網球按摩減緩護理人員肌肉骨骼不適及增強自我效能成效探討

Tennis Ball Massage Therapy in Clinical Nurses: Effect on Relieving Musculoskeletal Disorders and Enhancing Self-Efficacy

背景：肌肉骨骼不適是常見職業病，護理人員盛行率為65.1%–87.3%，以頸、肩及下背部為多數。
目的：探討網球按摩緩解肌肉疼痛及提升緩解疼痛自我效能之成效。
方法：本研究為類實驗、單組前後測設計，先普查216位地區教學醫院護理人員，普查出身體至少有一處疼痛者後，依單位屬性採系統性隨機抽樣，抽出36位護理人員，接受四週「打擊疼痛」介入方案，以「疼痛視覺量表」及「緩解疼痛自我效能量表」為評估工具，進行前測及3次後測評量，以單因子及二因子重複測量變異數分析、符號等級檢定及相依樣本中位數差異測試，檢測介入前後成效。
結果：肌肉疼痛以肩部最多（94.4%），其次頸部（88.9%）、上背部（55.6%）；頸肩背疼痛部位與四次測量時間具交互作用（F = 2.69, p = .020），事後比較，測量時間以第三次後測疼痛改善最佳，其次為第二次；前測與第三次後測疼痛改善均達顯著差異（t = 6.39, 8.68, 6.96, p < .001）。疼痛緩解自我效能方案於介入前後具顯著差異（F = 53.49, p < .001），事後比較，第三次後測提升最高，前測最低；前測與四週方案結束後測（t = -10.25, p < .001）達顯著差異。
結論／實務應用：經由本研究顯示，網球按摩確實能改善護理人員頸肩背疼痛及提升緩解疼痛自我效能，網球按摩具方便取用、無時間空間限制、無需假手他人的特點，運用於忙碌的護理工作中，可減輕肌肉疼痛的困擾，提升活動舒適感及工作效率，使肌肉疼痛不再是影響工作的絆腳石。

Background: Musculoskeletal disorders are a common occupational disease. The prevalence of musculoskeletal disorders among nurses is estimated at 65.1%–87.3%, with neck, shoulders, and lower back being most affected.
Purpose: To explore the effectiveness of tennis ball massage therapy in alleviating muscle soreness and improving pain relief self-efficacy.
Methods: In this quasi-experimental, single-group, pre- and post-test study, 216 nurses in regional teaching hospitals were screened for neck, shoulder, and back pain. Based on the unit attributes, systematic random sampling was employed to recruit 36 nurses to participate in a four-week“fighting pain”intervention program. The“Pain Visual Scale”and“Pain Relief Self-efficacy Scale”were used as the assessment tools. One-way and two-way repeated measure analysis of variance, a signed ranks test, and the Friedman test were used to assess longitudinal change in the data.
Results: Shoulders were the most reported site of muscle pain (94.4%), followed by the neck (88.9%) and the upper back (55.6%). The locations of neck, shoulder, and back pain were interacted differently with the four measurement times (F = 2.69, p = .020). In the post hoc comparison, pain relief effectiveness was most significant in the third posttest, followed by the second. The pain relief was significantly different between the pre-test and the third post-test (t = 6.39, 8.68, 6.96, p < .001). There was a significant difference before and after the intervention of the pain relief self-efficacy (F = 53.49, p < .001). The post hoc comparison results revealed that self-efficacy was lowest at pretest and highest at the third posttest. Significant differences were observed between the pre-test and third post-test at the end of the intervention (t = -10.25, p < .001).
Conclusions/ Implications for Practice: This study shows that tennis ball massage can improve neck, shoulder, and back pain in nurses and improve pain relief self-efficacy. Tennis ball massage is easy to implement, has no time and space restrictions, and requires no assistance to operate. This equipment can be used to effectively reduce muscle pain, improve the comfort of performing regular activities, and raise work efficiency, reducing the negative impact of muscle pain on work.