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Soler-Font M, Aznar-Lou I, Almansa J, Peña P, Silva-Peñaherrera M, Serra C, Ramada JM. Cost-Effectiveness of a Multi-faceted Workplace Intervention to Reduce Musculoskeletal Pain in Nursing Staff: A Cluster-Randomized Controlled Trial (INTEVAL_Spain). JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10227-6. [PMID: 39102106 DOI: 10.1007/s10926-024-10227-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/12/2024] [Indexed: 08/06/2024]
Abstract
PURPOSE To evaluate the cost-effectiveness of a multifaceted workplace intervention to reduce musculoskeletal pain (MSP) in nursing staff. METHODS The study was a 1-year cluster-randomized controlled trial. The intervention combined participatory ergonomics, health promotion, and case management. The control group received usual care. Societal and health system perspectives were used. Costs included direct health and indirect costs. The effects were MSP and quality-adjusted life years (QALYs). MSP was measured using the Standardized Nordic Questionnaire at baseline and 6- and 12-month follow-up. QALYs were measured using the EuroQol-5D-3L at 6- and 12-month follow-up. Incremental costs and QALYs were modelled using generalized linear models. MSP was analysed through generalized logistic models. Incremental cost-effectiveness ratios (ICERs) were calculated, and cost-effectiveness planes and acceptability curves were constructed. RESULTS Total mean costs per person were €614 and €216 for the intervention and control group, respectively, with a societal perspective. The intervention mean cost was €38/person. From the societal perspective, the ICER showed that overall additional €68 (€9 from a health system perspective) were required to achieve 1-extra-percentage-point reduction of MSP. ICERs were €34 from the societal and €4 from the health system perspectives for neck, shoulders and upper back pain; €53 and €7 for low back; €179 and €23 for hands; €39 and €5 for legs; €115 and €14 for the knees; €36 and €5 for feet For MSP in the elbows. For participants with pain in the elbow, and for QALYs, the ICER showed that the intervention group was dominated by the control group. CONCLUSION This intervention was not cost-effective in terms of QALYs. However, in terms of MSP, with a willingness to pay of €100, the probability of the intervention being cost-effective was around 90%. Further studies incorporating our recommendations are needed to confirm these findings. STUDY REGISTRATION ISRCTN15780649, retrospectively registered.
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Affiliation(s)
- Mercè Soler-Font
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Ignacio Aznar-Lou
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Josué Almansa
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Pilar Peña
- Occupational Health Service, Consorci Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Michael Silva-Peñaherrera
- Centre for Research in Occupational Health, University Pompeu Fabra/Hospital del Mar Research Institute, Edifici PRBB (campus del Mar), Doctor Aiguader, 8808003, Barcelona, Spain
| | - Consol Serra
- CIBER of Epidemiology and Public Health, Madrid, Spain.
- Centre for Research in Occupational Health, University Pompeu Fabra/Hospital del Mar Research Institute, Edifici PRBB (campus del Mar), Doctor Aiguader, 8808003, Barcelona, Spain.
- Occupational Health Service, Hospital del Mar, Barcelona, Spain.
