Effect of an Ergonomics Educational Program on Musculoskeletal Disorders in Nursing Staff Working in the Operating Room: A Quasi-Randomized Controlled Clinical Trial
Abstract
:1. Introduction
1.1. Significance of Ergonomics in Nursing
1.2. Education in Ergonomics for Nurses
2. Materials and Methods
2.1. Design
2.2. Setting and Participants
2.3. Sampling and Eligibility Criteria
2.4. Outcomes and Data Collection
- ⚬
- The modified version of the standardized Nordic questionnaire. This is a general questionnaire aided by a body map to indicate nine symptom sites of the neck, shoulders, upper back, elbows, low back, wrist/hands, hips/thighs, knees and ankles/feet for the assessment of the prevalence of MSDs in the last 12 months and last 7 days, which have prevented normal activities [26,27];
- ⚬
- The rapid entire body assessment (REBA) checklist for the assessment of the risk of MSDs [28]. Bias might have occurred during the completion of the REBA checklist through the researchers’ direct observation of the subjects’ activities. Therefore, the subjects’ postures and activities during surgery, working with the patient, packaging and sterilizing equipment, recovery and computer work were video-recorded by the researcher, after obtaining appropriate ethical permission. The films were then used to recheck activities and reduce the number of observational failures on the part of the first researcher (TA). Subsequently, the most frequent physical conditions and postures of the subjects during the 20 min observation period were scored. To recheck the videos and eliminate the possibility of bias, the videos were then reviewed and confirmed by a colleague who was a master of ergonomics and was not a member of the research group, so as to enhance the accuracy of the completed checklist. The overall agreement between evaluators for the REBA checklist was calculated as 0.82 using Cohen’s Kappa measures.
2.5. Intervention
2.6. Ethical Considerations
2.7. Data Analysis
3. Results
3.1. Demographic Data of the Participants
3.2. Prevalence of MSDs
3.3. Risk of MSDs
3.4. Job Satisfaction
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Lehto, R.H.; Heeter, C.; Forman, J.; Shanafelt, T.; Kamal, A.; Miller, P.; Paletta, M. Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective. Int. J. Environ. Res. Public Health 2020, 17, 6147. [Google Scholar] [CrossRef] [PubMed]
- Cetrano, G.; Tedeschi, F.; Rabbi, L.; Gosetti, G.; Lora, A.; Lamonaca, D.; Manthorpe, J.; Amaddeo, F. How are compassion fatigue, burnout, and compassion satisfaction affected by quality of working life? Findings from a survey of mental health staff in Italy. BMC Health Serv. Res. 2017, 17, 755. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Vaismoradi, M.; Tella, S.; Logan, P.A.; Khakurel, J.; Vizcaya-Moreno, F. Nurses’ Adherence to Patient Safety Principles: A Systematic Review. Int. J. Environ. Res. Public Health 2020, 17, 2028. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lemo, A.; Silva, A.G.; Tucherman, M.; Talerman, C.; Guastelli, R.L.; e Borba, C.L. Risk reduction in musculoskeletal practice assistance professional nursing pilot in semi intensive care unit. Work 2012, 41 (Suppl. 1), 1869–1872. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bolm-Audorff, U.; Hegewald, J.; Pretzsch, A.; Freiberg, A.; Nienhaus, A.; Seidler, A. Occupational Noise and Hypertension Risk: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2020, 17, 6281. [Google Scholar] [CrossRef] [PubMed]
