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Dіrgar E, Olgun N. Evaluating the Effectiveness of a Training on Ergonomic Risks of Measuring Blood Pressure. Creat Nurs 2024:10784535241248065. [PMID: 38698300 DOI: 10.1177/10784535241248065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Background: Musculoskeletal disorders (MSDs) occur as a result of long-term exposure to inappropriate working postures and repetitive use of body postures, leading to harmful consequences for patients, employees, and employers. Evaluating distinct working postures can contribute to effective interventions. Purpose: The aim of this study was to determine ergonomic risks of MSDs during repeated blood pressure measurement processes and to evaluate the effectiveness of a training on this topic. Methods: A pretest/posttest quasi-experimental design studied 64 nurses in a training and research hospital in Turkey. Participants were evaluated for the prevalence and risk of MSDs using the Nordic Musculoskeletal Questionnaire Extended Version and the Rapid Entire Body Assessment (REBA) Checklist, and by photographing them performing the procedure. Nurses with high risk for MSDs received an ergonomics training program and were followed up twice in 3 months. Results: Reduction in prevalence of MSDs in neck, shoulder, and hip/thigh areas, and in mean REBA scores after the training were statistically significant. Conclusion: Nurses should be trained about correct posture for specific high-risk activities that may cause MSDs, and offered exercise programs that support the musculoskeletal system.
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Affiliation(s)
- Ezgi Dіrgar
- Faculty of Health Sciences, Gaziantep University, Turkey
| | - Nermin Olgun
- Faculty of Health Sciences, Hasan Kalyoncu University, Turkey
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Abdul Halim NSS, Mohd Ripin Z, Ridzwan MIZ. Efficacy of Interventions in Reducing the Risks of Work-Related Musculoskeletal Disorders Among Healthcare Workers: A Systematic Review and Meta-Analysis. Workplace Health Saf 2023; 71:557-576. [PMID: 37539959 DOI: 10.1177/21650799231185335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND Work-related musculoskeletal disorders (WMSDs) are prevalent among healthcare professionals, including nurses, therapists, doctors, and paramedics, due to the potential injuries incurred during patient transfer and handling. This review aimed to assess the effectiveness of existing interventions in reducing the risks of WMSDs in this population. METHODS Four databases including PubMed/MEDLINE, Web of Science, Scopus, and ScienceDirect were searched to identify randomized and nonrandomized controlled trials, as well as studies with pre-post design. Two reviewers independently extracted data and assessed the quality of the included studies using the Effective Public Health Practice Project criteria. A meta-analysis was performed to obtain quantitative results. RESULTS A total of 40 studies were included in the review. Among the interventions, motorized assistive devices showed the most significant relative reduction in WMSD risks (p < .0000; standardized mean difference [SMD] = -3.32, 95% confidence interval [CI] = [-4.53, -2.12]), followed by combined interventions of cognitive and exercise (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), combined intervention of cognitive and assistive device intervention (p = .02; SMD = -0.77, 95% CI = [-1.42, -0.12]), nonmotorized assistive device (p = .02; SMD = -0.63, 95% CI = [-1.15, -0.12]), cognitive intervention (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), and physical exercise (p = .06; SMD = -0.16, 95% CI = [-0.32, 0.00]) intervention. CONCLUSION The overall evidence indicates that interventions have a significant effect in reducing the risk of WMSDs among healthcare workers, with motorized assistive devices showing the most promising results. The findings from this review can provide valuable guidance for hospital administrators, policymakers, and other experts in implementing effective strategies to prevent WMSDs among healthcare professionals.
