Low back pain among nurses working in clinical settings of Africa: systematic review and meta-analysis of 19 years of studies

Nurses' Attitudes Toward Holistic and Complementary Medicine in Pain Management

BACKGROUND

The effects of nurses' attitudes toward complementary and alternative medicine (CAM) in pain management in terms of safety and quality of life are important. Nurses turn to a CAM approach to deal with pain problems.

AIM

This study aimed to investigate nurses' attitudes toward CAM and to determine their sociodemographic and pain-related characteristics.

DESIGN

This study is a cross-sectional descriptive study.

METHODS

This study was carried out with 150 nurses between March 31 and April 30, 2023. Data were collected with the "Data Collection Form," "Pain Numerical Rating Scale," and "Attitudes toward Holistic and Complementary Medicine Scale" developed by the researchers.

RESULTS

The mean age of the nurses who participated in the study was 33.24 ± 8.69. It was determined that 55.3% of the nurses frequently used pharmacological and CAM treatments together in their pain management, and 71.3% of them used these treatments for less than 1 week. It was found that 65.3% of the nurses used massage, 60% used spa/hot-cold applications, 54.0% used acupuncture, 42.6% used art/color/music/dance therapy, and 12.6% used prayer or meditation in pain management.

CONCLUSIONS

It was determined that nurses used pharmacological and CAM methods together in pain management. Nurses can be offered CAM therapy options in addition to pharmacological treatments to manage their pain, and information can be given.

Perceived stress and lower back pain amongst nurses during the SARS-CoV-2, across hospitals in Durban, South Africa

BACKGROUND

 The coronavirus disease 2019 (COVID-19) pandemic strained the healthcare sector and workers. Nurses experienced stress and burnout because of strain in resources, limited staff and exposure risk. Resultant lower back pain was prevalent. Nurses were poorly equipped to manage these conditions physically and psychologically.

OBJECTIVES

 The study aims to investigate lower back pain and stress levels during COVID-19. It also aims to provide data describing any association between both.

METHOD

 Pain and stress were determined using questionnaires. Quantitative, descriptive design and convenient sampling were used. The Chi-square goodness-of-fit-test tests significant Back Pain Functional Scale (BPFS) responses (12 daily activities lower back pain) and determines the relationship between pain and stress before and during COVID-19 related to the current time. Chi-square test of independence is used on cross-tabulations to determine the relationship between stress and lower back pain. Fisher's exact test was used for conditions not met. The Binomial test was used for the significance check of yes/no response to medication use. A questionnaire was provided on exercise levels and provision by workplace.

RESULTS

 Higher pain and stress were noted during versus prior to COVID-19. Back Pain Functional Scale showed no difficulty performing the majority of activities. A small percentage used medication, showing no significant change. Majority did not perform exercise for reducing lower back pain prior to or during COVID-19. Exercise intervention was not provided by workplaces for the majority, during or prior to COVID-19.

CONCLUSION

 Lower back pain and perceived stress levels increased during the COVID-19 pandemic. Provision of lower back pain education and exercise intervention in preventing and managing lower back pain in hospital nurses was needed. This study adds to the stress and lower back pain knowledge base in South Africa.Contribution: The findings assist in understanding the effects of Covid-19 on stress and lower back pain in nurses, linkage of the two, and possible interventions to reduce these effects using knowledge enhancement and prescribed exercise interventions.

Impact of BMI and Work Environment Circumstances on Prevalence and Severity of Chronic Pain among Nurses

PURPOSE

The objective of this study was to explore the relationship between workplace conditions, demographic characteristics, and physical attributes with the prevalence and severity of chronic pain among nurses. The goal was to gain insights into the factors contributing to chronic pain within the nursing profession.

METHODS

A cross-sectional descriptive-analytic study was conducted among 415 nurses in Turkey using purposive convenience sampling. Data collection instruments included the Graded Chronic Pain Scale, a body diagram, a pain exacerbator/alleviator inquiry, and a socio-demographic form. Data were analyzed using SPSS 25.

