Work-related musculoskeletal disorders in nurses working in the Kingdom of Saudi Arabia

Relationship between mental workload and musculoskeletal disorders with intention to leave service among nurses working at neonatal and pediatric departments: a cross-sectional study in Iran

BACKGROUND

Despite the challenge of nursing shortage in the world and its subsequent impact on care quality as well as aggravation of the situation by intention to leave service, this issue has not been properly addressed, especially among neonatal and pediatric nurses. The present study aims to identify the relationship between mental workload and musculoskeletal disorders with intention to leave the service among nurses working at neonatal and pediatric departments.

METHODS

This descriptive-analytical study was conducted on 145 nurses working at neonatal and pediatric departments in six hospitals in Bushehr Province using full-census method. The data were collected using national aeronautics and space administration-task load index (NASA-TLX), Cornell musculoskeletal discomfort questionnaire(CMDQ) and Mobley and Horner's voluntary turnover questionnaire. The data were analyzed using descriptive statistics, independent t-test, Mann-Whitney U test, one-way analysis of variance (ANOVA), Kruskal-Wallis test, Pearson's and Spearman correlation tests and hierarchical linear regression in simultaneous model in SPSS 19.0.

RESULTS

The mean score of intention to leave the service was 9.57 ± 3.20 (higher than the moderate level) and the mean mental workload was 71.65 ± 15.14 (high level). Pain in at least one of the legs (100%), back (77.3%) and knees (76.6%) was highly prevalent. However, no statistically significant correlation was found between musculoskeletal disorder categories and intention to leave the service (p > 0.05). The regression analysis results revealed among mental workload domains, only effort-induced workload was negatively and significantly correlated with intention to leave the service (p = 0.003; β=-0.078). However, the number of night shifts per month was positively and significantly correlated with intention to leave the service (p = 0.001; β = 0.176).

CONCLUSIONS

Planning for appropriate allocation of night shifts, investigating the etiology of musculoskeletal disorders and providing solutions for reducing mental workload should be prioritized by policymakers, while maintaining pediatric nurses' motivation for making efforts.

Factors Influencing Occupational Health and Safety among Nursing Students in Their Clinical Placements: A Cross-Sectional Study

Occupational health and safety aims to promote and maintain optimal physical, mental, and social health for workers in their occupations. Within Saudi Arabia, adequate information must be gathered to address the various factors influencing occupational health and safety among nursing students to minimize occupational health hazards and ensure a safe clinical environment. This cross-sectional study was conducted in Riyadh, Saudi Arabia, between April and September 2023, involving 150 nursing students. Data collection included questions to gather sociodemographic information, and contained an instrument assessing the participants' knowledge of occupational health and safety and evaluation of risk control in clinical environments. Blood and other bodily fluids, workplace violence, needle-stick injuries, and injuries caused by sharp instrument tools were identified as the most prevalent occupational risks among the participants. Most nursing students were aware of occupational health and safety, with a high level of compliance with occupational health and safety measures and personal protective equipment use. We also identified a statistically significant correlation between occupational health and safety knowledge and risk control evaluation among nursing students. To ensure a safe and beneficial clinical training area, student nurses must complete extensive occupational health and safety courses before moving to clinical areas to reduce potential hazards that may affect their lives.

Computer simulation as a macroergonomic approach to assessing nurse workload and biomechanics related to COVID-19 patient care

This study uses Digital Human Modelling (DHM) and Discrete Event Simulation (DES) to examine how caring for COVID-19-positive (C+) patients affects nurses' workload and care-quality. DHM inputs include: nurse anthropometrics, task postures, and hand forces. DES inputs include: unit-layout, patient care data, COVID-19 status & impact on tasks, and task execution-logic. The study shows that reducing nurses' biomechanical workload increases mental workload and decreases direct patient care, potentially leading to stress, burnout, and errors. Compared to pre-pandemic conditions, when nurses were assigned five C+ patients, cumulative bilateral shoulder moments and lumbar load decreased by 38%, 36%, and 46%, respectively. However, this was accompanied by increases in mental workload (242%), task waiting-time (70%), and missed-care (353%). These effects were driven by the large increase in required infection control routines. Combining DHM and DES can help evaluate workplace/task designs and provide valuable insights for healthcare system design-policy setting and operational management decision-making.

