Risk Factors for Work-Related Musculoskeletal Disorders Among Intensive Care Unit Nurses in China: A Structural Equation Model Approach

Unveiling the key elements of effective preventive strategies: Insights into addressing work-related musculoskeletal disorders among physiotherapists

BackgroundPhysiotherapists play a critical role in managing musculoskeletal health, yet they remain highly vulnerable to work-related musculoskeletal disorders (WMSDs) due to the physical demands of their profession.ObjectiveThis study explores the awareness of strategies used in preventing WMSDs and their effectiveness, motivation, and barriers to preventing WMSDs among physiotherapists.MethodsThis qualitative study was administered among physiotherapists in Malaysia, where semi-structured interviews with a modified interview guide were used through an online platform. The interview was performed as an open conversation and follow-up questions to ensure the questions were answered in-depth.ResultsParticipants were aware of a range of strategies used in preventing WMSDs and acknowledged the effectiveness of these strategies. The strategies are proper body mechanics (61.5%), exercise (23.1%), proper work ergonomics (15.4%), adequate staffing (15.4%), use of equipment (15.4%), and proper warm-up (7.7%). Clinics or hospitals well equipped with devices and equipment (53.8%), encouraging proper body mechanics and posture (46.2%), and education (30.8%) were the most common themes that motivated participants in preventive WMSDs. Several barriers to the engagement of these preventive strategies were also acknowledged, namely the availability of equipment, heavy workload, and inadequate staffing.ConclusionsMalaysian physiotherapists recognize the importance of proper body mechanics, physical exercise, and education in preventing WMSDs. While they actively adopt strategies such as utilizing tools, promoting correct posture, and implementing preventive measures, challenges like equipment shortages, excessive workloads, and staffing issues remain significant barriers. Addressing such barriers is essential for effective and sustainable prevention strategies.

Safety climate, safety behavior, injury experience, and musculoskeletal disorders among Iranian manufacturing employees: A structural equation modeling study

BackgroundWhile safety climate and performance are extensively studied, few research studies have explored the relationship between safety climate and both retrospective and prospective indicators of safety performance.ObjectiveThis study aims to investigate the relationships between safety climate, safety behavior, musculoskeletal disorder (MSD) symptoms, and injury experience in manufacturing using structural equation modeling (SEM).MethodsThe study enrolled 409 employees from 15 manufacturing companies in Urmia, Iran in 2021. Data were collected using safety climate, safety behavior, and Nordic musculoskeletal disorders questionnaires. Occupational injury experiences from the past year were also recorded. SEM was used to analyze safety climate's relationships with performance variables.ResultsA positive relationship was observed between safety climate and safety behavior (r = 0.38, p < 0.01). Symptoms of MSD correlated significantly with safety climate (r = -0.12, p < 0.05) and injury experience (r = 0.10, p < 0.05). A significant association was found between safety climate and safety behavior factors in the first model (ß = 0.19, p = 0.001). The overall fit indices for the proposed model were acceptable. SEM confirmed a significant association between safety climate and safety behavior (ß = 0.20, p = 0.001). However, no relationship was found between safety climate/behavior and injury experience or MSD symptoms.ConclusionsThe safety climate influenced safety behavior but had no effect on employees' self-reported injuries or MSD symptoms. Enhancing workplaces safety climate could prevent unsafe behaviors. This study recommends exploring the association between safety climate and safety performance indicators, considering potential mediators and moderators.

Comprehensive investigation of ergonomic challenges and predictors of work-related musculoskeletal disorders among intensive care unit nurses of Western India through convergent mixed methods study

BACKGROUND

Work-related musculoskeletal disorders (WRMSDs) are significant concern in intensive care units (ICUs) due to distinct work environment. This study aims to comprehensively investigate determinants of WRMSDs and ergonomic challenges, specific to ICU nurses, providing valuable insights for targeted interventions.

METHODS

In this six-month convergent mixed methods study, 200 consenting nurses with over one year of experience from seven ICUs across three public tertiary hospitals of Ahmedabad participated. Structured questionnaires were used to collect data on socio-demographics, occupation, physical and workplace factors, risk perception, and musculoskeletal pain (through modified Nordic Musculoskeletal Questionnaire) and ergonomic issues using REBA (Rapid Entire Body Assessment) scale. Qualitative insights were obtained through in-depth interviews until saturation of responses. Statistical analysis involved chi-square, t-test and logistic regression, with a significance level set at p < 0.05. Thematic analysis was used to interpret the findings of qualitative study.

