Frequency and severity of low back pain in nurses working in intensive care units and influential factors

Low Back Pain and Its Risk Factors Among Nurses Working in East Bale, Bale, and West Arsi Zone Government Hospitals, Oromia Region, South East Ethiopia, 2021 -Multicenter Cross-Sectional Study

Background

Hospital nursing staff are particularly susceptible to low back pain (LBP) a widespread health issue worldwide. There was little available data on the prevalence of LBP and risk factors related to it in this population.

Objective

Assessed the prevalence of LBP and risk factors in nurses working in South-East Ethiopia's Oromia region in the East Bale, Bale, and West Arsi zone government hospitals.

Methods

A cross-sectional study was carried out within an institution in the East Bale, Bale, and West Arsi zone government hospitals; 440 nurses were chosen to use a process of systematic random sampling, and data was gathered between June 1 and July 30, 2021. Using pre-designed questionnaires, I interrogated participants. After being verified as complete, the gathered data was entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. Bi variate and multivariate logistic regressions with 95% confidence intervals and crude and adjusted odd ratios were generated and interpreted as necessary. To deem a result statistically significant, a p-value of 0.05 or lower was required.

Results

A total of 427 nurses engaged in the interview out of the 440 participants that wanted to take part in the study, yielding a response rate of 97.1%. Low back pain was 42.6% more common over a year [95% CI: (0.384, 0.476)]. According to the multivariate analysis, females [AOR = 1.791; 95% CI: (1.121, 2.861)], age higher than forty [AOR=2.388, 95% CI: (1.315, 4.337)], age grouped 31-40 years [(AOR=2.064, 95% CI: 1.233, 3.455)], divorced [(AOR=10.288, 95% CI: (3.063, 34.553)], married [(AOR=1.676 (1.675, 16.999)].

Conclusion

The study suggests that implementing preventive measures and offering ergonomic training can help reduce LBP among nurses in these hospitals.

Prevalence and Determinants of Work-Related Injuries Among Healthcare Workers in Jeddah, Saudi Arabia

Background and objective Work-related injuries (WRIs) are a major occupational health issue among healthcare workers (HCWs) worldwide. Unsafe work environments, including physical, chemical, and biological hazards, are significant contributing factors to WRIs. However, the prevalence of WRIs among HCWs in Jeddah, Saudi Arabia, and their associated risk factors remain largely unexplored. In light of this, this study aimed to investigate the prevalence of WRIs and associated risk factors among HCWs in Jeddah, Saudi Arabia. Methods This was an analytic cross-sectional study conducted at secondary hospitals of the Ministry of Health (MOH) in Jeddah by using a self-administered questionnaire to measure the prevalence of WRIs and their related factors. The Chi-squared test was used to compare variables. A p-value <0.05 was considered statistically significant. Results The study involved 387 participants, of whom 283 (73.1%) were female. Most of the participants (n=226, 58.4%) agreed that personal protective equipment (PPE) was always available at their hospitals. Approximately two-thirds (n=251, 64.9%) agreed that they always used PPE. The overall prevalence of WRIs was 52%, with back injuries (32.6%), eye/mouth splashes (20.4%), and needle stick injuries (19.9%) being the most common. Years of work experience (p=0.014), type of profession (p<0.001), training in safety management (p=0.028), working hours (p=0.0001), working shifts (p=0.001), PPE availability (p=0.010), and sharp container availability (p=0.030) were significantly associated with WRIs. Conclusion This study revealed a high prevalence of WRIs among HCWs in Jeddah, Saudi Arabia, with back injuries, eye/mouth splashes, and needle stick injuries being the most common types. The study also found that the injuries were significantly associated with the type of profession, experience, work hours, and shifts as well as the availability of safety management and equipment such as sharp containers and PPE.

