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Hansen AF, Hasle P, Caroly S, Reinhold K, Järvis M, Herrig AO, Heiberg BD, Søgaard K, Punnett L, Jensen Stochkendahl M. Participatory ergonomics: What works for whom and why? A realist review. ERGONOMICS 2024; 67:13-33. [PMID: 37070935 DOI: 10.1080/00140139.2023.2202842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
Abstract
Participatory workplace interventions to improve workforce musculoskeletal health are infrequently analysed regarding why they work, for whom or under what circumstances. This review sought to identify intervention strategies which achieved genuine worker participation. In total, 3388 articles on participatory ergonomic (PE) interventions were screened; 23 were suitable to analyse within a realist framework identifying contexts, mechanisms of change, and outcomes. The interventions which succeeded in achieving worker participation were characterised by one or more of these contexts: workers' needs as a core starting point; a positive implementation climate; clear distribution of roles and responsibilities; allocation of sufficient resources; and managerial commitment to and involvement in occupational safety and health. Interventions that were organised and delivered in this way generated relevance, meaning, confidence, ownership and trust for the workers in an interrelated and multi-directional manner. With such information, PE interventions may be carried out more effectively and sustainably in the future.Practitioner summary: This review focuses on the question: which mechanisms support genuine worker participation, in what context and with which necessary resources, to reduce musculoskeletal disorders. Results emphasise the importance of starting with workers' needs, making the implementation climate egalitarian, clarifying the roles and responsibilities of all involved, and providing sufficient resources.Abbreviations: PE: participatory ergonomic(s); WMSD: Work-related musculoskeletal disorders; EU: European Union; MSD: Muskuloskeletal disorders; OSH: Occupational health and safety; C: context; M: mechanism; O: outcome; CMOCs: CMO configurations; NPT: Normalization process theory; OECD: The Organisation for Economic Co-operation and Development: EU-OSHA: European Occupational Safety and Health Agency.
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Affiliation(s)
- Anne Faber Hansen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
- Department of Research and Education, University Library, University of Southern Denmark, Odense M, Denmark
| | - Peter Hasle
- Department of Technology and Innovation, SDU Global Sustainable Production, University of Southern Denmark, Odense M, Denmark
| | - Sandrine Caroly
- Pacte Laboratory- Grenoble Alpes University, Grenoble cedex 09, France
| | - Karin Reinhold
- Department of Business Administration, Tallinn University of Technology, Tallinn, Estonia
| | - Marina Järvis
- Department of Business Administration, Tallinn University of Technology, Tallinn, Estonia
- Estonian Entrepreneurship University of Applied Sciences, Tallinn, Estonia
| | - Astrid Overgaard Herrig
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Bibi Dige Heiberg
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Laura Punnett
- Center for the Promotion of Health in the New England Workplace (CPH-NEW), University of Massachusetts Lowell, Lowell, MA, USA
| | - Mette Jensen Stochkendahl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
- Chiropractic Knowledge Hub, Odense, Denmark
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Korshøj M, Poulsen VR, Sköld MB, Autrup SK, Oldenburg B, Mortensen OS. An integrated approach to health, wellbeing, and productivity at work: a design of a stepped wedge worksite intervention study. BMC Public Health 2023; 23:1057. [PMID: 37268907 DOI: 10.1186/s12889-023-16014-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/30/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Despite an intensive focus on workers' health during recent decades, the prevalence of work-related diseases remains unchanged in Denmark and internationally. Therefore, USA and Australian researchers have initiated new paradigms for integration of health promotion, prevention of work-related disease, and organization of work. Inspired by the Australian WorkHealth Improvement Network program (WIN), this paper describes the background, design, intervention methodologies, and evaluation methods of an Integrated Approach to Health, Wellbeing, and Productivity at Work (ITASPA) intervention aiming to prevent work-related injuries and diseases and promote the health, safety, and wellbeing of the worker. METHODS Using a stepped wedge design, worksites will be enrolled at baseline and offered the intervention starting at different times. Data will be collected at baseline, before the off-set of the intervention, and after each implementation period. The effect evaluation will be based on a mixed-methods approach. The qualitative data are based on semi-structured interviews and focus groups. The quantitative data consists of questionnaires, anthropometrics, and resting blood pressure and will be analyzed based on the intention-to-treat principle in linear mixed models with random slope and intercept. DISCUSSION Integrated interventions are shown to increase overall health and safety at worksites more effectively and rapidly than more narrowly focused programs. Still, previous integrated interventions are lacking successful implementation. In ITASPA, the effects of the intervention is tested in a strong scientific mixed-methods design. Thus, the ITASPA project contributes to the knowledge about what characterizes a best practice for the implementation of integrated worksite interventions. TRIAL REGISTRATION ITASPA is retrospectively registered in Clinicaltrials.gov on May 19, 2023 (NCT05866978).
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Affiliation(s)
- Mette Korshøj
- Department of Occupational and Social Medicine, Hospital Holbæk, Gl. Ringstedvej 4B, 4300, Holbæk, Denmark
| | - Vivian Rueskov Poulsen
- Department of Occupational and Social Medicine, Hospital Holbæk, Gl. Ringstedvej 4B, 4300, Holbæk, Denmark.
| | - Margrethe Bordado Sköld
- Department of Occupational and Social Medicine, Hospital Holbæk, Gl. Ringstedvej 4B, 4300, Holbæk, Denmark
| | - Sanna Koch Autrup
- Department of Occupational and Social Medicine, Hospital Holbæk, Gl. Ringstedvej 4B, 4300, Holbæk, Denmark
| | - Brian Oldenburg
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Ole Steen Mortensen
- Department of Occupational and Social Medicine, Hospital Holbæk, Gl. Ringstedvej 4B, 4300, Holbæk, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Virkkunen T, Husu P, Tokola K, Parkkari J, Kankaanpää M. Depressive Symptoms Are Associated With Decreased Quality of Life and Work Ability in Currently Working Health Care Workers With Recurrent Low Back Pain. J Occup Environ Med 2022; 64:782-787. [PMID: 35673261 PMCID: PMC9426739 DOI: 10.1097/jom.0000000000002586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study investigates the association between depressive symptoms and multisite pain and health-related quality of life and work ability in currently employed health care workers with recurrent low back pain (LBP). METHODS Multisite pain, depressive symptoms, quality of life, and work ability were assessed by validated questionnaires. A generalized linear model was used for statistical analysis. RESULTS Notably, 28% of female health care workers with LBP had at least moderate levels of depressive symptoms. Depressive symptoms were significantly associated with decreased health-related quality of life and work ability. Multisite pain was not significantly associated with work ability. CONCLUSIONS Depressive symptoms are relatively common in female health care workers with LBP, and treatment of these symptoms may be crucial to improve their work ability.
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Otto AK, Wollesen B. Multicomponent exercises to prevent and reduce back pain in elderly care nurses: a randomized controlled trial. BMC Sports Sci Med Rehabil 2022; 14:114. [PMID: 35729667 PMCID: PMC9210633 DOI: 10.1186/s13102-022-00508-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/15/2022] [Indexed: 12/03/2022]
Abstract
Background Sports science is making an important contribution to health services research and supports the development of tailored interventions, e.g., in nursing settings. Working in elderly care is associated with a high prevalence of low back pain (LBP). Due to the diverse requirements and high strains, multicomponent programs are essential to address all relevant factors. This randomized controlled trial investigated the effects of a tailored ten-week ergonomics and twelve-week strength training on lifting behavior, strength endurance, LBP, functional impairment and adherence. Methods n = 42 nurses were randomly assigned to the intervention (IG; n = 20) or control group (CG; n = 22). They were eligible for participation if they were active in residential care and if they provided written informed consent. Other employees were excluded. The data were collected at baseline, at ten weeks (after ergonomics training), at 22 weeks (after strength training), and at 34 weeks (follow-up). The analysis combined physical tests with questionnaires (Progressive Isoinertial Lifting Evaluation, PILE-Test; Biering-Sørensen-Test; Visual Analog Scale Pain, VAS; Oswestry Disability Index, ODI; self-developed questionnaire for adherence). Group differences were analyzed by Chi2-Tests, ANOVA, and Linear Mixed Models. Results The IG showed an improved lifting performance (PILE-Test; 95% CI 1.378–7.810, p = .006) and a reduced LBP compared to the CG (VAS; 95% CI − 1.987 to 0.034, p = .043) after ergonomics training (PILE-Test, F(1,34) = 21.070, p < .001; VAS, F(1,34) = 5.021, p = .032). The results showed no differences concerning the Biering-Sørensen-Test and the ODI. Positive adherence rates were observed. Conclusions This approach and the positive results are essential to derive specific recommendations for effective prevention. The study results can be completed in future research with additional strategies to reduce nurses’ burden further. Trial registration The trial was registered at DRKS.de (DRKS00015249, registration date: 05/09/2018).
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Affiliation(s)
- Ann-Kathrin Otto
- Department of Human Movement Science, University of Hamburg, Turmweg 2, 20148, Hamburg, Germany. .,Department of Biopsychology and Neuroergonomics, Technical University of Berlin, Fasanenstraße 1, 10623, Berlin, Germany.
| | - Bettina Wollesen
- Department of Human Movement Science, University of Hamburg, Turmweg 2, 20148, Hamburg, Germany
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Ipsen JA, Pedersen LT, Viberg B, Nørgaard B, Suetta C, Bruun IH. Rehabilitation for life: the effect on physical function of rehabilitation and care in older adults after hip fracture-study protocol for a cluster-randomised stepped-wedge trial. Trials 2022; 23:375. [PMID: 35526010 PMCID: PMC9077959 DOI: 10.1186/s13063-022-06321-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/21/2022] [Indexed: 11/11/2022] Open
Abstract
Background A hip fracture is a serious event for older adults, given that approximately 50% do not regain their habitual level of physical function, and the mortality rate is high, as is the number of readmissions. The gap in healthcare delivery, as separated into two financial and self-governing sectors, might be a contributing cause of inferior rehabilitation and care for these patients. Therefore, we aim to assess the effect of continuous and progressive rehabilitation and care across sectors for older adults after hip fracture. Methods/design The project is designed as a stepped-wedge cluster randomised controlled trial. The study population of patients are older adults 65 years of age and above discharged after a hip fracture and healthcare professionals in primary and secondary care (municipalities and hospitals). Healthcare professionals from different sectors (hospital and municipalities) will be engaged in the empowerment-orientated praxis, through a workshop for healthcare professionals with knowledge sharing to the older adults using a digital health application (app). The rehabilitation intervention consists of 12 weeks of progressive resistance exercises initiated 1–2 days after discharge. To improve communication across sectors, a videoconference involving the patient and physiotherapists from both sectors will be conducted. On day, 3 after discharge, an outreach nurse performs a thorough assessment including measurement of vital signs. A hotline to the hospital for medical advice is a part of the intervention. The intervention is delivered as an add-on to the usual rehabilitation and care, and it involves one regional hospital and the municipalities within the catchment area of the hospital. The primary outcome is a Timed Up and Go Test 8 weeks post-surgery. Discussion Using a stepped-wedge design, the intervention will be assessed as well as implemented in hospital and municipalities, hopefully for the benefit of older adults after hip fracture. Furthermore, the collaboration between the sectors is expected to improve. Trial registration The study is approved by the Regional Scientific Ethics Committees of Southern Denmark (S-20200070) and the Danish Data Protection Agency (20-21854). Registered 9 of June 2020 at ClinicalTrials.gov, NCT04424186. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06321-w.
