臺北市立醫院護理人員下背痛現況與教育需求之調查研究

Study on Prevalence of Lower-Back Pain among Nurses of Taipei Municipal Hospitals and their Training Needs

本研究主要目的在了解台北市立醫院護理人員下背痛罹患情形、處理方式、採取預防下背痛之障礙因素、探討工作負荷及工作內容、個人特質與下背痛關係，並進行教育訓練需求調查，以作為日後預防下背痛教育介入參考。本研究採橫斷式調查研究設計，以台北市立八家醫院之全體護理人員為對象，於 91 年 3~4 月間以自填式問卷方式進行施測，得有效樣本 2034 名，研究結果發現護理人員下背痛罹患率為 61.6%，比例偏高。其年盛行率、月盛行率、週盛行率分別為 42.4%、19.8%、14.3%，而多數護理人員在工作一年後便會發生下背痛的症狀，其中則有四成被醫師診斷罹患下背痛疾病。下背痛相關變項上則與「病房別」、「護理年資」、「兼職行政工作」、「工作時數」、「年齡」、「婚姻狀況」、「生育數」、「BMI」、「體重」與「規律運動」呈顯著性的相關，而「工作負荷大，沒時間注意」 、 「工作時容易緊張，忽略工作姿勢」 ，及擔心「會影響護理工作的效率」 、 「醫院硬體設備設計不佳」則是預防下背痛主要的障礙因素。在風險性評估方面「護理年資」、「婚姻狀況」及「規律運動」對於下背痛經驗之有無則具有顯著預測力。此外，有八成研究對象不知道或已確定醫院沒有下背痛預防教育，而有九成的研究對象願意參加下背痛預防教育活動，最希望教育介入的內容為「下背痛的症狀處及治療」 ，期望教材則是「錄影帶」 ，運用教學方法則以「示範教學」為主。未來擬定介入計畫時，也應針對護理人員所需要上課內容及教材教法方式，提供一套完善的教育介入，以維護護理人員肌肉骨骼健康，進而帶給服務之病患更好的護理品質。

The main purpose of this study was to explore the factors related to Taipei municipal hospital nurses of lower-back pain prevalence, and means to break the barriers for lower-back pain preventive behavior. This study focused on the lower-back pain problems associated with workload, work content, and personal factors. Finally, we investigated the training needs for intervention in the future. This study was a cross-sectional survey. The prevalence of nurses’ lower-back pain was 61.1%, the year prevalence was 42.2%, the month prevalence was 19.8%, and the week prevalence was 14.3 %. Most of the staff suffered lower-back pain after they worked for a year, and about 40% of them were diagnosed with lower-back pain by doctors. The results show that ward, number of years on the job, administrative responsibility, working hours, age, marital status, parities, BMI, weight, and regular exercise have significant impact on lower-back pain experience. On the other hand, heavy work load, too busy to pay attention to, nervousness, ignoring working postures, worrying about effectiveness, poor design of medical equipment were major factors discouraging nurses to take lower-back pain preventive measures. In addition, the research results show that most hospitals do not provide lower-back pain training programs, and 90% of the nurses are interested in such training. The most popular training subject was about the lower-back pain symptoms, and the most popular training material and method were video and live demonstration.