RESULTS

The majority of participants were female nurses (87.7%) with a mean age of 34.62 ± 9.32 and a body mass index (BMI) of 24.51 ± 4.32. Nearly half reported irregular exercise habits (49.9%), and 36.1% indicated high levels of work-related stress. A significant proportion exhibited moderate levels of work-related anxiety (39%), smoked (40%), and consumed alcohol (37.1%). Chronic pain was experienced by 40.9% on most days, with the head and lumbar regions being the most affected (45.5% and 44.1%, respectively). The study identified a significant association between BMI and pain frequency (p = .043) and severity (p < .014). Furthermore, pain localization and management strategies varied between male and female nurses.

DISCUSSION

The study's results underscore the substantial impact of chronic pain on nurses' quality of life, activity levels, and work attendance. Notably, the study provides results that support the relationship between BMI and chronic pain. The study revealed gender-specific differences in pain localization and management strategies among nurses, highlighting the importance of gender-tailored interventions in chronic pain management among nurses.

CONCLUSION

Addressing the interplay between BMI, work-related factors, and chronic pain is vital for nurses' well-being and a conducive work environment, potentially reducing financial costs associated with medical leave and absenteeism.

Prevalence, predisposing factors, and turnover intention related to low back pain among health workers in Accra, Ghana

BACKGROUND

Globally, low back pain (LBP) is responsible for disability among 60.1 million people. Health workers face a higher likelihood of being exposed to LBP compared to employees in the construction and manufacturing sectors. Data on LBP among hospital workers in Ghana are however limited. This study examined the prevalence, predisposing factors and turnover intention related to LBP among health workers in the Greater Accra region of Ghana.

METHODS

A multi-centred facility-based cross-sectional study was conducted in the Greater Accra region from January 30 -May 31, 2023. A multi-stage sampling technique was adopted, and the study participants were selected through proportion-to-size simple random sampling. STATA 15 software was used for analysis. Logistic regression analysis was used to determine the factors associated with LBP at a p < 0.05.

RESULTS

A survey was conducted among 607 health workers in 10 public and private hospitals. The prevalence of LBP was 81.6% [95% CI: (78.2%-84.6%)]. Advanced age [AOR = 1.07 (1.00, 1.16)], working for more than 5 days in a week [AOR = 8.14 (2.65, 25.02)], working overtime [AOR = 2.00 (1.16, 3.46)], rarely involved in transferring patients [AOR = 3.22 (1.08, 9.60)], most of the time involved in transferring patients [AOR = 6.95 (2.07, 23.26)], awkward posture during work [(AOR = 2.36 (1.31, 4.25)], perceived understaffing [(AOR = 1.84 (95% CI = 1.04-3.27)], sleep duration ≥ 8 [AOR = 0.54 (0.31, 0.97)] and sitting intermittently at work [AOR = 0.31 (0.12, 0.80)] were factors significantly associated with LBP. A substantial number, 123 (24.9%), occasionally had intention of leaving their jobs.

CONCLUSION

The study revealed a high proportion of low back pain (LBP), and turnover intention attributed to LBP. Moreover, organizational and occupational factors were found to be significantly associated with LBP. These findings underscore the importance of targeted interventions aimed at reducing the burden of LBP within these specific areas.

Ergonomics and Occupational Health: Knowledge, Attitudes and Practices of Nurses in a Tertiary Hospital in Botswana