- Da Costa, B.R.; Vieira, E.R. Risk factors for work-related musculoskeletal disorders: A systematic review of recent longitudinal studies. Am. J. Ind. Med. 2010, 53, 285–323. [Google Scholar] [CrossRef] [PubMed]
- Chung, Y.C.; Hung, C.T.; Li, S.F.; Lee, H.M.; Wang, S.G.; Chang, S.C.; Pai, L.W.; Huang, C.N.; Yang, J.H. Risk of musculoskeletal disorder among Taiwanese nurses cohort: A nationwide population-based study. BMC Musculoskelet. Disord. 2013, 14, 144. [Google Scholar] [CrossRef] [Green Version]
- Moazzami, Z.; Dehdari, T.; Taghdisi, M.H.; Soltanian, A. Effect of an Ergonomics-Based Educational Intervention Based on Transtheoretical Model in Adopting Correct Body Posture Among Operating Room Nurses. Glob. J. Health Sci. 2015, 8, 26–34. [Google Scholar] [CrossRef]
- Gupta, S. Ergonomic applications to dental practice. Indian J. Dent. Res. 2011, 22, 816–822. [Google Scholar] [CrossRef]
- Bos, E.; Krol, B.; van der Star, L.; Groothoff, J. Risk factors and musculoskeletal complaints in non-specialized nurses, IC nurses, operation room nurses, and X-ray technologists. Int. Arch. Occup. Environ. Health 2007, 80, 198–206. [Google Scholar] [CrossRef]
- Choobineh, A.; Movahed, M.; Tabatabaie, S.H.; Kumashiro, M. Perceived demands and musculoskeletal disorders in operating room nurses of Shiraz city hospitals. Ind. Health 2010, 48, 74–84. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Harcombe, H.; McBride, D.; Derrett, S.; Gray, A. Prevalence and impact of musculoskeletal disorders in New Zealand nurses, postal workers and office workers. Aust. N. Z. J. Public Health 2009, 33, 437–441. [Google Scholar] [CrossRef] [PubMed]
- Mahmud, N.; Kenny, D.T.; Md Zein, R.; Hassan, S.N. Ergonomic Training Reduces Musculoskeletal Disorders among Office Workers: Results from the 6-Month Follow-Up. Malays. J. Med. Sci. 2011, 18, 16–26. [Google Scholar] [PubMed]
- Khan, R.; Surti, A.; Rehman, R.; Ali, U. Knowledge and practices of ergonomics in computer users. J. Pak. Med. Assoc. 2012, 62, 213–217. [Google Scholar] [PubMed]
- Vural, F.; Sutsunbuloglu, E. Ergonomics: An important factor in the operating room. J. Perioper. Pract. 2016, 26, 174–178. [Google Scholar] [CrossRef]
- Szeto, G.P.; Wong, T.K.; Law, R.K.; Lee, E.W.; Lau, T.; So, B.C.; Law, S.W. The impact of a multifaceted ergonomic intervention program on promoting occupational health in community nurses. Appl. Ergon. 2013, 44, 414–422. [Google Scholar] [CrossRef]
- Mohammadi, S.; Halvani, G.H.; Mehrparvar, A.H.; Jambarsang, S.; Anoosheh, V. The Effect of Ergonomic Educational Intervention on Reducing Musculoskeletal Disorders among Nurses. Arch. Occup. Health 2020, 4, 493–501. [Google Scholar] [CrossRef]