Prevalence of Work-Related Musculoskeletal Disorders and Its Effects amongst Nurses in the Selected Intellectual Disability Unit of the Limpopo Province

The COVID-19 pandemic continuously highlights the need for occupational health and safety among healthcare professionals. Physical and mental health safety resulting from needle prick injuries, stress, infections, and chemical hazards are priority work-related musculoskeletal disorders for nurses, including those working in the intellectual disability unit. The intellectual disability unit provides basic nursing care to patients with known mental disabilities, such as learning, problem-solving, and judgment problems, which demand diverse physical activities. Nevertheless, the safety of nurses within the unit receives little attention. Thus, we adopted a quantitative cross-sectional epidemiological survey design to determine the prevalence of work-related musculoskeletal disorders amongst nurses working in the intellectual disability unit at the selected hospital in Limpopo Province, South Africa. A self-administered questionnaire collected data from 69 randomly selected nurses from the intellectual disability unit. Data were extracted, coded, and captured in MS Excel format (2016) and imported into the IBM Statistical Package for the Social Sciences (SPSS), software version 25.0, for analysis. The study reported a low (38%) prevalence of musculoskeletal disorders in the intellectual disability unit, with significant effects on nursing care and staffing. The effects of these WMSDs included missing work, interference with the daily routine, disturbance with sleeping patterns after work, and absenteeism from work. Since intellectually disabled patients depend entirely on nurses for the basic activities of daily living, this paper recommends the incorporation of physiotherapy among nurses in the intellectual disability unit to treat the incidence of lower back pain while mitigating nurses missing work or absenteeism.

Do sleep and psychological factors influence musculoskeletal pain among nurses?

BACKGROUND

The physical factors associated with musculoskeletal pain in nursing personnel have been largely investigated, although the role of sleep and psychological factors resulting in musculoskeletal pain has not been addressed thoroughly.

OBJECTIVE

This study aimed to explore the prevalence of musculoskeletal pain and investigate how sleep and psychological factors influence musculoskeletal pain in a nursing group.

METHODS

Nordic standard questionnaires were distributed to 230 female nurses. Chi-square tests were performed to assess the associations between sleep problems, psychological problems, and musculoskeletal pain symptoms. Binary logistic regression analysis was also conducted to identify the primary factors influencing the prevalence of musculoskeletal pain.

RESULTS

The highest prevalence of pain was observed in the lower back, neck, and shoulders, whereas the lowest prevalence of pain was observed in the ankles, feet, elbows, and hips/buttocks. Chi-square analysis and binary logistic regression showed that sleep duration, sleep onset time, and sleep quality all significantly contributed to the development of neck and upper back pain. With regard to the psychological factors, only occupational pride and stress had a significant effect on pain; in contrast, family support did not show any significant influence.

CONCLUSION

Compared with other body regions, musculoskeletal pain in the lower back, neck, and shoulders requires more attention and preventive interventions. Special efforts should be made to shift the workday system of the nursing group because of the strong correlation between sleep problems and pain. Incentives other than penalty mechanisms should be considered seriously in nursing to boost occupational pride and relieve job stress.

Prevalence of musculoskeletal disorders among chefs working in restaurants of twins cities of Pakistan

BACKGROUND

In the recent era, musculoskeletal disorders have affected millions of people worldwide. Chefs and other workers of the catering industry are at high risk of physical stresses, which makes them susceptible to develop various musculoskeletal pains and disorders.

OBJECTIVE

The aim of the study is to examine the frequency of musculoskeletal symptoms among chefs working in restaurants of Islamabad and Rawalpindi.

