Non-specific low back pain and its relation to the nursing work process

The prevalence and risk factors of work-related musculoskeletal disorders among nurses in China: A systematic review and meta-analysis

BACKGROUND

Work-related musculoskeletal disorders significantly impact the job performance and quality of life of nursing personnel in China, necessitating an understanding of their prevalence and risk factors to enhance occupational health and improve medical safety.

OBJECTIVE

To systematically evaluate the prevalence and risk factors of work-related musculoskeletal disorders among clinical nurses in China.

DESIGN

Systematic literature review and meta-analysis.

METHODS

A computerized search was conducted on databases, including the China Knowledge Resource Integrated Database, Wanfang Database, China Biomedical Literature Database, Weipu Database, Embase, PubMed, Web of Science, the Cochrane Library, and CINAHL, covering studies from inception to February 28, 2024, addressing the risk factors for work-related musculoskeletal disorders among clinical nursing professionals in China. The meta-analysis was performed using Review Manager 5.4 and Stata 14 software.

RESULTS

The analysis included 23 articles, involving a total of 21,042 cases, and revealed a prevalence rate of 79 % (95 % CI: 73 %-84 %) for work-related musculoskeletal disorders among clinical nursing staff in China. Subgroup analysis revealed that the prevalence of work-related musculoskeletal disorders was highest among those with length of service >15 years, at 87 %; the 31-40 age group had a higher prevalence than other age groups, at 85 %; female nurses exhibited a prevalence rate of 80 %, surpassing male nurses at 77 %, while surgical nurses had a higher prevalence rate (83 %) than those in other departments. The most affected body parts were the neck (58 %), waist (57 %), shoulders (49 %), and back (35 %). Identified risk factors for work-related musculoskeletal disorders among clinical nurses in China included age >35 years (OR = 1.69, 95 % CI: 1.16-2.45), length of service ≥10 years (OR = 3.30, 95 % CI: 1.84-5.92), marital status (married) (OR = 2.19, 95 % CI: 1.91-2.50), heavy workload (OR = 2.46, 95 % CI: 1.25-4.83), weekly work hours >40 h (OR = 1.50, 95 % CI: 1.34-1.67), daily work hours >8 h (OR = 1.71, 95 % CI: 1.32-2.21), strong sense of work fatigue (OR = 1.47, 95 % CI: 1.22-1.76), and high night shift frequency (OR = 1.81, 95 % CI: 1.62-2.02). Regular physical exercise was found to be a protective factor (OR = 0.68, 95 % CI: 0.56-0.82).

CONCLUSION

The overall prevalence of work-related musculoskeletal disorders among clinical nursing staff in China was 79 %. Age >35 years, length of service ≥10 years, marital status (married), heavy workload, weekly work hours >40 h, daily work hours >8 h, strong sense of work fatigue, and night shift frequency were identified as risk factors. Nursing administrators and staff can take proactive measures against the aforementioned factors to reduce the risk of illness and ensure the safety of medical care.

REGISTRATION

PROSPERO: CRD42023479433.

Disclosing Strain: How Psychosocial Risk Factors Influence Work-Related Musculoskeletal Disorders in Healthcare Workers Preceding and during the COVID-19 Pandemic

Healthcare workers, particularly nurses, engage in a daily work routine that takes a toll on their emotional well-being, rendering them vulnerable to psychosocial risk factors. This research seeks to analyse the influence of psychosocial risk factors on the occurrence of work-related musculoskeletal disorders among nurses. An additional analysis was performed to understand the role of age in work-related musculoskeletal disorders and the perception of psychosocial risk factors. The study was conducted during two separate periods-pre-pandemic and pandemic times-involving a sample of 456 nurses from both public and private hospitals in Portugal. The INSAT-Health and Work Survey-was used as measuring instrument. The primary observations indicated a consistency between psychosocial risk factors and the occurrence of work-related musculoskeletal disorders. The findings revealed a significant exposure to psychosocial risk factors, with work pace, intensity, work relationships, and emotional demands exhibiting higher global average percentages during both periods, pre-pandemic and pandemic. Nonetheless, we find that the psychosocial risk factors change when we analyse the pre-pandemic and pandemic results. During the period before the pandemic, the psychosocial risk factors that were most commonly reported included the demanding pace of work, long working hours, and emotional demands. Through the pandemic, the most pronounced psychosocial risk factors were work relationships, employment relationships, and ethical and values conflicts. Therefore, research in this domain is essential to understanding psychosocial risk factors and assessing the less obvious links between work and health.

Effects of an eight-week physical exercise program on low back pain and function in fruit workers: A randomized controlled trial

BACKGROUND

Low back pain is prevalent in workers' health and functional performance.

OBJECTIVE

To evaluate the effects of a physical exercise program on low back pain and disability in fruit workers.