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Affiliation(s)
- Jonas Ammundsen Ipsen
- Department of Physical Therapy and Occupational Therapy, Lillebaelt Hospital, University Hospital of Southern Denmark, Odense, Denmark. .,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Lars T Pedersen
- Department of Physical Therapy and Occupational Therapy, Lillebaelt Hospital, University Hospital of Southern Denmark, Odense, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Health Education, University College South Denmark, Odense, Denmark
| | - Bjarke Viberg
- Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Odense, Denmark
| | - Birgitte Nørgaard
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Charlotte Suetta
- Department of Geriatric and Palliative Medicine, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen, Denmark.,Department of Medicine, Herlev and Gentofte Hospitals, University of Copenhagen, Copenhagen, Denmark
| | - Inge H Bruun
- Department of Physical Therapy and Occupational Therapy, Lillebaelt Hospital, University Hospital of Southern Denmark, Odense, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Hip Lift Transfer Assistive System for Reducing Burden on Caregiver's Waist. SENSORS 2021; 21:s21227548. [PMID: 34833623 PMCID: PMC8623983 DOI: 10.3390/s21227548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/23/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022]
Abstract
In Japan, the aging population is expected to increase the number of elderly people in the future. The purpose of this study was to develop a hip lift transfer assistive system to improve the QOL of elderly living and to prevent back pain for caregivers. We extracted the impediment factor and the necessary scene for the assistance, decided on the transfer process from the wheelchair in the toilet, and considered the reduction method of the burden based on the quantitative evaluation of the caregiver's lumbar burden and developed the device. Then we proposed the algorithm of the system by grasping the behavior and lumbar burden characteristics at the time of using the hip lift transfer assistive system by the developed device in which the proposed support algorithm of standing seating assistance operation is implemented in the actual use environment. Through the assistive movement evaluation experiment and the actual operation in the toilet, we have verified that the use of this device can reduce the caregivers' lumbar burden below the standard value (3400 N) and have proved the effectiveness of the proposed transfer assistive system.
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Van Eerd D, D'Elia T, Ferron EM, Robson L, Amick B. Implementation of participatory organizational change in long term care to improve safety. JOURNAL OF SAFETY RESEARCH 2021; 78:9-18. [PMID: 34399935 DOI: 10.1016/j.jsr.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 02/02/2021] [Accepted: 05/05/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Long Term Care (LTC) facilities are fast-paced, demanding environments placing workers at significant risk for injuries. Health and safety interventions to address hazards in LTC are challenging to implement. The study assessed a participatory organizational change intervention implementation and impacts. METHODS This was a mixed methods implementation study with a concurrent control, conducted from 2017 to 2019 in four non-profit LTC facilities in Ontario, Canada. Study participants were managers and frontline staff. Intervention sites implemented a participatory organizational change program, control sites distributed one-page health and safety pamphlets. Program impact data were collected via Survey (self-efficacy, control over work, pain and general health) and observation (Quick Exposure Checklist). Interviews/focus groups were used to collect program implementation data. RESULTS Participants described program impacts (hazard controls through equipment purchase/modification, practice changes, and education/training) and positive changes in culture, communication and collaboration. There was a statistically significant difference in manager self-efficacy for musculoskeletal disorder (MSD) hazards between the control and intervention sites over time but no other statistical differences were found. Key program implementation challenges included LTC hazards, staff shortage/turnover, safety culture, staff time to participate, and communication. Facilitators included frontline staff involvement during implementation, management support, focusing on a single unit, training, and involving an external program facilitator. CONCLUSION A participatory program can have positive impacts on identifying and reducing MSD hazards. Key to success is involving frontline staff in identifying hazards and creating solutions and management encouragement on a unit working together. High turnover rates, staffing shortages, and time constraints were barriers as they are for all organizational change efforts in LTC. The implementation findings are likely applicable in any jurisdiction. Practical Application: Implementing a participatory organizational change program to reduce MSD hazards is feasible in LTC and can improve communication and aid in identification and control of hazards.
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Affiliation(s)
- Dwayne Van Eerd
- Institute for Work & Health, 481 University Ave, Toronto, ON M5G 2E9, Canada.
| | - Teresa D'Elia
- Institute for Work & Health, 481 University Ave, Toronto, ON M5G 2E9, Canada
| | - Era Mae Ferron
- Institute for Work & Health, 481 University Ave, Toronto, ON M5G 2E9, Canada
| | - Lynda Robson
- Institute for Work & Health, 481 University Ave, Toronto, ON M5G 2E9, Canada
| | - Benjamin Amick
- University of Arkansas Medical System, Fay W Boozman College of Public Health, 4301 West Markham, #820, Little Rock, AR 722 05, United States
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Interventions to promote physical and mental health of nurses in elderly care: A systematic review. Prev Med 2021; 148:106591. [PMID: 33930430 DOI: 10.1016/j.ypmed.2021.106591] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/09/2021] [Accepted: 04/25/2021] [Indexed: 10/24/2022]
Abstract
This systematic review focuses on the current evidence on interventions to promote physical and mental health in elderly care nurses. The literature was identified through the electronic databases Medline, PsycINFO and CINAHL using a combination of synonyms of the terms "elderly care nurses", "physical activity", "stress management", "occupational stress", "musculoskeletal diseases" and "incapacity to work". The search was performed in January 2020 and repeated in November 2020. N = 6 randomized controlled studies were included investigating the effect of physical activity interventions, cognitive-behavioral interventions, organizational interventions and multicomponent interventions on physical and mental health in elderly care nurses. Both, the content of the interventions and the used outcome measures were heterogeneous. Four of the included studies had a high quality. They scored same or higher than seven (out of a maximum quality score of 14) with low risks of performance and attrition bias. Results suggest that cognitive-behavioral and multicomponent interventions seem to have an influence on physical and mental health factors such as job satisfaction, burnout, mental health symptoms and neck complaints. This systematic review demonstrated the potential of health promotion programs in elderly care nurses. Nevertheless, high quality randomized controlled trials are needed. Further research should consider the bottom-up approach for planning programs as well as recommended and standardized outcome measures and interventions.
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Cimarras-Otal C, Marcen-Cinca N, Rabal-Pelay J, Lacrcel-Tejero B, Alczar-Crevilln A, Villalba-Ruete J, Bataller-Cervero AV. Adapted exercises versus general exercise recommendations on chronic low back pain in industrial workers: A randomized control pilot study. Work 2021; 67:733-740. [PMID: 33164978 DOI: 10.3233/wor-203322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Exercise has been demonstrated as effective for the treatment of low back pain (LBP) in workers. OBJECTIVE The purpose of this study was to investigate whether an exercise program adapted to the characteristics of the workplace is a useful supplement to general exercise recommendations in assembly line workers with chronic LBP. METHODS Workers were randomly assigned to intervention group-adapted exercises plus general exercise recommendations (n = 10), and control group-general exercise recommendations (n = 8). Both received 8-week exercise program through a mobile application (APP) to manage the intervention. Outcome was based on lumbar disability (Oswestry Disability Index), interference and lumbar pain intensity (Brief Pain Inventory), and kinematic parameters. RESULTS Significant differences were obtained for the intervention group in the "pain interference" variable, in the "mood" and "enjoyment" sub-variables, as well as in "flexion angle" variable. For the control group, significant differences occurred in the "pain intensity" variable. Adapted exercise plus general recommendations seems more effective than the general recommendations for the improvement of lumbar flexion. CONCLUSIONS An adapted exercise program for assembly line workers with chronic LBP could be an effective treatment. Future studies with a larger sample size and with an exhaustive control of the exercise adherence are required to confirm the findings of this pilot study.
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Affiliation(s)
- Cristina Cimarras-Otal
- Universidad San Jorge, Autovía A-23 Zaragoza-Huesca Km 299, 50830, Villanueva de Gállego, Spain
| | - Noel Marcen-Cinca
- Universidad San Jorge, Autovía A-23 Zaragoza-Huesca Km 299, 50830, Villanueva de Gállego, Spain
| | - Juan Rabal-Pelay
- Universidad San Jorge, Autovía A-23 Zaragoza-Huesca Km 299, 50830, Villanueva de Gállego, Spain
| | | | | | - JosAntonio Villalba-Ruete
- BSH Electrodomésticos España S.A., Pol. Industrial Otallana, Avenida La Industria, 50016, Zaragoza, Spain
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Munch PK, Jørgensen MB, Højberg H, Rasmussen CDN. Nation-Wide Dissemination of a Digital Checklist to Improve Work Environment in the Eldercare Sector in Denmark. Front Public Health 2020; 8:502106. [PMID: 33344392 PMCID: PMC7744467 DOI: 10.3389/fpubh.2020.502106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/12/2020] [Indexed: 12/01/2022] Open
Abstract
In this study, we evaluated the dissemination of a digital checklist for improving implementation of work environment initiatives in the Danish eldercare sector. We evaluated the impact of the checklist using the RE-AIM framework. Initiated in 2016, researchers and relevant stakeholders were responsible for disseminating the checklist to all workplaces in the eldercare sector in Denmark through a national campaign. The checklist guided the user to define an action plan to implement, and the checklist covered 11 implementation concept points that should be addressed to reach full implementation of the action in focus. One year after the launch of the campaign almost all municipalities in Denmark had visited the website hosting the checklist (96%), 17% of individual workers within the eldercare responding to a union survey was reached, 4% (n = 199) of all eligible eldercare workplaces in Denmark and 8% of all nursing homes had adopted the checklist. Of the workplaces that used the checklist, 46% typed an action in the checklist. There were 13% of the first time users that used the checklist twice and 29% of the actions were revised (maintenance) after working with the implementation. Finally, the workplaces that had used the checklist showed a higher prioritization of work environment compared to workplaces not using the checklist both at baseline and at follow up. In conclusion, this study employing various strategies, including a 1-year national campaign to disseminate a checklist shows potential to impact implementation of work environment initiatives in the Danish eldercare sector. While dissemination is satisfactory and likely to increase further with time, more efforts is needed to ensure maintenance.
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Affiliation(s)
| | | | - Helene Højberg
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Yu Y, Liu ZW, Li TX, Li YL, Xiao SY, Tebes JK. Test of the stress process model of family caregivers of people living with schizophrenia in China. Soc Sci Med 2020; 259:113113. [PMID: 32646627 DOI: 10.1016/j.socscimed.2020.113113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022]
Abstract
Across the world, people living with schizophrenia (PLS) are often cared for by family caregivers. This is especially true in China where community-based systems of care for PLS are underdeveloped. Thus, family caregivers of PLS may experience emotional distress and burden in the absence of community-based services. Pearlin (1990) proposed a highly influential model for understanding the stress process and its relationship to health and wellbeing. Although the model has been examined worldwide, it has yet to be studied in China for caregivers of PLS. In the present study, we use Pearlin's stress process model to examine the mediating effect of perceived caregiver burden, family functioning, and caregivers' positive feelings about caregiving on PLS global functioning and caregiver depressive symptoms. We also examine whether the model differs for parent and spouse caregivers. A total of 327 primary family caregivers of PLS in Hunan province, China, were assessed cross-sectionally using culturally-validated measures. Bootstrap methods with Hayes's PROCESS Macro were used to test multiple mediation models of global functioning scores of PLS and caregiver depressive symptoms. In this first study of the stress process model of family caregivers of PLS in China, the results generally support the model. Caregiver perceived burden, family functioning, and positive caregiver feelings about caregiving all mediate the relationship between PLS global functioning and caregiver depression, with perceived caregiver burden having the strongest indirect effect. Analyses also show that the stress process differs between parent and spouse caregivers, with perceived caregiver burden a mediator for both groups but family functioning only a mediator for parent depressive symptoms. We discuss implications of these findings for extending the stress process model cross-culturally; suggest hypotheses for future research to examine parent and spouse differences; and discuss fruitful directions for intervention.
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Affiliation(s)
- Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China; Division of Prevention & Community Research, Department of Psychiatry, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA.
| | - Zi-Wei Liu
- Department of Preventive Medicine, School of Medicine, Hunan Normal University, Tongzipo Road 172, Changsha, Hunan, 410008, China.
| | - Tong-Xin Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China.
| | - Yi-Lu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China
| | - Shui-Yuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China.
| | - Jacob Kraemer Tebes
- Division of Prevention & Community Research, Department of Psychiatry, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA.