METHODS

A cross-sectional observational study was conducted on 307 chef participants from the restaurants of the twin cities. The participants were included via convenient sampling and data was collected through Nordic musculoskeletal questionnaire, Fatigue Assessment Scale (FAS) and Numeric Pain Rating Scale (NPRS) from February to July 2021.

RESULTS

Out of 307 participants, 285 were males and 22 were females with a mean age of 32.87±7.03 years. The working duration of 192 chefs were 9-12 hours while 106 and 9 chefs worked only for 4-8 and more than 12 hours, respectively. A total of 101 chefs reported lower back and knee pain. The chefs presented with pain in the shoulders, upper back and ankle as well as feet areas were 98, 93 and 26 respectively.

CONCLUSION

Chefs can develop musculoskeletal symptoms including pain as a result of increased physical stress on their bodies during their work, specifically in the lower back and knee area.

Assessing the Work Activities Related to Musculoskeletal Disorder among Critical Care Nurses

Nurses are physically exhausted with an incidence of work-related musculoskeletal disorders (MSDs), especially those working in critical care units that require exhaustive physical efforts to fulfill patients' needs. The current study aims to assess work activities related to the occurrence of MSDs in nurses working in critical care units. A descriptive cross-sectional study was conducted on a sample of 100 nurses of critical care units, and the data were collected via a survey questionnaire. The study was conducted at King Fahad University Hospital for three months from February to April 2019. The study findings revealed that work activities related to MSD were associated with sociodemographic data, age, and neck pain (rho = 0.063) (p=0.03) and lower back pain (rho = 0.89) (p=0.03); education level with hip/thigh pain (rho = 0.64) (p=0.03); standing time with shoulder pain (rho = 0.66) (p=0.04), wrist/hand pain (rho = -0.75) (p=0.05), hip/thigh pain (rho = -0.78) (p=0.004), and knee pain (rho = -0.77) (p=0.005). An increased prevalence of MSDs with lower back pain (92%) and upper back pain (56%) was estimated among the nurses, and a negative impact of work-related MSDs on occupational health and daily life activities of the nurses was also observed. The study concluded that the occurrence of MSDs is significantly associated with sociodemographic data: age, BMI experience level, and educational level of nurses of critical care units.

The prevalence of upper quadrants work-related musculoskeletal disorders and their predictors among registered nurses

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) represent a significant health challenge facing nurses. However, very few studies investigated the prevalence of WMSDs among nurses and their predictors comprehensively using a valid and reliable set of standardized outcome measures.

OBJECTIVE

This study aimed to investigate the prevalence WMSDs of upper quadrants and their predictors among registered nurses in Jordanian hospitals.

METHODS

A cross-sectional study recruited 597 registered nurses from different hospitals in Jordan. A self-administered survey distributed in targeted hospitals wards. Outcome measures included Nordic Musculoskeletal Questionnaire (NMQ), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire (IPAQ), sociodemographic data, and manual handling and work habits. Prevalence of musculoskeletal complaints was reported using descriptive analysis. Logistic regression analyses were used to identify predictors of WMSDs at each upper quadrant body site.

RESULTS

Twelve-month WMSDs prevalence was the highest at the neck (61.1%), followed by the upper back (47.2%), shoulders (46.7%), wrist and hands (27.3%), and finally at the elbow (13.9%). Being a female, poor sleep quality, high physical activity level, poor ergonomics, increased workload, and mental stress were significant predictors of increased upper quadrant WMSDs among nurses.

CONCLUSIONS

Upper quadrant WMSDs among nurses in Jordan are highly prevalent. Identified significant predictors of these WMSDs should be given full consideration by clinicians and health policymakers. Future studies are needed to reveal the progressive nature of upper quadrant WMSDs and strategies to modify their risk factors.

The effect of the COVID-19 Pandemic on anxiety, depression, and musculoskeletal system complaints in healthcare workers

BACKGROUND

COVID-19 increased psychological and physical complaints, including anxiety, depression, and pain.