Background: Musculoskeletal disorders (MSD) are, to this day, considered one of the major occupational health risks, especially among healthcare workers. Poor working conditions, such as awkward postures, are associated with the development of MSD. This study aimed to evaluate the knowledge, attitudes, and practices (KAP) of nurses at a public tertiary hospital in Botswana relating to ergonomic principles. Methods: The researchers conducted a cross-sectional survey, using a self-administered questionnaire to collect the data. The researchers employed Stata v18 (StataCorp, USA) to perform descriptive and inferential statistics. The chi-square test was used to determine the association between knowledge levels and sociodemographic variables. p-values ≤ 0.05 were deemed statistically significant. Results: In total, 306 nurses participated in the study, and a response rate of 88.4% was achieved. The mean age was 35.5 (SD± 8.79) years. Most (69%) participants were female nurses. About 99.3% (95%CI: 97.7-99.9) of the participants were familiar with the concept of ergonomics. Only a small proportion of participants (26%) possessed high levels of knowledge, exhibited positive attitudes, and demonstrated good practices in relation to ergonomic principles, following the composite analysis. A statistically significant relationship was found to exist between sex and practice (p = 0.030) and between length of work and practice (p = 0.013). Conclusions: The KAP analysis indicated that most nurses had poor practices regarding essential ergonomic principles. These findings could inform policy development and enable employers to design prevention strategies, especially those aimed at preventing lower back pain (LBP).

Lower back pain amongst medical trainees in clinical rotations: implications for choosing future career regarding medical practice

Background

Low back pain (LBP) is an increasing concern amongst medical students. There is a dearth of publications regarding how the occurrence of LBP impact medical trainees' career decisions.

Objective

To determine: (i) the point and annual prevalence of LBP amongst Ugandan medical students, (ii) its associated factors, and (iii) whether the experience of LBP during clinical rotations influence medical students' career choices regarding medical practice.

Methods

A multi-center cross-sectional study of 387 randomly selected clinical-phase students was conducted in three Ugandan medical schools, during 17th January to 10th March 2023. Proportions of participants with current and 12-months history of LBP were computed as well as odds for career prospects. We performed binary logistic regression models to determine factors associated with LBP at 95% confidence interval regarding p < 0.05 as statistically significant.

Results

The response rate was 100%. Participants' mean age was 24.7 ± 3.2 years of which 66.2% (256/387) were males. The point and annual prevalence of LBP was 52.5% (203/387) and 66.1% (256/387) respectively. Age [OR 1.23, 95% CI (1.03-1.47), p = 0.02], time spent sitting per day [OR 1.08, 95% CI (1.06-1.3), p < 0.01], perceived influence of LBP on future medical career [OR 4.75, 95% CI (1.87-12.06), p < 0.01] were the significant predictors of LBP. LBP interrupted the students' learning for at least 6.8 ± 12.8 h in 42.4% of participants. Nearly half of participants affirmed that their LBP experience would influence their career prospects. Based on their LBP experiences, trainees ruled out surgery 51.5% (172/334), obstetrics/gynecology 29.6% (99/334), paediatrics 18.3% (61/334), and internal medicine 17.7% (59/334) as their future career specialties. The proportion of trainees that would not consider surgical as opposed to medical disciplines were 81.1% vs. 36.0%, respectively, (p < 0.001).

Conclusion

The high prevalence of low back pain among medical students impacts their choices of future medical career with an aversion towards specialization in surgical disciplines. This has far-reaching implications on the disparities in specialist physician health workforce in Low-middle-income countries.

The distribution of work-related musculoskeletal disorders among nurses in sub-Saharan Africa: a scoping review

BACKGROUND

Musculoskeletal injuries are noticeably high among the nursing fraternity, with lower back pain (LBP) being the most prevalent. Therefore, this study aimed to map evidence on the burden of occupational musculoskeletal disorders (MSD) among nurses in sub-Saharan Africa (SSA).

METHODS

This scoping review was guided by Arksey and O'Malley's framework. We conducted a comprehensive literature search with no date limit from the following databases: Science Direct, PubMed, Sabinet (SA ePublications), EBSCOhost platform, World Health Organization (WHO) Library, Google Scholar, SCOPUS, Taylor and Francis, and WorldCat Academic Search with full text for published studies. The search took place from May 2022 to December 2022. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used for reporting the search results, and a thematic content analysis was used to present the emerging themes from the included studies.

RESULTS

A total of 16,714 studies were identified after the database search. Only 29 studies met the inclusion criteria after full-article screening and were included for data extraction. The studies reported a total of 6343 participants from different regions in SSA. The 29 included studies showed evidence on the prevalence of MSD, associated risk factors of MSD and LBP among nurses in SSA with some recommendations on how to reduce the prevalence of MSD among nurses.