RESULTS

The study included predominantly female ICU nurses (78%) with a mean age of 34 years. A high prevalence of WRMSDs (84%) was observed, with the lower back and neck being the most affected regions. Nurses with WRMSDs reported significantly higher mean scores for physical factors (15.1 vs. 11.1, p = 0.00), physical workload (12.8 vs. 10.7, p = 0.001), work environment (13.1 vs. 10.1, p = 0.00), and risk perception (11.8 vs. 8.9, p = 0.00) compared to those without WRMSDs. Logistic regression identified key risk factors for WRMSDs, including longer ICU tenure [OR = 1.4 (1.13-1.66)], high shift frequency [OR = 2.7 (1.27-5.95)], higher physical factor score [OR = 1.2 (1.05-1.42)], higher physical workload score [OR = 1.2 (1.09-1.49)], higher risk perception [OR = 1.3 (1.10-1.78)], and lack of exercise [OR = 0.5 (0.27-0.93)]. The qualitative findings highlighted key ergonomic challenges, including inadequate equipment, heavy patient loads, poor posture during tasks, and insufficient breaks, contributing to WRMSDs among ICU nurses.

CONCLUSION

The findings underscore urgent need for targeted interventions to address risk factors associated with WRMSDs, including ergonomic training, workplace modifications, and education programs to enhance risk awareness and preventive behaviours. Future research should focus on developing and evaluating comprehensive interventions that integrate both physical and work environment factors to effectively mitigate WRMSDs among ICU nurses.

Disclosing Strain: How Psychosocial Risk Factors Influence Work-Related Musculoskeletal Disorders in Healthcare Workers Preceding and during the COVID-19 Pandemic

Healthcare workers, particularly nurses, engage in a daily work routine that takes a toll on their emotional well-being, rendering them vulnerable to psychosocial risk factors. This research seeks to analyse the influence of psychosocial risk factors on the occurrence of work-related musculoskeletal disorders among nurses. An additional analysis was performed to understand the role of age in work-related musculoskeletal disorders and the perception of psychosocial risk factors. The study was conducted during two separate periods-pre-pandemic and pandemic times-involving a sample of 456 nurses from both public and private hospitals in Portugal. The INSAT-Health and Work Survey-was used as measuring instrument. The primary observations indicated a consistency between psychosocial risk factors and the occurrence of work-related musculoskeletal disorders. The findings revealed a significant exposure to psychosocial risk factors, with work pace, intensity, work relationships, and emotional demands exhibiting higher global average percentages during both periods, pre-pandemic and pandemic. Nonetheless, we find that the psychosocial risk factors change when we analyse the pre-pandemic and pandemic results. During the period before the pandemic, the psychosocial risk factors that were most commonly reported included the demanding pace of work, long working hours, and emotional demands. Through the pandemic, the most pronounced psychosocial risk factors were work relationships, employment relationships, and ethical and values conflicts. Therefore, research in this domain is essential to understanding psychosocial risk factors and assessing the less obvious links between work and health.

Occupational low back pain prevention capacity of nurses in China: A multicenter cross-sectional study

Introduction

Nurses have a high prevalence of occupational low back pain, especially since the outbreak of the COVID-19 pandemic, which has increased the nurses' workloads. It has brought a huge burden on nurses and their professional development. Nurses' occupational low back pain prevention capacity is the logical starting point and core of interventions to prevent its occurrence. To date, there is no study investigating it with a scientific scale. Therefore, a multicenter cross-sectional study was conducted to explore the current status of nurses' capacity in occupational low back pain prevention and its influencing factors in China.

Methods

Using a two-stage, purposive and convenience mixed sampling method, 1331 nurses from 8 hospitals across 5 provinces (Hubei, Zhejiang, Shandong, Henan, and Sichuan) in the southern, western, northern, and central areas of mainland China were involved in this study. The demographic questionnaire and occupational low back pain prevention behavior questionnaire were used for data collection. The descriptive analysis, univariate analysis, and multiple stepwise linear regression were used for data analysis.

