Wester Christian Tolstrup, Brusaca Luiz Augusto, Palarea-Albaladejo Javier, Kyriakidis Stavros, Frost Anders Dreyer, Holtermann Andreas, Rasmussen Charlotte Diana Nørregaard
Ergonomics and Musculoskeletal Health, The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark.
Laboratory of Clinical and Occupational Kinesiology, Department of Physical Therapy, Federal University of Sao Carlos, Washington Luiz Road, km 235, SP310, 13565-905, São Carlos, São Paulo, Brazil.
Ann Work Expo Health. 2025 Jun 30;69(5):520-530. doi: 10.1093/annweh/wxaf016.
The childcare sector faces several challenges such as high rates of sick leave, employee turnover, and pain. We know that the physical behaviours the workers do at work are important for their musculoskeletal health and sick leave. However, we lack knowledge of which workplace factors determine the physical behaviours of workers. Therefore, we aimed to investigate which organisational levels and factors of Danish day nurseries determine the physical behaviours at work of childcare workers.
This cross-sectional study included 178 childcare workers from 73 teams and 16 day nurseries in Denmark. Workers were, on average, 36.5 years of age, mostly female (84%) and 57% were educated pedagogues. We measured physical behaviours (i.e. sedentary, light physical activity, and moderate-to-vigorous physical activity) during working hours using a thigh-worn accelerometer, and expressed them as isometric log-ratio coordinates for analysis according to compositional data analysis procedures. We examined 15 potential determinants of physical behaviours at work at three organisational levels: institutions (e.g. permanent-to-not-permanent staff ratio), teams (e.g. worker-to-child ratio), and workers (e.g. age, BMI, physical exertion). Variance component analysis identified the percentage contribution to the total variance of physical behaviours of each organisational level. Linear mixed models were used to investigate associations between determinants at each level and the physical behaviours.
The largest contribution to the total variance in childcare workers' physical behaviours was observed at the worker level (95.5%), while team (2%) and institution (2.5%) levels contributed to only a minor extent. Two individual factors at the worker level-physical exertion (P < 0.01) and pain intensity (P = 0.01)-were significantly, but weakly associated with physical behaviours. Specifically, an increased physical exertion was associated with a 3.7% increase in moderate-to-vigorous physical activity (P = 0.019) and a 6% decrease in sedentary behaviour (P = 0.009), relative to the remaining behaviours. Also, an increased pain intensity was associated with a 3.6% decrease in moderate-to-vigorous physical activity (P = 0.008), relative to the remaining behaviours. No determinants at the institution and team levels were significantly associated with physical behaviours.
In this study, worker level determines nearly all of the variability in physical behaviours while the institution and team levels only explain a little. That only two individual worker-level factors were weakly associated with physical behaviours indicates that other unmeasured worker-level factors are important determinants of the physical behaviours of childcare workers.
儿童保育部门面临着诸多挑战，如高病假率、员工流动率和疼痛问题。我们知道，员工在工作中的身体行为对其肌肉骨骼健康和病假情况很重要。然而，我们并不清楚哪些工作场所因素决定了员工的身体行为。因此，我们旨在调查丹麦日托中心的哪些组织层面和因素决定了儿童保育工作者在工作中的身体行为。
这项横断面研究纳入了来自丹麦73个团队和16所日托中心的178名儿童保育工作者。员工平均年龄为36.5岁，大多数为女性（84%），57%为受过教育的教育工作者。我们使用佩戴在大腿上的加速度计测量工作时间内的身体行为（即久坐、轻度身体活动和中度至剧烈身体活动），并根据成分数据分析程序将其表示为等距对数比坐标进行分析。我们在三个组织层面检查了15个工作中身体行为的潜在决定因素：机构（如长期员工与非长期员工比例）、团队（如员工与儿童比例）和员工（如年龄、体重指数、体力消耗）。方差成分分析确定了每个组织层面对身体行为总方差的贡献百分比。线性混合模型用于研究每个层面的决定因素与身体行为之间的关联。
在员工层面观察到对儿童保育工作者身体行为总方差的最大贡献（95.5%），而团队层面（2%）和机构层面（2.5%）的贡献较小。员工层面的两个个体因素——体力消耗（P < 0.01）和疼痛强度（P = 0.01）——与身体行为显著但微弱相关。具体而言，相对于其他行为，体力消耗增加与中度至剧烈身体活动增加3.7%（P = 0.019）和久坐行为减少6%（P = 0.009）相关。此外，相对于其他行为，疼痛强度增加与中度至剧烈身体活动减少3.6%（P = 0.008）相关。机构和团队层面的决定因素与身体行为均无显著关联。
在本研究中，员工层面决定了几乎所有身体行为的变异性，而机构和团队层面仅能解释一小部分。只有两个员工层面的个体因素与身体行为微弱相关，这表明其他未测量的员工层面因素是儿童保育工作者身体行为的重要决定因素。