Association of Low Back Pain with Shift Work: A Meta-Analysis

Shift work (SW) is the main working schedule worldwide, and it may cause sleep disorders, breast cancer, and cardiovascular disease. Low back pain (LBP) is a common problem in the workplace; however, the association between LBP and SW remains unclear. Therefore, we conducted a meta-analysis to determine the association between SW and LBP. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, and Web of Science databases using a set of associated keywords were queried. The inclusion criteria were as follows: (1) adult employees hired by a company or organization; (2) SW exposure; and (3) the outcome of LBP according to examination or assessment. A total of 40 studies were included that met the inclusion criteria for the meta-analysis. SW was significantly associated with LBP (odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.18−1.47, p < 0.00001). Furthermore, it was observed that LBP was significantly associated with night shift (NS) (OR: 1.49, 95% CI: 1.24−1.82, p < 0.0001) but not with rotating shift (RS) (OR: 0.96, 95% CI: 0.76−1.22, p = 0.49). Moreover, LBP was significantly associated with SW in health care workers (HCWs) (OR: 1.40, 95% CI: 1.20−1.63, p < 0.0001) but not in non-HCWs (OR: 1.19, 95% CI: 0.94−1.50, p = 0.14). SW was significantly associated with LBP. Furthermore, the subgroup analysis showed that NS, but not RS, was associated with LBP. Compared with SW in non-HCWs, SW in HCWs was significantly associated with LBP.

Promoting behavior-related low back health in nurses by in-person and social media interventions in the workplace

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.

Musculoskeletal Disorders and Caring Behaviors among Nursing Staff in Greek Hospitals: a Prospective Multicenter Study

Introduction:Care delivery from nursing staff to patients in hospital environment may involve the exertion of considerable muscular force and, as a result, there is a consequent risk of developing musculoskeletal disorders (MSDs). The aim of this prospective study was to investigate the relationship between reported MSDs and perceived caring behaviors among nursing staff. Methods: A total of 250 questionnaires were completed in three Greek hospitals during February and March 2019. The Nordic Musculoskeletal Questionnaire for the evaluation of MSDs and the Caring Behaviors Inventory-24 (CBI-24) for the assessment of caring behaviors were used. Results:A total of 185 participants (74%) were found to have at least one MSD. Back (64.3%), neck (63.2%) and shoulder (58.4%) pain were the most commonly reported MSDs. The mean score on the CBI-24 scale was 5.06 (SD=0.51) and the mean "Connectedness" dimension was 4.59 (SD=0.74). Elbow MSDs were significantly associated with the lowest score in the "Knowledge and skills" dimension (p=0.024) and the lowest overall nursing score (p=0.048). Linear regression analysis showed that the lowest nursing care score was associated with left-handed nurses (p=0.008) of low hierarchical position (p=0.013), suffering from elbow MSDs (p=0.002), for which they did not seek treatment (p=0.023). Participants who continued to work on a regular basis despite MSDs showed a lower score on the dimensions of "Respectful" (p=0.05) and "Connectedness" (p=0.01). Conclusion:The nursing staff showed high percentage of MSDs that negatively affected their perceived dimensions of caring behaviors. These findings could be used to prevent and deal with work-related MSDs, reduce occupational hazards and improve hospital patient care.

Non-specific Low Back Pain Among Nurses in Qassim, Saudi Arabia

Introduction

Non-specific low back pain (LBP) is a complex and multifactorial health problem. Evidence has shown that LBP is an important occupational hazard and nurses are particularly at high risk. While several studies have addressed the prevalence of LBP worldwide, the prevalence of LBP in Saudi Arabia remains unclear. In this study, we aimed to estimate the prevalence and associated factors of LBP among nurses in the Qassim region, Saudi Arabia.

Methods

This was a multicenter cross-sectional study carried out in four major public hospitals in the Qassim region. A total of 323 nurses were recruited through a two-stage sampling method. A previously validated questionnaire was used to gather data. The main outcome measures were; LBP prevalence during working life, demographic factors, lifestyle factors, work-related factors, and psychological factors. Multivariable logistic regression analysis was used to determine factors independently associated with LBP. 