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Kołcz A, Jenaszek K. Assessment of pressure pain threshold at the cervical and lumbar spine region in the group of professionally active nurses: A cross-sectional study. J Occup Health 2020; 62:e12108. [PMID: 32515885 PMCID: PMC7001494 DOI: 10.1002/1348-9585.12108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/21/2019] [Accepted: 12/16/2019] [Indexed: 01/23/2023] Open
Abstract
Objectives The problem of spinal pain among nurses and lack of compliance with workplace ergonomy is increasing. The study aimed to assess the pressure pain threshold (PPT) at the cervical and lumbar spine in nursing staff. Methods The sample of this prospective and observational study consisted of 30 female nurses with a mean age of 38.6 ± 11.1 years. The standardized Oswestry (ODI) and the Neck Disability Index (NDI) were used, as well as the Authors’ Designed Questionnaire (ADQ) was used to assess compliance with ergonomic principles. The PPT analysis using a computerized pressure algometer (CPA) was performed to examine the level of PPT. Results A mild disability was found in 56% of nurses (NDI and ODI). A value of <4 kg/cm2 (CPA), indicating musculoskeletal overload was observed in 57% of subjects. Also, 60% of nurses work with a lying patient; 73.4% grabs the patient's armpits while transferring in bed; 16.7% never adjusts the height of the bed, and only 13.4% choose specialist footwear for work. There is a correlation between PPT values for trapezius and erector spinae muscles on the same side of the body in nurses with mild and moderate disability (P < .05). Conclusions Pain complaints are associated with lower PPT of trapezius and erector spinae muscles and asymmetry of muscle tension. Also, it was noted that the lack of implementation of ergonomic principles by nursing staff affects their degree of disability.
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Affiliation(s)
- Anna Kołcz
- Laboratory of Ergonomics and Biomedical Monitoring, Wroclaw Medical University, Wroclaw, Poland.,Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland.,Department of Neurological Rehabilitation, Provincial Specialist Hospital, Wroclaw, Poland
| | - Karolina Jenaszek
- Laboratory of Ergonomics and Biomedical Monitoring, Wroclaw Medical University, Wroclaw, Poland
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13
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Rasmussen CDN, Højberg H, Larsen AK, Munch PK, Osborne R, Kwak L, Jensen I, Linnan L, Jørgensen MB. Evaluation and Dissemination of a Checklist to Improve Implementation of Work Environment Initiatives in the Eldercare Sector: Protocol for a Prospective Observational Study. JMIR Res Protoc 2020; 9:e16039. [PMID: 32401212 PMCID: PMC7254284 DOI: 10.2196/16039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/13/2020] [Accepted: 02/04/2020] [Indexed: 02/04/2023] Open
Abstract
Background To measure sustainable improvements in the work environment, a flexible and highly responsive tool is needed that will give important focus to the implementation process. A digital checklist was developed in collaboration with key stakeholders to document the implementation of changes in eldercare sector workplaces. Objective This paper describes the study protocol of a dissemination study that aims to examine when, why, and how the digital checklist is spread to the Danish eldercare sector following a national campaign particularly targeting nursing homes and home care. Methods This prospective observational study will use quantitative data from Google Analytics describing use of the checklist as documented website engagement, a survey among members in the largest union in the sector, information from a central business register, and monitoring of campaign activities. The evaluation will be guided by the five elements of the RE-AIM framework: reach, effectiveness, adoption, implementation, and maintenance. Results The study was approved in June 2016 and began in October 2018. The campaign that is the foundation for the evaluation began in 2017 and ended in 2018. However, the webpage where we collect data is still running. Results are expected in 2020. Conclusions This protocol provides a working example of how to evaluate dissemination of a checklist to improve implementation of work environment initiatives in the eldercare sector in Denmark. To our knowledge, implementation in a nationwide Danish work environment has not been previously undertaken. Given that the checklist is sector-specific for work environment initiatives and developed through systematic collaboration between research and practice, it is likely to have high utility and impact; however, the proposed evaluation will determine this. This study will advance dissemination research and, in particular, the evaluation of the impact of these types of studies. Finally, this study advances the field through digital tools that can be used for evaluation of dissemination efforts (eg, Google Analytics associated with website) in the context of a rigorous research design activity. International Registered Report Identifier (IRRID) DERR1-10.2196/16039
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Affiliation(s)
| | - Helene Højberg
- The National Research Centre for the Working Environment, København Ø, Denmark
| | - Anne Konring Larsen
- The National Research Centre for the Working Environment, København Ø, Denmark
| | - Pernille Kold Munch
- The National Research Centre for the Working Environment, København Ø, Denmark
| | - Richard Osborne
- Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Australia
| | - Lydia Kwak
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Irene Jensen
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Laura Linnan
- Carolina Collaborative for Research on Work & Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
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Kołcz A, Główka N, Kowal M, Paprocka-Borowicz M. Baropodometric evaluation of foot load distribution during gait in the group of professionally active nurses. J Occup Health 2019; 62:e12102. [PMID: 31837089 PMCID: PMC6970405 DOI: 10.1002/1348-9585.12102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/25/2019] [Accepted: 11/06/2019] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES Nurses are extremely exposed to musculoskeletal overloads. Prolonged standing postural balance distributions, functional deficits and pain may affect the symmetry of the load on the feet. The study aimed to assess the distribution of foot load during gait among nurses. METHODS The sample of this prospective and observational study consisted of 37 female nurses with mean age of 39 years. The Nordic Musculoskeletal Questionnaire (NMQ) was used to evaluate musculoskeletal disturbances and baropodometric gait analysis (BGA) was performed to register distribution of foot load during gait. RESULTS We showed that 68% of nurses declare that they know the principles of workplace ergonomics, but only 14% comply with them. NMQ results indicate that as many as 73% of the respondents feel ailments in the "lower back" area. An asymmetry was observed in the load of IV-V of the metatarsal head between the left and right foot (P = .000) and in the load of the left and right lateral part of the heel (P = .028) in the BGA test. Correlations between ailments occurring in the neck area and loading of the lateral arch of the right foot (P = .032) were found. Moreover, the load in this area correlated positively with the occurrence of "lower back" pain (P = .045). CONCLUSIONS Nurses have asymmetric distribution of foot load during gait, which results in a discrepancy between the loads on the three main support points of the foot and which may affect nurses' work productivity.
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Affiliation(s)
- Anna Kołcz
- Laboratory of Ergonomics and Biomedical Monitoring, Wroclaw Medical University, Wroclaw, Poland
| | - Natalia Główka
- Laboratory of Ergonomics and Biomedical Monitoring, Wroclaw Medical University, Wroclaw, Poland
| | - Mateusz Kowal
- Department of Physiotherapy, Wroclaw Medical University, Wroclaw, Poland
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15
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Prevost V, Heutte N, Leconte A, Licaj I, Delorme C, Clarisse B. Effectiveness of a therapeutic patient education program in improving cancer pain management: EFFADOL, a stepped-wedge randomised controlled trial. BMC Cancer 2019; 19:673. [PMID: 31286871 PMCID: PMC6615097 DOI: 10.1186/s12885-019-5836-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 06/14/2019] [Indexed: 01/29/2023] Open
Abstract
Background Despite numerous guidelines, nearly one of two patients with cancer pain remains undertreated, thereby affecting their quality of life. Active patient involvement through Therapeutic Patient Education (TPE) is considered as a relevant strategy to overcoming hurdles in pain management. The aim of the EFFADOL study is to assess the effectiveness of a TPE program in improving cancer pain management. Methods/design The EFFADOL study is a stepped-wedge randomised controlled trial. A total of 260 cancer patients with unbalanced background pain will be randomised over the institutional level, i.e. stepped-wedge cluster design. Six clusters will be formed, one at the regional level of “Basse-Normandie” for patients receiving the educational approach by health providers already trained to TPE. Then, five additional centers will be gradually included at the national level, making it possible to compare the “conventional” management of pain (before medical staff training to TPE) with the educational approach (after being trained). The main study parameter is pain interference on daily life assessed with the self-administrated and validated Brief Pain Inventory questionnaire. Secondary objectives comprised the evaluation of patients’ adherence to pain education program, the description of pain intensity, pain relief, analgesic adherence and pain emotional impact. Educational dimension of the program will be evaluated through the patients’ acquisition of knowledge and skills about their pain and treatment as well as their self-efficacy to participate actively in pain management. The patient’s feeling of pain changes will be measured. Finally, the satisfaction of participants and educators will be reported. We hypothetise active involvement of patients in TPE will lead to an improved pain management compared to standard care. Discussion Analyzing the impact of a TPE program in cancer pain patients will improve their pain management and quality of life. We expect that the dissemination of our project educational approach through the French territory will be accompanied by long term change in clinical practices with mutual benefit to patients and caregiver-educators. Trial registration NCT03297723, registered: 09/28/2017. Protocol version: Version n°1.1 dated from 2016/09/08.
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Affiliation(s)
- Virginie Prevost
- University of Normandy, 14000, Caen, France. .,UMR 1086 INSERM « ANTICIPE », Centre François Baclesse, 14000, Caen, France.
| | - Natacha Heutte
- Clinical Research Department, Centre François Baclesse, 14000, Caen, France
| | - Alexandra Leconte
- Clinical Research Department, Centre François Baclesse, 14000, Caen, France
| | - Idlir Licaj
- UMR 1086 INSERM « ANTICIPE », Centre François Baclesse, 14000, Caen, France.,Clinical Research Department, Centre François Baclesse, 14000, Caen, France
| | - Claire Delorme
- Bayeux Hospital, 14400, Bayeux, France.,Regional Pain Network for Lower Normandy, 14400, Bayeux, France
| | - Bénédicte Clarisse
- Clinical Research Department, Centre François Baclesse, 14000, Caen, France
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16
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Dalager T, Højmark A, Jensen PT, Søgaard K, Andersen LN. Using an intervention mapping approach to develop prevention and rehabilitation strategies for musculoskeletal pain among surgeons. BMC Public Health 2019; 19:320. [PMID: 30885182 PMCID: PMC6423851 DOI: 10.1186/s12889-019-6625-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 03/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the present study was to describe the development of strategies to prevent and rehabilitate musculoskeletal pain among surgeons. Musculoskeletal pain affects surgeons' life, and evidence on interventions for effective prevention and rehabilitation is lacking for this occupational group. METHODS An Intervention Mapping approach was used to develop intervention strategies specifically tailored to surgeons. This approach entailed conducting a systematic scoping literature search and semi-structured interviews with six surgeons. RESULTS The first step was to develop a logic model of the problem of musculoskeletal pain among surgeons. Step two was to formulate health-enhancing outcomes and performance objectives for the intervention, while in step three theory-based methods and practical strategies for the intervention were identified. CONCLUSION The present Intervention Mapping study demonstrated that musculoskeletal pain among surgeons is a complex area that needs attention. Our findings highlight a need for individual behavioural changes as well as organisational, attitudinal, and management changes.
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Affiliation(s)
- Tina Dalager
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Anne Højmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Pernille Tine Jensen
- Clinical Institute, University of Southern Denmark and Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Clinical Institute, University of Southern Denmark and Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark
| | - Lotte Nygaard Andersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
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17
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Yu Y, Zhou W, Liu ZW, Hu M, Tan ZH, Xiao SY. Gender differences in caregiving among a schizophrenia population. Psychol Res Behav Manag 2018; 12:7-13. [PMID: 30588138 PMCID: PMC6304241 DOI: 10.2147/prbm.s187975] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background The present study aimed to investigate differences in family burden and caregiver distress in a population of caregivers for schizophrenia, by separating patient gender and caregiver gender. Methods A sample of 327 primary family caregivers was recruited from a Chinese rural community through a one-stage cluster-sampling method. A cross-sectional design was employed, using validated measures to assess both family burden and primary caregivers' depression and anxiety. Results Significant differences by gender were detected in family burden and caregiver distress. Family burden was significantly higher for male patients on the domains of effect on physical and mental health of others, and significantly higher for female caregivers on the domains of financial burden and effect on physical and mental health of others. Caregivers of male patients were more likely to suffer from anxiety than caregivers of female patients (52.7% vs 38.1%, P=0.012); female caregivers were more likely to suffer from depression (51.2% vs 38.6%, P = 0.031) and anxiety (51.6% vs 38.1%, P=0.020) than male caregivers. Conclusion The results reinforced the expected differences in caregiving experiences of a schizophrenia population by gender, which has implications for the future design of gender-specific interventions to alleviate family burden and caregiver distress.