CONCLUSION

The study findings reveal that there is a high prevalence of MSD among nurses, especially LBP. The etiology of MSD among nurses is multifactorial, and multifaceted strategies to address MSD are recommended. Further research is recommended to explore strategies that can be used to curb the high prevalence of MSD among nurses.

Analysis of poor work postures during morning care operations of intensive care unit nurses: a field research

BACKGROUND

Poor working postures in morning care operations contribute significantly to work-related muscle fatigue and low back pain among ICU (Intensive Care Unit, ICU) nurses. However,there are few field studies on the relationship between Poor working postures and work-related muscle fatigue, low back pain among ICU nurses.

OBJECTIVE

This study aims to assess the frequency and degree of posture hazards associated with poor working postures during morning care operations of ICU nurses.

METHODS

Two ICUs in a Grade-A tertiary hospital in Hunan Province were randomly selected for the field study in May-June 2021 research. The image data of the participating nurses' morning care work postures were collected by observation method and image recording method, and the postural hazard level was assessed by the two-person interpretation method of the work posture analysis system. The mean and standard deviation, frequency and percentage were used for the basic statistical description, and the general linear model multivariate Hotelling's T2 test was used to calculate the Hotelling's T2 and F statistics to explore the pattern of change in the postural hazard score curves.

RESULTS

A total of 45 nurses were observed during morning care operations, resulting in 47.8 h of video data and 34,428 effective static operation posture pictures. Among these pictures, 21,166 (61.5%) depicted poor working postures. Nurses spent up to 7 min and 30 s maintaining a challenging posture during oral care, with the highest postural hazard score (M = 2.2, SD = 0.3) observed during defecation care. Each patient requires a total of 25-30 min of oral care per day.The Hotelling's T2 test indicated that the change curve of the postural hazard score in each step revealed the largest second-order F value, F = 52.931, P < 0.001.

DISCUSSION

ICU nurses frequently adopt poor working postures during morning care operations. Further research should focus on optimizing safe working postures to prevent or minimise detrimental occupational hazards resulting from poor working postures.Research on occupational low back pain among ICU nurses can help them work more efficiently, and thereby improving their nursing level.

More Than Just a Pain in the Back: Pain Among American Nurses and Its Relationship to Modifiable Work Factors and Work Performance

Nursing is a profession with high rates of workplace injuries, hazards, and turnover. Improving the health and safety of nurses at work is vital to retain and grow the workforce to meet future demands. The purpose of this study was to describe the breadth of pain among American nurses and explore the relationships between this pain and modifiable work factors and perceived work performance. We used a cross-sectional descriptive design of 2312 nurses from across the United States. Nurses completed a survey containing questions about demographics, the presence of pain in the past week, the number of pain sites, pain locations, severity, and the impact on work performance. The median number of pain locations reported was 2, back pain was the most reported pain site, and average pain severity ranged from 4 to 5. Significant modifiable work factors associated with pain were average patient load and shift length. Many participants indicated that their pain impacted work performance, while a smaller proportion acknowledged that their pain impacted patient care. Pain among nurses spans multiple locations, is moderately severe, and impacts work performance. Addressing related modifiable work factors may decrease pain and the impact on the health, safety, and work performance of the nursing workforce.

'Breakdown and healing' - adaptation experiences of postpartum nurses returning to work: a descriptive phenomenological study

BACKGROUND

Promoting the work adaptation of nurses returning to work after childbirth is key to improving their physical and mental health and ensuring the quality of nursing care. Although postpartum nurses have reported high work stress and poor adaptation after returning to work, little is known regarding the experiences, problems and further needs. This study aimed to explore the adaptation experiences of postpartum nurses returning to work.

METHODS

This was a qualitative study with descriptive phenomenological approach. Individual semi-structured interviews were conducted between March and May 2023 in four tertiary hospitals in Changsha, mainland China, which were selected using convenience sampling. A total of 16 postpartum nurses returning to work within one year were recruited using purposive sampling and maximum variation sampling. The interviews were analysed using the Colaizzi's 7-step method.