Results

The study showed that LBP prevalence was 65.6% (n=212). Over one-third of the study, participants sought treatment for LBP (n=82, 38.7%). Age and the type of ward were found significantly associated with LBP [adjusted odds ratios (aOR): 0.39; 95% confidence interval (CI): 0.19, 0.77; p value=0.007] & (aOR: 0.36; 95% CI: 0.15, 0.86; p-value =0.02), respectively. However, gender, working hours, number of patients, stress, and smoking were not identified as LBP risk factors in this study.

Conclusion

The findings of this study suggest that LBP is a highly prevalent occupational health problem among nurses in Qassim. Young nurses 20-30 years are more likely to suffer from LBP, while nurses working in the general surgery wards have a lower risk for LBP in this study. On-the-job training is essential particularly for new and young nurses on proper body mechanics when mobilizing patients or lifting heavy equipment. In addition, there is a need for evidence-based interventions to improve the workplace environment for nurses in hospitals in order to lower LBP prevalence.

Magnitude and associated factors of low back pain among nurses working at intensive care unit of public hospitals in Amhara region, Ethiopia

Background

Low back pain is a common public health problem throughout the world with a global prevalence from 28% to 86%. Nurses working in intensive care units are handling people who are critically ill and helpless, which requires more assistance for transferring and handling activities. This possesses a risk for low back pain but little is known about it in Ethiopia. This study aimed to assess the magnitude of low back pain and associated factors among nurses who work at intensive care units in Amhara region public hospitals, North Ethiopia.

Methods

A multi-centered institution-based cross-sectional study was conducted at Amhara region public hospitals from March 1-30, 2020. A simple random sampling technique after proportional allocation was used to select the study participants. Data were collected using a standard modified Nordic musculoskeletal assessment tool. After data were checked for completeness and consistency, it was entered into Epidata version 3.1 and exported to Statistical Package for Social Science software version 26 for analysis. Descriptive statistics were computed. A binary logistic regression model was used to identify factors associated with low back pain. Finally, those variables with a p-value of <0.05 in multivariable analysis were considered statistically significant.

Result

Study was conducted among 412 intensive care unit nurses giving a response rate of 97.6%. The magnitude of low back pain was 313 (76%) [95% CI: (71.6%-79.9%)]. Being female [AOR = 2.674 (1.404, 5.076)], unavailability of assistive device for patient handling [AOR = 2.139 (1.035, 4.410)], lack of training on intensive care [AOR = 2.017 (1.092, 3.943)], lack of regular exercise [AOR = 2.164 (1.164, 4.108)] and job stress [AOR = 3.66 (1.955, 6.498)] were factors significantly associated with low back pain.

Conclusions

In this study the magnitude of low back pain was high. Being female, unavailability of an assistive device for patient handling, lack of training on intensive care, lack of regular exercise and job stress were factors associated with low back pain. Policymakers and concerned bodies should emphasize the accessibility of assistive devices for patient care, provision of training on intensive care, and adaptive working environment for intensive care unit nurses.

Low back pain and its related risk factors in health care providers at hospitals: A systematic review

Background

Health care personnel are exposed to ergonomic hazards, musculoskeletal disorders, and other work-related injuries. Low back pain is the most common musculoskeletal disorder. The aim of this study was to determine the prevalence of low back pain and the risk factors in health care personnel at the hospital in a form of a systematic review and meta-analysis.

Methods

In this systematic review and meta-analysis, the articles published in international electronic databases including Web of Knowledge, Embase, Scopus, PubMed were searched until May 2019. We included cohort, case-control and cross-sectional studies estimate the prevalence and risk factors for low back pain in health personnel. Data were analyzed using Stata-14 software and random effect model at 95% confidence level.

Findings

154 studies were included in the study for analysis. The estimated lifetime prevalence of lower back pain in health care personnel was 54.8%. The estimated odds ratios were as follows: age 1.23, female gender 1.11, BMI 1.17, lack of regular physical activity 1.56 occupational factors 1.12, patient related factors 1.24, body position at work 2.55, and stress 1.67.

