Work factors as predictors of intense or disabling low back pain; a prospective study of nurses' aides
Work factors as predictors of intense or disabling low back pain; a prospective study of nurses' aides
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DOI：
10.1136/oem.2003.008482
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发表时间：
2004-05-01
影响因子：
4.9
通讯作者：
Knardahl, S
中科院分区：
文献类型：
--
作者：
Eriksen, W;Bruusgaard, D;Knardahl, S
目的：探讨影响护士助理发生强烈腰痛及腰痛相关病假的工作因素。方法：选取1999年邮寄问卷调查的4266名挪威护理员为样本，这些护理员在前3个月内没有或只有少量的LBP困扰，且未请病假。其中3808人（89.3%）在3个月后完成第二次问卷，3651人（85.6%）在15个月后完成第三次问卷。通过随访时的自我报告评估观察期间腰痛引起的腰背部症状和证明病假的强度。结果：对基线前三个月的腰痛、基线健康投诉、人口统计学和家族因素以及一系列身体、心理和社会工作因素进行调整后，logistic回归分析揭示了以下关联：患者在床上的频繁体位、感觉到缺乏直接上级的支持、感觉到工作单位缺乏愉快和放松的文化可以预测强烈的腰背痛症状。与腰痛相关的病假被预测为频繁处理重物、中等水平的工作需求、工作单位缺乏支持和鼓励的文化、工作夜班和在养老院工作。长期与腰痛相关的病假与观察期间工作或工作任务的变化有关，导致工作中支持和鼓励的减少。结论：除了频繁的机械暴露外，组织、心理和社会工作因素，如夜班工作、上级缺乏支持、工作单位缺乏愉快、放松或支持和鼓励的文化，都与护士助理出现强烈腰背症状和腰痛相关病假的风险增加有关。
Aims: To identify the work factors that predict intense low back pain (LBP) and LBP related sick leaves in nurses' aides.Methods: The sample comprised 4266 randomly selected Norwegian nurses' aides, not bothered or only a little bothered by LBP during the previous three months, and not on sick leave when completing a mailed questionnaire in 1999. Of these, 3808 (89.3%) completed a second questionnaire 3 months later and 3651 (85.6%) completed a third questionnaire 15 months later. Intensity of low back symptoms and certified sick leaves attributed to LBP during the observation period were assessed by self reports at the follow ups.Results: After adjustments for LBP during the three months prior to baseline, baseline health complaints, demographic and familial factors, and a series of physical, psychological, and social work factors, logistic regression analyses revealed the following associations: intense low back symptoms were predicted by frequent positioning of patients in bed, perceived lack of support from immediate superior, and perceived lack of pleasant and relaxing culture in the work unit. LBP related sick leaves were predicted by frequent handling of heavy objects, medium level of work demands, perceived lack of supportive and encouraging culture in the work unit, working night shifts, and working in a nursing home. Long term LBP related sick leaves were associated with changes of work or work tasks during the observation period that resulted in a perceived reduction of support and encouragement at work.Conclusions: Not only frequent mechanical exposures, but also organisational, psychological, and social work factors, such as night shift work, perceived lack of support from superior, and perceived lack of a pleasant and relaxing or supporting and encouraging culture in the work unit, are associated with an increased risk of intense low back symptoms and LBP related sick leaves in nurses' aides.