RESULTS

'Breakdown and healing' is a strong thread in postpartum nurses' work adaptation. It links 13 subthemes in the interview data, which can be grouped under three overarching themes: (a) changes and challenges of multiple roles; (b) self-coping and social support; and (c) further needs after returning to work. The phrase 'breakdown and healing' reflects the mutual relationship between stress and coping among postpartum nurses. The changes and challenges associated with being required to fulfil multiple roles of mothers, wives and nurses make the subjects feel on the verge of 'breakdown'. When returning to work, most of them move slowly towards 'healing' through positive self-management and support from their partners, families, supervisors and colleagues. Moreover, their ongoing demands and unsolved problems - such as their desire for a workplace that is friendly and serves their needs - were generated by the constant process of 'breakdown and healing'.

CONCLUSIONS

Understanding how postpartum nurses returning to work perceive adaptation experiences is essential for nursing managers, who can use the findings to implement targeted measures to shorten postpartum nurses' maladaptation period after returning to work and promote their work adaptation. This study underscores the critical importance of personalized return-to-work training, flexible work arrangements, support from colleagues and managers, well-established maternal facilities and services, and targeted policy efforts in enhancing postpartum nurses' work adaptation.

Role of the interaction between lumbar kinematics and accelerometer-measured physical activity in bodily pain, physical functioning and work ability among health care workers with low back pain

The aim of this study was to examine the associations of spinal kinematics and physical activity (PA) with bodily pain, physical functioning, and work ability among health care workers with low back pain (LBP). Spinal kinematics and PA were measured with a wireless Inertial Measurement Unit system (ValedoMotion®) and a waist-worn tri-axial accelerometer (Hookie AM20), respectively. Their association was assessed in relation to Work Ability Index (WAI), bodily pain and physical functioning (RAND-36) in 210 health care workers with recurrent LBP. Greater lumbar movement variability/less deterministic lumbar movement (in angular velocity) during a "Pick Up a Box" functional task was correlated with higher amounts of step counts (r = -0.29, p = 0.01) and moderate PA (r = -0.24, p = 0.03). A higher amount of PA (p = 0.03) as well as less movement control impairment (p = 0.04) and movement variability (p = 0.03) were associated with greater work ability, whilst greater vigorous PA was the only parameter to explain higher physical functioning (p = 0.02). PA and movement variability were relative to each other to explain bodily pain (p = 0.01). These findings show the importance of considering the interaction between lumbar kinematics and physical activity while planning strategies to improve bodily pain, physical functioning and work ability among health care workers with LBP.

Prevalence of Work-Related Musculoskeletal Disorders and Its Effects amongst Nurses in the Selected Intellectual Disability Unit of the Limpopo Province

The COVID-19 pandemic continuously highlights the need for occupational health and safety among healthcare professionals. Physical and mental health safety resulting from needle prick injuries, stress, infections, and chemical hazards are priority work-related musculoskeletal disorders for nurses, including those working in the intellectual disability unit. The intellectual disability unit provides basic nursing care to patients with known mental disabilities, such as learning, problem-solving, and judgment problems, which demand diverse physical activities. Nevertheless, the safety of nurses within the unit receives little attention. Thus, we adopted a quantitative cross-sectional epidemiological survey design to determine the prevalence of work-related musculoskeletal disorders amongst nurses working in the intellectual disability unit at the selected hospital in Limpopo Province, South Africa. A self-administered questionnaire collected data from 69 randomly selected nurses from the intellectual disability unit. Data were extracted, coded, and captured in MS Excel format (2016) and imported into the IBM Statistical Package for the Social Sciences (SPSS), software version 25.0, for analysis. The study reported a low (38%) prevalence of musculoskeletal disorders in the intellectual disability unit, with significant effects on nursing care and staffing. The effects of these WMSDs included missing work, interference with the daily routine, disturbance with sleeping patterns after work, and absenteeism from work. Since intellectually disabled patients depend entirely on nurses for the basic activities of daily living, this paper recommends the incorporation of physiotherapy among nurses in the intellectual disability unit to treat the incidence of lower back pain while mitigating nurses missing work or absenteeism.