Conclusions

/application to practice: The prevalence of low back pain in health care personnel is high. Body position at work, stress and lack of physical activity were the strongest risk factors, respectively. Future studies and educational programs are required to reduce the incidence of low back pain in health care personnel.

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Health care personnel are exposed to ergonomic hazards, musculoskeletal disorders.

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Low back pain is the most common musculoskeletal disorder.

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The prevalence of low back pain in health care personnel is high.

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Body position at work, stress and lack of physical activity were the strongest risk factors.

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Future studies and educational programs are required to reduce the incidence of low back pain.

A Diagnostic Assistant Tool for Work-Related Low Back Pain in Hospital Workers

Aims:

The study objective was to develop a clinical risk score to assist occupational medicine physicians in diagnosing hospital workers’ occupational lower back pain (LBP).

Settings and Design:

A cross-sectional data collection design was conducted at Saraburi Hospital, Thailand.

Methods and Materials:

The sample consisted of 220 hospital workers who cared for patients and had LBP. They were assessed for the frequency of targeted activities (CPR, lifting, transferring patients) and other activities from work as well as ergonomic assessments, and diagnosed with LBP by three occupational medicine physicians.

Statistical Analysis Used:

Predicted factors of multivariable logistic regression were analysed to find clinical risk scores to help the diagnosis.

Results:

The physicians agreed on the diagnosis, based on ergonomic risk factors and their experiences that 86 persons have occupational LBP. A diagnostic assistant tool consists of six predictors: the duration of LBP, having LBP within the last 7 days, bending, twisting, lateral bending, and reaching. The scores predicted occupational LBP correctly with an AuROC of 90.0% (95% CI; 84.8–93.5%). The positive likelihood ratio for occupational LBP was 0 in the low risk category (<6 points) and 16.8 (95% CI; 8.0–35.6) in the high risk (>8 points).

Conclusions:

A diagnostic assistant tool is used to assist occupational medicine physicians in diagnosing hospital workers' occupational LBP.

Prevalence and influencing factors of low back pain among nurses in China: a systematic review and meta-analysis

Background

Low back pain (LBP) is one of the most common occupational injuries that nurses experience in their daily work, which ultimately causes disability or difficulty in performing heavy physical activity. There is scarce information that presents a direct figure about the prevalence of LBP in Chinese nurses.

Objective

To systematically review and analyze the prevalence and influencing factors of LBP among nurses in China.

Methods

Related literature extracted from PubMed, Web of Science, Scopus, China National Knowledge Infrastructure databases were selected and reviewed based on the PRISMA guideline. Random effects models were used for data analysis, where heterogeneity was tested through I2. Egger's test was used to analyze the literature publication bias.

Results

The combined data indicated that the prevalence of LBP among nurses in China was 78% [95% confidence interval (CI) = 0.72–0.83]. The prevalence of LBP among nurses in China has declined in the past decade. Nurses presented a high risk of LBP in terms of female (OR = 2.38, 95% CI = 1.23–3.44, P < 0.0001), married (OR = 2.79, 95% CI = 1.57–3.86, P < 0.0001), 24 ≤ BMI < 28 (OR = 2.03, 95% CI = 1.18–3.08, P < 0.0001), and working for more than ten >10 years (OR = 2.54, 95% CI = 2.03–3.32, P < 0.0001).

Conclusions

There is a high prevalence of LBP among nurses in China. Interventions that include healthy dietary habits and physical activity mainly focusing on female married nurses who are working for at least 10 years should be implemented. Furthermore, nurses ought to apply ergonomic principles for personal protection at the workplace.

Differences between fixed day shift nurses and rotating and irregular shift nurses in work-related musculoskeletal disorders: A literature review and meta-analysis

OBJECTIVES

Work-related musculoskeletal disorders (WMSDs) are common occupational injuries for nurses. Furthermore, rotating and irregular shift work may exacerbate muscle tension and pain in nurses. The objective of this study was to examine the differences between fixed day shift (FDS) nurses and rotating and irregular shift (RS + IS) nurses in WMSDs using a systematic literature review and meta-analysis.