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Affiliation(s)
- Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan 410008, China,
| | - Wei Zhou
- Hospital Administration Institute, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Zi-Wei Liu
- Department of Psychiatry, Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Mi Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan 410008, China,
| | - Zhi-Hui Tan
- Department of Gynaecology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Shui-Yuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan 410008, China,
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18
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Prevost V, Clarisse B, Heutte N, Leconte A, Bisson C, Bignon R, Cauchin S, Feuillet M, Gehanne S, Gicquère M, Grach MC, Guillaumé C, Le Gal C, Le Garrec J, Lecaer F, Lepleux I, Millet AL, Ropartz MC, Roux N, Hieng VS, Van Delook C, Le Chevalier A, Delorme C. Therapeutic Patient Education in Cancer Pain Management: from Practice to Research: Proposals and Strategy of the French EFFADOL Program. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:1355-1361. [PMID: 28804809 DOI: 10.1007/s13187-017-1258-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In the field of cancer pain, therapeutic patient education (TPE) allows patients to develop skills to better manage their pain. In the Lower Normandy region of France, the management of pain is based on networking, thus allowing proximity and accessibility for all concerned. We have thus designed and initiated a broad five-stage research program that includes the following: (1) training for caregivers in TPE; (2) identifying the educational expectations of patients and their relatives with regard to cancer pain; (3) the design of a TPE program; (4) the evaluation of its quality; and (5) the evaluation of its effectiveness by comparative randomization. This article presents this approach and more particularly the research phases (stages 2, 4, 5) for which the objectives, the methodology, and the expected results are justified. Among the key points, particular attention is paid to the evaluation of the educational dimension that provides patients with self-efficacy to participate actively in the management of their pain, their perception of changes in relation to it and its impact. The choice of a specific assessment criterion (subscale 9 of the Brief Pain Inventory) and of the step-wedge design are thus argued. This approach, which is based on a partnership between health care professionals and researchers, aims to demonstrate the benefits provided by TPE to patients in order to enable them to better manage their pain on a daily basis.
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Affiliation(s)
- Virginie Prevost
- UMR 1086 INSERM « ANTICIPE » and University of Normandy, Caen, France.
- François Baclesse Regional Cancer Center, Caen, France.
- UMR 1086 INSERM « ANTICIPE », Centre Francois Baclesse, Av. du Général Harris, 14076, Caen, Cedex 05, France.
| | | | - Natacha Heutte
- François Baclesse Regional Cancer Center, Caen, France
- UNIROUEN, CETAPS EA 3832, University of Normandy, Mont Saint Aignan, France
| | | | - Cécile Bisson
- Bayeux Hospital, Bayeux, France
- Regional Pain Network for Lower Normandy, Bayeux, France
| | - Rachel Bignon
- Regional Pain Network for Lower Normandy, Bayeux, France
- Lisieux Hospital, Lisieux, France
| | - Sonia Cauchin
- Regional Pain Network for Lower Normandy, Bayeux, France
- Alençon-Mamers Intercommunal Hospital, Alençon, France
| | - Maryline Feuillet
- Regional Pain Network for Lower Normandy, Bayeux, France
- Saint-Lô Hospital, Saint-Lô, France
| | - Sylvie Gehanne
- Regional Pain Network for Lower Normandy, Bayeux, France
- Saint-Lô Hospital, Saint-Lô, France
| | - Maud Gicquère
- François Baclesse Regional Cancer Center, Caen, France
- Regional Pain Network for Lower Normandy, Bayeux, France
| | - Marie-Christine Grach
- François Baclesse Regional Cancer Center, Caen, France
- Regional Pain Network for Lower Normandy, Bayeux, France
| | - Cyril Guillaumé
- Regional Pain Network for Lower Normandy, Bayeux, France
- University Hospital, Caen, France
| | - Christine Le Gal
- Regional Pain Network for Lower Normandy, Bayeux, France
- Argentan Hospital, Argentan, France
| | - Joelle Le Garrec
- Regional Pain Network for Lower Normandy, Bayeux, France
- Alençon-Mamers Intercommunal Hospital, Alençon, France
| | - Franck Lecaer
- Regional Pain Network for Lower Normandy, Bayeux, France
- Flers Hospital, Flers, France
| | - Isabelle Lepleux
- Regional Pain Network for Lower Normandy, Bayeux, France
- Cherbourg Hospital, Cherbourg, France
| | - Anne-Laure Millet
- Regional Pain Network for Lower Normandy, Bayeux, France
- Flers Hospital, Flers, France
| | - Marie-Claude Ropartz
- Regional Pain Network for Lower Normandy, Bayeux, France
- Avranches-Granville Hospital, Granville, France
| | - Nathalie Roux
- Regional Pain Network for Lower Normandy, Bayeux, France
- University Hospital, Caen, France
| | - Virith Sep Hieng
- Regional Pain Network for Lower Normandy, Bayeux, France
- Lisieux Hospital, Lisieux, France
| | - Carole Van Delook
- Regional Pain Network for Lower Normandy, Bayeux, France
- Argentan Hospital, Argentan, France
| | - Aline Le Chevalier
- Regional Pain Network for Lower Normandy, Bayeux, France
- Avranches-Granville Hospital, Granville, France
| | - Claire Delorme
- Bayeux Hospital, Bayeux, France
- Regional Pain Network for Lower Normandy, Bayeux, France
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19
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Prevost V, Leconte A, Heutte N, Delorme C, Clarisse B, Le Chevalier A. [Therapeutic education and cancer pain: Strategy and strengths of the EFFADOL program]. Presse Med 2018; 47:921-924. [PMID: 30366740 DOI: 10.1016/j.lpm.2018.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- Virginie Prevost
- Université de Caen Normandie, unité de recherche interdisciplinaire pour la prévention et le traitement des cancers « ANTICIPE », UMR 1086 Inserm, 14076 Caen, France; Centre régional de lutte contre le cancer François-Baclesse, 14076 Caen, France.
| | - Alexandra Leconte
- Centre régional de lutte contre le cancer François-Baclesse, 14076 Caen, France
| | - Natacha Heutte
- Centre régional de lutte contre le cancer François-Baclesse, 14076 Caen, France
| | - Claire Delorme
- Centre hospitalier, 14400 Bayeux, France; Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France
| | - Bénédicte Clarisse
- Centre régional de lutte contre le cancer François-Baclesse, 14076 Caen, France
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20
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Prevost V, Clarisse B, Heutte N, Leconte A, Bisson C, Bignon R, Cauchin S, Feuillet M, Gehanne S, Gicquère M, Grach MC, Guillaumé C, Le Gal C, Le Garrec J, Lecaer F, Lepleux I, Millet AL, Ropartz MC, Roux N, Sep Hieng V, Van Delook C, Bechet C, Le Chevalier A, Delorme C. [Elaboration and evaluation of a therapeutic education program in cancer pain management]. Bull Cancer 2018; 105:1074-1083. [PMID: 30327192 DOI: 10.1016/j.bulcan.2018.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 07/10/2018] [Accepted: 08/27/2018] [Indexed: 10/28/2022]
Abstract
Pain, one of the most feared symptoms for patients with cancer, remains insufficiently alleviated and impairs quality of life. Therapeutic patient education (TPE) is a relevant approach to this problem while allowing patients to develop skills to better manage their pain. In the "Basse-Normandie" French region, the management of pain relies on two organized networks, thus allowing proximity and accessibility for all concerned. In this context, our team has begun a broad five-step research program that is part of a regional health policy: (1) training in TPE of 10 doctor/nurse pairs; (2) identification of educational expectations of patients and their relatives in the field of cancer pain; (3) design and optimization of a TPE program dedicated to cancer pain; (4) regional pilot study aiming to assess the feasibility, quality and transferability of the program; (5) evaluation of the TPE program by interventional comparative randomization at the national level. This article aims to present the program which originality and strengths are based on collaborative work between health stakeholders. Objectives, methodology and expected results of the research phase (stages 2, 4, 5) are notably developed. The main expected outcomes are to prove the effectiveness of the program in improving the knowledge and skills of patients in the field of pain cancer in order to promote their adherence to treatment and, consequently, to enable them to better manage it. The long-term objective is to disseminate the educational approach by modifying practices that provide a mutual benefit for caregivers and patients.
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Affiliation(s)
- Virginie Prevost
- Université de Caen Normandie, UMR 1086 Inserm, unité de recherche interdisciplinaire pour la prévention et le traitement des cancers « ANTICIPE », 14000 Caen, France; Centre régional de lutte contre le cancer François-Baclesse, 14000 Caen, France.
| | - Bénédicte Clarisse
- Centre régional de lutte contre le cancer François-Baclesse, 14000 Caen, France
| | - Natacha Heutte
- Centre régional de lutte contre le cancer François-Baclesse, 14000 Caen, France; Normandie université, UNIROUEN, CETAPS EA 3832, 76130 Mont-Saint-Aignan, France
| | - Alexandra Leconte
- Centre régional de lutte contre le cancer François-Baclesse, 14000 Caen, France
| | - Cécile Bisson
- Centre hospitalier, 14400 Bayeux, France; Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France
| | - Rachel Bignon
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 14100 Lisieux, France
| | - Sonia Cauchin
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier intercommunal Alençon-Mamers, 61000 Alençon, France
| | - Maryline Feuillet
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 50000 Saint-Lô, France
| | - Sylvie Gehanne
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 50000 Saint-Lô, France
| | - Maud Gicquère
- Centre régional de lutte contre le cancer François-Baclesse, 14000 Caen, France; Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France
| | - Marie-Christine Grach
- Centre régional de lutte contre le cancer François-Baclesse, 14000 Caen, France; Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France
| | - Cyril Guillaumé
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; CHU, 14000 Caen, France
| | - Christine Le Gal
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 61200 Argentan, France
| | - Joelle Le Garrec
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier intercommunal Alençon-Mamers, 61000 Alençon, France
| | - Franck Lecaer
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 61100 Flers, France
| | - Isabelle Lepleux
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 50100 Cherbourg, France
| | - Anne-Laure Millet
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 61100 Flers, France
| | - Marie-Claude Ropartz
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 50400 Avranches-Granville, France
| | - Nathalie Roux
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; CHU, 14000 Caen, France
| | - Virith Sep Hieng
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 14100 Lisieux, France
| | - Carole Van Delook
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 61200 Argentan, France
| | | | - Aline Le Chevalier
- Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France; Centre hospitalier, 50400 Avranches-Granville, France
| | - Claire Delorme
- Centre hospitalier, 14400 Bayeux, France; Réseau régional douleur en Basse-Normandie, 14400 Bayeux, France
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21
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Abstract
BACKGROUND Low back pain (LBP) is a significant work-related problem, especially among nurses. This is due to its high prevalence and impact on the healthcare system, either directly through treating affected nurses, or indirectly through the decrease in nurses' productivity. AIM The aim of this study is to measure the prevalence rates of LBP among nurses in Jordan, and to uncover the associated factors and consequences. METHODS A cross-sectional design study. Data were collected through a data collection sheet, developed based on literature, from seven public hospitals and one university hospital over a period of 2 months. RESULTS A total of 384 nurses completed the data sheet with a response rate of 76.8%. Current prevalence of LBP was 69% (n = 265), 1-year prevalence was 78.9% (n = 303), while accumulative prevalence was 83.6% (n = 321). Factors associated with LBP were older age, female gender, being overweight, and having longer experience in nursing; 40% of nurses agreed that the LBP increased their number of sick leaves, 58.7% agreed it lowered their productivity, and 9% reported that it forced them to change unit. CONCLUSION LBP is a significant work-related problem among Jordanian nurses, with high-prevalence rates, and debilitating medical and professional consequences. Interdisciplinary efforts are needed to reduce these consequences.
