New low back pain in nurses: work activities, work stress and sedentary lifestyle

BACKGROUND: Low back pain is common among nurses. Previous studies have shown that the risk of low back pain increases rapidly with greater amounts of physical work and psychological stress, but is inversely related to leisure activities. However, these previous studies were predominantly retrospective in design and not many took account of three factors simultaneously. AIMS: This 12-month prospective study examined the relationships between work activities, work stress, sedentary lifestyle and new low back pain. METHODS: A total of 144 nurses from six Hong Kong district hospitals completed a face-to-face baseline interview, which was followed-up by a telephone interview. The main study measures were demographic characteristics, work activities, work stress, physical leisure activities and the nature of new low back pain during the 12-month follow-up period. Level of work stress, quality of relationships at work, level of enjoyment experienced at work, and work satisfaction were self-reported. RESULTS: Fifty-six (38.9%) nurses reported experiencing new low back pain. Sedentary leisure time activity was not associated with new low back pain. Being comparatively new on a ward (adjusted relative risk 2.90), working in bending postures (adjusted relative risk 2.76) and poor work relationships with colleagues (adjusted relative risk 2.52) were independent predictors of new low back pain. CONCLUSION: The findings of this study suggest that low back pain is a common problem in the population of nurses in Hong Kong. Being comparatively new on a ward, bending frequently during work and having poor work relationships with colleagues are independent predictors of new low back pain. Training for high-risk work activities and ergonomic assessment of awkward work postures are essential. Moreover, relaxation and team-building workshops for nurses, especially those who are less experienced in the type of work on their current ward, are recommended.     

护理人员腰背疼痛与抑郁情绪的相关性研究

目的探讨护理人员腰背疼痛(low back pain,LBP)与抑郁情绪之间的相关关系。方法采用一般情况、数字疼痛量表(numerical rating scale,NRS)及Beck抑郁问卷(Beck depression inventory,BDI)对502名临床在职护理人员进行调查。按有无LBP分为LBP组和无LBP组。采用χ2检验、秩和检验及等级相关分析法分析LBP与抑郁情绪间的相关关系。结果与无LBP组比较,LBP组BDI指数明显升高。LBP发生率及疼痛程度与抑郁程度呈正相关。结论做好躯体症状和心理症状双重干预可降低护理人员LBP的发生。     

Manual handling activities and injuries among nurses: an Australian hospital study

The aims of this study were to identify patterns of manual handling activities and their associated injuries and consequences among nurses working at a large teaching and referral medical centre in Melbourne, Australia. A self-report 140-item questionnaire was distributed to 523 registered nurses working full time at the medical centre. Of the 269 (51.4%) nurses who completed the questionnaire, 108 (40.1%) retrospectively reported an injury associated with manual handling activity, of which 75.9% (82) comprised back injuries. When all full-time nurses working at the medical centre are considered, the prevalence of all manual handling injuries was 20.6% (n=108) and 15.7% (n=87) for back injuries. About two-thirds (67.6%) of all manual handling injuries were associated with direct patient care activities and another third (32.4%) with non-direct patient care activities. Approximately one-third (34.3%) of all injuries were associated with lifting patients and this activity comprised one half of all causes associated with injuries arising from direct patient care activities. The consequences of injuries were significant. Recommendations for reducing manual handling activities and injuries are made and future research directions are discussed.     

Prior depression and incident back pain among military registered nurses: A retrospective cohort study