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Affiliation(s)
- Nur Shuhaidatul Sarmiza Abdul Halim
- Neurorehabilitation Engineering and Assistance Systems Research (NEAR), School of Mechanical Engineering, Engineering Campus, Universiti Sains Malaysia
| | - Zaidi Mohd Ripin
- Neurorehabilitation Engineering and Assistance Systems Research (NEAR), School of Mechanical Engineering, Engineering Campus, Universiti Sains Malaysia
| | - Mohamad Ikhwan Zaini Ridzwan
- Neurorehabilitation Engineering and Assistance Systems Research (NEAR), School of Mechanical Engineering, Engineering Campus, Universiti Sains Malaysia
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Heidarimoghadam R, Mosaferchi S, Ray PK, Saednia H, Najafi Ghobadi K, Mortezapour A. The differences between normal and obese patient handling: re- structural analysis of two questionnaires. BMC Musculoskelet Disord 2023; 24:359. [PMID: 37149564 PMCID: PMC10164314 DOI: 10.1186/s12891-023-06479-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 04/30/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Precise causes of musculoskeletal complaints among nurses are not known well, but many studies have pointed to manual patient handling tasks. Subjective judgment and decision-making process for patient lifting is crucial for gathering data regards patient handling. The aim of this study was to consider reliability and validity and re-structure of two special tools for patient handling's tasks. METHODS In this cross- sectional study 249 nurses were fully participated. As recommended by literature for cultural adaptation of instruments, forward/backward translation method was applied. Reliability of the translated version was assessed by Cronbach's alpha coefficient. Validity testing for the two scales was based on content validity index/ratio analysis and also Exploratory Factor Analysis was run to extract latent factors. RESULTS Reliability estimated by internal consistency reached a Cronbach's Alpha of above 0.7 for all subscales of two questionnaires. After testing the validity, the final version of questionnaires was remained by 14 and 15 questions respectively. CONCLUSIONS These instruments evaluated for manual handling of normal and obese patients had acceptable validity and reliability in Iranian Nursing context. So, these tools can be used in further studies with the same cultures.
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Affiliation(s)
- Rashid Heidarimoghadam
- Health Sciences Research Center, Department of Ergonomics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeedeh Mosaferchi
- Department of Industrial Engineering, University of Salerno, Fisciano, Salerno, Italy
| | - Pradip Kumar Ray
- Department of Industrial and Systems Engineering, Indian Institute of Technology Kharagpur, Kharagpur, 721302 India
| | - Hamid Saednia
- Department of Ergonomics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khadijeh Najafi Ghobadi
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alireza Mortezapour
- Department of Ergonomics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Albanesi B, Piredda M, Bravi M, Bressi F, Gualandi R, Marchetti A, Facchinetti G, Ianni A, Cordella F, Zollo L, De Marinis MG. Interventions to prevent and reduce work-related musculoskeletal injuries and pain among healthcare professionals. A comprehensive systematic review of the literature. JOURNAL OF SAFETY RESEARCH 2022; 82:124-143. [PMID: 36031239 DOI: 10.1016/j.jsr.2022.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/26/2021] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Work-related musculoskeletal disorders (WMSDs) are among the main causes of injury and pain in healthcare professionals. Previous reviews provided a fragmented view of the interventions available for WMSDs. This review aims to provide a comprehensive description of interventions for preventing and reducing work-related musculoskeletal injuries and/or pain among healthcare professionals, and to assess the methodological quality of studies. METHODS A systematic literature review was performed, based on the Effective Public Health Practice Project process. A comprehensive search was conducted on six peer-reviewed databases and manually. The methodological quality of the studies included was rated as weak, moderate, or strong. The studies were organized based on the 2019 classification of the interventions by Oakman and colleagues. RESULTS Twenty-seven articles were included reporting individual (n = 4), task-specific (n = 4), work organization and job design (n = 2), work environment (n = 1), and multifactorial (n = 16) interventions. Overall quality rating was strong for 6 studies, moderate for 16, and weak for 5. Individual interventions such as neuromuscular and physical exercise were effective in reducing pain. Task-specific and work organization interventions could prevent certain injuries. Significant reduction of both injuries and pain resulted from multifactorial interventions, which were reported by the majority of strong (n = 5) and moderate (n = 10) quality articles. CONCLUSIONS This review provides healthcare professionals with evidence-based information to plan interventions targeted towards reducing WMSDs. In particular, more efforts are needed to implement and extend effective multifactorial interventions. Moreover, studies about each professional healthcare target group are needed. PRACTICAL APPLICATION Our results can guide policy-makers, healthcare managers and professionals to choose the best strategies to prevent and reduce WMSDs and to shape continuous education programs. This study prompts clinicians to develop inter-professional collaborations and to practice physical activities in order to reduce WMSDs.
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Affiliation(s)
- Beatrice Albanesi
- Research Unit Nursing Science, Campus Bio-Medico University, Rome, Italy; Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Michela Piredda
- Research Unit Nursing Science, Campus Bio-Medico University, Rome, Italy.