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Affiliation(s)
- Mohammad Suliman
- Faculty of Nursing, Community and Mental Health Nursing Department, Al al-Bayt University, Mafraq, Jordan
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22
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Stevens ML, Boyle E, Hartvigsen J, Mansell G, Søgaard K, Jørgensen MB, Holtermann A, Rasmussen CDN. Mechanisms for reducing low back pain: a mediation analysis of a multifaceted intervention in workers in elderly care. Int Arch Occup Environ Health 2018; 92:49-58. [PMID: 30173369 DOI: 10.1007/s00420-018-1350-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 08/28/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE A multifaceted workplace intervention consisting of participatory ergonomics, physical training, and cognitive-behavioural training (CBT) has shown effectiveness for reducing low back pain (LBP). However, the mechanisms of action underlying these intervention components are not well understood. METHODS This was a mediation analysis of a cluster-randomised controlled trial of a multifaceted intervention in 420 workers in elderly care. Mediation analysis was carried out via structural equation modelling. Potential mediators investigated were: fear-avoidance beliefs, perceived muscle strength, use of assistive devices at work and perceived physical exertion at work. LBP outcomes assessed were: days with LBP, LBP intensity and days with bothersome LBP. RESULTS There were no significant indirect effects of the intervention on LBP outcomes. There were significant effects of the intervention on both fear-avoidance measures [β = - 0.63, 95% CI (1.23, 0.03); β = - 1.03, 95% CI (- 1.70, - 0.34)] and the use of assistive devices [β = - 0.55, 95% CI (- 1.04, - 0.05)], but not on perceived muscle strength [β = - 0.18, 95% CI (- 0.50, 0.13)] or physical exertion [β = - 0.05, 95% CI (- 0.40, 0.31)]. The only potential mediator with a significant effect on LBP outcomes was physical exertion, which had a significant effect on LBP intensity [β = 0.14, 95% CI (0.04, 0.23)]. CONCLUSIONS A multifaceted intervention consisting of participatory ergonomics, physical training, and CBT was able to decrease fear-avoidance beliefs and increase use of assistive devices in the workplace. However, these changes did not explain the effect of any of the intervention components on days with LBP, LBP intensity and days with bothersome LBP.
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Affiliation(s)
- Matthew L Stevens
- Musculoskeletal Health Sydney, School of Public Health, The University of Sydney, PO Box M179, Missenden Rd, Sydney, NSW, 2050, Australia.
| | - Eleanor Boyle
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Gemma Mansell
- Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Marie B Jørgensen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,The National Research Centre for the Working Environment, Copenhagen, Denmark
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23
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Sezgin D, Esin MN. Effects of a PRECEDE-PROCEED model based ergonomic risk management programme to reduce musculoskeletal symptoms of ICU nurses. Intensive Crit Care Nurs 2018; 47:89-97. [DOI: 10.1016/j.iccn.2018.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 12/21/2017] [Accepted: 02/20/2018] [Indexed: 11/27/2022]
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24
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Rasmussen CDN, Hendriksen PR, Svendsen MJ, Ekner D, Hansen K, Sørensen OH, Svendsen SW, van der Beek AJ, Holtermann A. Improving work for the body - a participatory ergonomic intervention aiming at reducing physical exertion and musculoskeletal pain among childcare workers (the TOY-project): study protocol for a wait-list cluster-randomized controlled trial. Trials 2018; 19:411. [PMID: 30064464 PMCID: PMC6069746 DOI: 10.1186/s13063-018-2788-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 07/05/2018] [Indexed: 12/03/2022] Open
Abstract
Background The prevalence of musculoskeletal pain (MSP) is persistently high throughout the world. Work-related factors such as high physical workload (lifting, bending and twisting of the back) are considered to be among the main causes of MSP. Work in childcare includes the need to lift, carry, and support children in a range of activities, requiring several demanding postures and movements, such as bending forward and twisting of the back and sitting on the floor. Participatory ergonomics may represent a solution for decreasing the physical workload to reduce MSP. We present the protocol of a study aiming to evaluate the effect and process of a participatory ergonomics intervention designed to reduce physical exertion during work and MSP (including MSP interfering with work) among childcare workers. Methods/design This study will use a two-arm cluster-randomized design employing a wait-list control, with childcare institutions forming the clusters. Three workshops will be conducted during the 4-month intervention period. Participants will identify risk factors for strenuous work and MSP, develop solutions for reducing the identified risk factors, and implement them in their team. An ergonomic consultant will guide the process. The data collection will consist of questionnaires and objective measures of heart rate and physical activity, observations of physical workload, and information on sickness absence based on company records. Primary outcomes are physical exertion during work and MSP (including pain-related work interference) measured at 4 months. Secondary outcomes measured at 4 months are sickness absence due to MSP; objectively measured occupational physical activity and heart rate; and self-reported self-efficacy, employee involvement, and need for recovery. Alongside the trial, a process evaluation and an economic evaluation will be conducted. Discussion The study will evaluate the effect and process of a participatory ergonomics intervention to reduce physical exertion at work and MSP among childcare workers. By performing a cluster-randomized controlled trial with an effect evaluation based on both objective and self-reported measures with the addition of a process evaluation and economic evaluation, this study will contribute to the evidence for prevention of MSP among a less studied occupational group. Results are expected in 2018–2019. Trial registration ISRCTN, ISRCTN10928313. Registered on 11 January 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2788-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Peter Rasmus Hendriksen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Malene Jagd Svendsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Dorte Ekner
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Klaus Hansen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Ole Henning Sørensen
- Center for Industrial Production, Aalborg University Copenhagen, A. C. Meyers Vænge 15, 2450, Copenhagen, Denmark
| | - Susanne Wulff Svendsen
- Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland-University Research Clinic, Herning, Denmark
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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25
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Abstract
STUDY DESIGN A prospective cohort study. OBJECTIVE The aim of the present study was first to compare monthly measurements of low back pain (LBP) with quarterly and yearly retrospective measurements of LBP, and second to investigate possible bias effects for recall bias of LBP. SUMMARY OF BACKGROUND DATA LBP is a subjective experience often measured by a single rating of recalled pain over a certain time interval. However, retrospectively reported pain may be subject to recall bias. METHODS The agreement between monthly measurements of LBP and quarterly and yearly retrospective measurements of LBP was evaluated by Spearman rank order correlation coefficients, intraclass correlation coefficients, and Bland-Altman plots. Bias effects for recall bias were investigated by a linear regression model. RESULTS There were no statistical significant differences in mean values of monthly measurements of LBP compared with quarterly and yearly retrospective measurements of LBP on a group level. However, the Bland-Altman plots revealed that within individuals, the difference between monthly measurements of LBP and quarterly and yearly retrospective measurements of LBP was highly variable. For both quarterly and yearly recall, social support from colleagues and average LBP days were significantly associated with the recall bias. CONCLUSION The agreement of pain recall among workers in the current study seems to be good on a group level, but both between and within individuals, the difference between monthly and quarterly and yearly retrospective measurements was quite high. Factors that impacted the recall bias were social support from colleagues and average LBP days over the recall period. LEVEL OF EVIDENCE 3.
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26
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Van Eerd D, Ferron EM, D'Elia T, Morgan D, Ziesmann F, Amick BC. Process evaluation of a participatory organizational change program to reduce musculoskeletal and slip, trip and fall injuries. APPLIED ERGONOMICS 2018; 68:42-53. [PMID: 29409654 DOI: 10.1016/j.apergo.2017.10.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 07/06/2017] [Accepted: 10/22/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Long-term care (LTC) workers are at significant risk for occupational-related injuries. Our objective was to evaluate the implementation process of a participatory change program to reduce risk. METHODS A process evaluation was conducted in three LTC sites using a qualitative approach employing structured interviews, consultant logs and a focus group. RESULTS Findings revealed recruitment/reach themes of being "voluntold", using established methods, and challenges related to work schedules. Additional themes about dose were related to communication, iterative solution development, participation and engagement. For program fidelity and satisfaction, themes emerged around engagement, capacity building and time demands. CONCLUSION Process evaluation revealed idiosyncratic approaches to recruitment and related challenges of reaching staff. Solutions to prioritized hazards were developed and implemented, despite time challenges. The iterative solution development approach was embraced. Program fidelity was considered good despite early program time demands. Post implementation reports revealed sustained hazard identification and solution development.
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Affiliation(s)
- Dwayne Van Eerd
- Institute for Work & Health, 481 University Ave, Toronto, Ontario, Canada; School of Public Health and Health Systems, University of Waterloo, 200 University Ave, Waterloo, Ontario, Canada.
| | - Era Mae Ferron
- Institute for Work & Health, 481 University Ave, Toronto, Ontario, Canada
| | - Teresa D'Elia
- Institute for Work & Health, 481 University Ave, Toronto, Ontario, Canada
| | - Derek Morgan
- Public Services Health and Safety Association, 4950 Yonge St #1800, North York, Ontario, Canada
| | - Frances Ziesmann
- Public Services Health and Safety Association, 4950 Yonge St #1800, North York, Ontario, Canada
| | - Benjamin C Amick
- Institute for Work & Health, 481 University Ave, Toronto, Ontario, Canada; Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC5 505, Miami, FL 33199, USA
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27
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Ferm L, Rasmussen CDN, Jørgensen MB. Operationalizing a model to quantify implementation of a multi-component intervention in a stepped-wedge trial. Implement Sci 2018; 13:26. [PMID: 29422080 PMCID: PMC5806452 DOI: 10.1186/s13012-018-0720-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 01/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is challenging to interpret the results of multifaceted interventions due to complex program theories that are difficult to measure in a quantifiable manner. The aims of this paper were, first, to develop a model for a comprehensive quantitative implementation evaluation and, second, to operationalize it in the process evaluation of the stepped-wedge cluster randomized controlled trial: "Prevention of low back pain and its consequences among nurses' aides in elderly care" to investigate if implementation differed across intervention components, steps, and settings (workplaces). METHODS Operationalization of a quantifiable measure of implementation requires three steps: (1) development of a program logic and intervention protocol, (2) description of a complete and acceptable delivery of the intervention, and (3) description of what determines the receipt of the intervention. Program logic from a previously developed multifaceted stepped-wedge intervention was used. The optimal delivery of the intervention was defined as the deliverers' full understanding and following of the intervention protocol and that they performed their best and contributed to the participants' attention and motivation (fidelity). The optimal receipt of the intervention was defined as participants being fully present at all intervention activities (participation), being motivated and satisfied, and having a good social support (responsiveness). Measurements of the fidelity, participation, and responsiveness were obtained from logbooks and questionnaires. Fidelity was multiplied by participation to measure exposure of the intervention to the individual. The implementation was determined from optimal delivery and optimal receipt on a scale from 0 (no implementation) to 100 (full implementation) on individual and organizational level. RESULTS Out of 753 sessions, 95% were delivered. The sessions were delivered with 91% success (fidelity) across the organization. Average participation, fidelity, exposure, and responsiveness were 50, 93, 48, and 89% across all participants. The implementation of the intervention was uniform across steps (p = 0.252) and workplaces (p = 0.125) but not for intervention components (p = 0.000). However, participation, fidelity, exposure, and responsiveness varied between workplaces. CONCLUSIONS This study developed a quantifiable implementation evaluation measuring participation, fidelity, exposure, and responsiveness. The quantifiable implementation evaluation was suitable for comparing implementation across steps, components, and settings and can be applied in the analyses on the impact of implementation of complex interventions.