| | - José Maria Ramada
- CIBER of Epidemiology and Public Health, Madrid, Spain
- Centre for Research in Occupational Health, University Pompeu Fabra/Hospital del Mar Research Institute, Edifici PRBB (campus del Mar), Doctor Aiguader, 8808003, Barcelona, Spain
- Occupational Health Service, Hospital del Mar, Barcelona, Spain
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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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Fadel M, Roquelaure Y, Descatha A. Interventions on Well-being, Occupational Health, and Aging of Healthcare Workers: A Scoping Review of Systematic Reviews. Saf Health Work 2023; 14:135-140. [PMID: 36941932 PMCID: PMC10024230 DOI: 10.1016/j.shaw.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/12/2022] [Accepted: 12/12/2022] [Indexed: 12/25/2022] Open
Abstract
Introduction With recent higher awareness of the necessity of improving healthcare workers' well-being, we aimed to overview systematic reviews dealing with interventions on well-being, occupational health, and aging of healthcare workers. Methods From three databases (PubMed, Embase, and Web of Science), a scoping review of systematic reviews was carried out to determine current knowledge on interventions focused on the well-being or aging of healthcare workers. Only systematic reviews were considered, with appropriate extraction and quality evaluation. Results Of the total of 445 references identified, 10 systematic reviews were included, mostly published since 2019. Nurses were the most frequent targets of interventions, and mental health was the main outcome described. The overall level of quality was also heterogenous, with high to low-quality reviews. Conclusions Workers' mental health well-being was the major outcome targeted by intervention, with varying level of evidence. Further studies are needed with integrative approaches on global health and life course perspectives, with a focus on the plurality of settings, worker types, and women.
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Affiliation(s)
- Marc Fadel
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, Angers, France
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, Angers, France
| | - Alexis Descatha
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, Angers, France
- Department of Occupational Medicine, Epidemiology and Prevention, Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, USA
- Corresponding author. Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, IRSET-ESTER, SFR ICAT, CAPTV CDC, Angers, France
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Kazemi SS, Tavafian SS, Hiller CE, Hidarnia A, Montazeri A. Promoting behavior-related low back health in nurses by in-person and social media interventions in the workplace. BMC Nurs 2022; 21:271. [PMID: 36199140 PMCID: PMC9535867 DOI: 10.1186/s12912-022-01045-3] [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: 03/14/2022] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nurses are put at high risk of work-related low back pain due to the nature of their work. The aim of this study was to develop and evaluate intervention based on the PRECEDE-PROCEED Model on promoting behaviors of low back health via two educational approaches. METHODS This study was a community randomized-controlled clinical trial. The educational content was developed with six modules: knowledge, attitude, self-efficacy, reinforcing factors, enabling factors, and behavior. Intervention was delivered by two modes: (1) in-person (n = 60) and (2) social media (n = 60). Data were evaluated by a self-designed questionnaire at baseline, 3, and 6 months. Baseline comparisons between groups were made with Mann-Whitney U Test and T-Test. Comparison of change scores between groups and two delivery types across the three time periods used the mixed between-within subject analysis of variance. RESULTS A total of 120 nurses received the allocated intervention. All educational component scores increased at 3-months in both groups. At the 6-month follow-up scores increased for enabling factors and behavior in the intervention group, while in the control group all scores increased except for attitude. Based on Bonferroni Post hoc analysis social media was more effective in knowledge, self-efficacy, reinforcing factors, and behavior than the in-person intervention. CONCLUSION An educational program for low back health based on the PRECEDE-PROCEED model proved effective at improving all components. However, social media was more successful than in-person in the maintenance of behavior over the long term. TRIAL REGISTRATION IRCT20170313033054N2: 25-02-2018. https://www.irct.ir/trial/25598.
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Affiliation(s)
- Seyedeh-Somayeh Kazemi
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Sedigheh-Sadat Tavafian
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Claire E Hiller
- School of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Alireza Hidarnia
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Montazeri
- Faculty of Humanity Sciences, University of Sciences & Culture, ACECR, Tehran, Iran.,Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
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Does Postural Feedback Reduce Musculoskeletal Risk?: A Randomized Controlled Trial. SUSTAINABILITY 2022. [DOI: 10.3390/su14010583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: There is a high prevalence of musculoskeletal disorders among personnel working in the healthcare sector, mainly among nursing assistants and orderlies. Objective: The objective is to analyze the effectiveness of a multi-component intervention that included postural feedback in reducing musculoskeletal risk. Method: A total of 24 nursing assistants and orderlies in a hospital setting were randomly assigned to an intervention group or a control group. After collecting sociodemographic information, a selection of tasks was made and assessed using the REBA (rapid entire body assessment) method. A multi-component intervention was designed combining theoretical and practical training, including feedback on the postures performed by the professionals involved, especially those involving high musculoskeletal risk. This program was applied only to participants in the intervention group. Subsequently, eight months after the first assessment and intervention, the second assessment was carried out using the same method and process as in the first evaluation. Results: The results indicate that the musculoskeletal risk in the second assessment in the intervention group was significantly reduced. However, no significant changes were observed in the control group. Conclusion: The multi-component intervention applied can significantly reduce the musculoskeletal risk of nursing assistants and orderlies. In addition, it is a low-cost intervention with great applicability.
