- 學位論文
某醫院護理人員肌肉骨骼傷害及其危害原因研究
Study on musculoskeletal disorder of nurses and risk factors in a hospital
摘要
目的:探討護理人員肌肉骨骼傷害之情形，並研究其危害因子。應用人因基準線風險認定檢核表，評估護理人員之「人因工程暴露量」，來探討工作及肌肉骨骼疾病之相關因素，將作為改善之參考。 對象:本研究採橫斷面研究，針對中部某區域醫院全院之233位護理人員為研究對象，將各單位護理人員依工作性質分類並加以探討。 方法:採用肌肉骨骼傷害問卷(Noridc Musculoskeletal Questionnaire,簡稱NMQ)、工作壓力調查、自覺疲勞量表問卷及人因基準線風險認定檢核表(Baseline Risk Identification of Ergonomic Factors,簡稱BRIEF)，對護理人員進行問卷訪視，加以整理建檔，以SPSS統計軟體進行資料分析及探討。 結果：1.三個不同工作類別護理人員在性別、不同年齡、身體質量指數、婚姻狀況、教育程度及運動習慣等有顯著統計上差異(P＜0.05)。2.整體護理人員肌肉骨骼不適之平均盛行率為34.2%，其中肩膀疼痛盛行率為78.1%、脖子為70.4%及下背部為50.2%，此三部位的情形最為嚴重。3.護理人員在肌肉骨骼不適的盛行率大略相同，並無顯著差異，且「四肢問題較小」為其共同點。4.護理人員每日平均工作時間中，打電腦時間為158分鐘、打針及抽血36.8分鐘及推拉工作車34.7分鐘。分析14項護理工作，其中電腦工作、換點滴、搬病人、量血壓、打針抽血、推拉工作車及換藥，與肌肉骨骼不適達到統計學上的顯著差異(P<0.05)。推論該醫院的主要危害因子為上述之工作內容。 結論：護理人員發生肌肉骨骼不適的機會較高，且不同工作別發生不適情形有所差異，建議院方主管可針對護理人員不同工作性質及屬性，給予相關教育訓練。早期發現醫院環境中危害因素，並透過人因工程改善及適當的工作姿勢與方法，預防或降低護理人員罹患肌肉骨骼疾病。
並列摘要
Objective: This study aimed to examine the musculoskeletal injuries of nurses and the related risk factors. Baseline Risk Identification of Ergonomic Factors Checklist was applied to assess "the human factors engineering exposure of nurses" as well as to investigate the relationship between the work-related factors and musculoskeletal diseases. Object: With a cross-sectional research method, this study involved 233 nurses at a certain Regional Hospital of the central Taiwan. The participants in each unit were classified according to their work assignment. Methods: The data were collected by using Noridc Musculoskeletal Questionnaire (NMQ), a work pressure survey, a consciously fatigue scale questionnaire and a Baseline Risk Identification of Ergonomic Factors (BRIEF) checklist. The nurses responded to the questionnaires, with SPSS analysis and discussion. The data were filed and analyzed with SPSS 22.0. Results: The results were summarized as follows: 1.Among the three different categories of nurses , there are statistically significant differences in gender, age, body mass index, marital status, educational attainment, and exercise habits (P <.05). 2.Overall, the nurses prevalence of musculoskeletal discomfort was 34.18 %of the findings, the most serious was shoulder pain(78.1%), neck pain(70.4%) and lower back pain(50.2%). 3.Overall, the prevalence of musculoskeletal discomfort was roughly the same. There was no significant difference between the different groups. In addition, the "less limbs problem" was indicated as a common point. 4.The average daily working hours of nurses are 158 minutes for working on the computer, 36.8 minutes for injections and blood draw and 34.7 minutes for pushing work car. Analysis of 14 kinds of nursing work indicated a significant correlation (p<.05) between the musculoskeletal discomfort and such nursing work as computer work, changing bit, moving patients, blood pressure, blood injections, sliding work car and dressing musculoskeletal discomfort. The result implies that the hidden hazard factors might lie in the above mentioned work assignments. Conclusion: The results suggested that the chance of occurrence of musculoskeletal discomfort in nurses is quite high, and different work assignment will result in different type of discomfort. This study recommends that hospital supervisor should provide education and training for the nurses, according to their different nature of work. By using early detection of hazards in the hospital environment and through human factors engineering to improve proper posture and method of work, this study might help the nurses to prevent or reduce the risk of musculoskeletal disorders.