| | - Marco Bravi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Rome, Italy
| | - Federica Bressi
- Physical Medicine and Rehabilitation Unit, Campus Bio-Medico University, Rome, Italy
| | - Raffaella Gualandi
- Research Unit Nursing Science, Campus Bio-Medico University, Rome, Italy
| | - Anna Marchetti
- Research Unit Nursing Science, Campus Bio-Medico University, Rome, Italy
| | | | - Andrea Ianni
- Research Unit in Hygiene, Statistics and Public Health, Campus Bio-Medico University, Rome, Italy
| | - Francesca Cordella
- CREO Lab - Advanced Robotics and Human Centred Technologies, Campus Bio-Medico University, Rome, Italy
| | - Loredana Zollo
- CREO Lab - Advanced Robotics and Human Centred Technologies, Campus Bio-Medico University, Rome, Italy
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Does Postural Feedback Reduce Musculoskeletal Risk?: A Randomized Controlled Trial. SUSTAINABILITY 2022. [DOI: 10.3390/su14010583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: There is a high prevalence of musculoskeletal disorders among personnel working in the healthcare sector, mainly among nursing assistants and orderlies. Objective: The objective is to analyze the effectiveness of a multi-component intervention that included postural feedback in reducing musculoskeletal risk. Method: A total of 24 nursing assistants and orderlies in a hospital setting were randomly assigned to an intervention group or a control group. After collecting sociodemographic information, a selection of tasks was made and assessed using the REBA (rapid entire body assessment) method. A multi-component intervention was designed combining theoretical and practical training, including feedback on the postures performed by the professionals involved, especially those involving high musculoskeletal risk. This program was applied only to participants in the intervention group. Subsequently, eight months after the first assessment and intervention, the second assessment was carried out using the same method and process as in the first evaluation. Results: The results indicate that the musculoskeletal risk in the second assessment in the intervention group was significantly reduced. However, no significant changes were observed in the control group. Conclusion: The multi-component intervention applied can significantly reduce the musculoskeletal risk of nursing assistants and orderlies. In addition, it is a low-cost intervention with great applicability.
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Wåhlin C, Stigmar K, Strid EN. A systematic review of work interventions to promote safe patient handling and movement in the healthcare sector. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2520-2532. [PMID: 34789085 DOI: 10.1080/10803548.2021.2007660] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPUSE The aim of this systematic review was to describe interventions which promote safe patient handling and movement (PHM) among workers in healthcare by reviewing the literature of their effectiveness for work and health-related outcomes. METHODS Data bases were searched for studies published 1997‒2018. Measures was operationalised broadly, capturing outcomes of work and health. Only Randomized controlled trials (RCTs) and cohort studies with control group were included. Quality was assessed using evidence-based checklists by Swedish Agency for Health Technology Assessment and Assessment of Social Services. RESULTS The systematic review included 10 RCTs and 19 cohort. Providing work equipment and training workers is effective: it can increase usage. Training workers to be peer coaches is associated with fewer injuries. Other effective strategies are participatory ergonomics and management engagement in collaboration with workers, facilitating safe PHM. CONCLUSIONS This systematic review suggests interventions for safe PHM with an impact of health-related outcomes should include access to work equipment, training as well as employer and employee engagement. The additional impact of multifaceted interventions is inconclusive. PRACTITIONER SUMMARY In clinical practice, there is a need for employers in healthcare to; 1) provide healthcare workers access to suitable work equipment. 2) provide training on how to use work equipment to prevent work-related injuries. Furthermore, the study also indicates that 3) training and appointing peer coaches can facilitate safe manual handling and movement (PHM) and, 4) It can be beneficial to involve workers in a participatory approach.
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Affiliation(s)
- Charlotte Wåhlin
- Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Linköping University, Linköping, Sweden.,Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Kjerstin Stigmar
- Department of Health Sciences, Lund University, Lund, Sweden.,Skåne University Hospital, Region Skåne, Lund, Sweden
| | - Emma Nilsing Strid
- University Health Care Research Center, Region Örebro County, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Schmidt KG, Holtermann A, Jørgensen MB, Svendsen MJ, Rasmussen CDN. Developing a practice and evidence-based guideline for occupational health and safety professionals to prevent and handle musculoskeletal pain in workplaces. APPLIED ERGONOMICS 2021; 97:103520. [PMID: 34246072 DOI: 10.1016/j.apergo.2021.103520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/21/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Practice guidelines can facilitate the translation of evidence-based knowledge into better occupational health and safety (OHS) prevention. This paper describes the development process, findings and content of a practice and evidence-based guideline for musculoskeletal pain (MSP) to OHS professionals in Denmark. We used a participatory process with involvement of more than 100 OHS professionals in the development of the guideline. The guideline contains three sections: 1) Rapid review of risk factors for MSP (Push/pull, Screen work, Lifting, Awkward postures and Psychosocial factors related to MSP) and single- and multi-stranded interventions targeting MSP. 2) Process recommendations for use of the guideline by a three-phase participatory process 3) Practical recommendations that contain advice and methods for the three-phase participatory process. This paper can promote future guideline development, as it provides specific insight into how OHS professionals can be included in the development of practice and evidence-based guideline through a participatory process.