Effectiveness and Safety of Inelastic Versus Elastic Lumbosacral Orthoses on Low Back Pain Prevention in Healthy Nurses: A Randomized Controlled Trial

STUDY DESIGN

A randomized controlled trial.

OBJECTIVE

To evaluate the effects of inelastic and elastic lumbosacral orthoses (LSOs) on the prevention of low back pain (LBP) in healthy nurses.

SUMMARY OF BACKGROUND DATA

Over 80% of people experience LBP during their lifetime. LSOs, as a device used to maintain lumbar stability, were widely used in LBP management. The effects of inelastic LSOs (iLSOs) and elastic LSOs (eLSOs) on the prevention of LBP are controversial.

METHODS

A randomized clinical trial recruiting healthy nurses was conducted from November 2011 to June 2013 at a tertiary hospital in China. A total of 300 eligible participants aged 20 to 25 years were randomly assigned to iLSO, eLSO, or control groups. The intervention period was 6 months, and follow-ups were continued for an additional 6 months. Participants in both iLSO and eLSO groups were required to wear LSOs daily. Outcomes included the incidence of LBP, changes in trunk muscle endurance, and spinal range of motion assessed at baseline, 6months, and 12 months from the starting date. The incidence of LBP among groups was analyzed by ANOVA. Wilcoxon rank-sum test, Kruskal-Wallis H test, etc. were used for secondary outcomes comparison across groups.

RESULTS

Two hundred seventy-eight out of 300 participants (92.7%) completed the trial. No statistically significant differences were observed in LBP incidence among the three groups. No difference was observed in abdominal/back muscle endurance among groups at 6 months. In secondary outcome analysis regarding spinal range of motion, flexion and extension improved in iLSO groups at 12 months compared with that at baseline (flexion, P  = 0.01; extension, P  = 0.01), whereas only extension motion improved at 12 months in the eLSO group (P  = 0.00).

CONCLUSIONS

Six-month wearing of LSO showed neither a significant difference in preventing LBP nor causing adverse effects to participants.Level of Evidence: 1.

Lower Back Pain as an Occupational Hazard Among Ugandan Health Workers

Background: Lower back pain is a public health concern affecting 70–85% of the world's population. There is paucity of published data on the prevalence, disability and risk factors for lower back pain among health workers in Uganda.

Objective: To determine the frequency rate (note that is it implicit that frequency is a rate like incidence so including rate seems redundant here. This is bounded by zero and infinity. In contrast, prevalence is bounded by 0 and 1 and is thus a proportion not a rate) of lower back pain and its associated risks amongst health professionals in the Arua District of Uganda.

Methods: Cross-sectional descriptive study of 245 consecutive participants conducted during February-April 2020. We stratified risks as individual or work related and analyzed the data using IBM SPSS version 25. Chi-square was used to measure the significance of association between categorical variables at 95% confidence interval, regarding a p ≤ 0.05 as significant.

Results: The mean age of participants was 40.87 years ± 8.74 (SD), with female predominance (69.8%). Majority were either general nurses or midwives (64.9%) and more than half had practiced for over 6–10 years. The frequency rate of lower back pain was 39.6% (n = 97). Individual factors associated with LBP were; cigarette smoking (X² = 33.040; P ≤ 0.001), alcohol consumption (X² = 13.581; P ≤ 0.001), age (X² = 14.717; P = 0.002), and female gender (X² = 4.802; P = 0.028). The work related factors significantly associated with lower back pain were: being a nurse/midwife (X² = 9.829; P = 0.007), working in the outpatient department (X² = 49.752; P ≤ 0.001), bending (X² = 43.912; P ≤ 0.001), lifting (X² = 33.279; P < 0.001), over standing (X² = 40.096; P ≤ 0.001), being in awkward positions (X² = 15.607; P= < 0.001), and pushing patients (X² = 21.999; P ≤ 0.001).