OBJECTIVE

We aimed to examine anxiety, depression, and musculoskeletal complaints that may occur in healthcare workers during the COVID-19 pandemic.

METHODS

Data were cross-sectional, collected by the online questionnaire method consisted of demographic questions, Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), Nordic Musculoskeletal System Query (NMQ), and Visual Analogue Scale (VAS).

RESULTS

Among the groups, the number of doctors in the frontline group, the fear of being infected, the number of tests performed, and personal protective equipment were higher than the second-line group (p < 0.05). It was found that 73.4% of the participants had anxiety, 83.5% had depression, and 94.9% had musculoskeletal pain. It was observed that there was no statistically significant difference between the applied scale scores between the groups (p > 0.05). About musculoskeletal system complaints of the participants, neck pain presence was determined as 73.4% in the last 12 months, and upper back pain was the highest with 61.4% in the last week. Neck (p < 0.005) and upper back pain (p = 0.04) parameters in the last seven days of the NMQ scale applied to the participants were found to be statistically significantly higher in the contact group.

CONCLUSIONS

Anxiety, depression, and musculoskeletal pain of healthcare workers were found to be high. While neck and back pain was the most common in musculoskeletal complaints, it was found that these pains were higher in the frontline group. In this regard, healthcare professionals can be given psychological support and exercise training.

Sleep quality and its predictors among hospital-based nurses: a cross-sectional study

PURPOSE

Sleep disorders are common among nurses and may have negative effects on their performance and well-being. This study aimed to investigate the level of sleep quality and its possible associated factors among hospital-based nurses in Jordan.

METHODS

A cross-sectional design targeting Jordanian hospital-based nurses. In addition to demographics and work habits, the outcome measures included Pittsburgh Sleep Quality Index (PSQI), Nordic Musculoskeletal Questionnaire (NMQ), and Depression Anxiety Stress Scale (DASS). Data were analyzed descriptively and by a multiple variable linear regression analysis to identify predictors of sleep quality.

RESULTS

In total, 597 nurses with a mean age of 32.1 (± 5.7) years participated in this study and 47% were men. PSQI mean score was 7.8 (± 3.7) and 68% of the participants showed sleep quality deficits. Stress (β = 0.15 [95%CI 0.13 to 0.19, P < 0.001), depression (β = 0.05 [95%CI 0.009 to 0.08], P = 0.015), the number of joints with 12 months musculoskeletal pain (β = 0.25 [95%CI 0.15 to 0.36], P < 0.001) positively predicted decreased sleep quality. Manual handling training (β = - 0.48 [95%CI -0.96 to 0.003], P = 0.048) and years of experience (β = - 0.05 [95%CI -0.09 to 0.002], P = 0.039) negatively predicted decreased sleep quality.

CONCLUSIONS

Nurses reported poor levels of sleep quality, high levels of mental health symptoms, and musculoskeletal pain complaints. Sleep quality among nurses and its predictors should be carefully considered by administrations of healthcare services.

Investigation of psychosocial factors on upper limb musculoskeletal disorders and the prevalence of its musculoskeletal disorders among nurses: a systematic review and meta-analysis

OBJECTIVE

Musculoskeletal disorders are one of the most important occupational problems especially among nurses. The aim of this study was to investigate the prevalence of musculoskeletal disorders in upper limbs and its associated psychosocial factors in the workplace.

METHODS

A systematic review was conducted by searching the Medline/PubMed, EMBASE, Scopus, ISI/web of knowledge and Google Scholar databases. The authors classified studies into categories of psychological work stressors and musculoskeletal problems. The statistical analysis was performed using Stata software.

RESULTS

We found 1742 articles in our initial search. After reviewing the titles, abstracts and full texts, 66 articles were finally analyzed. Psychosocial factors affecting the prevalence of upper limb musculoskeletal disorders among nurses were identified which included boring work, inadequate staffing, job demands, insufficient support, time pressure, decision latitude, job dissatisfaction, and job stress. There was a significant relationship between these factors and prevalence of musculoskeletal disorders in the wrists, shoulders, neck and shoulders, and wrists and hands.

