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

Exploring the challenges and risks of dead body handling faced by healthcare professionals during the coronavirus pandemic: Cross sectional survey study

The coronavirus pandemic shocked the already overwhelmed global healthcare system, challenging its preparedness to deal with mass fatalities. Our research examines the safety issues faced by healthcare workers when handling dead (deceased) bodies, highlighting the need for better strategies in the event of mass fatalities. Healthcare providers involved in dead body handling during the COVID-19 pandemic in the U.S. were eligible to participate in our study. Using a web-based survey, we analyzed responses of 206 participants across 43 U.S. states. We used the Systems Engineering Initiative for Patient Safety (SEIPS) framework to deduce themes from participants' open-ended responses. The study showed how routine tasks become extraordinarily challenging during pandemic due to increased workload, emotional stress, and resource constraints. Tasks such as lifting and transferring bodies, underscored physical and emotional toll on workers. The mental strain induced by mass fatalities and the complexities of communicating with families and peers were also prominent, adding to the overall burden on healthcare workers. The participants emphasized the importance of specialized training, policy refinements, and improvements in its implementation. In conclusion, our study contributes to understanding the complexities of dead body handling during a pandemic. It underscores the need for emergency response planning and systemic changes in healthcare policies and practices to ensure the safety and well-being of healthcare workers engaged in these critical tasks.

Ten-Minute Physical Activity Breaks Improve Attention and Executive Functions in Healthcare Workers

Occupational health is a major problem in modern work environments. Physical activity breaks (PABs), short exercise periods delivered during working hours, incorporating exergames or outdoor activities, have emerged as a novel approach that could be used to improve work efficiency and workplace wellbeing. Therefore, this study aimed to investigate the impact of PABs on attention levels and executive functions in healthcare workers. A total of 27 healthcare workers (M = 14, W = 13; 49.55 ± 12.46 years), after 4 h of work, randomly performed one of three 10 min conditions weekly in a counterbalanced order: No Physical Activity Break (NPAB); Outdoor Physical Activity Break (OPAB); Physical Activity Break with Exergame (PABEx). After the conditions, executive functions and selective attention were assessed by the Stroop Color and Word Test (SCWT), and the Trail Making A,B test (TMT A,B), respectively. Significant differences between OPAB and NPAB as well as between PABEx and NPAB in the TMT-A test χ2(2) = 44.66 (p < 0.001) and TMT-B test χ2(2) = 48.67 (p < 0.001) were found, respectively. TMT-A and SCWT interference/time scores of the PABEx and OPAB conditions were significantly lower than those of NPAB (p < 0.001). In the SCWT interference/error score, no significant difference was found between the PABEx and NPAB (p > 0.05), but the score was statistically lower in the OPAB condition than PABEx (p = 0.001) and PABEx condition compared to OPAB for TMT-A (p = 0.001). Findings showed that the OPAB and PABEx conditions are effective in improving selective attention and executive functions in healthcare workers. Employers can foster a healthier and more productive workforce by promoting a culture of movement and prioritizing employee health, which in turn can enhance patient care outcomes.

Prevalence of low back pain and associated factors among nurses working in public hospitals of Hawassa city, southern Ethiopia: A cross-sectional study

Background

Low back pain is a prevalent musculoskeletal ailment that affects numerous individuals, particularly those in the workforce. Nurses, in particular, are highly susceptible to this condition. In developing countries, nurses may encounter physically demanding environments requiring them to lift or transfer patients or equipment without access to proper lifting aids. Such circumstances increase their chances of developing low back pain. Hence, it is crucial to determine the prevalence and risk factors of low back pain to assess the effect and suggest preventive measures.

Objective

This study aims to assess the prevalence of low back pain and associated factors among nurses working in public hospitals in Hawassa City, Sidama Region, Southern Ethiopia, 2021.

Methods

An institutional-based cross-sectional study was conducted from May 15 to Jun 15, 2021, among randomly selected 398 nurses working in public hospitals of Hawassa City, southern Ethiopia. Data were collected using a standard, modified Nordic Musculoskeletal assessment tool. The data was entered into EPI-Data version 4.6.0.2 and exported to STATA version 14.0 for analysis. A multivariable logistic regression model was used to identify factors associated with the prevalence of low back pain. Significance was considered at p < 0.05 with a 95 % confidence interval.