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Affiliation(s)
- Kathrine Greby Schmidt
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Marie Birk Jørgensen
- Health and Safety, Municipality of Copenhagen, Enghavevej 82, 2450, Copenhagen, SV, Denmark
| | - Malene Jagd Svendsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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Kluwak K, Klempous R, Chaczko Z, Rozenblit JW, Kulbacki M. People Lifting Patterns-A Reference Dataset for Practitioners. SENSORS 2021; 21:s21093142. [PMID: 33946528 PMCID: PMC8124157 DOI: 10.3390/s21093142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/24/2021] [Accepted: 04/28/2021] [Indexed: 12/02/2022]
Abstract
Many health professionals do not use correct person transfer techniques in their daily practice. This results in damage to the paraspinal musculature over time, resulting in lower back pain and injuries. In this work, we propose an approach for the accurate multimodal measurement of people lifting and related motion patterns for ergonomic education regarding the application of correct patient transfer techniques. Several examples of person lifting were recorded and processed through accurate instrumentation and the well-defined measurements of kinematics, kinetics, surface electromyography of muscles as well as multicamera video. This resulted in a complete measurement protocol and unique reference datasets of correct and incorrect lifting schemes for caregivers and patients. This understanding of multimodal motion patterns provides insights for further independent investigations.
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Affiliation(s)
- Konrad Kluwak
- Faculty of Electronics, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland;
- Correspondence: ; Tel.: +48-71-320-31-20
| | - Ryszard Klempous
- Faculty of Electronics, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland;
| | - Zenon Chaczko
- DIVE IN AI, 53-307 Wroclaw, Poland;
- School of Electrical and Data Engineering, University of Technology Sydney, Ultimo 2007, Australia
| | - Jerzy W. Rozenblit
- Department of Electrical and Computer Engineering, University of Arizona, Tucson, AZ 85721, USA;
- Department of Surgery, University of Arizona, Tucson, AZ 85721, USA
| | - Marek Kulbacki
- R&D Center, Polish-Japanese Academy of Information Technology, 02-008 Warszawa, Poland;
- DIVE IN AI, 53-307 Wroclaw, Poland;
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Riccoboni JB, Monnet T, Eon A, Lacouture P, Gazeau JP, Campone M. Biomechanical comparison between manual and motorless device assisted patient handling: sitting to and from standing position. APPLIED ERGONOMICS 2021; 90:103284. [PMID: 33070065 DOI: 10.1016/j.apergo.2020.103284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 07/25/2020] [Accepted: 10/08/2020] [Indexed: 06/11/2023]
Abstract
Although lots of assistive devices have been studied to fight against caregivers' work-related musculoskeletal disorders, stand-and-turn devices effects on biomechanical constraints are still unknown. The aim of this study is to provide and compare quantitative data on loads in the low back area resulting from the use of a motorless stand-and-turn device and from manual patient handling. Nine caregivers participated to motion capture and ground reaction forces measurement sessions of three cases of handling: manual handling with one caregiver, manual handling with two caregivers, motorless device assisted handling. Forces and torques at the L5/S1 joint were computed through Inverse Dynamics process. Motorless device assisted handling required the smallest loads whereas manual handling with one caregiver required the biggest loads, the latter being in some cases twice as big as the former. Caregivers should use a stand-and-turn device when handling a patient from sitting/standing to standing/sitting position whenever it is possible.
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Affiliation(s)
- Jean-Baptiste Riccoboni
- Institut de Cancérologie de l'Ouest, 15 Rue André Boquel, 49055 Angers, France; Institut PPRIME, Université de Poitiers, CNRS, UPR 3346, 11 Boulevard Marie et Pierre Curie, Site du Futuroscope, 86073 Poitiers, France; Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers, 151 Boulevard de l'Hôpital, 75013 Paris, France.