BackgroundOccupational back pain rates are substantial among registered nurses, and nurses also report high rates of depression. The role of depression as a potential predictor of back pain among nurses appears understudied.ObjectivesThe objective of the study was to determine whether a history of depression predicted incident back pain in a population of military registered nurses when controlling for relevant risk factors.DesignWe employed a retrospective cohort approach using longitudinal data in which gender-specific subject groups were followed from the beginning of duty as a registered nurse to the occurrence of an outcome, or to censoring due to completion of service or the end of available data.ParticipantsThis study included all United States Army registered nurses who began work during 2011–2014 without evidence of prior back pain in clinical records.MethodsData from automatically-collected medical and administrative sources were combined and used to provide 2134 person-years of observation on 1248 individuals. These data were organized at the person-month level in a panel data structure to support discrete-time multivariable logistic regression models. The models examined the relationships between prior depression, Body Mass Index, the presence of prior combat duty and selected control variables and the outcome, the incident occurrence of back pain.ResultsThe incidence rate of back pain was 18.6 per 100 person-years and the period prevalence was 31.7%. Prior depression was a statistically-significant predictor of incident back pain among female subjects (odds ratio [OR]: 1.75, 95% confidence interval [CI]: 1.08–2.83, P-value < 0.05). Body Mass Index of 30 kg/m² or greater, prior combat deployments, and age 36 years or older was each associated with back pain for male and female nurses.ConclusionsThe study’s findings provide the first evidence of a temporal link between antecedent depression and later back pain among female military nurses. High Body Mass Index was found to be a further, modifiable risk factor for back pain in this population.     

泉州市部分三级甲等医院护士腰背痛状况及相关因素分析

目的调查分析护士易患腰背痛的相关因素,并提出相应防治对策。方法对泉州市2所三级甲等医院护龄1年以上的171名护士进行问卷调查。结果 74.27%的护士有腰背痛史,近半年内的发病率为59.65%;年龄为(24.65±2.81)岁;易患腰背痛的危险因素有年龄、护龄、社会心理因素、工作性质、组织管理因素等。结论护士易患职业性腰背痛是多种因素协同作用的结果,防治腰背痛关键在于护士应提高自我保护意识,做好初级预防、早期干预及合理的组织管理。     

Prevalence of low back pain among physical therapists in Edmonton,Canada

Questionnaires were sent to 462 physical therapists in Edmonton, Canada, to determine the prevalence of work-related low back pain (LBP) and to characterize those who reported pain. Of the 311 (67·3%) valid questionnaires returned, 49·2% reported back pain due to work. The occurrence rates of work-related LBP among physical therapists in Edmonton was higher than that of the general population reported in Canada (27%), Great Britain (27%), and the United States (26·29%). There was no significant difference (p ≤ 005) between those with and without work-related LBP. The initial onset of work-related LBP frequently occurred within the first 5 years of practice as a physical therapist, and before the age of 30. Hospitals and private practices were the most prevalent work settings in which injury occurred. Patient handling, bending, stooping, lifting, carrying, pushing, and pulling were the commonly described activities causing precipitation of injury. The severity of back discomfort had been sufficient to require 13·7% of therapists to stop their work. Despite LBP, 35·3% of the pain sufferers continued to work. Over half (55·4%) of the respondents with current work-related LBP demonstrated little or no disability.     

Functional activities and psychosocial factors in the rehabilitation of patients with low back pain

A four-week rehabilitation programme for back patients, focusing on functional activities and psychosocial factors in the demands of work and daily living, was evaluated. The programme is a combination of training of functional activities and increased psychological knowledge, body awareness and coping. A total of 40 patients with lumbago or lumbago ischias participated in the program and were compared with a matched control group. The results showed that the patients had significantly more ergonomic and psychosocial problems in their working environment than did the controls. A significant reduction in ratings of low back pain was noted in patients compared with controls after rehabilitation. Increased functional ability and physical fitness were shown in the patient group after rehabilitation. Significantly more patients than controls returned to work after the rehabilitation.     

护士角色压力、组织支持感与工作投入的关系研究

[目的]探讨护士角色压力、组织支持感和工作投入的关系。[方法]采用角色压力量表、组织支持感量表和工作投入量表对天津5所三级甲等医院420名护士进行问卷调查,并对其影响因素进行 Pearson 相关分析和多重线性回归分析。[结果]护士角色压力与工作投入呈显著负相关,与组织支持感也呈显著负相关;护士组织支持感与工作投入呈显著的正相关;组织支持感在护士角色压力对工作投入的关系中起部分中介作用。[结论]管理者应采取措施,提高护士的组织支持感,从而降低其角色压力,促使护士以积极状态投入工作,改善整体护理服务质量。     