- Coskun Beyan, A.; Dilek, B.; Demiral, Y. The Effects of Multifaceted Ergonomic Interventions on Musculoskeletal Complaints in Intensive Care Units. Int. J. Environ. Res. Public Health 2020, 17, 3719. [Google Scholar] [CrossRef]
- Sundstrup, E.; Seeberg, K.G.V.; Bengtsen, E.; Andersen, L.L. A Systematic Review of Workplace Interventions to Rehabilitate Musculoskeletal Disorders Among Employees with Physical Demanding Work. J. Occup. Rehabil. 2020. [Google Scholar] [CrossRef] [Green Version]
- Matern, U.; Koneczny, S. Safety, hazards and ergonomics in the operating room. Surg. Endosc. 2007, 21, 1965–1969. [Google Scholar] [CrossRef]
- Sheikhzadeh, A.; Gore, C.; Zuckerman, J.D.; Nordin, M. Perioperating nurses and technicians’ perceptions of ergonomic risk factors in the surgical environment. Appl. Ergon. 2009, 40, 833–839. [Google Scholar] [CrossRef] [PubMed]
- Clari, M.; Garzaro, G.; Di Maso, M.; Donato, F.; Godono, A.; Paleologo, M.; Dimonte, V.; Pira, E. Upper Limb Work-Related Musculoskeletal Disorders in Operating Room Nurses: A Multicenter Cross-Sectional Study. Int. J. Environ. Res. Public Health 2019, 16, 2844. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Garg, A.; Kapellusch, J.M. Long-term efficacy of an ergonomics program that includes patient-handling devices on reducing musculoskeletal injuries to nursing personnel. Hum. Factors 2012, 54, 608–625. [Google Scholar] [CrossRef] [PubMed]
- Tamminen-Peter, L.; Nygren, K. Development of an education scheme for improving perioperative nurses’ competence in ergonomics. Work 2019, 64, 661–667. [Google Scholar] [CrossRef]
- Ali, A.H.; Abdel-Hakeim, E. The Effect of Ergonomics Program on Nurses’ Knowledge and Practice in Operating Room Heba. IOSR J. Nurs. Health Sci. 2018, 7, 6–15. [Google Scholar] [CrossRef]
- Kuorinka, I.; Jonsson, B.; Kilbom, A.; Vinterberg, H.; Biering-Sørensen, F.; Andersson, G.; Jørgensen, K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl. Ergon. 1987, 18, 233–237. [Google Scholar] [CrossRef]
- Mehrdad, R.; Dennerlein, J.T.; Morshedizadeh, M. Musculoskeletal disorders and ergonomic hazards among Iranian physicians. Arch. Iran. Med. 2012, 15, 370–374. [Google Scholar]
- Bridger, R. Introduction to Ergonomics, 3rd ed.; Taylor & Francis: London, UK, 2009. [Google Scholar]
- Buitendach, J.H.; Rothmann, S. The validation of the Minnesota Job Satisfaction Questionnaire in selected organisations in South Africa. SA J. Hum. Resour. Manag. 2009, 7. [Google Scholar] [CrossRef] [Green Version]
- Arsalani, N.; Fallahi-Khoshknab, M.; Josephson, M.; Lagerström, M. Musculoskeletal disorders and working conditions among Iranian nursing personnel. Int J. Occup. Saf. Ergon. 2014, 20, 671–680. [Google Scholar] [CrossRef]
- Harutunian, K.; Gargallo-Albiol, J.; Figueiredo, R.; Gay-Escoda, C. Ergonomics and musculoskeletal pain among postgraduate students and faculty members of the School of Dentistry of the University of Barcelona (Spain). A cross-sectional study. Med. Oral. Patol. Oral. Cir. Bucal. 2011, 16, 425–429. [Google Scholar] [CrossRef] [Green Version]
- Davis, K.G.; Kotowski, S.E. Prevalence of Musculoskeletal Disorders for Nurses in Hospitals, Long-Term Care Facilities, and Home Health Care: A Comprehensive Review. Hum. Factors 2015, 57, 754–792. [Google Scholar] [CrossRef] [PubMed]
