护理人员肌肉骨骼疾患接触风险与患病关系研究

Research on the relationship between exposure risk and disease of musculoskeletal disorders in nurses

目的研究护理人员肌肉骨骼疾患(musculoskeletal disorders, MSDs)发生现状和职业接触风险间的关系。方法采用流行病学横断面调查和现场观察的方法,应用快速接触评估检查表(QEC)和经过修订的中文版MSDs调查问卷,对7家医院的内科、外科、妇产科、儿科、重症医学科、职业病科、手术室等科室护理人员的MSDs发生情况与职业接触情况开展调查和现场检查。结果近1年来,1 412名护理人员发生MSDs共计946人(占6700%)。排在前三位的科室依次为内科(7085%)、外科(6927%)和重症医学科(6833%);发生部位排在前三位的依次为颈部(4658%)、肩/臂部(3701%)和下背部(3463%);不同科室护理人员之间,肘、手/腕、足/踝3个部位MSDs的发生率存在差异,且均以手术室为最高。QEC分析结果显示,儿科颈部QEC分值最高,肩/臂部、手/腕部、背部QEC分值均以重症医学科最高;仅有外科、内科、妇产科、重症医学科的手/腕部QEC分值与其MSDs发生率显示一定正相关。结论医院护理人员的MSDs发生情况较为严重,主要集中在内科、外科和重症医学科,以颈、肩/臂和下背部最为严重,手/腕部MSDs的发生率随QEC分值增高而增高,建议医院加强对重点科室护理人员MSDs重点发生部位开展相关防治工作。

Objective To investigate the current status of musculoskeletal disorders(MSDs) in hospital nursing staff,and explore their relationship.Methods An epidemiological cross-sectional survey and field investigation, using quick expo-sure assessment checklist( QEC) and revised Chinese questionnaire on musculoskeletal disorders was adopted on nurses ofthe departments of internal medicine, surgery, obstetrics and gynecology, pediatrics, intensive care, occupational diseases,and operating room from seven hospitals.Results It was showed that in recent year, there were 946 MSDs cases in these1 412 nurses(67. 00%), the leading departments were internal medicine(70. 85%), surgery(69. 27%), and intensivecare(68. 33%), respectively;the leading suffering location were neck(46. 58%), shoulder/arm(37. 01%) and lowerback(34. 63%), respectively;there were some differences in the incidence rate of MSDs in elbow, wrist/hand, foot/ankleamong different departments, but operating room was the highest. QEC analysis results showed that the highest QEC score wasneck of pediatric department, while the highest QEC scores of other parts(shoulder/arm, wrist/hand, back) all were thedepartment of critical care medicine. Additionally, only wrist/hand QEC scores in surgery, internal medicine, obstetrics andgynecology, and intensive care medicine departments showed some positive correlationship with the incidence rate of MSDs.Conclusion The results suggested that the incidence situation of MSDs in hospital nurses was more serious, especially in thedepartments of internal, surgery and critical care, and in those locations such as neck, shoulder/arm and lower back;the in-cidence rate of wrist/hand MSDs even increased with the QEC exposure score. Therefore, it is necessary to strengthen the pre-vention and control in key departments and key locations.