对护士进行职业腰背痛相关知识培训的效果评价

目的通过对护士进行职业性腰背痛发生相关知识的培训,提高其对腰背痛发生的认知能力,以减少职业伤害。方法选择2009年3月一2010年4月在上海市第八人民医院工作的执业护士48名,均为女性,年龄23～54岁。参考相关文献,结合日常护士工作中存在的诱发腰背痛的相关危险因素,自行设计护士职业性腰背痛情况调查表,并进行问卷测评,根据结果给予相应的教育培训、现场指导。经培训后5个月再次测评,比较培训前后护理人员对职业腰背痛的认知状况。结果培训后护士对职业性腰背痛认知水平较培训前均有所提高,培训前后比较差异有统计学意义（P〈0．001）。结论有针对性的健康知识培训能有效提高护士职业性腰背痛的认知水平,改善护士不良工作方法和生活习惯,预防和降低腰背痛的发生率,从而保障护士的自身健康,有利于提高护理人员的生活质量。     

某三级甲等医院临床护士腰痛情况调查与分析

目的：掌握临床护士腰痛发病情况以及相关职业因素,加强护士职业保护。方法：采用自行设计调查问卷对692名护士进行问卷调查。结果：护士腰痛发病率高达97.4%,年龄、护龄、夜班频度、弯腰频度、弯腰时间、科室的差异导致了腰痛频度的差异。结论：医院有关部门应重视护士腰痛的职业防护,促进护士身体健康。     

Patient-centredness in physiotherapy from the perspective of the chronic low back pain patient

Objective

To define patient-centredness from the patient's perspective in the context of physiotherapy for chronic low back pain (CLBP).

Design

Qualitative study using semi-structured interviews to explore perceptions of various aspects of physiotherapy management of CLBP.

Setting

Physiotherapy departments in one geographical area of the UK National Health Service.

Participants

Twenty-five individuals who had received physiotherapy for CLBP within the previous 6 months.

Results

Six key themes emerged as the dimensions that the participants perceived to be important for patient-centred physiotherapy: communication; individual care; decision-making; information; the physiotherapist; and organisation of care. Communication was the most important dimension, underpinning the five other dimensions as well as being a distinct dimension of patient-centred physiotherapy.

Conclusions

Physiotherapists should have an understanding of the six dimensions of patient-centred physiotherapy for CLBP. Improving physiotherapists’ communication skills may better facilitate patient-centred physiotherapy, and therefore enhance the experience of physiotherapy for this client group.     

心理因素与下腰痛

尽管临床上下腰痛很常见,但目前仍有很多不明确的问题,文章从下腰痛发生的影响因素及生理、心理学机制等方面,对心理因素与下腰痛的相关性进行了综述。指出一些下腰痛患者表现出“抑郁-疑病-癔病”之神经三联征的个性特征;并建议在下腰痛的处理上对患者的心理和躯体成分予以同样重视。     

Concerns and expectations about returning to work with low back pain: Identifying themes from focus groups and semi-structured interviews

Purpose. Studies of occupational low back pain (OLBP) have shown that return to work after injury is influenced by workers' concerns and expectations; however, these theoretical constructs have not been explored. The specific aim of this study was to identify themes related to self-efficacy and outcome expectancy for returning to work using qualitative research methods.

Method. Twenty-eight individuals who recently returned to work (<6 months) after an onset of OLBP responded to a newspaper advertisement and participated in focus groups. In a second phase of the study, patients with OLBP and an impending return to work (n=23) were referred by their physiotherapists and interviewed to provide more immediate accounts of their concerns and experiences. Notes and recordings from both sources were searched for utterances describing beliefs about self-efficacy or outcome expectancy for returning to work.

Results. Two primary self-efficacy constructs emerged: self-efficacy for resuming physical activity and self-efficacy for resuming work. Self-efficacy for resuming physical activity included 8 sub-domains: lift, carry, sit, stand, push/pull, bend, climb, and reach. Self-efficacy for resuming work included 3 sub-domains: pain control, obtaining help, and meeting job demands. Outcome expectancy included four sub-domains: financial/job security, re-injury, workplace support, and self-image.

Conclusions. Hesitation to return to work after OLBP involves not only concerns about pain and re-injury, but also the perceived ability to perform physical tasks, meet role expectations, obtain workplace support, and maintain job security.