| | - Tony Monnet
- Institut PPRIME, Université de Poitiers, CNRS, UPR 3346, 11 Boulevard Marie et Pierre Curie, Site du Futuroscope, 86073 Poitiers, France
| | - Antoine Eon
- Institut PPRIME, Université de Poitiers, CNRS, UPR 3346, 11 Boulevard Marie et Pierre Curie, Site du Futuroscope, 86073 Poitiers, France
| | - Patrick Lacouture
- Institut PPRIME, Université de Poitiers, CNRS, UPR 3346, 11 Boulevard Marie et Pierre Curie, Site du Futuroscope, 86073 Poitiers, France
| | - Jean-Pierre Gazeau
- Institut PPRIME, Université de Poitiers, CNRS, UPR 3346, 11 Boulevard Marie et Pierre Curie, Site du Futuroscope, 86073 Poitiers, France
| | - Mario Campone
- Institut de Cancérologie de l'Ouest, 15 Rue André Boquel, 49055 Angers, France
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Roman-Liu D, KamiŃska J, Tokarski T. Effectiveness of workplace intervention strategies in lower back pain prevention: a review. INDUSTRIAL HEALTH 2020; 58:503-519. [PMID: 32968038 PMCID: PMC7708737 DOI: 10.2486/indhealth.2020-0130] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/14/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study was to identify effective work place intervention strategies for the prevention of low back pain (LBP). The study focused on interventions to two major groups: personal interventions and technical interventions. Data basis were searched for with inclusion criteria: study design based on randomised controlled trial; outcome measures including non-specific LBP occurrence expressed by prevalence or intensity; intervention met the definition of the technical and/or personal (physical exercises, behavioural training, educational) intervention programme. Eighteen papers were selected for full analysis. The diversification of quantitative indicators of differences between control and intervention groups were carried out using Cohen's d index. The results of analysis showed strong differences in effects among intervention strategies, as well as among different cases within similar intervention strategies. LBP severity before intervention and the length of intervention were discussed as potentially influencing factors. The results of the analysis suggest that the most effective strategies for LBP prevention include technical modifications of the workstand and education based on practical training. Behavioural and physical training seems to be of lesser importance. LBP severity before intervention and the time when the measurements of outcome measures take place play an important role in the effectiveness of intervention.
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Affiliation(s)
- Danuta Roman-Liu
- Central Institute for Labour Protection, National Research Institute (CIOP-PIB), Poland
| | - Joanna KamiŃska
- Central Institute for Labour Protection, National Research Institute (CIOP-PIB), Poland
| | - Tomasz Tokarski
- Central Institute for Labour Protection, National Research Institute (CIOP-PIB), Poland
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Sundstrup E, Seeberg KGV, Bengtsen E, Andersen LL. A Systematic Review of Workplace Interventions to Rehabilitate Musculoskeletal Disorders Among Employees with Physical Demanding Work. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:588-612. [PMID: 32219688 PMCID: PMC7716934 DOI: 10.1007/s10926-020-09879-x] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Purpose This systematic review investigates the effectiveness of workplace interventions to rehabilitate musculoskeletal disorders (MSDs) among employees with physically demanding work. Methods A systematic search was conducted in bibliographic databases including PubMed and Web of Science Core Collection for English articles published from 1998 to 2018. The PICO strategy guided the assessment of study relevance and the bibliographical search for randomized controlled trials (RCTs) and non-RCTs in which (1) participants were adult workers with physically demanding work and MSD (including specific and non-specific MSD and musculoskeletal pain, symptoms, and discomfort), (2) interventions were initiated and/or carried out at the workplace, (3) a comparison group was included, and (4) a measure of MSD was reported (including musculoskeletal pain, symptoms, prevalence or discomfort). The quality assessment and evidence synthesis adhered to the guidelines developed by the Institute for Work & Health (Toronto, Canada) focusing on developing practical recommendations for stakeholders. Relevant stakeholders were engaged in the review process. Results Level of evidence from 54 high and medium quality studies showed moderate evidence of a positive effect of physical exercise. Within this domain, there was strong evidence of a positive effect of workplace strength training. There was limited evidence for ergonomics and strong evidence for no benefit of participatory ergonomics, multifaceted interventions, and stress management. No intervention domains were associated with "negative effects". Conclusions The evidence synthesis recommends that implementing strength training at the workplace can reduce MSD among workers with physically demanding work. In regard to workplace ergonomics, there was not enough evidence from the scientific literature to guide current practices. Based on the scientific literature, participatory ergonomics and multifaceted workplace interventions seem to have no beneficial effect on reducing MSD among this group of workers. As these interventional domains were very heterogeneous, it should also be recognized that general conclusions about their effectiveness should be done with care.Systematic review registration PROSPERO CRD42018116752 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=116752 ).