METHODS

This randomized controlled trial assigned 44 workers (37 ± 9 years) to two groups. The experimental group consisted of 10 men and 12 women with an average age of 38 (± 9) years, and the control group consisted of 8 men and 14 women with an average age of 36 (± 10) years. The experimental group (EG) performed a program of strength and flexibility exercises for eight weeks, twice a week. The control group (CG) received minimal care, with a booklet with guidelines for performing exercises. The primary outcomes included changes in perceived disability and the intensity of pain evaluated by the Rolland-Morris questionnaire and the Numerical Pain Scale, respectively. All outcomes were measured at baseline and after eight weeks of intervention.

RESULTS

A significant difference was observed in the within-group analysis, with a mean reduction in pain intensity in the EG and CG of -4.55 (95%CI -7.01 to -2.09) and -3.81 (95%CI 1.72-5.90), respectively. For disability, a reduction of -4.45 (95% CI -8.89 to -0.02) was observed in the EG and of -4.43 (-7.38 to -1.48) in the CG. There were no significant differences in the between-groups analysis.

CONCLUSIONS

The exercise program was not superior to using the educational booklet. However, both interventions showed substantial decreases in pain and disability levels.

Quality of Work Life and Work Process of Assistance Nurses

Background: The concept of Quality of Work Life (QWL) has been built multidimensionally through social reproduction; it is impacted by the perceptions of each individual and by the relationship between workers and the work environment. Objective: to analyze the Work Process and QWL of assisting nurses in public health. Methods: Research in a critical paradigm, descriptive, exploratory with a qualitative approach. The population corresponds to nurses who work in care work. Semi-structured guiding questions were applied and were analyzed with content analysis. Results: seven participants declared female; all Chilean; seven are young adults; six singles; only one has children, and one has a person dependent on her care; six are heads of household, and five receive help with housework. All have a nursing degree, five have a diploma, but none have a postgraduate. The work process has three subcategories: work object, instrument, organization, and work conditions; the QWL category has six subcategories: definition and perception of QWL, QWL potentiating factors, QWL exhausting factors, QWL improvement strategies, the emotional burden associated with QWL, and health problems. Conclusions: In this way, the lifestyle built by the assistance in the health area has repercussions on the quality of life and health in general.

Health and Work Conditions of Garbage Collectors: A Cross-Sectional Study

Background:

Waste is considered everything that has lost utility after being use; therefore, it no longer has value to a person or a community. After objects have lost their value, they need to be removed from homes, workplaces, stores, markets, etc. Hence, waste collectors remove the garbage left on the streets and allocate it to appropriate places. From a historical perspective, waste disposal is closely related to consumption and values of cleanliness, purity, and organization of the current society.

Objective:

To analyze health and work conditions of waste collectors and the association of these parameters with the length of service.

Methods:

Cross-sectional study. The sample consisted of 112 participants. Questionnaires addressing sociodemographic, work, and health conditions were used. The analysis of the association between health conditions and length of service was performed using Fisher's exact test with a significance level of p < 0.05.

Results:

There was a statistically significant difference between the length of service (more than two years) and a higher occurrence of injuries such as sharp injuries (p <0.001), headache (p = 0.036), back pain (p = 0.008) and work leave (p = 0.021).

Conclusion:

The working health conditions of waste collectors described in this study are associated with back pain, headache, and work and sick leave.

The effectiveness of Chair Massage on Stress and Pain in Oncology

Background

There is a high prevalence of moderate-to-high levels of chronic stress among nurses, as well as an occurrence of musculoskeletal disorders.

Purpose

To evaluate the effectiveness of chair massage to reduce chronic stress and musculoskeletal pain in the Oncology Nursing team.

Setting

Two teaching cancer hospitals, one public and the other private, in São Paulo city, Brazil.

Participants

A total of 60 women from the Oncology Nursing team.

Research Design

A randomized controlled trial divided into two groups: chair massage and control without intervention.

Intervention

The massage group received two chair massage sessions lasting 15 minutes, twice a week, for three weeks.

Main Outcome Measure

Reduction of stress and pain measured by the List of Signs and Symptoms (LSS) and the Brief Pain Inventory (BPI), respectively.

Results

The average age was 32 (± 5.3) years. There was a reduction of stress measured by the LSS with a statistical difference in the group-time interaction (p < .001), with a Cohen’s d value of 1.21 between groups. The BPI analysis showed a statistically significant difference in the group-time interaction for general activity (p < .008), mood (p < .03), work (p < .000), and sleep (p = .03), with reduced pain interference in these components.

Conclusion

Chair massage reduced stress and pain interference in the team’s daily life activities, bringing a positive impact in the context of work stress and pain in Oncology nursing professionals.

Association and correlation between stress, musculoskeletal pain and resilience in nurses before hospital accreditation maintenance assessment

OBJECTIVE

to associate and correlate musculoskeletal pain, stress and resilience of nurses in the maintenance of Hospital Accreditation Certification.

METHOD

longitudinal study in two moments, before and after the Accreditation maintenance visit, March and June 2019, with 53 nurses from a hospital institution. The data collected was: sociodemographic, clinical and occupational variables, stress, osteomuscular pain and resilience. Descriptive variables, Chi-square test, t test, Fisher's exact test, Pearson's correlation and Spearman's correlation coefficient were used.

