醫院員工肌肉骨骼疼痛之流行病學研究

An Epidemiological Study of Musculoskeletal Pain in Hospital Personnel

物理治療於職場員工健康促進的角色日趨重要，針對醫院員工常見的肌肉骨骼系統疼痛問題，物理治療師可協助其預防與治療，然而醫院員工的肌肉骨骼疼痛之危險因子的有關資料尚有限。因此本研究目的在探討醫院員工肌肉骨骼疼痛之發生情況，並探索可能與之相關的危險因子，以幫助建立與肌肉骨骼疼痛相關之健康促進計劃。本研究招募臺灣北部某醫院之員工，由物理治療師以北歐肌肉骨骼問卷與台灣版國際身體活動問卷量表分別評估其肌肉骨骼疼痛以及體能活動，並進行體適能檢查（包括腰圍、肌力、肌耐力、柔軟度、平衡能力與心肺耐力）。本研究共有645 名員工參與，80%為女性，平均年齡為34 歲；20%為男性，平均年齡為36.4 歲。自覺肌肉骨骼疼痛問卷的結果顯示464 人（72%）在過去一年中曾有肌肉骨骼方面的疼痛，其中上半身疼痛（頸、肩或上背部）佔55%，下半身疼痛（下背部、腰、髖或大腿）佔43%；443 人（69%）自覺會因為疼痛而影響工作。多變項迴歸模型分析發現腹肌耐力不好者有比較高的機會自覺有下半身疼痛（勝算比=1.8, p＝0.03）；女性比男性抱怨上半身疼痛的機會高（勝算比=2.2, p=0.001）。而過去7 天內工作時坐著的總時間較長者，較易抱怨上半身疼痛（勝算比=1.001, p=0.035）。本研究結果顯示醫院員工的腹肌耐力不足與其下半身疼痛有關，而女性與長時間坐姿工作則與上半身疼痛。物理治療師參與醫院員工健康促進工作，在政策上能以其專業佐以實證醫學證據，協助推行健康促進計畫。

The role of physical therapy in health promotion in workplace is increasingly important. Musculoskeletal pain is a common problem for hospital personnel that physical therapists may assist in its prevention and management. However, the information concerning risk factors related to musculoskeletal pain in hospital personnel has been limited. This study therefore aimed to examine the prevalence of musculoskeletal pain in hospital personnel and to explore its risk factors. The information will help provide the reference for planning health promotion program for hospital personnel. This study prospectively enrolled employees from a hospital in northern Taiwan. All subjects were examined their musculoskeletal pain using the Nordic Musculoskeletal Questionnaire and the physical activity using the International Physical Activity Questionnaire- Taiwan version. Their fitness including waist girth, muscle strength and endurance, flexibility, balance and cardiopulmonary index were assessed by physical therapists. Logistic regression analysis was used to examine the associations of potential influencing factors (i.e., sex, occupation, physical activity and fitness) with the occurrence of musculoskeletal pain. This study included 645 hospital employees, 80% being females with mean age of 34 years and 20% being males with mean age of 36.4 years. 464 employees (72%) reporting musculoskeletal pain in the past one year, 55% encountered upper quarter pain and 43% encountered lower quarter pain. 443 employee (69%) reported that musculoskeletal pain influenced work. Multivariable logistic regression analysis revealed that individuals having poor muscle endurance were more likely to have pain over the lower quarter (odds ratio [OR]=1.8, p=0.03). Females had higher risk of sustaining upper quarter pain than males (OR=2.2, p=0.001). Furthermore, employees with prolonged sitting time during work in the past 7 days were more likely to have upper quarter pain (OR=1.001, p=0.035). Our results indicated association of poor abdominal muscle endurance with lower quarter pain; and relation of female and prolonged sitting during work with upper quarter pain. Through participation in the health promotion committee and activities, physical therapists can provide evidence-based services to help implement the policy of health promotion.