- Zayed, H.A.; Saied, S.M.; Rania, M.; Shehata, W.M. Work-Related Musculoskeletal Disorders among Nursing Staff of Tanta University Hospitals: Pattern, Risk Factors, and Coping Strategies. Egypt. J. Commun. Med. 2019, 37, 51–61. [Google Scholar] [CrossRef]
- Tirgar, A.; Khallaghi, S.; Taghipour, M. A Study on Musculoskeletal Disorders and Personal and Occupational Risk Factors Among Surgeons. Iran. J. Health Sci. 2013, 1, 50–57. [Google Scholar] [CrossRef]
- Ratzon, N.Z.; Bar-Niv, N.A.; Froom, P. The effect of a structured personalized ergonomic intervention program for hospital nurses with reported musculoskeletal pain: An assigned randomized control trial. Work 2016, 54, 367–377. [Google Scholar] [CrossRef] [Green Version]
- Atefi, N.; Lim Abdullah, K.; Wong, L.P.; Mazlom, R. Factors influencing job satisfaction among registered nurses: A questionnaire survey in Mashhad, Iran. J. Nurs. Manag. 2015, 23, 448–458. [Google Scholar] [CrossRef]
- Han, R.M.; Carter, P.; Champion, J.D. Relationships among factors affecting advanced practice registered nurses’ job satisfaction and intent to leave: A systematic review. J. Am. Assoc. Nurse Pract. 2018, 30, 101–113. [Google Scholar] [CrossRef]
Group | Control | Intervention | p-Value | ||
---|---|---|---|---|---|
Mean | SD | Mean | SD | ||
Age (years) | 26.64 | 5.83 | 31.45 | 8.19 | 0.005 |
Work experience (years) | 2.70 | 5.07 | 8.51 | 7.64 | 0.000 |
Control (n%) | Intervention (n%) | p-Value | ||||
---|---|---|---|---|---|---|
Gender | Male | 7 | 18.9% | 11 | 29.7% | 0.278 |
Female | 30 | 81.1% | 26 | 75.3% | ||
Education level | Associate degree | 5 | 13.5% | 12 | 32.4% | 0.053 |
Bachelor’s degree | 32 | 86.5% | 25 | 67.6% | ||
Work shift | Morning | 22 | 59.5% | 5 | 13.5% | 0.000 |
Circulating | 15 | 40.5% | 32 | 86.5% | ||
Job task | Scrub or circulate | 25 | 67.6% | 19 | 51.4% | 0.225 |
Anesthesia | 10 | 27% | 12 | 32.4% | ||
Others | 2 | 5.4% | 6 | 16.2% | ||
Total | 37 | 100 | 37 | 100 |
Pain | Control | Intervention | ||||
---|---|---|---|---|---|---|
n% | n% | p-Value | ||||
Before | After | Before | After | Before | After | |
Neck | 17 (45.9) | 12 (32.4) | 16 (43.2) | 2 (5.4) | 0.810 | 0.003 |
Shoulder | 13 (35.1) | 14 (37.8) | 14 (37.8) | 5 (13.5) | 0.892 | 0.043 |
Elbow | 2 (5.4) | 3 (8.1) | 2 (5.4) | 2 (5.4) | 1.000 | 0.640 |
Hand wrist | 9 (24.3) | 12 (32.4) | 9 (24.3) | 5 (13.5) | 1.000 | 0.041 |
Back | 16 (43.2) | 14 (37.8) | 16 (43.2) | 8 (21.6) | 1.000 | 0.126 |
Low back | 23 (62.2) | 24 (64.9) | 20 (54.1) | 8 (21.6) | 0.480 | 0.000 |
Hip | 9 (24.3) | 12 (32.4) | 3 (8.1) | 1 (2.7) | 0.058 | 0.001 |
Knee | 21 (56.8) | 20 (54.1) | 17 (45.9) | 14 (37.8) | 0.351 | 0.161 |
Ankle | 13 (35.1) | 16 (43.2) | 11 (29.7) | 5 (13.5) | 0.610 | 0.005 |
Logistic Regression | Variables | OR | 95%CI | p-Value |
---|---|---|---|---|
Regression analysis of pain in different parts of the body after the intervention | Intervention vs. control | 0.10 | 0.02–0.51 | 0.006 |
Primary neck pain (referent = no) | 7.80 | 1.78–34.27 | 0.007 | |