METHODS

Databases including PubMed, CINAHL, Cochrane Library, EBSCOhost, and Google Scholar were searched for relevant studies published between 2010 and 2020 using the target keywords.

RESULTS

This study obtained data on a total of 18 199 nurses, among which 12 786 comprised the RS + IS group and 5413 constituted the FDS group. The result of the heterogeneity test was Q = 79.27 (P < .001) and I squared = 57.11%, indicating that heterogeneity existed among the studies. Subgroup analyses were also conducted with four groups: neck pain (n = 1818), shoulder and upper limb pain (n = 2525), back pain (n = 11 962), and hip and lower limb pain (n = 1894). Significant differences were found between the RS + IS group and the FDS group with regard to back pain, with the forest plot presenting an odds ratio equaling 1.40 (95% CI: 1.19-1.64, P < .001).

CONCLUSIONS

This meta-analysis indicated that RS + IS nurses are more likely to experience back pain associated with WMSD than are FDS nurses. The results can serve as a reference to the clinical management for work improvement and thereby reduce or prevent the adverse effects of rotating and irregular shift work on back pain experienced by nurses.

Evaluation of the occurrence of work-related musculoskeletal pain among anesthesiology, intensive care, and surgical nurses: An observational and descriptive study

Clinical nurses can encounter musculoskeletal pain episodes stemming from regular exposure to workplace risk factors that contribute to overloads. This study aimed to evaluate the occurrence and location of work‐related musculoskeletal pain among Polish nurses. An observational and descriptive survey study was conducted among 136 nurses working in the anesthesiology, intensive care, and surgery units. An extended version of the Nordic Musculoskeletal Questionnaire was used to investigate musculoskeletal pain. Only 8% of the participating nurses experienced no musculoskeletal pain, while 85% suffered from pain in more than one location. The lower back (67%), upper back (59%), and neck (66%) were the most common pain locations. In summary, nurses experienced multiple musculoskeletal pain episodes, occurring most frequently in the spinal region (lower and upper back and neck). It is crucial to determine the real causes of musculoskeletal pain and to take appropriate preventive measures to improve workplace ergonomics.

Analysis of Selected Body Composition Parameters and Ergonomic Safety among Professionally Active Nurses in Poland: A Preliminary Prospective Monocentric and Observational Study

Nurses consist of an occupational group that is particularly exposed to harmful work-related factors such as prolonged working hours, severe stress, fatigue, and excessive strain on the musculoskeletal system. According to nurses, the limitation of the application of ergonomic principles of work may contribute to the occurrence of numerous dangerous behaviors, improper eating habits, or deficiency of systematic physical activity. The most common consequences are nutritional disorders and musculoskeletal system dysfunctions. This prospective observational study was aimed at evaluating selected parameters of the body composition of professionally active nurses and at determining work-related risks during nursing activities. The study group consisted of 37 active nurses (38.38 ± 11.33 years). The research tool was a device for bioelectrical impedance analysis (BIA). A questionnaire designed by the authors was also implemented, which covered ergonomic principles, musculoskeletal injuries, and nutritional habits. In the present study, it was shown that all average values of the tested nurses' body composition parameters were within the normal range. The majority of respondents (97.3%) reached a high level of body water. A statistically significant correlation was found between the knowledge of the workplace ergonomic principles and body mass index. In conclusion, musculoskeletal pain and lack of implementation of ergonomic behaviors are a significant problem among nurses, which may be the cause of overweight or obesity in this occupational group.

