工作相关因素对护理人员职业性肌肉骨骼疾患影响的研究

Study on the influence of job related factors on occupational musculoskeletal disorders among nurses

目的探讨护理人员工作相关因素对职业性肌肉骨骼疾患(WMSDs)的影响。方法采用分层整群抽样的方法,对5 438名综合医院护士采用自评肌肉骨骼疾患量表进行调查,分析护士工作因素中的动态负荷、静态负荷、体力负荷、工效环境因素以及劳动组织因素对护士WMSDs患病率的影响。结果共调查5 438名护士,护理人员工作状况分析显示,动态负荷中,经常大幅度弯腰、稍微转身及大幅度转身、弯腰和转身同时存在、经常走动、经常以手或臂去取物、经常用胳膊或手使出很大的力气、经常用手捏住物体的动作,其对应的WMSDs患病率高;静态负荷中,长时间站立、颈部前倾或长时间保持前倾姿势、经常手保持在肩或肩部以下水平3个姿势比例最高,其对应的WMSDs患病率较高;体力负荷中,搬举、推拉、搬运重物(>5 kg、>20 kg)、以不舒服的体位搬举重物、用一只手搬举重物、举重物过肩等动作的百分比均<50%;工效学环境的评价,工作中脚底打滑、没有东西依靠的环境对应的患病率高;劳动组织评价,认为休息时间不充分、休息后就开始工作、不能决定工间休息、经常替同事上班、经常加班的护士WMSDs患病率高。结论护理人员工作相关因素对护士WMSDs患病率有一定影响,应积极探索改善护士工作环境、缓解工作负荷等方法降低护士WMSDs患病率,造福护士群体健康。

Objective To explore the effect of job related factors on occupational musculoskeletal disorders(WMSDs) among nurses. Methods A total of 5 438 nurses in general hospital were investigated with self-rated musculoskeletal disease scale by stratified cluster sampling, and analyzed the influence of dynamic load, static load, physical load, ergonomic environment factors and labor organization factors on the prevalence of WMSDs among nurses. Results The analysis of the working conditions of the nurses showed that, in the dynamic load, the corresponding WMSDs prevalence of the nurses with frequently bending down significantly, turning around slightly and a lot, bending and turning at the same time, frequently walking around, and picking up objects with their hands or arms, frequently making the arms or hands with great strength, frequently holding an object with the hands were higher;in the static load, the corresponding prevalence of WMSDs of the nurses with standing for a long time, neck tilting forward for a long time or keeping forward posture for a long time, often keeping hands at the shoulder or below the level of the shoulders(being the three highest proportion of the postures) were higher;in the physical load, lifting, pushing and pulling, carrying heavy objects(>5 kg,>20 kg), lifting weights in uncomfortable position, and lifting weights with one hand, and the percentage of weights lifting over the shoulder were less than 50%;in the ergonomics environment evaluation, the corresponding prevalence rate of the nurses with the soles of the feet slide at work, and the environment with nothing leaning were high;in the labor organization evaluation, the WMSDs prevalence rate of the nurses concerning insufficient rest time, starting work right after rest, no breaks at the workshop, frequently substitute for colleagues working, frequently overtime were higher. Conclusion The related factors of nurses undefined work have a certain influence on the prevalence of WMSDs among nurses. The nursing administrators and health administration departments should actively explore ways to improve the working environment of nurses and ease the workload of nurses to reduce the prevalence of WMSDs among nurses, so as to benefit the health of nurses.