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Affiliation(s)
- Linnea Ferm
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark
| | | | - Marie Birk Jørgensen
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100, Copenhagen, Denmark.
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28
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Skela-Savič B, Pesjak K, Hvalič-Touzery S. Low back pain among nurses in Slovenian hospitals: cross-sectional study. Int Nurs Rev 2017; 64:544-551. [PMID: 28444732 DOI: 10.1111/inr.12376] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AIM The study investigated the prevalence and factors predicting low back pain among nurses in Slovenian hospitals. BACKGROUND The risk factors for low back pain are physical and psychosocial. Implementation of interventions for reducing low back pain calls for management support, accessible equipment, education, knowledge and risk assessment. INTRODUCTION Low back pain prevalence and incidence among healthcare workers is very high compared to the general population and is a strong risk factor for long-term sickness absence. METHODS A cross-sectional study design was utilized. We used validated instruments: Nordic Musculoskeletal Disorder Questionnaire, Stanford Presenteeism Scale and Perceived Stress Scale. The sample included 1744 nursing employees from 16 Slovenian hospitals, ranging from practical nurses, registered nurses, nurses with a bachelor's degree and those with a master's degree. FINDINGS Results revealed a prevalence of low back pain among 85.9% of respondents. Relevant risk factors included female gender, age, length of employment, years in current position, shift work and the number of nurses per shift. In the regression model, factors predicting low back pain included presenteeism with a negative effect on work, presenteeism and maintaining work productivity, inability to control daily life, number of nurses per shift and respondents' age. CONCLUSIONS Future activities should be oriented towards eliminating or reducing risks for low back pain incidents and towards different strategies, guidelines and actions which empower individuals and provide knowledge to manage and prevent low back pain. IMPLICATIONS FOR MANAGEMENT AND HEALTH POLICY Slovenian healthcare system planning needs a national strategy to successfully promote LBP preventive and controlling strategies. Management can plan preventive and curative measures to reduce low back pain prevalence among nursing personnel. Management should also implement policies reflecting research findings.
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Affiliation(s)
- B Skela-Savič
- Fakulteta za zdravstvo Angele Boškin/Angela Boškin Faculty of Health Care, Jesenice, Slovenia
| | - K Pesjak
- Fakulteta za zdravstvo Angele Boškin/Angela Boškin Faculty of Health Care, Jesenice, Slovenia
| | - S Hvalič-Touzery
- Fakulteta za zdravstvo Angele Boškin/Angela Boškin Faculty of Health Care, Jesenice, Slovenia
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29
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Rasmussen CDN, Lindberg NK, Ravn MH, Jørgensen MB, Søgaard K, Holtermann A. Processes, barriers and facilitators to implementation of a participatory ergonomics program among eldercare workers. APPLIED ERGONOMICS 2017; 58:491-499. [PMID: 27633246 DOI: 10.1016/j.apergo.2016.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 08/02/2016] [Accepted: 08/08/2016] [Indexed: 06/06/2023]
Abstract
This study aimed to investigate the processes of a participatory ergonomics program among 594 eldercare workers with emphasis on identified risk factors for low back pain and solutions, and reveal barriers and facilitators for implementation. Sixty-nine per cent of the identified risk factors were physical ergonomic, 24% were organisational and 7% were psychosocial risk factors. Most solutions were organisational (55%), followed by physical (43%) and psychosocial solutions (2%). Internal factors (e.g. team or management) constituted 47% of the barriers and 75% of the facilitators. External factors (e.g. time, financial resources, collaboration with resident or relatives) constituted 53% of the barriers and 25% of the facilitators. This study revealed the processes and implementation of a participatory ergonomics program among eldercare workers. The findings can be transferred to workers, workplaces, health and safety professionals, and researchers to improve future participatory ergonomics programs.
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Affiliation(s)
- Charlotte Diana Nørregaard Rasmussen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark; Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
| | - Naja Klærke Lindberg
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Marie Højbjerg Ravn
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - Marie Birk Jørgensen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - Karen Søgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark; Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
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30
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Budhrani-Shani P, Berry DL, Arcari P, Langevin H, Wayne PM. Mind-Body Exercises for Nurses with Chronic Low Back Pain: An Evidence-Based Review. Nurs Res Pract 2016; 2016:9018036. [PMID: 27446610 PMCID: PMC4947504 DOI: 10.1155/2016/9018036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 06/05/2016] [Indexed: 11/29/2022] Open
Abstract
Background. Chronic low back pain (CLBP) among nurses is a growing health concern. The multimodal nature of mind-body exercises has potential to impact physiological and psychological processes associated with chronic pain, affording possible advantages over conventional unimodal therapies. This paper summarizes the prevalence of and risk factors for CLBP among nurses, reviews the effectiveness in treating pain and disability of mind-body exercises (yoga and tai chi) for CLBP among the general and nursing population, and describes implications. Methods. Articles, published during or prior to 2015, were systematically identified through the PubMed/MEDLINE, Web of Science, and ScienceDirect databases using the following search terms: nurses, mind-body, integrative, biopsychosocial, yoga, tai chi, back pain, and/or risk factors. Results. Prevalence estimates of CLBP among nurses ranged from 50% to 80%. Associated risk factors for CLBP included lifestyle and physical, psychological, psychosocial, and occupational factors. No published studies were identified that evaluated yoga or tai chi for nurses with CLBP. Studies in the general population suggested that these interventions are effective in reducing pain and disability and may improve factors/processes predictive of CLBP. Conclusion. This review suggests that evaluating the impact of multimodal interventions such as yoga and tai chi for nurses with CLBP warrants investigation.
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Affiliation(s)
- Pinky Budhrani-Shani
- Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX 77030, USA
- Phyllis F. Cantor Center for Research in Nursing & Patient Care Services, Dana-Farber/Harvard Cancer Center, Boston, MA 02215, USA
| | - Donna L. Berry
- Phyllis F. Cantor Center for Research in Nursing & Patient Care Services, Dana-Farber/Harvard Cancer Center, Boston, MA 02215, USA
| | | | - Helene Langevin
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Peter M. Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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31
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Rasmussen CDN, Holtermann A, Jørgensen MB, Ørberg A, Mortensen OS, Søgaard K. A multi-faceted workplace intervention targeting low back pain was effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence: Stepped wedge cluster randomised trial. Scand J Public Health 2016; 44:560-70. [DOI: 10.1177/1403494816653668] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 11/15/2022]
Abstract
Aims: The aims of this study were to test whether a multi-faceted intervention effective for low back pain was effective for physical capacity, work demands, maladaptive pain behaviours, work ability and sickness absence due to low back pain. Methods: A stepped wedge cluster randomised, controlled trial with 594 nurses’ aides was conducted. The intervention lasted 12 weeks and consisted of physical training (12 sessions), cognitive behavioural training (two sessions) and participatory ergonomics (five sessions). Occupational lifting, fear avoidance, physical exertion, muscle strength, support from management, work ability and sickness absence due to low back pain were measured every 3 months. Before and after the intervention we measured physical capacity, kinesiophobia and need for recovery. Linear mixed models adjusted for baseline values of the outcome were used to estimate the effect. Results: Significant reduction in occupational lifting (–0.35 (95% confidence interval −0.61 to −0.08)), and improvement in two measures of fear avoidance ((–0.75 (95% confidence interval −1.05 to −0.45) and −0.45 (95% confidence interval −0.80 to −0.11)) were found for the intervention group compared to the control. There were no significant effects on physical exertion, muscle strength, support from management, work ability or sickness absence due to low back pain. After the intervention, significant increased physical capacity and improvements in kinesiophobia were found, but no change in need for recovery. Conclusions: The intervention was significantly effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence due to low back pain. To improve work ability or reduce sickness absence due to low back pain more specific interventions should probably be developed.
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Affiliation(s)
- Charlotte Diana Nørregaard Rasmussen
- National Research Centre for the Working Environment, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | | | - Anders Ørberg
- National Research Centre for the Working Environment, Denmark
| | - Ole Steen Mortensen
- National Research Centre for the Working Environment, Denmark
- Department of Occupational Medicine, Holbæk Hospital, Denmark
| | - Karen Søgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
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32
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Barker D, McElduff P, D'Este C, Campbell MJ. Stepped wedge cluster randomised trials: a review of the statistical methodology used and available. BMC Med Res Methodol 2016; 16:69. [PMID: 27267471 PMCID: PMC4895892 DOI: 10.1186/s12874-016-0176-5] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 05/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous reviews have focussed on the rationale for employing the stepped wedge design (SWD), the areas of research to which the design has been applied and the general characteristics of the design. However these did not focus on the statistical methods nor addressed the appropriateness of sample size methods used.This was a review of the literature of the statistical methodology used in stepped wedge cluster randomised trials. METHODS Literature Review. The Medline, Embase, PsycINFO, CINAHL and Cochrane databases were searched for methodological guides and RCTs which employed the stepped wedge design. RESULTS This review identified 102 trials which employed the stepped wedge design compared to 37 from the most recent review by Beard et al. 2015. Forty six trials were cohort designs and 45 % (n = 46) had fewer than 10 clusters. Of the 42 articles discussing the design methodology 10 covered analysis and seven covered sample size. For cohort stepped wedge designs there was only one paper considering analysis and one considering sample size methods. Most trials employed either a GEE or mixed model approach to analysis (n = 77) but only 22 trials (22 %) estimated sample size in a way which accounted for the stepped wedge design that was subsequently used. CONCLUSIONS Many studies which employ the stepped wedge design have few clusters but use methods of analysis which may require more clusters for unbiased and efficient intervention effect estimates. There is the need for research on the minimum number of clusters required for both types of stepped wedge design. Researchers should distinguish in the sample size calculation between cohort and cross sectional stepped wedge designs. Further research is needed on the effect of adjusting for the potential confounding of time on the study power.
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Affiliation(s)
- D Barker
- School of Medicine and Public Health, Faculty of Health, CCEB, HMRI Building, Level 4 West, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - P McElduff
- School of Medicine and Public Health, Faculty of Health, CCEB, HMRI Building, Level 4 West, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - C D'Este
- School of Medicine and Public Health, Faculty of Health, CCEB, HMRI Building, Level 4 West, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, 0200, Australia
| | - M J Campbell
- Medical Statistics Group, ScHARR, University of Sheffield, Sheffield, UK
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Kraaijeveld RA, Schaafsma FG, Ketelaar SM, Boot CRL, Bültmann U, Anema JR. Implementation of the participatory approach for supervisors to prevent sick leave: a process evaluation. Int Arch Occup Environ Health 2016; 89:847-56. [PMID: 26970753 PMCID: PMC4871914 DOI: 10.1007/s00420-016-1118-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 01/25/2016] [Indexed: 11/29/2022]
Abstract
Purpose To perform a process evaluation of a multifaceted strategy to implement the participatory approach for supervisors to prevent sick leave in three organisations. Methods The implementation strategy incorporated a working group meeting with stakeholder representatives, supervisor training, and optional supervisor coaching. Context, recruitment, reach, dose delivered, dose received, fidelity, and satisfaction with the strategy were assessed at organisational and supervisor level using questionnaires and registration forms. Results At least 4 out of 6 stakeholders were represented in the working group meetings, and 11 % (n = 116) of supervisors could be reached. The working group meetings and supervisor training were delivered and received as planned and were well appreciated within all three organisations. Three supervisors made use of coaching. At 6-month follow-up, 11 out of 41 supervisors (27 %) indicated that they had applied the participatory approach at least one time. Conclusion The implementation strategy was largely carried out as intended. However, reach of both supervisors and department managers should be improved. Future studies should consider targeting employees with the strategy.
