Towards rehabilitative handling in caring for patients following stroke: a participatory action research project

Aim of the study. This study aimed to facilitate nurses to take ownership of their moving and handling practice. Objectives. To (i) facilitate nurses in sharing their insights in moving and handling patients following stroke, (ii) enable nurses to identify facilitators of safer moving and handling practice, and (iii) empower nurses in collaboration with physiotherapists to direct changes in their practice. Background. Traditional top down moving and handling training has had variable impact on nursing practice. A moving and handling incident in a stroke unit demonstrated that there were professional development needs for staff in the stroke unit in relation to their moving and handling practice in the care of patients following stroke. Methods. An insider participatory action research approach was utilized. Data were analysed from focus group meetings, brainstorming sessions, observational studies, and from written reflective accounts. Findings. Peer pressure, communication, rehabilitative handling awareness, teamwork between nurses and physiotherapists, equipment and environmental issues were affecting moving and handling practice. Nurses identified that equipment, environment, communication and teamwork strategies would facilitate them in using rehabilitative moving and handling practice. Nurses in collaboration with physiotherapists directed changes in their practice. Participant staff members felt involved and valued, and reported changes in understanding, in their handling practice, and enhanced teamwork. Conclusion. Participatory action research creates a supportive environment, where those directly involved in moving and handling patients can investigate and direct changes in their practice. Thus it is a significant vehicle for delivering professional development in moving and handling practice. Relevance to clinical practice. Professional development initiatives in moving and handling practice must incorporate processes that enhance inter‐disciplinary teamwork and value and utilize the views and experiences of the staff who move and handle patients.     

The Economic and Social Consequences of Work-related Musculoskeletal Disorders: The Connecticut Upper-extremity Surveillance Project (CUSP)

Abstract

A population-based telephone survey was conducted in Connecticut to determine the social and economic impact of work-related musculoskeletal disorders (WRMSDs). Only 10.6% of cases had filed for workers' compensation. Respondents had spent an average of 489 annually out-of-pocket. Only 21% of individuals who had had medical visitsor procedures reported having them paid for by workers' compensation. The WRMSDcases reported much higher levels of difficulty in daily tasks rated by the activities of daily living (ADL) scale, with odds ratios (ORs) ranging from 8.2 (child care) to 35.2 (bathing). The cases were significantly more likely to have moved for financial reasons (OR = 2.41), including having lost a home (OR = 3.44). The caseswere also significantly more likely to have lost a car due to finances (OR = 2.45), more likely to have been divorced (OR = 1.91), and less likely to have been promoted (OR = 0.45). The study supports significant externalization of costs for WRMSD out of the workers' compensation system and a substantial social and economic impact on workers.     

Lateral epicondylitis in a hospital phlebotomist--an ergonomic solution.

This report outlines a case of lateral epicondylitis in a hospital phlebotomist thought to be due to the forceful gripping, and repetitive twisting, involved in breaking the seals on green vacutainer needles. An ergonomic solution in the form of a device to aid breaking of the vacutainer seals is presented. The importance of seeking ergonomic solutions with manufacturers is highlighted.     

视屏显示终端操作人员骨骼肌疲劳症候群的调查研究

对１３０名ＶＤＴ操作者的调查结果表明，骨骼肌疲劳症候群阳性率比对照组高，女性的阳性率比男性高，经统计学处理，差异有显著性，骨骼肌疲劳症候群阳性率似乎有随接触工龄增加而上升的趋势，提示可能与人体工效学因素有关。     

Disability management and the cardiac rehabilitation patient: Job simulation and transitional work strategies

Medical advances and treatment interventions among patients with coronary heart diseases have not resulted in more timely return to work outcomes among cardiac rehabilitation programs. This article reviews vocational rehabilitation outcomes among persons with coronary heart disease, and the importance of employer-based disability management concepts. Job simulation, transitional work strategies, and ergonomic job site modifications, when integrated within the cardiac rehabilitation protocol, may yield promising results. The article discusses an experimental research project at the University of Cincinnati Medical Center that addresses worker-work environment interaction, encourages direct employer involvement, and promotes employer accommodation under the Americans with Disabilities Act.     

冰箱生产流水线工人慢性肌肉骨骼损伤工效学研究

对５１５名冰箱生产流水线工人进行了职业性慢性肌肉骨骼损伤的工效学研究，并采用多瞬间调查法分析了流水线操作工的工作体位。研究结果提示，工作体位、操作方式、静态作业和身高因素与职业性颈臂疾患及下背痛发病有关。颈和上臂重复活动和静态作业是职业性颈臂疾患主要发病因素，而下背痛的主要发病因素则是不良工作姿式。