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Affiliation(s)
- Emil Sundstrup
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | | | - Elizabeth Bengtsen
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - Lars Louis Andersen
- National Research Centre for the Working Environment (NRCWE), Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
- Sport Sciences, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
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Awareness of Patient Physical Handling Issues Associated with Routine Nursing Care. NURSING REPORTS 2020; 10:56-65. [PMID: 34968350 PMCID: PMC8608131 DOI: 10.3390/nursrep10020009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction: Physical handling (PH) of patients is an essential component of nursing care. It is an intervention that is troublesome for patients and strenuous for general nurses and other nursing staff. Handling techniques and mechanical aids for PH have improved through the years; however, they are not routinely used in nursing practice. Aim: The aim of this research was to determine (1) the level of awareness of PH issues within the management of South Bohemian hospitals, (2) how management perceives, organizes and implements PH protocols, and (3) how PH protocols are applied in everyday nursing practice. Method and Research Sample: Two qualitative methods were used: a semi-structured interview and observation. The participants were management representatives of South Bohemian hospitals in Czech Republic. Fifty nurses were observed during PH at the same hospitals. Results: The study found that PH was not monitored, nor was it provided systematically. In spite of this, no serious drawbacks were found; nonetheless, many areas were identified where the quality of PH could be improved. For example, awareness of PH issues by management, educational programs teaching new handling techniques, and provision of state-of-the-art PH aids. Several issues related to PH were found to be related to staff shortages, which remains a major problem. Conclusion: This issue needs more attention; it should be addressed by both those doing nursing research as well as those engaged in everyday nursing practice. Both will require the assistance of hospital staff and management.
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Spelten E, Thomas B, O'Meara PF, Maguire BJ, FitzGerald D, Begg SJ. Organisational interventions for preventing and minimising aggression directed towards healthcare workers by patients and patient advocates. Cochrane Database Syst Rev 2020; 4:CD012662. [PMID: 32352565 PMCID: PMC7197696 DOI: 10.1002/14651858.cd012662.pub2] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Workplace aggression is becoming increasingly prevalent in health care, with serious consequences for both individuals and organisations. Research and development of organisational interventions to prevent and minimise workplace aggression has also increased. However, it is not known if interventions prevent or reduce occupational violence directed towards healthcare workers. OBJECTIVES To assess the effectiveness of organisational interventions that aim to prevent and minimise workplace aggression directed towards healthcare workers by patients and patient advocates. SEARCH METHODS We searched the following electronic databases from inception to 25 May 2019: Cochrane Central Register of Controlled Trials (CENTRAL) (Wiley Online Library); MEDLINE (PubMed); CINAHL (EBSCO); Embase (embase.com); PsycINFO (ProQuest); NIOSHTIC (OSH-UPDATE); NIOSHTIC-2 (OSH-UPDATE); HSELINE (OSH-UPDATE); and CISDOC (OSH-UPDATE). We also searched the ClinicalTrials.gov (www.ClinicalTrials.gov) and the World Health Organization (WHO) trials portals (www.who.int/ictrp/en). SELECTION CRITERIA We included randomised controlled trials (RCTs) or controlled before-and-after studies (CBAs) of any organisational intervention to prevent and minimise verbal or physical aggression directed towards healthcare workers and their peers in their workplace by patients or their advocates. The primary outcome measure was episodes of aggression resulting in no harm, psychological, or physical harm. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods for data collection and analysis. This included independent data extraction and 'Risk of bias' assessment by at least two review authors per included study. We used the Haddon Matrix to categorise interventions aimed at the victim, the vector or the environment of the aggression and whether the intervention was applied before, during or after the event of aggression. We used the random-effects model for the meta-analysis and GRADE to assess the quality of the evidence. MAIN RESULTS We included seven studies. Four studies were conducted in nursing home settings, two studies were conducted in psychiatric wards and one study was conducted in an emergency department. Interventions in two studies focused on prevention of aggression by the vector in the pre-event phase, being 398 nursing home residents and 597 psychiatric patients. The humour therapy in one study in a nursing home setting did not have clear evidence of a reduction of overall aggression (mean difference (MD) 0.17, 95% confidence interval (CI) 0.00 to 0.34; very low-quality evidence). A short-term risk assessment in the other study showed a decreased incidence of aggression (risk ratio (RR) 0.36, 95% CI 0.16 to 0.78; very low-quality evidence) compared to practice as usual. Two studies compared interventions to minimise aggression by the vector in the event phase to practice as usual. In both studies