Kammerhofer Kathrin, Mildner Sarah, Sengoelge Mathilde, Seebacher Barbara
Department for Clinical Neurosciences and Preventive Medicine, University for Continuing Education Krems, Dr.-Karl-Dorrek-Straße 30, Krems an der Donau 3500, Austria.
Department of Rehabilitation Science, Clinic for Rehabilitation Muenster, Groeben 700, Muenster 6232, Austria.
Contemp Nurse. 2025 Apr;61(2):111-126. doi: 10.1080/10376178.2024.2445271. Epub 2024 Dec 27.
The number of patients with neurological disorders and severe disability is increasing globally. These patients often need help with positioning and the amount of support varies with their level of impairment. High rates of work-related musculoskeletal disorders are observed among healthcare professionals (HCP) with patient contact due to injuries during manual handling. There is insufficient research on manual handling by nurses and other HCP.
The primary aim of this study was to explore manual handling strategies by HCP in neurological inpatient and outpatient settings. A secondary aim was to explore pain during and post manual handling activities.
A convergent parallel mixed methods design.
A quantitative survey was combined with qualitative semi-structured telephone interviews of HCP. The inclusion criteria were licensed allied HCP with at least seven years of experience with neurological patients in inpatient and/or outpatient settings and expertise in manual handling. Exclusion criteria included insufficient proficiency in German and pre-existing illness prior to start of professional education. The survey data were analysed using descriptive statistics and interviews were evaluated through inductive-reflexive thematic analysis.
Ten nurses, 10 occupational, 12 physiotherapists participated. Survey findings showed moderate time pressure, body strain, and low back and neck pain during patient transfers. HCPs spent an average of 7.3 (± 5.5) hours per week on personal endurance and strength training. They considered transfer aids moderately important and accessible, predominantly using the transfer board. Interdisciplinary collaboration in patient transfers was reported as crucial and usually available. We identified three themes from interviews: (1) individualised manual handling; (2) facilitating active patient participation during transfers; (3) maintaining personal physical fitness.
Neurological symptoms, patient fears, and goal setting necessitated personalised transfer strategies. Patient characteristics, lack of space and time complicated transfers, prompting HCPs to use perception-oriented techniques, leverage, gravity, and momentum.
全球神经系统疾病和严重残疾患者的数量正在增加。这些患者在体位摆放方面通常需要帮助，且所需支持的程度因损伤程度而异。由于在人工搬运患者过程中受伤，从事患者护理工作的医护人员中与工作相关的肌肉骨骼疾病发生率很高。关于护士和其他医护人员人工搬运患者的研究不足。
本研究的主要目的是探讨医护人员在神经科住院和门诊环境中的人工搬运策略。次要目的是探讨人工搬运活动期间及之后的疼痛情况。
采用收敛平行混合方法设计。
对医护人员进行定量调查，并结合定性半结构化电话访谈。纳入标准为具有执照的专职医护人员，在住院和/或门诊环境中至少有七年护理神经科患者的经验且具备人工搬运方面的专业知识。排除标准包括德语水平不足以及在开始专业教育之前就已存在疾病。调查数据采用描述性统计进行分析，访谈通过归纳 - 反思性主题分析进行评估。
10名护士、10名职业治疗师、12名物理治疗师参与了研究。调查结果显示，在患者转移过程中存在中度的时间压力、身体劳损以及腰颈部疼痛。医护人员平均每周花费7.3（±5.5）小时进行个人耐力和力量训练。他们认为转移辅助工具具有一定重要性且容易获得，主要使用转移板。据报告，在患者转移过程中的跨学科协作至关重要且通常能够实现。我们从访谈中确定了三个主题：（1）个性化人工搬运；（2）在转移过程中促进患者积极参与；（3）保持个人身体健康。
神经症状、患者恐惧和目标设定需要个性化的转移策略。患者特征、空间和时间的限制使转移变得复杂，促使医护人员使用以感知为导向的技术、杠杆作用、重力和动量。
