Effects of intervention program for systematic use of transfer equipment on care workers' low back pain in elderly care facilities

[Factors affecting quality of working life among caregivers in care facilities for the elderly]

OBJECTIVE

The shortage of caregivers in care facilities has become a problem in Japan. Building a comfortable workplace and improving the quality of working life (QWL) of caregivers are essential. However, the factors of QWL that should be prioritized remain unclear. The purpose of this study was to identify the major factors currently affecting the QWL of caregivers in care facilities for the elderly and recognize the priorities that should be addressed.

METHODS

A questionnaire survey targeting administrators and caregivers working in care facilities for the elderly was conducted from October to December in 2018. In total, 1,000 care facilities located throughout Japan were selected via random sampling. Eight caregivers who differed by sex, age, and years of experience were selected from each facility (a total of 8,000 caregivers). A logistic regression analysis was used to analyze the association between QWL and the factors affecting it.

RESULTS

Ultimately, data from 504 facilities and 3,478 caregivers were included in the analysis. Human relationships (OR: 3.92, 95% CI: 3.09-4.97) had the highest odds ratio in terms of caregivers' QWL, followed by the number of workers (OR: 3.69, 95% CI: 2.56-5.32), communication (OR: 3.42, 95% CI: 2.66-4.40), support from the facility (OR: 3.37, 95% CI: 2.69-4.23), working hours or time off (OR: 3.20, 95% CI: 2.53-4.04), and discretion of responsibility level (OR: 3.09, 95% CI: 2.46-3.88). In contrast, salary (OR: 2.81, 95% CI: 2.19-3.61) was associated with QWL but the association was lower than that of human relationships and the other factors. Lower back pain among caregivers was also associated with QWL.

CONCLUSIONS

Findings of this study show that improvement in human relationships is the primary factor for improved QWL among caregivers in care facilities. Thus, it should be prioritized. Secondary factors that affect QWL are the number of workers, communication, support from the facility, working hours or time off, and discretion of responsibility level. Considering the reasons for caregivers' dissatisfaction, improving their QWL requires promoting the exchange of information with superiors and colleagues. It also involves consulting with persons in charge about working hours, time off, and mental health. Salary is related to QWL but is less important than the aforementioned factors. The prevention of lower back pain, however, contributes to improving QWL.

Effectiveness of re-education based on appropriate care methods using welfare equipment on the prevention of low back pain among care workers: a 1.5 year follow-up study

Many care workers at elderly care facilities in Japan suffer occupational low back pain (LBP) despite the utilization of welfare equipment. When introducing welfare equipment such as hoists and sliding boards, education on appropriate care methods using welfare equipment is usually conducted, but the effect of education diminishes with time. This intervention study aimed to examine the effect of re-education on appropriate care methods using welfare equipment on the prevention of care workers' LBP at an elderly care facility. At the intervention facility, 49 care workers were enrolled in ergonomic education program for 1.5 yr in order to improve care methods using welfare equipment. At the non-intervention facility, 33 care workers were not enrolled in the program. Rates of severe LBP were not significantly different between the facilities. However, during the study period, the rate of severe LBP among care workers did not increase at the intervention facility, while it doubled among care workers at the non-intervention facility. The care workers at the intervention facility showed improvement in care methods using welfare equipment during the study period. Hence, we think that re-education regarding appropriate care methods using welfare equipment has the potential to prevent exacerbation of LBP.