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Affiliation(s)
- R A Kraaijeveld
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - F G Schaafsma
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. .,Research Center for Insurance Medicine, Collaboration Between AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands.
| | - S M Ketelaar
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - C R L Boot
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,Body@Work, Research Center Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands
| | - U Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J R Anema
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,Research Center for Insurance Medicine, Collaboration Between AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
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Bantoft C, Summers MJ, Tranent PJ, Palmer MA, Cooley PD, Pedersen SJ. Effect of Standing or Walking at a Workstation on Cognitive Function: A Randomized Counterbalanced Trial. HUMAN FACTORS 2016; 58:140-149. [PMID: 26408647 DOI: 10.1177/0018720815605446] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 08/18/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE In the present study, we examined the effect of working while seated, while standing, or while walking on measures of short-term memory, working memory, selective and sustained attention, and information-processing speed. BACKGROUND The advent of computer-based technology has revolutionized the adult workplace, such that average adult full-time employees spend the majority of their working day seated. Prolonged sitting is associated with increasing obesity and chronic health conditions in children and adults. One possible intervention to reduce the negative health impacts of the modern office environment involves modifying the workplace to increase incidental activity and exercise during the workday. Although modifications, such as sit-stand desks, have been shown to improve physiological function, there is mixed information regarding the impact of such office modification on individual cognitive performance and thereby the efficiency of the work environment. METHOD In a fully counterbalanced randomized control trial, we assessed the cognitive performance of 45 undergraduate students for up to a 1-hr period in each condition. RESULTS The results indicate that there is no significant change in the measures used to assess cognitive performance associated with working while seated, while standing, or while walking at low intensity. CONCLUSION These results indicate that cognitive performance is not degraded with short-term use of alternate workstations.
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Affiliation(s)
| | | | - Peter J Tranent
- University of Tasmania, Launceston, AustraliaUniversity of the Sunshine Coast, Queensland, AustraliaUniversity of Tasmania, Launceston, Australia
| | - Matthew A Palmer
- University of Tasmania, Launceston, AustraliaUniversity of the Sunshine Coast, Queensland, AustraliaUniversity of Tasmania, Launceston, Australia
| | - P Dean Cooley
- University of Tasmania, Launceston, AustraliaUniversity of the Sunshine Coast, Queensland, AustraliaUniversity of Tasmania, Launceston, Australia
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Jay K, Friborg MK, Sjøgaard G, Jakobsen MD, Sundstrup E, Brandt M, Andersen LL. The Consequence of Combined Pain and Stress on Work Ability in Female Laboratory Technicians: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15834-42. [PMID: 26690466 PMCID: PMC4690960 DOI: 10.3390/ijerph121215024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 12/02/2015] [Accepted: 12/08/2015] [Indexed: 11/16/2022]
Abstract
Musculoskeletal pain and stress-related disorders are leading causes of impaired work ability, sickness absences and disability pensions. However, knowledge about the combined detrimental effect of pain and stress on work ability is lacking. This study investigates the association between pain in the neck-shoulders, perceived stress, and work ability. In a cross-sectional survey at a large pharmaceutical company in Denmark 473 female laboratory technicians replied to questions about stress (Perceived Stress Scale), musculoskeletal pain intensity (scale 0-10) of the neck and shoulders, and work ability (Work Ability Index). General linear models tested the association between variables. In the multi-adjusted model, stress (p < 0.001) and pain (p < 0.001) had independent main effects on the work ability index score, and there was no significant stress by pain interaction (p = 0.32). Work ability decreased gradually with both increased stress and pain. Workers with low stress and low pain had the highest Work Ability Index score (44.6 (95% CI 43.9-45.3)) and workers with high stress and high pain had the lowest score (32.7 (95% CI 30.6-34.9)). This cross-sectional study indicates that increased stress and musculoskeletal pain are independently associated with lower work ability in female laboratory technicians.
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Affiliation(s)
- Kenneth Jay
- Department of Physical Activity and Health, Institute for Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense 5230, Denmark.
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark.
| | | | - Gisela Sjøgaard
- Department of Physical Activity and Health, Institute for Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense 5230, Denmark.
| | - Markus Due Jakobsen
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark.
| | - Emil Sundstrup
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark.
| | - Mikkel Brandt
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark.
- Physical Activity and Human Performance group, SMI Department of Health Science and Technology, Aalborg University, Aalborg 9220, Denmark.
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Copenhagen 2100, Denmark.
- Physical Activity and Human Performance group, SMI Department of Health Science and Technology, Aalborg University, Aalborg 9220, Denmark.
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Organizing workplace health literacy to reduce musculoskeletal pain and consequences. BMC Nurs 2015; 14:46. [PMID: 26388697 PMCID: PMC4574516 DOI: 10.1186/s12912-015-0096-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 09/04/2015] [Indexed: 11/21/2022] Open
Abstract
Background Despite numerous initiatives to improve the working environment for nursing aides, musculoskeletal disorders (pain) is still a considerable problem because of the prevalence, and pervasive consequences on the individual, the workplace and the society. Discrepancies between effort and effect of workplace health initiatives might be due to the fact that pain and the consequences of pain are affected by various individual, interpersonal and organizational factors in a complex interaction. Recent health literacy models pursue an integrated approach to understanding health behavior and have been suggested as a suitable framework for addressing individual, organizational and interpersonal factors concomitantly. Therefore, the aim of the trial is to examine the effectiveness of an intervention to improve health literacy (building knowledge, competences and structures for communication and action) at both the organizational and individual level and reduce pain among nursing aides. Methods/design The intervention consists of 2 steps: 1) Courses at the workplace for employees and management in order to organize a joint fundament of knowledge and understanding, and a platform for communication and action about pain prevention in the organization. 2) Organizing a fixed 3-weekly structured dialogue between each employee and her/his supervisor, with particular focus on developing specific plans to prevent and reduce pain and its consequences. This enables the workplace to generate knowledge about employee resources and health challenges and to act and convey this knowledge into initiatives at the workplace. Discussion Previous studies to improve health literacy have primarily targeted patients or specific deprived groups in health care or community settings. Recently the idea of the workplace as an arena for improving health literacy has developed emphasizing the organizational responsibility in facilitating and supporting that employees obtain basic knowledge and information needed to understand and take action on individual and occupational health concerns. The literature about workplace health literacy is very limited but points at the importance of educating employees to be able to access, appraise and apply health information and of organizing the infrastructure and communication in the organization. This study suggests a concrete operationalization of health literacy in a workplace setting. Results are expected published in 2016.
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Rasmussen CDN, Holtermann A, Bay H, Søgaard K, Birk Jørgensen M. A multifaceted workplace intervention for low back pain in nurses' aides: a pragmatic stepped wedge cluster randomised controlled trial. Pain 2015; 156:1786-1794. [PMID: 25993549 PMCID: PMC4617291 DOI: 10.1097/j.pain.0000000000000234] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 05/06/2015] [Accepted: 05/07/2015] [Indexed: 11/25/2022]
Abstract
This study established the effectiveness of a workplace multifaceted intervention consisting of participatory ergonomics, physical training, and cognitive-behavioural training (CBT) for low back pain (LBP). Between November 2012 and May 2014, we conducted a pragmatic stepped wedge cluster randomised controlled trial with 594 workers from eldercare workplaces (nursing homes and home care) randomised to 4 successive time periods, 3 months apart. The intervention lasted 12 weeks and consisted of 19 sessions in total (physical training [12 sessions], CBT [2 sessions], and participatory ergonomics [5 sessions]). Low back pain was the outcome and was measured as days, intensity (worst pain on a 0-10 numeric rank scale), and bothersomeness (days) by monthly text messages. Linear mixed models were used to estimate the intervention effect. Analyses were performed according to intention to treat, including all eligible randomised participants, and were adjusted for baseline values of the outcome. The linear mixed models yielded significant effects on LBP days of -0.8 (95% confidence interval [CI], -1.19 to -0.38), LBP intensity of -0.4 (95% CI, -0.60 to -0.26), and bothersomeness days of -0.5 (95% CI, -0.85 to -0.13) after the intervention compared with the control group. This study shows that a multifaceted intervention consisting of participatory ergonomics, physical training, and CBT can reduce LBP among workers in eldercare. Thus, multifaceted interventions may be relevant for improving LBP in a working population.
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Affiliation(s)
- Charlotte Diana Nørregaard Rasmussen
- National Research Centre for the Working Environment, Copenhagen Ø, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen Ø, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Hans Bay
- National Research Centre for the Working Environment, Copenhagen Ø, Denmark
| | - Karen Søgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
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Beard E, Lewis JJ, Copas A, Davey C, Osrin D, Baio G, Thompson JA, Fielding KL, Omar RZ, Ononge S, Hargreaves J, Prost A. Stepped wedge randomised controlled trials: systematic review of studies published between 2010 and 2014. Trials 2015; 16:353. [PMID: 26278881 PMCID: PMC4538902 DOI: 10.1186/s13063-015-0839-2] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 07/01/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In a stepped wedge, cluster randomised trial, clusters receive the intervention at different time points, and the order in which they received it is randomised. Previous systematic reviews of stepped wedge trials have documented a steady rise in their use between 1987 and 2010, which was attributed to the design's perceived logistical and analytical advantages. However, the interventions included in these systematic reviews were often poorly reported and did not adequately describe the analysis and/or methodology used. Since 2010, a number of additional stepped wedge trials have been published. This article aims to update previous systematic reviews, and consider what interventions were tested and the rationale given for using a stepped wedge design. METHODS We searched PubMed, PsychINFO, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Web of Science, the Cochrane Library and the Current Controlled Trials Register for articles published between January 2010 and May 2014. We considered stepped wedge randomised controlled trials in all fields of research. We independently extracted data from retrieved articles and reviewed them. Interventions were then coded using the functions specified by the Behaviour Change Wheel, and for behaviour change techniques using a validated taxonomy. RESULTS Our review identified 37 stepped wedge trials, reported in 10 articles presenting trial results, one conference abstract, 21 protocol or study design articles and five trial registrations. These were mostly conducted in developed countries (n = 30), and within healthcare organisations (n = 28). A total of 33 of the interventions were educationally based, with the most commonly used behaviour change techniques being 'instruction on how to perform a behaviour' (n = 32) and 'persuasive source' (n = 25). Authors gave a wide range of reasons for the use of the stepped wedge trial design, including ethical considerations, logistical, financial and methodological. The adequacy of reporting varied across studies: many did not provide sufficient detail regarding the methodology or calculation of the required sample size. CONCLUSIONS The popularity of stepped wedge trials has increased since 2010, predominantly in high-income countries. However, there is a need for further guidance on their reporting and analysis.
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Affiliation(s)
- Emma Beard
- Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - James J Lewis
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Andrew Copas
- MRC Clinical Trials Unit at University College London, 175 Tottenham Court Road, London, W1T 7NU, UK.
| | - Calum Davey
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - David Osrin
- Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
| | - Gianluca Baio
- Department of Statistical Science, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Jennifer A Thompson
- MRC Clinical Trials Unit at University College London, 175 Tottenham Court Road, London, W1T 7NU, UK.
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Katherine L Fielding
- MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Rumana Z Omar
- Department of Statistical Science, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Sam Ononge
- Department of Obstetrics and Gynaecology, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
| | - James Hargreaves
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Audrey Prost
- Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
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Prevost V, Delorme C, Grach MC, Chvetzoff G, Hureau M. Therapeutic Education in Improving Cancer Pain Management: A Synthesis of Available Studies. Am J Hosp Palliat Care 2015; 33:599-612. [PMID: 25991567 DOI: 10.1177/1049909115586394] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This literature review aims to synthesize available studies and to update findings in order to obtain a current, comprehensive estimate of the benefits of pain education. Forty-four original articles obtained from the PubMed database were analyzed to investigate which protocols could be most effective in improving pain management. Recent studies indicate a growing interest in evaluating patients' skills and attitudes; these include satisfaction with cancer pain treatment, patient-reported improvement, and patient participation-all of which could be dependable benchmarks for evaluating the effectiveness of educational programs. Besides pain measurement, recent studies advance support for the importance of assessing newly developed outcome criteria. In this sense, patients' active participation and decision making in their pain management are probably the most relevant goals of pain education.