Intervention vs. control | 0.20 | 0.05–0.69 | 0.012 | |
Primary shoulder pain (referent = no) | 4.75 | 1.43–15.71 | 0.0011 | |
Intervention vs. control | 0.36 | 0.11–1.18 | 0.093 | |
Primary back pain (referent = no) | 9.28 | 2.11–31.12 | 0.000 | |
Intervention vs. control | 0.12 | 0.04–0.39 | 0.000 | |
Primary lumbar pain (referent = no) | 5.81 | 1.77–19.01 | 0.004 | |
Intervention vs. control | 0.46 | 0.03–5.80 | 0.552 | |
Primary elbow pain (referent = no) | 11.69 | 0.78–173–88 | 0.074 | |
Intervention vs. control | 0.25 | 0.70–0.92 | 0.038 | |
Primary hand wrist pain (referent= no) | 6.45 | 1.81–22.92 | 0.004 | |
Intervention vs. control | 0.03 | 0.002–0.56 | 0.001 | |
Primary hip pain (referent = no) | 64.50 | 6.66–624.54 | 0.000 | |
Intervention vs. control | 0.53 | 0.16–1.74 | 0.291 | |
Primary knee pain (referent = no) | 19.84 | 5.87–67.07 | 0.000 | |
Intervention vs. control | 0.16 | 0.04–0.60 | 0.007 | |
Primary ankle pain (referent= no) | 7.41 | 2.17–25.30 | 0.001 | |
The results of the REBA for assessing the risk of MSDs | Intervention vs. control | 0.22 | 0.07–0.70 | 0.011 |
Mean of the REBA scores (referent = no) | 11.67 | 2.47–55.12 | 0.002 |
Risk | Low | Medium | High | p-Value | ||||
---|---|---|---|---|---|---|---|---|
n% | n% | n% | ||||||
Time | Before | After | Before | After | Before | After | Before | After |
Intervention group | 5 (13.5%) | 18 (48.6%) | 19 (51.4%) | 19 (51.4%) | 13 (35.1%) | 0 (0%) | 0.35 | 0.03 |
Control group | 8 (21.6%) | 10 (27%) | 25 (67.6%) | 26 (70.3%) | 4 (10.8%) | 1 (2.7%) | ||
Total | 13 (17.5%) | 28 (37.8%) | 44 (59.5%) | 45 (60.8) | 17 (23%) | 1 (1.4%) |
Time/Group | Before | After | Statistical Analysis ANCOVA Test *, p Value | ||
---|---|---|---|---|---|
Mean | SD | Mean | SD | ||
Intervention | 48.07 | 10.45 | 45.05 | 12.63 | df = 1, F = 2.90, 0.093 |
Control | 50.28 | 12.70 | 50.17 | 11.75 |
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Abdollahi, T.; Pedram Razi, S.; Pahlevan, D.; Yekaninejad, M.S.; Amaniyan, S.; Leibold Sieloff, C.; Vaismoradi, M. Effect of an Ergonomics Educational Program on Musculoskeletal Disorders in Nursing Staff Working in the Operating Room: A Quasi-Randomized Controlled Clinical Trial. Int. J. Environ. Res. Public Health 2020, 17, 7333. https://doi.org/10.3390/ijerph17197333
Abdollahi T, Pedram Razi S, Pahlevan D, Yekaninejad MS, Amaniyan S, Leibold Sieloff C, Vaismoradi M. Effect of an Ergonomics Educational Program on Musculoskeletal Disorders in Nursing Staff Working in the Operating Room: A Quasi-Randomized Controlled Clinical Trial. International Journal of Environmental Research and Public Health. 2020; 17(19):7333. https://doi.org/10.3390/ijerph17197333
Chicago/Turabian StyleAbdollahi, Tahereh, Shadan Pedram Razi, Daryoush Pahlevan, Mir Saeed Yekaninejad, Sara Amaniyan, Christina Leibold Sieloff, and Mojtaba Vaismoradi. 2020. "Effect of an Ergonomics Educational Program on Musculoskeletal Disorders in Nursing Staff Working in the Operating Room: A Quasi-Randomized Controlled Clinical Trial" International Journal of Environmental Research and Public Health 17, no. 19: 7333. https://doi.org/10.3390/ijerph17197333