CONCLUSION

Collectively, the results of this study provide strong evidence of some psychosocial factors affecting the prevalence of upper limb musculoskeletal disorders among nurses. Thus, organizational interventions to minimize these stressors may be promising in reducing one risk factor for the development of nurses' musculoskeletal disorders. These interventions should not only consider the factors of physical ergonomics but also seek to improve the organizational aspects of the workplace.

Active and passive work breaks during simulated laparoscopy among laparoscopic surgeons: study protocol for a controlled, randomised cross-over laboratory trial

INTRODUCTION

Laparoscopy has partially replaced open surgery due to the lower infection rate for the patient and hence better and shorter recovery. However, the surgeon's physical load is higher due to longer duration static and awkward body postures, increasing the risk for developing work-related musculoskeletal disorders. Interventions of an organisational nature are work breaks, being either passive or active. The primary objectives of this study are to determine whether passive and active work breaks lead to less discomfort than no work breaks and whether active work breaks lead to less discomfort than passive work breaks.

METHODS AND ANALYSIS

A controlled, randomised cross-over trial will be performed in the laboratory, of which its protocol is described here according to the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Statement. Recruitment of 21 laparoscopic surgeons started in April 2019 and the study is ongoing. The participating surgeons will perform three 1.5 hour experimental conditions, one without work breaks, one with 2.5 min passive work breaks including rest, and one with 2.5 min active work breaks including mobility and stretching exercises. The work breaks will be taken after 30 and 60 min of work. During the experiments, outcomes will be recorded. The primary outcome is rating of perceived discomfort measured on an 11-point numeric rating scale. The secondary outcomes are performance, muscle activity of selected muscles, upper body angles, heart rate, workload and subjective evaluation of both interventions. The collected data will be tested using a one-way or two-factorial repeated-measures analysis of variance.

ETHICS AND DISSEMINATION

Ethical approval of the study protocol was received by the local medical ethical committee of the University of Tübingen in February 2019 (no 618/2018BO2). The results of this study will be presented at national and international conferences, submitted for publications in peer-reviewed journals and serve as the starting point for a feasibility study.

TRIAL REGISTRATION NUMBER

NCT03715816.

Low back pain prevalence and risk factors among health workers in Saudi Arabia: A systematic review and meta-analysis

OBJECTIVES

Low back pain (LBP) has a major impact on health workers, and its prevalence and risk factors among them in Saudi Arabia have been investigated previously. However, the results have never been comprehensively reviewed. Therefore, the aim of this study was to perform a systematic review and meta-analysis of the available literature to identify the prevalence and risk factors of LBP among health workers in Saudi Arabia.

METHODS

MEDLINE/PubMed, Web of Science, Scopus, CINAHL, and Saudi peer-reviewed journals were searched for relevant literature. After quality assessment of the eligible articles, 18 studies targeting seven occupational categories, with a total number of 5345 health workers, were analyzed.

RESULTS

Pooled prevalence rates of 40.8% (n = 7 studies), 65.0% (n = 13 studies), and 81.4% (n = 2 studies) were obtained for week, year, and career, respectively, across all professional groups. Nurses and physical therapists were more susceptible to LBP, in that order, than the other categories considering week and career periods. Age, body mass index, and female gender were the most commonly reported individual risk factors. Occupational risk factors mainly included work-related activities requiring back bending and twisting, lifting and pulling objects, and manual patient-handling.

CONCLUSIONS

The results of this review indicate that LBP is highly prevalent among health workers in Saudi Arabia when compared with international rates. Proper prophylactic measures are necessary to reduce LBP and minimize its consequences. Further high-quality research is needed in different Saudi regions to achieve a broader understanding of LBP prevalence and causes.