Low Back Pain and Its Associated Factors among Nurses in Public Hospitals of Penang, Malaysia

Objectives: To determine the prevalence of low back pain (LBP) and its associated factors among the nurses working in the public hospitals of Penang, Malaysia. Methods: A cross-sectional study was conducted on nurses, aged 25–60 years, who had been working for at least three months at six public hospitals of Penang. A proportionate stratified random sampling method was applied to select 1292 respondents. The Malay-validated BACKS Tool questionnaire using a 5-point Likert scale was used to obtain data. Simple and multiple logistic regression analyses were performed. Results: A total of 989 (76.5%) nurses suffered from LBP at a point of time. The factors significantly associated with LBP among the nurses included working more than seven hours [adjusted odds ratio (AOR) (95% confidence interval (CI)) 1.48 (1.06, 1.98)], twisting of the body while working [AOR (95% CI) 1.60 (1.13, 2.26)], manual handling of patients in wards [AOR (95% CI) 1.44 (1.08, 2.07)], and fatigue [AOR (95% CI) 2.63 (1.94, 3.58)]. Conclusion: The prevalence of LBP among the nurses in the public hospitals of Penang was relatively high. The factors predicting LBP included working more than seven hours a day, twisting of the body while working, manual handling, and fatigue. The findings from this study may better enable policymakers to devote resources to minimize low back pain among nurses. The nurses should be encouraged to comply with safe working procedures.

Effectiveness of the back school program on the low back pain and functional disability of Iranian nurse

Low back pain (LBP) as a recurrent and costly health problem and one of the leading causes of disability, is common in nurses. It can have adverse effects on the quality of life of nurses and quality of care of patients. The aim of the study was to evaluate the effectiveness of Back School program on the LBP and functional disability of Iranian nurses. A quasi-experimental methodological design was utilized for this study. Participants were nurses with back pain who participated in the Back School program workshop and completed a self-report visual analogue scales and Roland–Morris Disability questionnaire that measuring LBP and functional disability. Data were analyzed descriptively and comparisons in LBP and functional disability made between groups with t-test for pre-intervention and analysis of covariance for after intervention. Sixty-four participants (16 males, 48 females) completed this survey. The study participants’ mean age was 38.9 ± 8.1 years in intervention group and 38.1 ± 8.2 in control group. There were no significant differences in terms of pain (P = 0.575) and disability scores (P = 0.844) before intervention. Although, the intervention led to a decrease in the functional ability and LBP scores of the nurses (P<0.001) in the intervention group compared with that in the control group. Overall, Back School program as an educational strategy can reduce the LBP and functional disability in nurses. This program can be suitable for preventing of pain and functional disability among nurses working in hospital settings.

Pain-related factors associated with lost work days in nurses with low back pain: A cross-sectional study

Background and aims

Chronic low back pain is known to contribute to lost work days (LWDs) in nurses. However, there is a limited understanding of the factors that moderate the impact of low back pain (LBP) on LWDs – in particular factors that are modifiable and that could therefore be the treatment targets of interventions designed to help nurses more effectively manage LBP.

This study aims to identify pain-related factors that are associated with LWDs in nurses with LBP, in order to inform the development of interventions that could reduce LBP-related work dysfunction and improve patient care.

Methods

A cross sectional study was conducted on 111 female nurses who were asked to answer questions regarding demographic information, work history, presence or absence of LBP, number of LWDs due to illness, and a number of factors that could potentially be related to LWDs including: (1) average and worst pain intensity; (2) the temporal pattern of LBP (constant versus intermittent); (3) pain aggravating factors (lifting, bending, walking, and standing); and (4) pain alleviating factors (medications, rest, exercise).

Results

Sixty-five percent (n = 72) of the sample reported LBP. Constancy of pain and having a LBP problem that was alleviated by rest were significantly associated with the number of LWDs, while maximum and average LBP intensity were only weakly associated.

Conclusion

The findings provide important new information regarding whatis (and of equal importance) what is not associated with LWDs in nurses with LBP.

Implications

To effectively reduce LBP-related work disability, interventions may need to teach nurses how to better manage constant pain and remain active despite pain, rather than focus on pain reduction. Research to examine the potential efficacy of such treatment approaches for nurses with LBP is warranted.