RESULTS

most of the study participants had average stress levels before and after the evaluation. Most of those who reported pain were at medium stress levels at both times. The resilience capacity increased after the evaluation, which demonstrates that the experienced stressors were adequately addressed. There was no significant association between the cortisol levels and the perceived stress.

CONCLUSION

occupational stress and musculoskeletal pain were experienced by nurses during the Accreditation processes. It was evident that individuality permeated the perception of stress and resilience allowed to overcome the tensions experienced. The study identified that there is a need for planning and implementation of actions to collaborate with the nurses in the best confrontation, aiming to promote resilience.

Relationship between Musculoskeletal Disorders and Work Performance of Nursing Staff: A Comparison of Hospital Nursing Departments

This study aimed to explore the relationship between musculoskeletal disorders and the work performance of nursing staff. This cross-sectional study used the Checklist for Musculoskeletal Disorders (MSDs), the Nordic Musculoskeletal Questionnaire (NMQ), and the Work Ability Index to survey the prevalence of MSDs, as well as to determine the impact of MSDs on 117 nursing staff working in an emergency department, an intensive care unit, and general wards. The findings indicate that the nursing staff were exposed to a workplace environment with a high risk of MSDs. Nursing staff in the emergency department were at a particularly high risk of MSDs in their upper and lower limbs, while those working in the intensive care unit had a particularly high risk of injuries caused by manual material handling. Analyzing the relationship between MSD risk factors and NMQ scores showed a 6 times, 3.25 times, and 2.28 times increase in MSD conditions with a high workload compared to a low workload in the hand and wrist, the lower back or waist, and the knee, respectively. Medium and high workloads were found to increase the risk of MSD, which in turn affected the work ability of the nurses.

Prevalence of Low Back Pain among Nursing Staff in Najran, Saudi Arabia: A Cross-Sectional Study

This study aimed to determine the various demographic and work-related professional characteristics associated with low back pain among nursing professionals in Najran, Saudi Arabia. A self-administered modified questionnaire (electronic), which included information on general subject demographics and work conditions, was sent through various electronic channels to which 187 nurses working across various health institutions in the Najran region responded. Among the included respondents, 35.3% were Saudis, 64.7% were Non-Saudis, and 88.8% were in the young to middle-age group (21–40 years). Similarly, 57.8% were females, while a majority (91%) had completed a bachelor’s degree. In total, 140 respondents (74.8%) reported experiencing low back pain. Among the various work-related factors, gender, place of work, nature of work, and direct contact hours with patients per week were found to be significantly associated with low back pain. Assessment of pain characteristics found that a majority (88.2%) had mild to moderate localized back pain. A significant number of nursing professionals included herein reported to have low back pain, which appeared to be moderated by work-related characteristics, including place and nature of work. Our findings can help to establish policies and interventions aimed at reducing the risk and onset of low back pain.

Prevalence of somatic and psychiatric morbidity across occupations in Switzerland and its correlation with suicide mortality: results from the Swiss National Cohort (1990-2014)

BACKGROUND

Suicide is a major and complex public health problem. In Switzerland, suicide accounts for about 1000 deaths yearly and is the fourth leading cause of mortality. The first nationwide Swiss study of suicides identified eight male and four female occupations with statistically significant excess of suicide compared to the general Swiss population. Working time, self-employer status, low socio-economic status and low skill level required for occupation were associated with increase in suicide risk. Presently, we aim to compare the distribution of suicide risk across occupations with the prevalence of somatic and psychiatric morbidity in Swiss working-aged adults. We hypothesized that some diseases would cluster in particular occupations, indicating potential work-relatedness of suicides found in these occupations.

METHODS

We used the Swiss National Cohort (SNC) and included 10575 males and 2756 females deceased by suicide between 1990 and 2014. We estimated the prevalence of 16 categories of concomitant diseases in each occupation, using national mortality records, and assessed the homogeneity of diseases distribution across occupations. For diseases, which prevalence varied significantly across occupations, we analyzed the correlation with the distribution of suicide risk, estimated as the standardized mortality ratio (SMR) of suicide.

RESULTS

Mental and behavioral disorders were the most commonly reported concomitant diseases in our population. In men, the prevalence of these disorders and more specifically, the prevalence of substance-related and addictive disorders, and of psychotic disorders varied significantly across occupations and was correlated with the SMR of suicide. The prevalence of malignant neoplasms and the prevalence of diseases of the musculoskeletal system and connective tissue also varied significantly across male occupations, while in women, such a variation was observed for neoplasms of uncertain or unknown behavior and diseases of the nervous system and sense organs, without being correlated with the SMR of suicide.

CONCLUSION

Some of the identified morbidities can be occupation-related and could negatively affect the working capacity and the employability, which in turn could be related to the suicide. Disentangling concomitant diseases according to their work-relatedness and relationship with the suicide risk is important for identifying occupation-related suicides, understanding their characteristics, and developing appropriated interventions for their prevention.