the event was aggression during bathing of nursing home patients. In one study, involving 18 residents, music was played during the bathing period and in the other study, involving 69 residents, either a personalised shower or a towel bath was used. The studies provided low-quality evidence that the interventions may result in a medium-sized reduction of overall aggression (standardised mean difference (SMD -0.49, 95% CI -0.93 to -0.05; 2 studies), and physical aggression (SMD -0.85, 95% CI -1.46 to -0.24; 1 study; very low-quality evidence), but not in verbal aggression (SMD -0.31, 95% CI; -0.89 to 0.27; 1 study; very low-quality evidence). One intervention focused on the vector, the pre-event phase and the event phase. The study compared a two-year culture change programme in a nursing home to practice as usual and involved 101 residents. This study provided very low-quality evidence that the intervention may result in a medium-sized reduction of physical aggression (MD 0.51, 95% CI 0.11 to 0.91), but there was no clear evidence that it reduced verbal aggression (MD 0.76, 95% CI -0.02 to 1.54). Two studies evaluated a multicomponent intervention that focused on the vector (psychiatry patients and emergency department patients), the victim (nursing staff), and the environment during the pre-event and the event phase. The studies included 564 psychiatric staff and 209 emergency department staff. Both studies involved a comprehensive package of actions aimed at preventing violence, managing violence and environmental changes. There was no clear evidence that the psychiatry intervention may result in a reduction of overall aggression (odds ratio (OR) 0.85, 95% CI 0.63 to 1.15; low-quality evidence), compared to the control condition. The emergency department study did not result in a reduction of aggression (MD = 0) but provided insufficient data to test this. AUTHORS' CONCLUSIONS We found very low to low-quality evidence that interventions focused on the vector during the pre-event phase, the event phase or both, may result in a reduction of overall aggression, compared to practice as usual, and we found inconsistent low-quality evidence for multi-component interventions. None of the interventions included the post-event stage. To improve the evidence base, we need more RCT studies, that include the workers as participants and that collect information on the impact of violence on the worker in a range of healthcare settings, but especially in emergency care settings. Consensus on standardised outcomes is urgently needed.
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Affiliation(s)
- Evelien Spelten
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Brodie Thomas
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Peter F O'Meara
- Department of Emergency Health and Paramedic Practice, Monash University, McMahons Road, Australia
| | - Brian J Maguire
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | | | - Stephen J Begg
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
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14
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Sivakanthan S, Blaauw E, Greenhalgh M, Koontz AM, Vegter R, Cooper RA. Person transfer assist systems: a literature review. Disabil Rehabil Assist Technol 2019; 16:270-279. [PMID: 31607186 DOI: 10.1080/17483107.2019.1673833] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Novel developments in the robotics field have produced systems that can support person wheelchair transfers, maximize safety and reduce caregiver burden. The purpose of this study was to identify and describe these systems, their usability (or satisfaction), the context for which they have been or can be used and how they have been evaluated to determine evidence for their effectiveness. METHOD Available research on Person Transfer Assist Systems (PTAS) was systematically gathered using similar standards to the PRISMA guidelines. The search terms were derived from common terms and via exploring similar review articles. Initial search terms displayed 1330 articles and by using the inclusion/exclusion criteria 96 articles were selected for abstract review. After full- text reviewing 48 articles were included. RESULTS 29 articles concerned research in robotic transfer systems, 10 articles used both ceiling and floor-mounted lifts and 9 articles used only floor-mounted lifts as an intervention/control group. The results of this analysis identified a few usability evaluations for robotic transfer prototypes, especially ones comparing prototypes to existing marketed devices. CONCLUSION Robotic device research is a recent development within assistive technology. Whilst usability evaluations provided evidence that a robotic device will provide better service to the user, the sample number of subjects used are minimal in comparison to any of the intervention/control group articles. Experimental studies between PTASs are required to support technological advancements. Caregiver injury risk has been the focus for most of the comparison articles; however, few articles focus on the implications to the person.IMPLICATIONS FOR REHABILITATIONCeiling mounted lifts are preferred over floor-based lifts due to lower injury rates.Many robotic transfer systems have been developed; however, there is a paucity of quantitative and qualitative studies.Based on the results of this review, rehabilitation settings are recommended to use ceiling over floor assist systems, and it is recommended to provide training on using devices to assist with patient transfers to lower the risk of injuries.
