長期照護機構女性照護人員病人搬運活動與肌肉骨骼傷害之相關性探討

Patient-Handling Activities and Musculoskeletal Disorders among Female Nursing Personnel in Long-term Care Facilities

目標：比較長期照護機構護士及護佐在自述肌肉骨骼傷害盛行部位之差異，並探討病人搬運活動與特定部位傷害之相關性。方法：本橫斷研究以結構式問卷且採面對面訪問方式收集資料，共收集台灣27 家長期照護機構283女性照護人員的資料，其中護士112人，護佐171人。結果：護士及護佐之肌肉骨骼傷害部位盛行率前兩名均為下背及肩部；但是第三盛行部位護士出現在頸部，護佐則出現在手／手腕。經過人口學變項調整，護佐的手／手腕傷害的危險性高於護士（OR=2.63, 95%CI=1.25-5.53） 。不論護士及護佐肌肉骨骼傷害之危險比（OR）有隨某些搬運病人活動頻率增加而增加的傾向，特別是「幫病人洗澡」與護佐的頸、肩、下背及手／手腕傷害及護士的肩部與下背傷害都有達到統計相關。此外，護佐的手／手腕傷害與本研究的 5 項搬運活動都有相關。結論：護士雖然從事搬運病人的活動比護佐少，但是依然發現病人搬運活動與護士的肌肉骨骼傷害有相關。另外，護佐在手／手腕部位傷害的高盛行率是過去研究未曾見的。故建議建立搬運病人之標準作業程序，以降低長期照護機構照護人員之肌肉骨骼傷害。

Objects: To compare the prevalence difference of self-reported musculoskeletal disorders (MSDs) for female nurses and nursing aides (NAs) in long-term care facilities (LTCFs) and to explore their patient- handling activities related to specific-site MSDs. Methods: A structured questionnaire was used, and by means of face-to-face interviews to collect data. We carried out a cross-sectional survey with a total of 283 nursing personnel, which included 112 nurses and 171 NAs from 27 LTCFs in central Taiwan. Results: The top two sites, the most prevalence of MSDs, were low back and shoulder to nurses and NAs. However, the third MSDs site was different. For nurse and NA cases, they were happening at neck and hand/wrist, respectively. After adjustment for some demographic variables, we found that NAs (vs. nurses) got a higher odds ratio (OR=2.63, 95%CI=1.25-5.53) in hand/wrist disorders. The odds ratio of MSDs revealed the positive tendency followed by the increasing of some patient-handling activities to nurses or NAs. Especially in “bathing for patient”, there were statistically associated with NA’s neck, shoulder, low back and hand/wrist disorder, that also associated with nurses’ shoulder and low back disorder. Additionally, NAs’ hand/wrist disorder related to five types of patient-handling activities in this study. Conclusions: Although the frequency of patient-handling activities to nurses was lower than NAs, but still had a relationship between nurses’ MSDs and patient-handling activities. Moreover, the high prevalence of hand/wrist disorder to NAs was different from previous studies. We suggest that to establish a standard operation procedure for patient-handling tasks are necessary to decrease nursing personnel’s MSDs in LTCFs.