护理人员骨骼肌肉系统疾患多层面干预的效果

Effect of multifaceted interventions on musculoskeletal disorders in nurses

目的探讨参与式人体工程学、体能训练和认知行为训练多层面干预方式对护理人员肌肉骨骼系统疾患（MSDs）的干预效果。方法采用前瞻性对照研究的方法，2013年6月使用《Nordic肌肉骨骼系统疾病自评量表》调查420名护理人员肌肉骨骼系统疾患情况。根据调查结果，采用简单随机化方法划分干预组（n=229）和对照组（n=191），其中干预组中患MSDs者141人，非MSDs者88人；对照组中患MSDs者102人，非MSDs者89人。干预组护理人员接受多层面干预，对照组护理人员不进行干预。6个月后比较干预前后两组护理人员MSDs的持续时间、强度和相关花费的变化。结果患MSDs的护理人员中，干预前两组护理人员在持续时间、强度和相关花费方面差异均无统计学意义（P〉0．05）；干预后，干预组的MSDs持续时间、强度和相关花费分别为（8．1±4．3）d，（3．5＋2．6）分，（648．7±128．0）元，均低于对照组[（12．7±7．2）d，（5．0±3．4）分，（950．8±103．6）元]，差异有统计学意义（t值分别为-6．211，-3．896，-19．631；P〈0．01）。干预前未患MSDs的护理人员在MSDs的持续时间、强度和相关花费上均无相应记录；干预后，未患MSDs的干预组护理人员其MSDs持续时间、强度和相关花费分别为（7．6±4．7）d，（3．4±2．2）分，（525-3±140．6）元，均低于对照组[（9．2±3．5）d，（4．5±3．3）分，（820．4±120．5）元]，差异有统计学意义（t值分别为-2．571，-2．606，-14．998；P〈0．05）。结论包括参与式人体工程学、体能训练和认知行为训练在内的多层面干预方式，能够降低护理人员肌肉骨骼系统疾患的持续时间、强度和相关花费，同时，对护理人员MSDs的发生也有一定的预防作用。

Objective To explore the effect of multifaceted interventions on musculoskeletal disorders （MSDs） in nurses which consists of participatory ergonomics, physical training and cognitive behavioral training. Methods Totally 420 nurses were investigated about their situation of MSDs in June 2014 by Nordic self-rating MSDs scale.＇ Nurses were assigned to the control group （n= 191 ） and the intervention group （n= 229） according to the survey. In the intervention group, the number of nurses with MSDs was 141, and the number of nurses without MSDs was 88; in the control group, the number of nurses with MSDs was 102, and the number of nurses without MSDs was 89. Nurses in the intervention group received multifaceted intervention, while nurses in the control group received no intervention. The changes on duration, intensity and related expenses of MSDs were compared between two groups after 6 months.Results For nurses with MSDs, there was no significance among the duration, intensity and related expenses between two groups before intervention （P〉0.05）. After intervention, the duration, intensity and related expenses of nurses with MSDs in the intervention group were （8.1±4.3）d, （3.5±2.6） points and （648.7± 128.0） yuan, and they were lower than that of nurses with MSDs in the control group [ （12.7±7.2） d, （3.4±2.2） points, （950.8±103.6） yuan] （t=-6.211, -3.896, -19.631;P〈0.01）. Before intervention, there were no records of the duration, intensity and related expenses of nurses without MSDs ; after intervention, the duration, intensity and related expenses of nurses without MSDs were （7.6±4.7） d, （3.4± 2.2） points and （525.3±140.6） yuan, which were lower than that of the control group [ （9.2±3.5） d, （4.5± 3.3） points, （820.4±120.5） yuan] （t=-2.571, -2.606, -14.998;P〈0.05）.Conclusions Muhifaceted interventions consisting of participatory ergonomics, physical training and cognitive behavioral training can reduce the duration, intensity and related expenses of nurses with MSDs, and they also have a preventive effect for nurses without MSDs.