- 學位論文
看護人員生理負荷與肌肉骨骼危害評估
Measurement of physiological load and musculoskeletal disorders among nursing assistants.
摘要
看護人員在照護病患過程中，需抬舉/移動病患，或為病患拍背翻身與復健，常因過度施力或不當姿勢，而造成肌肉骨骼不適與傷害。有鑑於看護作業所造成的下背及頸肩危害的嚴重性，已有少數研究深入探討其危害成因與介入現場改善方式。雖然這些研究提供了許多對看護作業危害機轉的瞭解與可行的解決方案，然而，絕大部分的改善策略均有作業特定性，而無法一體適用於所有看護作業。因此，是否有其他的方案可以更進一步的來減輕作業人員的肌肉骨骼傷害與疲勞，是值得進一步研究。 本研究將模擬看護人員幫病患進行移位作業的生理負荷，並以人因工程協助輔具介入方式評估是否能有效降低移位作業的危害。 研究結果顯示，卸下/抬舉作業中，由主觀Borg量表可得知病床作業高度50公分施力負荷大於70公分，無使用輔具之施力負荷亦大於使用移位腰帶或移位轉盤；而肌肉負荷方面，量測肌肉群之%MVC皆高於15%MVC，超出文獻建議負荷值，容易導致職業上的肌肉骨骼傷害；OWAS方法分析結果顯示，「頭頸部」姿勢「前傾」AC值為2，「背部」姿勢「重彎曲」、「彎曲且扭轉」AC值為2，「腿部」姿勢「單腳蹲姿」、「雙腳蹲姿」AC值為2，姿勢「屈膝」AC值為3。 本研究建議看護人員應加強肌肉骨骼不適與傷病預防的教育訓練，以達到降低其肌肉骨骼傷害的風險，以避免彎腰或蹲姿造成背部及腿部的危害。
並列摘要
During the process of caring for patients, nursing attendants frequently require to help patients with lifting/transferring, patting/turning and rehabilitation. Nursing attendants are required to exert forceful and awkward postures for extended periods of time that caused musculoskeletal disorders. In consideration of prolonged nursing attendance associated with serious problem on low back and neck/shoulder, few studies have investigated intensively on the causes of problem and improved with field intervention. These studies proposed that the reasons the low back and neck/shoulder may be affected is possibly due to prolonged nursing attendance, but most of the ergonomic intervention was task specific and may not be applied on general tasks. Hence, whether other ergonomic improvements can decrease workers’ musculoskeletal fatigue is needed to further consideration. In this study, the physiological load of the nursing attendents was simulated, and the risk of translocation was measured by means of ergonomical intervention. The results show that in the unloading/lifting operation, the 50 cm bed height loading load is greater than 70 cm bed height, and the force load, without the use of auxiliary tools is greater than that of the displacement belt or the displacement turntable by the subjective Borg scale. Furthermore, in muscle loading, all measured %MVC are higher than 15%, surpasses the literature proposed load value, easily causes the occupational musculoskeletal injury; OWAS method Analysis results show, "head and neck" posture "forward tilt"are AC2, "" Back posture " Bending "," bending and torsion "are AC2," leg "posture" squat posture "," feet squat "are AC2, posture" knee "is AC3. This study suggests that caregivers should strengthen the training of musculoskeletal discomfort and injury prevention in order to reduce the risk of musculoskeletal injury, so as to avoid the damage of the back and legs caused by stooping or squatting.