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Soler-Font M, Ramada JM, Montero-Moraga JM, Palencia-Sánchez F, Merelles A, Macdonald EB, Serra C. What is meant by case management for the return-to-work of workers with musculoskeletal disorders? A scoping review. Work 2021; 70:1069-1087. [PMID: 34842208 DOI: 10.3233/wor-205172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Case management interventions have shown to be effective to prevent musculoskeletal pain and disability, but a single definition has not been achieved, nor an agreed profile for case managers. OBJECTIVE To describe the elements that define case management and case managers tasks for return-to-work of workers with musculoskeletal disorders (MSDs). METHODS A comprehensive computerized search of articles published in English until February 16, 2021 was carried out in several bibliographic databases. Grey literature was obtained through a search of 13 key websites. A peer-review screening of titles and abstracts was carried out. Full text in-depth analysis of the selected articles was performed for data extraction and synthesis of results. RESULTS We identified 2,422 documents. After full-text screening 31 documents were included for analysis. These were mostly European and North American and had an experimental design. Fifteen documents were published between 2010 to 2021 and of these 7 studies were published from 2015. Fifteen elements were identified being the commonest "return-to-work programme" (44.4%) and "multidisciplinary assessment/interdisciplinary intervention" (44.4%). Of 18 tasks found, the most frequent was "establishing goals and planning return-to-work rehabilitation" (57.7%). Eighteen referral services were identified. CONCLUSIONS Despite there were several elements frequently reported, some elements with scientific evidence of their importance to deal with MSDs (e.g. early return-to-work) were almost not mentioned. This study proposes key points for the description of case management and case managers tasks.
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Affiliation(s)
- Mercè Soler-Font
- Center for Research in Occupational Health (CiSAL), University Pompeu Fabra - Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain
| | - José Maria Ramada
- Center for Research in Occupational Health (CiSAL), University Pompeu Fabra - Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain.,Occupational Health Service, Parc de Salut Mar, Barcelona, Spain
| | - José Maria Montero-Moraga
- Public Health and Preventive Medicine Training Unit, Parc de Salut Mar, University Pompeu Fabra - Public Health Agency of Barcelona, Barcelona, Spain
| | - Francisco Palencia-Sánchez
- Departamento de Medicina Preventiva y Social, Facultad de Medicina, Pontificia Universidad Javerina, Bogotá, Colombia
| | - Antoni Merelles
- Center for Research in Occupational Health (CiSAL), University Pompeu Fabra - Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Nursing Department, Nursing and Podiatry Faculty, University of Valencia, Valencia, Spain
| | | | - Consol Serra
- Center for Research in Occupational Health (CiSAL), University Pompeu Fabra - Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain.,Occupational Health Service, Parc de Salut Mar, Barcelona, Spain
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7
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Soler-Font M, Ramada JM, Merelles A, Amat A, de la Flor C, Martínez O, Palma-Vasquez C, Sancho C, Peña P, Bültmann U, van Zon SKR, Serra C. Process evaluation of a complex workplace intervention to prevent musculoskeletal pain in nursing staff: results from INTEVAL_Spain. BMC Nurs 2021; 20:189. [PMID: 34615522 PMCID: PMC8493695 DOI: 10.1186/s12912-021-00716-x] [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: 05/12/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background INTEVAL_Spain was a complex workplace intervention to prevent and manage musculoskeletal pain among nursing staff. Process evaluations can be especially useful for complex and multifaceted interventions through identifying the success or failure factors of an intervention to improve