临床护士职业性腰背痛现状多中心调查及影响因素分析

Multi-center investigation and the relative factors of the clinical nurse occupational low back pain

目的 了解临床护士职业性腰背痛现状，并分析其影响因素。方法 采用方便抽样法，于2016 年4—12 月采用一般人口学特征调查表、VAS、中文版恐惧- 回避信念量表（FABQ-CHI）对我国华北、华中、华南、西南及西北地区5 座省会城市的7 所三级甲等医院的1 300 名临床护士进行问卷调查。共发放问卷1 300 份，回收有效问卷1 279 份。采用SPSS 21.0 进行统计学分析。结果 1 279 名护士中 115 名（8.99%）无腰背痛，1 164 名（91.01%）患有腰背痛。疼痛程度以轻度疼痛为主，占64.69%。无腰背痛护士FABQ-CHI 量表平均得分（50.11±17.5）分，患有腰背痛护士平均得分（55.24±8.2）分，两者比较差异有统计学意义（t=14.56，P ＜ 0.001）。单因素分析结果显示，不同年龄、婚姻状况、生育状况、职称、工作年限、是否参加培训护士VAS评分比较，差异均有统计学意义（P ＜ 0.01）。Logistic 回归分析显示，年龄（OR=1.40）和职称（OR=1.84）是腰背痛发生的影响因素（P ＜ 0.05）。结论 护士职业性腰背痛发生率较高，且与个体、工作及心理因素相关，建议高度重视临床护士腰痛防治知识的普及和职业防护技能的培训。特别是重视心理因素与护士职业性腰背痛中的相关性，逐渐改善护理人员的工作环境和不良生活习惯，减少腰痛的发生，以提高临床护士的职业满意度。

Objective To understand the present situation of occupational low back pain of clinical nurses, and analyze its influence factors. Methods A questionnaire survey was conducted among 1 300 clinical nurses from 7 Class IU Grade A general hospitals in 5 provincial capital cities, in the region of north China, central China, southern China, southwest and northwest, from April to December 2016. The survey tools included general demographic characteristics questionnaire, Visual Analogue Scale （VAS） and Chinese version of Fear-Avoidance Belief Questionnaire （FABQ-CHI）. A total of 1 300 questionnaires were distributed, and 1 279 valid were collected. SPSS 21.0 was applied for statistical analysis. Results In the 1 279 nurses, 115 （8.99%） had no low back pain, and 1 164 （91.01%） was positive. The majority of nurses suffered with mild pain, account for 64.69%. The average score of FABQ-CHI in negative nurses was （50.11 ± 17.5）, and that in positive nurses was （55.24 ±8.2）, the difference was statistically significant （t=14.56, P 〈 0.001）. Univariate analysis showed that there were significant differences in VAS scores among nurses of different ages, marital status, fertility status, professional titles, working years, and whether or not they participated in training （P 〈 0.01）. Multivariate analysis showed that age （OR=l.40） and professional title （OR=1.84） were the influencing factors of low back pain. Conclusions The incidence of occupational low back pain in nurses is high, and it is related to individual factors, work related factors and psychological factors. It is suggested that great attention should be paid to the popularization of knowledge on prevention and treatment of low back pain and the training of occupational protection skills for clinical nurses. Especially, we should pay attention to the correlation between psychological factors and nurses＇ occupational low back pain, graduallyimprove the working environment and bad living habits of nurses, reduce the occurrence of low back pain, and improve the job satisfaction of clinical nurses.