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Affiliation(s)
- Virginie Prevost
- INSERM U1086, Cancers et Préventions and Université de Caen Basse-Normandie EA 3936, Caen, France Centre Régional de Lutte Contre le Cancer François Baclesse, Caen, France
| | - Claire Delorme
- Centre Régional de Lutte Contre le Cancer François Baclesse, Caen, France Centre d'Etude et de Traitement de la Douleur et Réseau Régional Douleur en Basse-Normandie, Bayeux, France
| | | | - Gisèle Chvetzoff
- Centre Régional de Lutte Contre le Cancer Léon Bérard, Lyon, France
| | - Magalie Hureau
- Centre Régional de Lutte Contre le Cancer Léon Bérard, Lyon, France Direction de la Recherche Clinique et de l'Innovation, Centre Léon Bérard, Lyon, France
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Lundberg G, Gerdle B. The relationships between pain, disability, and health-related quality of life: an 8-year follow-up study of female home care personnel. Disabil Rehabil 2015; 38:235-44. [PMID: 25864984 DOI: 10.3109/09638288.2015.1035459] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE To investigate the development of pain conditions, disability, and health-related quality of life over an 8-year period in home care personnel. METHOD In earlier studies of 607 women, we reported baseline data concerning home care personnel. This study reports the results from an 8-year follow-up using a postal questionnaire. RESULTS The questionnaire was completed by 87%. Prevalences of pain in upper back, lower back, and knees as well as pain intensity of the low back had decreased. Participants with the highest pain intensities of the low back at baseline had relatively lower pain intensities at follow-up. Anatomical spreading of pain was associated with higher average pain intensity. Disability had increased significantly during the time period. In the regression of disability at follow-up, average pain intensity together with disability rating index at baseline were the most important regressors; a similar pattern was found for quality of life. CONCLUSIONS The development of disability differed from that of low-back pain intensity. Spreading of pain and pain intensity across the anatomical regions influenced disability and quality of life over 8 years. When assessing pain, it seems important to determine the spread of pain rather than just focusing on the area with intense pain. IMPLICATIONS FOR REHABILITATION Spreading of pain and the average intensity of pain across the involved anatomical regions have importance for future pain and disability and quality of life. The clinical assessment of subjects with chronic pain prior to rehabilitation interventions has to determine the spreading of pain rather than just focusing on the area with the most intense pain. The different developments over time for pain intensity and disability indicate the need for applying a bio-psycho-social view of pain both when assessing the patient with pain and when discussing the prognosis and course of the actual pain condition with the patient.
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Affiliation(s)
- Gunnar Lundberg
- a Department of Pain and Rehabilitation Centre and.,b Department of Medical and Health Sciences (IMH), Faculty of Health Sciences , Linköping University , Linköping , Sweden
| | - Björn Gerdle
- a Department of Pain and Rehabilitation Centre and.,b Department of Medical and Health Sciences (IMH), Faculty of Health Sciences , Linköping University , Linköping , Sweden
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Gupta N, Wåhlin-Jacobsen CD, Henriksen LN, Abildgaard JS, Nielsen K, Holtermann A. A participatory physical and psychosocial intervention for balancing the demands and resources among industrial workers (PIPPI): study protocol of a cluster-randomized controlled trial. BMC Public Health 2015; 15:274. [PMID: 25886354 PMCID: PMC4378265 DOI: 10.1186/s12889-015-1621-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 03/08/2015] [Indexed: 11/26/2022] Open
Abstract
Background Need for recovery and work ability are strongly associated with high employee turnover, well-being and sickness absence. However, scientific knowledge on effective interventions to improve work ability and decrease need for recovery is scarce. Thus, the present study aims to describe the background, design and protocol of a cluster randomized controlled trial evaluating the effectiveness of an intervention to reduce need for recovery and improve work ability among industrial workers. Methods/Design A two-year cluster randomized controlled design will be utilized, in which controls will also receive the intervention in year two. More than 400 workers from three companies in Denmark will be aimed to be cluster randomized into intervention and control groups with at least 200 workers (at least 9 work teams) in each group. An organizational resources audit and subsequent action planning workshop will be carried out to map the existing resources and act upon initiatives not functioning as intended. Workshops will be conducted to train leaders and health and safety representatives in supporting and facilitating the intervention activities. Group and individual level participatory visual mapping sessions will be carried out allowing team members to discuss current physical and psychosocial work demands and resources, and develop action plans to minimize strain and if possible, optimize the resources. At all levels, the intervention will be integrated into the existing organization of work schedules. An extensive process and effect evaluation on need for recovery and work ability will be carried out via questionnaires, observations, interviews and organizational data assessed at several time points throughout the intervention period. Discussion This study primarily aims to develop, implement and evaluate an intervention based on the abovementioned features which may improve the work environment, available resources and health of industrial workers, and hence their need for recovery and work ability.
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Affiliation(s)
- Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | | | | | | | - Karina Nielsen
- Norwich Business School, University of East Anglia, Norwich, UK.
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.
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Jay K, Brandt M, Sundstrup E, Schraefel M, Jakobsen MD, Sjøgaard G, Andersen LL. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain, stress and work ability among laboratory technicians: randomized controlled trial protocol. BMC Musculoskelet Disord 2014; 15:444. [PMID: 25519844 PMCID: PMC4325961 DOI: 10.1186/1471-2474-15-444] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 12/15/2014] [Indexed: 12/03/2022] Open
Abstract
Background Among laboratory technicians, the prevalence of neck and shoulder pain is widespread possibly due to typical daily work tasks such as pipetting, preparing vial samples for analysis, and data processing on a computer including mouse work - all tasks that require precision in motor control and may result in extended periods of time spent in static positions. In populations characterized by intense chronic musculoskeletal pain and diagnosed conditions in conjunction with psycho-physiological symptoms such as stress-related pain and soreness and other disabling conditions, multifactorial approaches applying a combination of individually tailored physical and cognitive strategies targeting the areas most needed, may be an effective solution to the physical and mental health challenges. The aim of this study is therefore to investigate the effect of an individually tailored biopsychosocial intervention strategy on musculoskeletal pain, stress and work disability in lab technicians with a history of musculoskeletal pain at a single worksite in Denmark. Methods/design In this single-blind two-armed parallel-group randomized controlled trial with allocation concealment, participants receive either an individualized multifactorial intervention or “usual care” for 10 weeks at the worksite. Inclusion criteria: 1) female laboratory technician (18-67 years of age) and 2) Pain intensity ≥ 3 (0-10 Visual Analogue Scale) lasting ≥3 months with a frequency of ≥ 3 days per week in one or more of the following regions: i) upper back i) low back iii) neck, iv) shoulder, v) elbow and/or vi) hand. Exclusion criteria: 1) life-threatening disease and 2) pregnancy. Stress, as measured by Cohen´s perceived stress questionnaire is not an inclusion criteria, thus participants can participate regardless of their stress level. We will implement an individualized intervention addressing biopsychosocial elements of musculoskeletal pain with the following components; i) increasing physical capacity through strength- and motor control training; ii) lowering or preventing development of stress through mindfulness practice and learning de-catastrophizing pain management strategies through cognitive training. The primary outcome at 10-week follow-up is the between-group difference in intensity of perceived musculoskeletal pain during the last week (average value of back, neck, shoulder, elbow and hand) assessed by questionnaire (modified visual analogue scale 0-10). Discussion This study will provide experimental evidence to guide workplace initiatives designed towards reducing chronic musculoskeletal pain and stress. Trial registration number ClinicalTrials.gov NCT02047669. Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-444) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kenneth Jay
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, Denmark.
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Hemming K, Lilford R, Girling AJ. Stepped-wedge cluster randomised controlled trials: a generic framework including parallel and multiple-level designs. Stat Med 2014; 34:181-96. [PMID: 25346484 PMCID: PMC4286109 DOI: 10.1002/sim.6325] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 09/10/2014] [Accepted: 09/20/2014] [Indexed: 11/27/2022]
Abstract
Stepped-wedge cluster randomised trials (SW-CRTs) are being used with increasing frequency in health service evaluation. Conventionally, these studies are cross-sectional in design with equally spaced steps, with an equal number of clusters randomised at each step and data collected at each and every step. Here we introduce several variations on this design and consider implications for power. One modification we consider is the incomplete cross-sectional SW-CRT, where the number of clusters varies at each step or where at some steps, for example, implementation or transition periods, data are not collected. We show that the parallel CRT with staggered but balanced randomisation can be considered a special case of the incomplete SW-CRT. As too can the parallel CRT with baseline measures. And we extend these designs to allow for multiple layers of clustering, for example, wards within a hospital. Building on results for complete designs, power and detectable difference are derived using a Wald test and obtaining the variance–covariance matrix of the treatment effect assuming a generalised linear mixed model. These variations are illustrated by several real examples. We recommend that whilst the impact of transition periods on power is likely to be small, where they are a feature of the design they should be incorporated. We also show examples in which the power of a SW-CRT increases as the intra-cluster correlation (ICC) increases and demonstrate that the impact of the ICC is likely to be smaller in a SW-CRT compared with a parallel CRT, especially where there are multiple levels of clustering. Finally, through this unified framework, the efficiency of the SW-CRT and the parallel CRT can be compared.
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Affiliation(s)
- Karla Hemming
- Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, U.K
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Rasmussen CDN, Larsen AK, Holtermann A, Søgaard K, Jørgensen MB. Adoption of workplaces and reach of employees for a multi-faceted intervention targeting low back pain among nurses' aides. BMC Med Res Methodol 2014; 14:60. [PMID: 24885476 PMCID: PMC4021388 DOI: 10.1186/1471-2288-14-60] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 04/22/2014] [Indexed: 11/14/2022] Open
Abstract
Background Workplace adoption and reach of health promotion are important, but generally poorly reported. The aim of this study is therefore to evaluate the adoption of workplaces (organizational level) and reach of employees (individual level) of a multi-faceted workplace health promotion and work environment intervention targeting low back pain among nurses’ aides in elderly care. Methods Percentage of adopters was calculated among eligible workplaces and differences between adopters and non-adopters were evaluated through workplace registrations and manager questionnaires from all eligible workplaces. From the adopted workplaces reach was calculated among eligible employees as the percentage who responded on a questionnaire. Responders were compared with non-responders using data from company registrations. Among responders, comparisons based on questionnaire data were performed between those consenting to participate in the intervention (consenters) and those not consenting to participate in the intervention (non-consenters). Comparisons were done using Student's t-test for the continuous variables, Fisher's exact test for dichotomous variables and the Pearson’s chi2 for categorical variables. Moreover odds ratios for non-responding and non-consenting were investigated with binary logistic regression analyses. Results The project was adopted by 44% of the offered workplaces. The main differences between adopters and non-adopters were that workplaces adopting the intervention had a more stable organization as well as a management with positive beliefs of the intervention’s potential benefits. Of eligible employees, 71% responded on the questionnaire and 57% consented to participate. Non-responders and non-consenters did not differ from the responders and consenters on demographic factors and health. However, more non-responders and non-consenters were low skilled, worked less than 30 hours pr. week, and worked evening and nightshift compared to responders and consenters, respectively. Consenters had more musculoskeletal pain and reduced self-rated health, as well as higher physical exertion during work compared to non-consenters. Conclusions Our recruitment effort yielded a population of consenters that was representative of the target population of nurses’ aides with respect to demographic factors, and health. Moreover more consenters had problems like pain and high physical exertion during work, which fitted the scope of the intervention. Trial registration The study is registered as ISRCTN78113519.
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