the intervention implementation. Objectives This study performed a process evaluation of INTEVAL_Spain and aimed to examine whether the intervention was conducted according to the protocol, to investigate the fulfilment of expectations and the satisfaction of workers. Methods The intervention was a two-armed cluster randomized controlled trial and lasted 1 year. The process evaluation included quantitative and qualitative methods. Quantitative methods were used to address the indicators of Steckler and Linnan’s framework. Data on recruitment was collected through a baseline questionnaire for the intervention and the control group. Reach and dose received were collected through participation sheets, dose delivered and fidelity through internal registries, and fulfilment of expectations and satisfaction were collected with two questions at 12-months follow-up. Qualitative methods were used for a content analysis of discussion groups at the end of the intervention led by an external moderator to explore satisfaction and recommendations. The general communication and activities were discussed, and final recommendations were agreed on. Data were synthesized and results were reported thematically. Results The study was performed in two Spanish hospitals during 2016-2017 and 257 workers participated. Recruitment was 62 and 51% for the intervention and the control group, respectively. The reach of the activities ranged from 96% for participatory ergonomics to 5% for healthy diet. The number of sessions offered ranged from 60 sessions for Nordic walking to one session for healthy diet. Fidelity of workers ranged from 100% for healthy diet and 79% for participatory ergonomics, to 42 and 39% for Nordic walking and case management, respectively. Lowest fidelity of providers was 75% for case management and 82% for Nordic walking. Fulfilment of expectations and satisfaction ranged from 6.6/10 and 7.6/10, respectively, for case management to 10/10 together for the healthy diet session. Discussion groups revealed several limitations for most of the activities, mainly focused on a lack of communication between the Champion (coordinator) and the workers. Conclusions This process evaluation showed that the implementation of INTEVAL_Spain was predominantly carried out as intended. Process indicators differed depending on the activity. Several recommendations to improve the intervention implementation process are proposed. Trial registration ISRCTN15780649. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00716-x.
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Affiliation(s)
- Mercè Soler-Font
- Center for Research in Occupational Health, University Pompeu Fabra/ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain
| | - José Maria Ramada
- Center for Research in Occupational Health, University Pompeu Fabra/ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain.,Occupational Health Service, Parc de Salut Mar, Barcelona, Spain
| | - Antoni Merelles
- Nursing Department, Nursing and Podiatry Faculty, University of Valencia, Valencia, Spain
| | - Anna Amat
- Center for Research in Occupational Health, University Pompeu Fabra/ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Carmen de la Flor
- Center for Research in Occupational Health, University Pompeu Fabra/ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Olga Martínez
- Center for Research in Occupational Health, University Pompeu Fabra/ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Claudia Palma-Vasquez
- Center for Research in Occupational Health, University Pompeu Fabra/ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Consuelo Sancho
- Occupational Health Service, Parc de Salut Mar, Barcelona, Spain
| | - Pilar Peña
- Occupational Health Service, Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sander K R van Zon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Consol Serra
- Center for Research in Occupational Health, University Pompeu Fabra/ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. .,CIBER of Epidemiology and Public Health, Madrid, Spain. .,Occupational Health Service, Parc de Salut Mar, Barcelona, Spain.
