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针对血液透析护士开展的含运动计划的人体工程学培训对工作相关肌肉骨骼疾病的有效性:一项初步随机对照试验。

Effectiveness of an ergonomic training with exercise program for work-related musculoskeletal disorders among hemodialysis nurses: A pilot randomized control trial.

作者信息

Lee Meng-Jung, Wang Chi-Jane, Chang Jer-Hao

机构信息

Department of Rehabilitation, Tainan Sin Lau Hospital, Tainan, Taiwan.

Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

J Safety Res. 2024 Dec;91:481-491. doi: 10.1016/j.jsr.2024.09.007. Epub 2024 Sep 19.

Abstract

INTRODUCTION

Hemodialysis nurses suffer a high prevalence of work-related musculoskeletal disorders due to the nursing job contents and high repetition. A practical ergonomic program was expected to improve their occupational health and musculoskeletal discomfort. This study developed an ergonomic training program with exercise and examined its effectiveness for musculoskeletal discomfort and muscle strength in hemodialysis nurses.

METHOD

A cluster pilot randomized control trial was conducted. Participant nurses were from two hemodialysis units at two medical centers in Taiwan in 2019 and 2020. A 12-week ergonomic program with exercise customized by the job analysis of hemodialysis nursing tasks applied to the intervention group (n = 14). A mobile messenger application was adopted to remind, monitor, and consult the implementation of exercises. The musculoskeletal discomfort degree and muscle strength were measured before and after training as well as the follow-up after another 12 weeks. The training effect between the intervention group and the control group (n = 20), was analyzed by the generalized estimating equations model.

RESULTS

The significant improvements in muscle strength of the wrist and pinch power of the dominant hand were identified after training. The sustaining effect showed significant decreases in musculoskeletal discomfort degrees in the elbows, wrists/hands, knees, and ankles/feet. Training participants achieved an 80% adherence rate to the exercise program, facilitated by a convenient mobile messenger application. They also responded with very high satisfaction with all the ergonomic education, exercise regimen, and use of resistance devices.

CONCLUSIONS

This trial approves the effectiveness of the developed program for hemodialysis nurses and its feasibility in clinical practice.

PRACTICAL APPLICATIONS

This ergonomic training with a customized exercise program for hemodialysis nurses can serve as a valuable educational resource for hemodialysis nurses to mitigate work-related musculoskeletal disorders and improve occupational strength. Integrating the support of remote technology can enhance program adherence in hectic work environments.

摘要

引言

由于护理工作内容和高重复性,血液透析护士患与工作相关的肌肉骨骼疾病的比例很高。一个实用的人体工程学计划有望改善他们的职业健康和肌肉骨骼不适。本研究制定了一项包含运动的人体工程学培训计划,并检验其对血液透析护士肌肉骨骼不适和肌肉力量的效果。

方法

进行了一项整群试点随机对照试验。参与研究的护士来自台湾两个医疗中心的两个血液透析科室,时间为2019年和2020年。一项为期12周的人体工程学计划,其中包含根据血液透析护理任务的工作分析定制的运动,应用于干预组(n = 14)。采用移动即时通讯应用程序来提醒、监测和咨询运动的实施情况。在训练前后以及再过12周后的随访中测量肌肉骨骼不适程度和肌肉力量。通过广义估计方程模型分析干预组和对照组(n = 20)之间的训练效果。

结果

训练后发现,手腕肌肉力量和优势手捏力有显著改善。持续效果显示,肘部、手腕/手部、膝盖和脚踝/脚部的肌肉骨骼不适程度显著降低。借助便捷的移动即时通讯应用程序,训练参与者对运动计划的依从率达到了80%。他们对所有人体工程学教育、运动方案和阻力装置的使用也给予了非常高的满意度评价。

结论

该试验证实了所制定的计划对血液透析护士的有效性及其在临床实践中的可行性。

实际应用

这项为血液透析护士定制运动计划的人体工程学培训,可作为血液透析护士减轻与工作相关的肌肉骨骼疾病和提高职业力量的宝贵教育资源。整合远程技术的支持可以在繁忙的工作环境中提高计划的依从性。

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