Results

The study was conducted among 391 nurses, giving a response rate of 98.2 %.The one-year prevalence of low back pain was 242(61.9 %) with (95 % CI: 57%-66 %). Being female [AOR 1.82; 95%CI (1.07-3.08)], body mass index ≥25 kg/m2 [AOR 2.17; 95 %CI (1.24-3.79)], not getting assistance from coworkers [AOR 1.80; 95 % CI (1.07-3.02)] and not using of the assistive device were [AOR 1.77; 95 % CI (1.04-3.01)] were factors significantly associated with low back pain among nurses. Conclusion: Based on the findings of this study, a high proportion of nurses reported having low back pain among nurses in Hawassa public hospitals. The study suggests emphasizing the accessibility of assistive devices for patient care, having a balanced body weight, and working in collaboration among nurses to reduce the risk of low back pain among nurses.

Low back pain knowledge and associated disability among nursing staff in Oman

BACKGROUND

Low back pain is a prevalent issue worldwide, impacting all healthcare professionals, in particular nurses, and leading to disability.

OBJECTIVE

This study aimed to explore the predictive contribution of demographic factors, the presence of LBP, and knowledge about LBP in forecasting the level of disability among nurses in Oman.

METHOD

A cross-sectional study was conducted using a paper-based questionnaire comprising two valid tools: the Low Back Pain Knowledge Questionnaire and the Oswestry Low Back Disability Questionnaire. A total of 236 nurses working in two tertiary hospitals in Oman participated in the study.

RESULT

The findings indicate that 66.8% of nurses had low back pain. The low back pain knowledge score was 13.81(SD 4.42). The mean disability score was 9.13 (SD 8.56), indicating mild disability. There is a negative significant association between low back pain knowledge (r = -0.24, p < .004) and disability level. The low back pain presence was also significantly associated with disability level (t (233) = 4.606, p < .001). The results of the regression indicated the two predictors (i.e., knowledge level and low back pain) explained 13 % of the variation in nurses' disability level [F (3,230) = 11.447, p = .01].

CONCLUSION

Low back pain is prevalent among nurses in Oman, and it is associated with disability. Preventive strategies need to be implemented.

The global prevalence of overweight and obesity among nurses: A systematic review and meta-analyses

BACKGROUND

Several studies have reported the prevalence of overweight and obesity in various countries but the global prevalence of nurses with overweight and obesity remains unclear. A consolidation of figures globally can help stakeholders worldwide improve workforce development and healthcare service delivery.

OBJECTIVE

To investigate the global prevalence of overweight and obesity among nurses.

DESIGN

Systematic review with meta-analysis.

SETTING

29 different countries across the WHO-classified geographical region.

PARTICIPANTS

Nurses.

METHODS

Eight electronic databases were searched for articles published from inception to January 2023. Two independent reviewers performed the article screening, methodological appraisal and data extraction. Methodological appraisal was conducted using Newcastle-Ottawa Scale (NOS). Inter-rater agreement was measured using Cohen's Kappa. Meta-analyses were conducted to pool the effect sizes on overweight, obesity and waist circumference using random effects model and adjusted using generalised linear mixed models and Hartung-Knapp method. Logit transformation was employed to stabilise the prevalence variance. Subgroup analyses were performed based on methodological quality and geographical regions. Heterogeneity was assessed using the I2 statistic.

RESULTS

Among 10,587 studies, 83 studies representing 158,775 nurses across 29 countries were included. Based on BMI, the global prevalence of overweight and obesity were 31.2% (n = 55, 95% CI: 29%-33.5%; p < .01) and 16.3% (n = 76, 95% CI: 13.7%-19.3%, p < .01), respectively. Subgroup analyses indicated that the highest prevalence of overweight was in Eastern Mediterranean (n = 9, 37.2%, 95% CI: 33.1%-41.4%) and that of obesity was in South-East Asia (n = 5, 26.4%, 95% CI: 5.3%-69.9%). NOS classification, NOS scores, sample size and the year of data collected were not significant moderators.

CONCLUSIONS

This review indicated the global prevalence of overweight and obesity among nurses along with the differences between regions. Healthcare organisations and policymakers should appreciate this increased risk and improve working conditions and environments for nurses to better maintain their metabolic health.

PATIENT OR PUBLIC CONTRIBUTION

Not applicable as this is a systematic review.

REGISTRATION

PROSPERO (ref: CRD42023403785) https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=403785.

TWEETABLE ABSTRACT

High prevalence of overweight and obesity among nurses worldwide.

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.

On the Restorative Break: Understanding the Role of Break Room Design on Nurse Engagement and Satisfaction

BACKGROUND

Healthcare organizations need to attract and retain qualified nurses, and break areas may influence nurse engagement with breaks, but this has not been studied in situ. The goal of this study was to understand nurse perception of breaks and ways building design and culture impact the frequency, duration, and location of nurse breaks.

