上海市某医院护理人员肌肉骨骼疾患调查及其危险因素的分析
Prevalence of musculoskeletal disorders and associated risk factors of healthcare workers in a hospital of Shanghai
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摘要:
目的 调查上海市某医院护理人员肌肉骨骼疾患（MSDs）的患病现状，探究患病的相关影响因素。
方法 采用横断面调查方法，应用中文版肌肉骨骼疾患调查表，于2016年1月对上海市某三级乙等医院全院护理人员进行问卷调查，调查内容包括：个体信息、各部位MSDs的患病情况及其严重程度及相关职业危险因素等，采用卡方检验、logistic回归以及敏感性分析识别MSDs患病的影响因素。
结果 共发放问卷464份，收集有效问卷423份，有效应答率91.2%。护理人群在过去一年肌肉骨骼疾患的患病率达91.4%，其中患病率最高为腰部（80.5%），其次为颈部（73.2%）、肩部（64.8%）。经logistic分析，颈部疼痛与长时间站立（OR=1.91，95% CI：1.23~2.95）、颈部不良姿势（OR=2.57，95% CI：1.38~4.77）、人员短缺（OR=1.73，95% CI：1.00~2.99）存在统计学关联，另外体力感觉累的人员更易出现颈部疼痛；腰部疼痛与搬抬患者（OR=2.15，95% CI：1.03~4.47）、人员短缺（OR=2.03，95% CI：1.14~3.62）存在统计学关联。体感累的错分比例超过3%时，体累感与腰痛的关联统计学意义消失；图形分析显示加班与搬动病人，以及用力与重复动作间有交互作用，但未呈现统计学意义。
结论 护理人群中肌肉骨骼疾患的患病率较高，其中腰部的患病率高于其他部位，可能的危险因素包括长时间站立、不良姿势、人员短缺以及搬抬患者等，亟需相应的政策和措施来降低护理人员肌肉骨骼疾患的患病率，提高护理人员的健康水平。
Abstract:Objective To survey the prevalence of musculoskeletal disorders (MSDs) and identify associated risk factors in healthcare workers in a hospital of Shanghai.
Methods A cross-sectional study was conducted using the Chinese Musculoskeletal Disorders Questionnaire in January 2016 in a tertiary grade 2 hospital in Shanghai. The questionnaire covered personal information, prevalence and severity of MSDs in various body parts, and related occupational risk factors. Chi-square test, logistic regression model, and sensitivity analysis were used to assess the factors affecting the prevalence of MSDs.
Results A total of 464 questionnaires were distributed, and 423 valid questionnaires were returned with a valid response rate of 91.2%. The overall prevalence rate of MSDs in the selected healthcare workers was 91.4% over the past 12 months, and the highest MSDs prevalence rate was reported in low back (80.5%), followed by neck (73.2%) and shoulder (64.8%). After adjusted by selected confounders, the results of logistic regression analysis showed that long-time standing (OR=1.91, 95%CI:1.23-2.95), awkward neck postures (OR=2.57, 95%CI:1.38-4.77), staff shortage (OR=1.73, 95%CI:1.00-2.99), and being exhausted after work were significantly associated with neck pain, whereas moving patients (OR=2.15, 95%CI:1.03-4.47) and staff shortage (OR=2.03, 95%CI:1.14-3.62) were associated with low back pain. When the proportion of misclassification on self-reported physical exhaustion was over 3%, the statistical association between physical exhaustion and low back pain disappeared. Interactions between working overtime & moving patient and between exertion & repetitive operation were identified by graph analysis; however, those effects did not reach statistical significance.
Conclusion A high prevalence of MSDs is identified in the healthcare workers in the selected hospital, especially in low back. Long-time standing, awkward postures, staff shortage, and moving patients are the possible risk factors. It urges multi-dimensional policies and solutions to control MSDs in healthcare workers and promote their health.
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