伊朗院前急救医护人员的道德困扰与肌肉骨骼疾病

Moral distress and musculoskeletal disorders in Iranian prehospital EMS workers.

作者信息

Sheikhi Hossein, Nobahar Monir, Saleh Elahe

机构信息

Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran.

Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, 3513138111, Iran.

出版信息

BMC Emerg Med. 2025 Sep 2;25(1):177. doi: 10.1186/s12873-025-01342-5.

DOI:10.1186/s12873-025-01342-5

PMID:40898038

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12403901/

Abstract

BACKGROUND

Prehospital emergency personnel are exposed to a high prevalence of musculoskeletal disorders (MSDs), and moral distress. This study aimed to assess the impact of moral distress on MSDs among prehospital emergency workers.

METHODS

This cross-sectional study, conducted in 2024, by using a census sampling approach, involved 125 employees from the prehospital emergency centers of Semnan University of Medical Sciences. Data collection tools included a demographic questionnaire, a moral distress scale, and the Nordic Musculoskeletal Questionnaire (NMQ) for assessing ergonomic complications and discomforts. Data analysis methods were structural equation modeling (SEM).

RESULTS

The results indicated that the most common pain complaints were in the lower back and buttocks (52.8%) and the back (42.4%). Over the past week, neck pain was the most frequently reported (44%), followed closely by lower back and buttocks pain (42.4%). At the time of the study, the highest pain prevalence was in the neck (73.6%) and the lower back and buttocks (36.8%). The mean moral distress score was 54.5 ± 41.9, with 86.4% of participants reporting low levels of moral distress. The moral distress was not significantly affect MSDs ( = 0.061). However, age and work experience were significantly associated with MSDs ( = 0.001) and moral distress ( = 0.005).

CONCLUSION

The findings demonstrate that nearly half of the prehospital emergency workers experienced MSDs, particularly in the neck and back. Most participants reported low levels of moral distress, which did not significantly influence MSDs. This P-value may indicate the presence of a true effect that could become more apparent with a larger sample size or a different study design. It is recommended to include intervention studies and qualitative research. In order to reduce moral distress and MSDs in prehospital emergency workers, in addition to regular screenings, it is recommended that the amount of work-related pressure be reduced, especially for older employees and those with more extensive work experience.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

院前急救人员面临着较高的肌肉骨骼疾病（MSD）患病率以及道德困扰。本研究旨在评估道德困扰对院前急救工作者肌肉骨骼疾病的影响。

方法

本横断面研究于2024年采用普查抽样方法进行，涉及塞尔柱医科大学院前急救中心的125名员工。数据收集工具包括一份人口统计学调查问卷、一份道德困扰量表以及用于评估人体工程学并发症和不适情况的北欧肌肉骨骼问卷（NMQ）。数据分析方法为结构方程模型（SEM）。

结果

结果表明，最常见的疼痛主诉部位是下背部和臀部（52.8%）以及背部（42.4%）。在过去一周内，颈部疼痛是最常报告的（44%），紧随其后的是下背部和臀部疼痛（42.4%）。在研究时，疼痛患病率最高的部位是颈部（73.6%）以及下背部和臀部（36.8%）。道德困扰平均得分是54.5±41.9，86.4%的参与者报告道德困扰程度较低。道德困扰对肌肉骨骼疾病没有显著影响（=0.061）。然而，年龄和工作经验与肌肉骨骼疾病（=0.001）以及道德困扰（=0.005）显著相关。

结论

研究结果表明，近一半的院前急救工作者患有肌肉骨骼疾病，尤其是颈部和背部。大多数参与者报告道德困扰程度较低，这对肌肉骨骼疾病没有显著影响。这个P值可能表明存在一种真实效应，在更大样本量或不同研究设计下可能会更明显。建议纳入干预研究和定性研究。为了减少院前急救工作者的道德困扰和肌肉骨骼疾病，除了定期筛查外，建议减少与工作相关的压力量，尤其是对年长员工和工作经验更丰富的员工。