Conclusion: The frequency rate of low back pain was high amongst health workers and its main associated individual and work related factors could have been prevented. Health workers should strike a balance between caring for their personal back-health and meeting clients' needs while manually handling patients. Ergonomic structuring, job organization, back health care courses and use of assistive equipment could reduce such occupational hazards in our low resourced settings.

Prevalence of Self-Reported Work-Related Lower Back Pain and Its Associated Factors in Ethiopia: A Systematic Review and Meta-Analysis

Introduction

Low back pain is the commonest musculoskeletal disorder affecting every socioeconomic group of the world's population. The lifetime risk of developing low back pain is about 60%–80%. The pooled prevalence and associated factors of low back pain have not yet been determined in Ethiopia. Thus, this study was aimed at assessing the overall prevalence of low back pain and its associated factors in Ethiopia.

Methods

A systematic search of PubMed, Scopus, Science Direct, and Google Scholar for observational studies reporting data on the prevalence and associated factors of low back pain was conducted. Relevant data were extracted with a standardized data extraction excel form. Stata 14 was employed for the meta-analysis. Heterogeneity was assessed by Cochran's Q test and I² values of a forest plot. Publication bias was checked using a funnel plot and Egger's test. A random-effects model was used in the analysis.

Result

A total of thirty-two studies were included for the systematic review. Twenty-four and sixteen studies were used to pool the overall low back pain prevalence and associated factors, respectively. The overall pooled annual prevalence of low back pain in Ethiopia was estimated to be 54.05% (95% CI: 48.14–59.96). Age, sex, body mass index, work experience, working hours, lack of safety training, awkward working posture, work shift, prolonged standing, lifting heavy objects, sleeping disturbance, history of back trauma, previous medical history of musculoskeletal disorder, and lack of adequate rest interval at work were significantly associated with low back pain.

Conclusion

The current systematic review and meta-analysis revealed a higher prevalence of lower back pain in Ethiopia. Most of the low back pain epidemiological studies conducted in Ethiopia focused on specific occupational settings, making pooling of data and comparison with other countries challenging. Thus, further general population studies are recommended.

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.

Relationship Between the Exposure to Occupation-related Psychosocial and Physical Exertion and Upper Body Musculoskeletal Diseases in Hospital Nurses: A Systematic Review and Meta-analysis

PURPOSE

Nurses' musculoskeletal diseases (MSDs) are worldwide prevalent and are considered to be a costly occupational injury. This study aims to investigate the relationship between exposure to occupation-related psychosocial factors, physical workload, and upper body musculoskeletal diseases among hospital nurses.

METHODS

An electronic search was implemented using nine databases with June 2019 as the latest search date. English and Chinese studies were chosen, and data were independently and separately extracted by two investigators. Pooled odds ratio (OR) and its 95% confidence interval (CI) were estimated for each subset, using the fixed or random-effects model, following heterogeneity between studies for research synthesis. The source of heterogeneity was explored through subgroup, sensitivity, and meta-analyses.

RESULTS

Eighteen studies were included in the meta-analysis. Most participants were women (51.4%-100.0%), aged between 20 and 60. A correlation was found between high job demand and the prevalence of low back pain (OR = 1.41; 95% CI = 1.23-1.62). Total job strain was related to the risk of low back pain (OR = 1.71; 95% CI = 1.15-2.55), neck pain (OR = 1.67; 95% CI = 1.26-2.20), shoulder pain (OR = 1.62; 95% CI = 1.06-2.48) and back pain (OR = 1.45; 95% CI = 1.10-1.91). Furthermore, the physical workload was significantly associated with the prevalence of low back pain (OR = 1.76; 95% CI = 1.32-2.35), neck pain (OR = 1.17; 95% CI = 1.08-1.27), shoulder pain (OR = 1.59; 95% CI = 1.37-1.85) and back pain (OR = 1.66; 95% CI = 1.45-1.90).

CONCLUSION

There were significant associations between occupational strain, more physical workload and upper body MSDs, but the evidence advocating a growth risk in MSDs due to low levels of social support is quite weak.