Results

The results showed that the occupational low back pain prevention behavior questionnaire score was 89.00 (80.00, 103.00) [M (Q1, Q3)], which indicated that nurses' ability was at a moderate level. Participation in prevention training before, perceived stress at work, and working hours per week were predictors for nurses' occupational low back pain prevention capacity.

Discussion

To improve nurses' prevention ability, nursing managers should organize various training programs, strengthen regulations to reduce nurses' workload and stress, provide a healthy workplace, and offer incentives to motivate nurses.

Prevalence and factors associated with work-related musculoskeletal disorder among health care providers working in the operation room

Background

Work-related musculoskeletal disorder is a major and frequently underappreciated problem on people, countries, healthcare services, and society as a whole. Not only have detrimental health impacts, but it had considerable damage on healthcare services and costs.

Objective

The aim of this study was to determine the prevalence and factors associated with work-related musculoskeletal diseases among health care providers working in the operating room of University of Gondar comprehensive specialized hospital and Tibebe Ghion comprehensive specialized hospital, North West Ethiopia, 2021.

Method

Institution-based cross-sectional study was conducted on 394 healthcare providers. Purposive sampling was used to select the study participants. Data were collected through a self-administer questionnaire using the standard Nordic Musculoskeletal Questionnaire. Descriptive statistics and bivariate logistic regression were done to identify factors associated with work-related musculoskeletal disorders. Variables with P-value≤ 0.05 with 95% confidence interval in a multivariate model were taken as statistically significant. Finally, AOR with 95% confidence interval at a P-value<0.05 was reported.

Result

The prevalence of work-related musculoskeletal disorder among study participants was 64.2% with 95% CI: (59.4, 69.0). In multivariate logistic regression analysis; working overtime [AOR:1.74; 95% CI (1.05, 2.86)], previous history of MSD [AOR:6.85; 95%CI:(1.91, 22.7)], being diploma holder [AOR:5.27; 95% CI (1.12, 24.68)], being 1st degree holder [AOR:2.65; 95% CI (1.11, 6.28)], absence of assistance during procedures [AOR:1.73; 95% CI (1.02, 2.85)], and working in night shifts [AOR:1.72; 95% CI (1.08, 2.74)] were significantly associated with work related musculoskeletal disease among health care providers working in operation room.

Conclusion

A high proportion of hospital care providers working in the operation room reported MSD at different body parts. Lower back pain was the most often complained. Working overtime, not having assistance during procedures, educational status (diploma and 1st degree holder), and working at night shifts were statistically significant associated with musculoskeletal disorders.

Prevalence of low back pain among intensive care nurses: A meta-analysis

BACKGROUND

Low back pain (LBP) is a ubiquitous health problem affecting most of healthcare staff. However, there have been not effort to derive robust prevalence estimates of LBP among intensive care unit (ICU) nurses.

AIMS AND OBJECTIVES

To determine the prevalence of LBP among ICU nurses.

METHODS

A systematic review and meta-analysis was conducted. Five databases were searched: Web of Science, PubMed, MEDLINE (Ovid), Embase, and CINHAL databases. Original research that reported the prevalence of LBP among ICU nurses using a 12-month recall period were included. In order to assess methodological quality, we used a quality rating system which is specifically developed for LBP studies. Cochran's Q and the I² test were applied to assess heterogeneity. Subgroup analysis was applied to identify factors that may contribute to heterogeneity. Presence of potential publication bias was assessed by using Egger's test and visual inspection of the symmetry in funnel plots.

RESULTS

Twenty-seven studies reporting data from 2004 to 2020 on the prevalence of LBP in a defined ICU nurses were included (participants:6258; range: 3-1345). Twenty-one (77.8%) studies were of "high" quality. Among the included studies, the lowest and the highest prevalence were found to be 34.5% and 100.0%, respectively. Meta-analysis of included studies yielded a pooled prevalence of 12-month LBP at 76.0% (95% CI, 69.0%-81.8%). (I²  = 96.0%, Chi-squared = 722, P-value < .01).

CONCLUSION

LBP is prevalent among ICU nurses. Greater attention is urgently needed to address this burdensome health problem among ICU nurses, particularly with an emphasis to develop preventive strategies.

RELEVANCE TO CLINICAL PRACTICE

The results of our meta-analysis have important consequences for ICU nurse managers. Our finding of high prevalence rate of LBP among ICU nurses suggests that more attention should be devoted to develop and apply prevention programs for ICU nurses to manage this global issue.