李云霞, 虞仁和, 李琦, 范璐, 黄先桃, 陈冲, 刘瑶红, 袁素娥. 湖南省三级综合医院护理人员颈肩痛现况及工作负荷相关因素[J]. 环境与职业医学, 2022, 39(6): 695-700. DOI: 10.11836/JEOM21342
引用本文: 李云霞, 虞仁和, 李琦, 范璐, 黄先桃, 陈冲, 刘瑶红, 袁素娥. 湖南省三级综合医院护理人员颈肩痛现况及工作负荷相关因素[J]. 环境与职业医学, 2022, 39(6): 695-700. DOI: 10.11836/JEOM21342
LI Yunxia, YU Renhe, LI Qi, FAN Lu, HUANG Xiantao, CHEN Chong, LIU Yaohong, YUAN Su’e. Prevalence and workload-related risk factors of neck-shoulder pain among nurses in Hunan tertiary general hospitals[J]. Journal of Environmental and Occupational Medicine, 2022, 39(6): 695-700. DOI: 10.11836/JEOM21342
Citation: LI Yunxia, YU Renhe, LI Qi, FAN Lu, HUANG Xiantao, CHEN Chong, LIU Yaohong, YUAN Su’e. Prevalence and workload-related risk factors of neck-shoulder pain among nurses in Hunan tertiary general hospitals[J]. Journal of Environmental and Occupational Medicine, 2022, 39(6): 695-700. DOI: 10.11836/JEOM21342

湖南省三级综合医院护理人员颈肩痛现况及工作负荷相关因素

Prevalence and workload-related risk factors of neck-shoulder pain among nurses in Hunan tertiary general hospitals

  • 摘要: 背景 颈肩痛是护理人员常有不适症状之一,多由于工作量繁重、工作空间限制、长时间姿势不良等引起。

    目的 了解湖南省三级综合医院护理人员颈肩痛的发生情况,并分析工作负荷相关因素。

    方法 2018年10—12月,采用多阶段分层随机整群抽样法,选取湖南省5个地理分区的6所三级综合医院中符合纳入排除标准的1 200名护理人员为研究对象。采用自行设计的一般资料问卷收集护理人员的一般人口学特征和近1个月颈肩痛发生情况,采用中文版颈椎功能障碍指数量表评估颈痛对日常生活的影响,颈椎功能受损指数进行功能障碍分级;采用自行设计并经基于德尔菲法的专家函询构建的问卷收集工作负荷相关因素(工作时长、姿势负荷和用力负荷3个维度)。回收有效问卷1 161份,运用χ检验和logistic回归模型探究颈肩痛的影响因素。

    结果 过去1个月颈肩痛发生率为87.5%(1 016/1 161),不同特征的护理人员颈肩痛发生率介于76.9%~91.2%。颈椎功能障碍指数量表10个条目的得分从0~5分均有,但大部分集中在0、1和2分,在颈痛对日常生活影响的10个方面中,颈痛对睡眠影响最大(1.30±1.21)分,对个人护理影响最小(0.35±0.65)分;颈椎功能受损指数显示大部分(65.4%)护理人员的颈椎处于轻度功能障碍,30.1%处于中度功能障碍。单因素分析显示31条工作负荷相关影响因素中,有24个条目差异有统计学意义;多因素分析显示有3个变量进入回归模型。在同等条件下,每班次做手术/伤口换药/输液等需低头操作累计时长5 h以上者颈肩痛发生风险是1 h以下者的3.03倍;“有时”和“经常”颈部后仰并长时间保持这种姿势者颈肩痛发生风险是“偶尔或从来不”的2.36倍和2.94倍;工作时因姿势不自然很难用得上劲“有时”和“经常”发生者颈肩痛发生概率是“偶尔或从来不”发生者的2.78倍和7.08倍。

    结论 湖南省三级综合医院护理人员颈肩痛报告率较高,但多为轻度功能障碍。工作时长、姿势负荷可能与颈肩痛发病有关。

     

    Abstract: Background Neck-shoulder pain is one of the most common discomfort symptoms among nursing staff, mostly caused by a heavy workload, restricted workstation, and prolonged poor posture.

    Objective To investigate the prevalence of neck-shoulder pain among nursing staff in tertiary general hospitals in Hunan Province, and to analyze workload-related risk factors.

    Methods From October to December 2018, a multi-stage stratified randomized cluster sampling method was adopted to select a total of 1 200 nursing staff who met the inclusion andexclusion criteria in six tertiary general hospitals from five geographic subdivisions of Hunan Province were selected. A self-designed questionnaire was used to collect demographic characteristics, and past 1-month prevalence of neck-shoulder pain, a neck disability index (NDI) was used to assess the impact of neck pain on daily life, and functional disability was graded by the index of impaired neck function; a self-designed questionnaire was adopted to evaluate potential workload-related risk factors (working time, postural load, and force load) of neck-shoulder pain after a Delphi expert consultation. A total of 1 161 valid questionnaires were returned, and χtest and logistic regression model were used to screen the potential risk factors for neck-shoulder pain.

    Results The prevalence rate of neck-shoulder pain in the past 1 month was 87.5% (1 016/1 161) and varied by different characteristics of the nursing staff, ranging from 76.9% to 91.2%. The scores of the 10 items of the NDI ranged from 0 to 5, but most of them were 0, 1, and 2; of the 10 items, neck pain had the greatest impact on sleep (1.30±1.21) and the least impact on self-care behaviors (0.35±0.65). The index of impaired neck function showed that the majority (65.4%) of nurses had mild cervical spine dysfunction and 30.1% had moderate cervical spine dysfunction. The univariate analysis results revealed that 24 out of the 31 workload-related risk factors had significant differences, and further multiple analysis results showed that three variables entered the logistic regression model. Under the same conditions, nurses with ≥5 h of cumulative head-down tasks per shift had 3.03 times higher neck-shoulder pain risks compared with those with <1 h. Compared with “occasionally or never”, nurses who “sometimes” and “often” tilted their necks back and maintained this posture for a long time showed 2.36 and 2.94 times higher risks for neck-shoulder pain respectively. The nurses who reported “sometimes” and “often” having difficulty using their force at work due to unnatural posture had 2.78 times and 7.08 times higher neck-shoulder pain risks than those who “occasionally or never” respectively.

    Conclusion The reported rate of neck-shoulder pain among nurses in tertiary general hospitals in Hunan Province is high, but most of them are mild dysfunction. Working hours and posture load may affect the risk of neck-shoulder pain.

     

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