METHODS

This was Part 1 of a two-part study. Mixed-method approaches included on-site behavior mapping, focus groups, online survey, and break room usage rates analysis.

FINDINGS

In this study, nurses did not take restorative breaks but focused on quick "bio" breaks in rooms nearest the central nurse station. When nurses left care floors, they preferred the cafeteria and outdoor eating spaces.

CONCLUSION

Nurses' proclivity to minimize restorative breaks remains a major organizational concern. Future studies should investigate leadership activities impacting nurses' perception of shifts and break-taking behavior.

APPLICATION TO PRACTICE

By optimizing the break setting and changing the cultural perspective of breaks, occupational health services and healthcare management can support nurses' engagement in restorative activities.

Prevalence and Risk Factors of Low Back Pain in Malaysia: A Scoping Review

Data on the prevalence and risk factors of low back pain (LBP) in Malaysia remain unclear as they are currently limited to specific settings and occupational groups. Therefore, this study aims to determine the prevalence and risk factors of low back pain in Malaysia. In this scoping review, we had systematically searched PubMed, Scopus, ScienceDirect and Google Scholar from January 2016 to April 2020. In addition, we had included cross-sectional studies on LBP in Malaysia. Studies without data on the prevalence and risk factors were excluded. The settings, population, design, sample size, evaluation methods, prevalence and risk factors of the studies were summarised. The literature search identified 435 potentially eligible studies; of these, 21 had met the inclusion criteria. The prevalence of LBP in Malaysia among various types of the population had ranged from 12.4% to 84.6%. Among the various types of occupation, the prevalence of LBP was the highest among nurses (67.9%), followed by drivers (65.7%). In addition, age, gender, body mass index (BMI), lifting heavy objects, working posture, lifestyle, working hours and mental health were identified as the risk factors of LBP in Malaysia. The current evidence suggests that LBP is a serious health problem among several occupational groups in Malaysia. Therefore, it is crucial to implement the correct interventions for the prevention of LBP among these groups.

Occupational Disease and Injury in Malaysia: A Thematic Review of Literature from 2016 to 2021

Introduction

Working people are exposed to occupational hazards and are at risk of having occupational disease or injury in a rapidly industrializing country like Malaysia. This study aims to review and summarize the occupational disease and injury in Malaysia from 2016 to 2021.

Methods

This study used PubMed and Scopus databases to conduct a systematic literature search using a set of keywords. The selected records dated from 1 January 2016 to 8 September 2021 were extracted into the Mendeley Desktop and ATLAS.ti 8 software. Systematic screening was conducted by two independent researchers and finalized by the third researcher. Data were coded and grouped according to the themes. The results were presented as the table for descriptive analysis and cross-tabulation between the themes.

Results

A total of 120 records were included in this study. Under the theme of main health problems, the findings showed that mental health, infectious disease, and work-related musculoskeletal disorders are the top three problems being discussed in the literature for the working people in Malaysia. The findings also showed an increasing trend of mental health problems during pandemic COVID-19 years. In addition, hospital was the highest workplace where the occupational health problems were reported.Discussion/Conclusion. There was substantial work on the mental health problem, infectious diseases, and work-related musculoskeletal disorders as the main health problem among workers in Malaysia in the past five years. The employers must report any occupational health and injury case to the authority and prompt intervention can be initiated.

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.

Psychometric Evaluation of the Chinese Version of Occupational LowBack Pain Prevention Behaviors Questionnaire Among Clinical Nurses: A Validation Study

Objective

This study aimed to translate and validate of the Chinese version of the Occupational Low Back Pain Prevention Behaviors Questionnaire among clinical nurses.

Methods

A total of 1,186 clinical nurses were recruited from three provinces in northeast China. The reliability of the translated questionnaire was measured by internal consistency, split-half reliability, and test-retest reliability. The validity of the translated questionnaire was evaluated by content validity index, exploratory factor analysis and confirmatory factor analysis.

Results

The Cronbach's α value of the questionnaire was 0.891, and the coefficient values for the six domains ranged between 0.804 and 0.917. The split-half reliability and test-retest reliability were 0.663 and 0.734, respectively. Furthermore, the content validity index of the questionnaire was 0.938. The 6-factor structure, supported by the eigenvalues, total variance explained, and scree plot accounted for 63.038% of the total variance. In the confirmatory factor analysis, as the results of model fitting, χ²/df = 3.753, RMSEA = 0.048, GFI = 0.929, AGFI = 0.913, TLI = 0.934, IFI = 0.943, CFI = 0.943, PGFI = 0.759, PNFI = 0.807.