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Affiliation(s)
- Sivashankar Sivakanthan
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.,Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eline Blaauw
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.,Centre for Human Movement Sciences, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Mark Greenhalgh
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.,Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alicia M Koontz
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.,Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Riemer Vegter
- Centre for Human Movement Sciences, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Rory A Cooper
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.,Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, USA
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Abstract
BACKGROUND Devices to lift, transfer, and reposition patients are recommended for healthcare workers' and patients' safety, but their intended use has yet to be fully realized. OBJECTIVE The aim of this study was to describe hospital nursing staff use of lift/transfer devices and the presence of factors at the time of lifts/transfers with potential to influence whether devices are used. METHODS Participants were 108 US nursing staff in a university-based medical center and two community hospitals. A self-completed questionnaire was used to collect demographic and work characteristics, typical frequency of patient lifts/transfers, training in and typical use of lift equipment, and specific factors that could influence use. Proportional distributions of lifting/transferring and repositioning frequencies in a typical shift, amount of equipment use, and factors present were examined overall and across worker and work-related characteristics. RESULTS Although trained in equipment use, only 40% used equipment for at least half of lifts/transfers. During lifts/transfers, factors often present included patient unable to help with lift/transfer (91.3%) or of a size/weight where participant needed assistance to help lift/transfer (87.5%); availability of others who could assist with manual lift (86.3%) or use of lift equipment (82.4%); and equipment functioning properly (86.4%), having supplies available (82.5%), and being easy to retrieve from storage (81.6%). During repositioning tasks, physical assistance was "always/almost always" provided from coworkers (83.3%) and often perceived as "very helpful" (92.6%) in reducing physical demands. Physical assistance from patients was less common (14.0% "always/almost always") yet perceived as "very helpful" by 66.3%. One fifth always used friction-reducing devices. DISCUSSION Despite training in their use, nursing staff use of available lift equipment and assistive devices is limited. Factors present at the time of lifts/transfers that may influence equipment/device use reflect a complex mix of patient, worker, equipment, and situational characteristics.
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Iwakiri K, Sotoyama M, Takahashi M, Liu X, Koda S, Ichikawa K. Effectiveness of re-education based on appropriate care methods using welfare equipment on the prevention of low back pain among care workers: a 1.5 year follow-up study. INDUSTRIAL HEALTH 2018; 56:419-426. [PMID: 29910229 PMCID: PMC6172185 DOI: 10.2486/indhealth.2017-0175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Many care workers at elderly care facilities in Japan suffer occupational low back pain (LBP) despite the utilization of welfare equipment. When introducing welfare equipment such as hoists and sliding boards, education on appropriate care methods using welfare equipment is usually conducted, but the effect of education diminishes with time. This intervention study aimed to examine the effect of re-education on appropriate care methods using welfare equipment on the prevention of care workers' LBP at an elderly care facility. At the intervention facility, 49 care workers were enrolled in ergonomic education program for 1.5 yr in order to improve care methods using welfare equipment. At the non-intervention facility, 33 care workers were not enrolled in the program. Rates of severe LBP were not significantly different between the facilities. However, during the study period, the rate of severe LBP among care workers did not increase at the intervention facility, while it doubled among care workers at the non-intervention facility. The care workers at the intervention facility showed improvement in care methods using welfare equipment during the study period. Hence, we think that re-education regarding appropriate care methods using welfare equipment has the potential to prevent exacerbation of LBP.
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Affiliation(s)
| | | | | | - Xinxin Liu
- National Institute of Occupational Safety and Health, Japan
| | - Shigeki Koda
- National Institute of Occupational Safety and Health, Japan
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Pihl-Thingvad J, Brandt LPA, Andersen LL. Consistent Use of Assistive Devices for Patient Transfer Is Associated With Less Patient-Initiated Violence: Cross-Sectional Study Among Health Care Workers at General Hospitals. Workplace Health Saf 2018; 66:453-461. [PMID: 29486660 DOI: 10.1177/2165079917752714] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated whether factors related to bodily contact between health care workers and patients were associated with patient-initiated violence. This cross-sectional study surveyed 496 Danish health care workers measuring patient-initiated violence, use of assistive devices, body mass index, physical exertion, frequency of patient transfers, psychosocial work environment, gender, age, and seniority. Associations were modeled using logistic regression analyses using patient-initiated violence as the outcome. Twenty-five percent of the respondents had experienced physical or verbal violence during the past year. Infrequent use of assistive devices, high physical strain, and severe obesity all significantly increased the risk of physical violence (risk ratio [RR] = 1.18, RR = 1.18, and RR = 1.16, respectively), whereas only the lack of assistive device use significantly increased the risk of verbal violence (RR = 1.13 and RR = 1.08). Consistent use of assistive devices appears to reduce the risk of patient-initiated violence. Managers should require the use of assistive devices when designing work processes for patient transfers.
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Affiliation(s)
| | | | - Lars L Andersen
- 3 National Research Centre for the Working Environment.,4 Aalborg University
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