看護人員肌肉骨骼傷害盛行率及危險因子回顧探討

Prevalence and Risk Factors for Musculoskeletal Discomfort among Nursing Attendants: A Comparative Review

李雪楨(Hsuei-Chen Lee) ； 林姵君(Pei-Chun Lin) ； 周嫚君(Man-Chun Chou) ； 黃裕淨(Yu-Ching Huang) ； 利怡慧(Yi-Hui Li) ； 林慧敏(Hui-Min Lin) ； 洪禎雯(Jen-Wen Hung) ； 張谷州(Ku-Chou Chang)

《物理治療》 36卷2期 (2011/06) Pp. 55-66

摘要

背景與目的：看護人員為發生肌肉骨骼傷害的高危險群，與護理人員相比看護人員研究甚少。本文以對比護理人員文獻回顧方式，探討看護人員肌肉骨骼傷害盛行率及危險因子，期以物理治療專業觀點切入，提供未來規劃預防策略的設計基礎。方法：以看護人員／外籍看護工／護理人員，肌肉骨骼傷害／不適，及危險因子／體適能／身體力學等關鍵字的結合，搜尋全國博碩士論文網、政府研究資訊系統與PubMed等資料庫至2010年4月，排除基本特質及變項數據無法供判別比較的文獻。依北歐肌肉骨骼問卷分類，統整一年肌肉骨骼傷害盛行率，並將危險因子歸納為生理、社會心理、個人與機構組織因子。結果：符合本研究收錄標準共計18篇文獻。一年肌肉骨骼傷害盛行率：看護人員72-83%（外籍看書護工81-83%，本籍照服員72-81%），護理人員65-95%。看護人員肌肉骨骼傷害較常發生於下背部(42-65%)、肩部(37-73%)及頸部(25-63%)。危險因子包括生理因子（重複搬運、轉位、抬舉、荷重、持久彎腰或站立）、社會心理因子（低工作滿意度或成就感、壓力大或經眠不良、缺乏主管或組織支持以及付出與報酬失衡）、個人因子（年紀大、體適能差、運動次數少），及機構組織因子（輪值夜班、放假或空檔較少、較差的工作環境）。缺乏身體力學技巧或體適能與肌肉骨骼傷害相關性研究，亦少見結合臨床醫學檢驗或生物指標的研究。結論：看護人員及護理人員一年的肌肉骨骼傷害盛行率高達65-95%，但看護人員研究相對不足。現有肌肉骨骼傷害研究多以問卷量表測量，欠缺身體力學、體適能、臨床醫學檢驗或生化指標驗證。借鏡護理人員研究成果加上身體力學及臨床醫學指標，將有助於改善看護人員職場環境，提升照護供給品質。

關鍵字

護理人員 ； 看護人員 ； 外籍看護工 ； 肌肉骨骼傷害 ； 相關危險因子

並列摘要

Background: Nursing attendants (NA) are at high risk of musculoskeletal discomfort (MSD); however, there were scarce studies for NA relative to the nurses (N). This study performed a comparative review regarding the prevalence of and risk factors for MSD among nursing personnel. Methods: Literature search up to April 2010 was conducted from 1) publication of thesis and PhD dissertations in Taiwan, 2) Government Research Bulletin, Taiwan, and 3) U.S. National Library of Medicine National Institutes of Health (PubMed) with English literature. Medical subject headings and keywords used were: nursing attendants (NA), foreign NA (FNA), nursing profession (N), MSD, fitness, and biomechanical analysis. Studies lacking demographics or information necessary for analyses were excluded. Descriptive analyses were pooled categorized by NA, FNA and N to explore the prevalence of MSD in a year. Risk factors related to MSD were categorized by physical, psychosocial, individual and organizational factors. Results: Eighteen eligible studies were included in this review. The overall 1-year prevalence of MSD was 72-83% in NA and 65-95% in N, with most prevalence on low back (42-65%). shoulders (37-73%). and neck (25-63%). Physical (repetitive lifting, handling, transfer or persistent awkward posturing), psychosocial (low work satisfaction or achievement, high work stress, poor sleep quality, lack of superior support, or effort-reward imbalance), individual (older, low physical fitness, lack of regular exercise), and organizational factors (night shift, less holidays or break, poor working environment) were identified to be significantly associated with MSD. There were scarce studies exploring the relationship of body mechanics or physical fitness with MSD. Moreover, there was lack of biomedical or laboratory tests to verify the self-reported MSD. Conclusion: Past studies regarding MSD and related risk factors in NA were relatively inadequate, considering their comparable prevalence rate. This review offered important fundamental descriptions for MSD among N and NA. Further intervention studies aiming to minimize the MSD and caregiver burden of NA are anticipated.

並列關鍵字

Nursing attendant ； Foreign nursing attendant ； Nurse ； Musculoskeletal disorder ； Risk factor