醫院護理人員肌肉骨骼不適之相關因素探討

Factors Related to Musculoskeletal Disorders Among Hospital Nurses

背景：護理人員是肌肉骨骼不適的高危險族群，然而國內文獻針對護理人員工作特性、心理健康與肌肉骨骼不適的相關性研究仍顯不足。
目的：探討醫院護理人員肌肉骨骼不適情形，以及其相關因素。
方法：本研究採次級資料分析之研究法，資料來源為南部二家區域醫院於2018年醫院員工健康調查資料，以通過試用期且到職滿6個月以上的護理人員共計328位納入分析，採羅吉斯迴歸模式進行統計分析。
結果：護理人員肌肉骨骼不適之各部位盛行率，依序為肩膀（73.8%）、腰或下背（72.9%）及脖子（64.0%）。睡眠時間、工作壓力、解決工作壓力的信心、工作負荷、主管支持、職場正義、憂鬱程度與是否有全身肌肉骨骼不適有統計上顯著差異。羅吉斯迴歸模式結果顯示，憂鬱程度重度者與無憂鬱者相比，肌肉骨骼不適勝算比為4.27倍（odds ratio 4.27, 95% confidence interval [1.27, 14.41]），重度憂鬱程度對於肌肉骨骼不適有顯著的影響。
結論／實務應用：護理人員有肌肉骨骼不適盛行率高，且因心理健康、工作環境與工作負荷有所差異，應積極改善職場之相關危害因子，進而預防護理人員發生肌肉骨骼不適的情形。

Background: Nurses are a high-risk group for musculoskeletal disorders. Few studies conducted in Taiwan have been published regarding the relationships among work characteristics, psychological well-being, and musculoskeletal discomfort in nursing personnel.
Purpose: This study was designed to investigate musculoskeletal discomfort among hospital nursing staff, as well as its associated factors.
Methods: A secondary data analysis design was used to examine hospital staff health survey data for 2018 from two regional hospitals in southern Taiwan. Data from 328 full-time nurses who had passed their probationary period and been employed for more than 6 months were included in the analysis, which was conducted using a logistic regression model.
Results: The prevalence of musculoskeletal disorders was found to be highest in the shoulders (73.8%), lower back (72.9%), and neck (64.0%), respectively. Number of sleep hours, work stress, confidence in dealing with work stress, workload, supervisor support, workplace justice, and depression level differed significantly between the groups with and without full-body musculoskeletal disorders (p < .05). The results of the logistic regression model analysis showed individuals with severe depression have 4.27 times higher odds of experiencing musculoskeletal discomfort compared to those without depression (odds ratio 4.27, 95% confidence interval [1.27, 14.41]). Severe depression was found to be a significant predictor of musculoskeletal disorders.
Conclusions/ Implications for Practice: Nurses are at high risk for musculoskeletal disorders. The results of this study indicate that level of risk is influenced significantly by psychological well-being, work environment, and workload. Efforts should be made to improve the relevant risk factors in the workplace to reduce the incidence of musculoskeletal disorders among nurses.