Conclusion

The Chinese version of the Occupational Low Back Pain Prevention Behaviors Questionnaire had suitable reliability and validity among clinical nurses. Under the high prevalence of occupational low back pain, the questionnaire can provide a reference for developing educational intervention plans among clinical nurses.

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.

The factors of non-specific chronic low back pain in nurses: A meta-analysis

BACKGROUND

Numerous studies have investigated factors for non-specific chronic low back pain (NSCLBP) in nurses, and have reached different conclusions. Evidence-based recommendations are required for the prevention and treatment of NSCLBP in nurses.

OBJECTIVE

This meta-analysis aimed to systematically review and quantify the factors of NSCLBP in nurses.

METHODS

Eleven databases were searched. The odds ratios (OR) with 95% confidence intervals (CIs) were pooled using meta-analysis, and either a fixed-effect or random-effect model was used based on heterogeneity across included studies.

RESULTS

Eighteen publications including 11,752 nursing staff were included. Being female (pooled estimate [95% CI], 1.56 [1.24-1.96]; P< 0.001), married (1.89 [1.38-2.60]; P< 0.001), overweight (0.63 [0.43-0.93]; P= 0.02), working at least 10 years (0.65 [0.48-0.89]; P= 0.007), and working night shifts (2.19 [1.16-4.21]; P= 0.02) were positively related to NSCLBP. Junior college education (0.60 [0.47-0.77]; P< 0.001) and job satisfaction (0.58 [0.47-0.73]; P< 0.001) were negatively related. Age (0.80 [0.50-1.27]; P= 0.34) and physical exercise (0.99 [0.39-2.49]; P= 0.98) were not related.

CONCLUSIONS

This is the first meta-analysis to quantify the risk factors for NSCLBP in nurses. Being female, married, working night shifts, overweight, working at least 10 years and dissatisfied with work are risk factors. High-quality prospective studies are required to validate the findings of this study.

Prevalence of Low Back Pain and Associated Risk Factors among Nurses at King Abdulaziz University Hospital

AIM

To determine the prevalence of LBP and the associated risk factors among nurses at King Abdulaziz University Hospital (KAUH).

METHODS

A cross-sectional study design was adopted with a convenience sample of 234 nurses recruited from nine different departments at KAUH in Jeddah, Saudi Arabia. Participants completed the questionnaire, which had two parts: Part I: Socio-demographic data, medical factors, and work-related factors; and Part II: Standardized Nordic Musculoskeletal Questionnaire was used to obtain data. Data collection was carried out from March to April 2020. Data were analyzed using the SPSS version 22.

RESULTS

Cumulative prevalence of LBP was 82.9%, annual prevalence was 85.5%, while one-week prevalence of LBP was 53.6%. The factor significantly associated with LBP over the past 12 months was manual lifting of patients (p = 0.030). Nurses working in surgical wards had higher prevalence of LBP. About 24.7% of them changed their working unit, hospitalization was necessary for 11.9%, and 39.8% sought medical care.

CONCLUSIONS

The findings from this study may better enable policymakers to adopt certain strategies toward reducing the burdens and challenges of LBP among nurses.

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.

Interactive Low Back Pain Intervention Module Based on the Back School Program: A Cluster-Randomized Experimental Study Evaluating Its Effectiveness among Nurses in Public Hospitals

The prevalence of low back pain (LBP) among nurses is high. The main aim of this study was to evaluate the effectiveness of an interactive LBP module based on the Back School Program in improving Oswestry Disability Scores (ODSs) among nurses in government hospitals in Penang, Malaysia. A cluster-randomized experimental study was conducted within four public hospitals. These hospitals were randomized to intervention and control groups. A total of 284 nurses from the selected hospitals were randomly selected (142 in each group). An interactive LBP intervention module based on the Back School Program was designed and prescribed. Both the intervention and control groups were assessed using the Oswestry Disability Questionnaire at baseline and at the end of the third and sixth weeks. Out of 284 participants, 281 completed this study. A between-group comparison revealed that ODSs were significantly lower in the intervention group than in the control group at the ends of the third (p = 0.006) and sixth weeks (p < 0.001). Within-group changes revealed a significant reduction in ODSs within the intervention group from baseline to the third (p < 0.001) and sixth weeks (p < 0.001) of the intervention. This simple interactive LBP module was effective in reducing symptoms of LBP among nurses as early as three weeks, and this effect was sustained until the sixth week of the intervention.