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Kazemi S, Tavafian S, Hiller CE, Hidarnia A, Montazeri A. The effectiveness of social media and in-person interventions for low back pain conditions in nursing personnel (SMILE). Nurs Open 2021; 8:1220-1231. [PMID: 33905171 PMCID: PMC8046039 DOI: 10.1002/nop2.738] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/28/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022] Open
Abstract
AIM To compare two educational approaches to reduce low back pain in nurses. DESIGN A community randomized controlled clinical trial. METHODS Data were collected with two interventions and a control arm between August 2018 and January 2019. Participants were recruited from three hospitals. Hospital 1 received an in-person educational programme, Hospital 2 received via the website and Hospital 3 received nothing. Statistical analysis was carried out with a follow-up of 3 and 6 months. RESULTS A total of 180 female nurses with low back pain participated in the study. Dimensions of the quality of life improved over 3 and 6 months, pain and disability decreased over 3 months in both intervention groups and over 6 months in the social media group. CONCLUSION Two educational approaches can be effective in decreasing pain, disability and improving quality of life. However, the findings suggest that the social media approach was more successful over the long-term and might be a better way to present the programme.
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Affiliation(s)
- Seyedeh‐Somayeh Kazemi
- Department of Health Education & Health PromotionFaculty of Medical SciencesTarbiat Modares UniversityTehranIran
| | - Sedigheh‐Sadat Tavafian
- Department of Health Education & Health PromotionFaculty of Medical SciencesTarbiat Modares UniversityTehranIran
| | - Claire E. Hiller
- Faculty of Health SciencesSchool of PhysiotherapyUniversity of SydneySydneyNSWAustralia
| | - Alireza Hidarnia
- Department of Health Education & Health PromotionFaculty of Medical SciencesTarbiat Modares UniversityTehranIran
| | - Ali Montazeri
- Health Metrics Research CenterIranian Institute for Health Sciences ResearchACECRTehranIran
- Faculty of Humanity SciencesUniversity of Sciences & CultureACECRTehranIran
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Soler-Font M, Ramada JM, van Zon SKR, Almansa J, Bültmann U, Serra C. Multifaceted intervention for the prevention and management of musculoskeletal pain in nursing staff: Results of a cluster randomized controlled trial. PLoS One 2019; 14:e0225198. [PMID: 31738798 PMCID: PMC6860418 DOI: 10.1371/journal.pone.0225198] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/28/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Nurses and nursing aides are at high risk of developing musculoskeletal pain (MSP). This study aimed to evaluate a multifaceted intervention to prevent and manage MSP in two hospitals. MATERIAL AND METHODS We performed a two-armed cluster randomized controlled trial, with a late intervention control group. Clusters were independent hospital units with nursing staff as participants. The intervention comprised three evidence-based components: participatory ergonomics, health promotion activities and case management. Both the intervention and the control group received usual occupational health care. The intervention lasted one year. MSP and work functioning data was collected at baseline, six and 12-month follow-up. Odds ratios (OR) and their 95% confidence intervals (95%CI) were calculated for MSP risk in the intervention group compared to the control group using logistic regression through GEE. Differences in work functioning between the intervention and control group were analyzed using linear regression through GEE. The incidence of sickness absence was calculated through logistic regression and Cox proportional hazard modeling was used to analyze the effect of the intervention on sickness absence duration. RESULTS Eight clusters were randomized including 473 nurses and nursing aides. At 12 months, the intervention group showed a statistically significant decrease of the risk in neck, shoulders and upper back pain, compared to the control group (OR = 0.37; 95%CI = 0.14-0.96). A reduction of low back pain was also observed, though non statistically significant. We found no differences regarding work functioning and the incidence and duration of sickness absence. CONCLUSIONS The intervention was effective to reduce neck, shoulder and upper back pain. Our results, though modest, suggests that interventions to prevent and manage MSP need a multifactorial approach including the three levels of prevention, and framed within the biopsychosocial model.
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Affiliation(s)
- Mercè Soler-Font
- Center for Research in Occupational Health, University Pompeu Fabra/ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
| | - José Maria Ramada
- Center for Research in Occupational Health, University Pompeu Fabra/ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
- Occupational Health Service, Parc de Salut Mar, Barcelona, Spain
| | - Sander K. R. van Zon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Josué Almansa
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Consol Serra
- Center for Research in Occupational Health, University Pompeu Fabra/ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
- Occupational Health Service, Parc de Salut Mar, Barcelona, Spain
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