将用于为外科住院医师创建一项人体工程学计划。

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