手术室护士职业性骨骼肌肉疾患现状及影响因素分析

Current situation and influencing factors of work-related musculoskeletal disorders among Operating Room nurses

目的调查手术室护士职业性肌肉骨骼疾患的患病情况并分析其相关的影响因素。方法采用便利抽样的方法,2019年4—9月抽取沈阳市2家三级甲等综合医院的手术室护士进行横断面与回顾性调查结合的方法,发放手术室护士肌肉骨骼疾患标准调查表和自设的手术室护士人体工效学情况调查问卷,对300名手术室护士近1年职业性肌肉骨骼疾患的现况及影响因素进行调查。应用SPSS 21.0软件进行χ2检验及Logistic回归分析,探讨职业性肌肉骨骼疾患发生的影响因素。结果共发放300份问卷,回收有效问卷为284份,有效回收率为94.67%。(1)近1年手术室护士职业性肌肉骨骼疾患的患病率为86.62%(246/284),颈部患病率最高72.54%(206/284),其他依次为腰部71.13%(202/284)、肩部62.68%(178/284)、背部48.94%(139/284)、膝34.15%(97/284)、手腕30.99%(88/284)、踝足25.35%(72/284)、髋臀21.48%(61/284)、肘14.79%(42/284)。(2)手术室护士工效学负荷总分为(51.21±8.10)分。负荷水平"高""中""低"者分别占3.17%(9/284)、80.28%(228/284)、16.55%(47/284),且各组间差异有统计学意义(F=171.962,P<0.001)。(3)患病组与非患病组不同特征比较,结果显示,不同职称(χ2=8.883,P=0.031)、BMI(χ2=9.023,P=0.011)、每日平均工作时长(χ2=5.212,P=0.022)、人体工效学负荷(χ2=8.098,P=0.017)的护士差异具有统计学意义(P<0.05)。Logistic回归分析结果显示,工作年限(OR=1.808)、文化程度(OR=2.104)、职称(OR=1.686)、婚姻状况(OR=3.739)、每日平均工作时长(OR=2.205)是手术室护士职业性肌肉骨骼疾患发生的影响因素(P<0.05)。结论手术室护士职业性肌肉骨骼疾患患病率高,人体工效学负荷水平处于中等水平。每日平均工作时长、工作年限、职称、文化程度、婚姻状况是导致发生职业性肌肉骨骼疾患的危险因素。

Objective To explore the current situation of work-related musculoskeletal disorders(WRMSDs)among Operating Room nurses and its influencing factors.Methods From April to September 2019,we selected Operating Room nurses at two ClassⅢGrade A general hospitals in Shenyang by convenience sampling to carry out cross-sectional survey combined with retrospective survey.The Nordic Musculoskeletal Questionnaire(NMQ)for Operating Room nurses and the self-designed Ergonomics Questionnaire for Operating Room Nurses were sent out to investigate the WRMSDs and its influencing factors among 300 Operating Room nurses nearly a year.SPSS 21.0 software was used toχ2 test and Logistic regression analysis to explore the influencing factors of WRMSDs.Results A total of 300 questionnaires were sent out and 284 valid questionnaires were collected with 94.67%for the valid recovery rate.The incidence of WRMSDs among Operating Room nurses in the past year was 86.62%(246/284),and the highest incidence of neck was 72.54%(206/284)followed by the waist 71.13%(202/284),shoulder 62.68%(178/284),back 48.94%(139/284),knee 34.15%(97/284),wrist 30.99%(88/284),ankle and foot 25.35%(72/284),hip and buttock 21.48%(61/284)as well as elbow 14.79%(42/284).Among those Operating Room nurses,the total score of ergonomic loads was(51.21±8.10).Nurses with the high,medium and a low level of bure accounted for 3.17%(9/284),80.28%(228/284)and 16.55%(47/284)respectively with statistical difference(F=171.962,P<0.001).Between diseased group and non-diseased group,there were statistical differences in the positional titles(χ2=8.883,P=0.031),body mass index(BMI)(χ2=9.023,P=0.011),working hours(χ2=5.212,P=0.022)and ergonomics load(χ2=8.098,P=0.017)among nurses(P<0.05).Logistic regression analysis showed that the influencing factors of WRMSDs among Operating Room nurses were the working lives(OR=1.808),education levels(OR=2.104),positional titles(OR=1.686),marital status(OR=3.739)and working hours per day(OR=2.205)with statistical differences(P<0.05).Conclusions Operating Room nurses have a high incidence of WRMSDs and a medium level of ergonomic loads.The risk factors of WRMSDs include the working hours,working lives,positional titles,education levels and marital status.