某醫學中心護理人員肌肉骨骼不適之盛行率及其影響因素探討

Prevalence and Associated Factors of Musculoskeletal Disorder of Nurses in a Medical Center

目的：本研究旨在瞭解某醫學中心護理人員肌肉骨骼不適（MSDs）之盛行率及其影響因素。方法：本研究為描述性研究，研究期間自2006年6月至2006年12月，主要研究對象為某醫學中心之護理人員，有接受肌肉骨骼不適問卷及專科醫師理學檢查護理人員共363人，其中問卷或理學檢查整理後，有MSDs者共236人，有完整資料的MSDs之研究對象為198人。資料收集後，以SPSS for window 14.0進行統計分析。結果：各護理單位之護理人員肌肉骨骼不適之盛行率為65.0％，經問卷或理學檢查MSDs部位以肩膀佔最多67.2％（122人）；其次為頸部61.6％（122人）；下背佔第三位，42.9％（85人）。護理人員九大部位MSDs和基本屬性之相關探討，發現「工作負荷量」會影響肩膀及腕／手之不適，「有壓力不勝負荷」的勝算比是「適度的可負荷」2.364倍及2.463倍；「運動習慣」會影響腕／手之不適，「無運動」的勝算比只有「有運動」的0.240倍；「做伸展操」會影響上背之不適，「無做的」勝算比是「有做的」0.415倍；而「工作單位」會影響頸部之不適，「病房單位」的勝算比是「加護及手術單位」的1.889倍，且均達統計上顯著差異（p＜0.05）。結論：本醫療機構之護理人員MSDs之盛行率高，發生MSDs前三名之部位分別為肩膀、頸部和下背，影響因素為工作負荷量、運動習慣、有無做伸展操及工作單位。本研究建議護理工作單位之適時、適度輪調，將有助改善重複性活動或長時間靜態的負荷所造成之傷害，而醫院設備採購及設置時，應注重人因工程設施、增加輔助工具，主管單位宜建立職場壓力管理方案，並積極推動社團或健康促進活動，適時、適度的執行伸展操並鼓勵儘早養成規律運動的習慣，如此，將可減少MSDs的情況並可提高工作效率。

Purpose: The purpose of this study was to explore the prevalence and risk factors of musculoskeletal disorders (MSDs) in nurses.Methods: From June 2006 to December 2006 a total of 363 nurses were examined for MSDs. 236 nurses were found to have MSDs. A survey was sent out to all participants, and 198 of them have completed and returned the questionnaire. Data were analyzed by SPSS for Windows 14.0.Result: The results showed the prevalence rate of MSDs was 65%. Of those with MSDs, 67.2% (133 nurses) had problems related to the shoulders, followed by the neck 61.6% (122 nurses) and lower back 42.9% (85 nurses). We found the odds ratio (OR) for discomfort in shoulder and hand/wrist to be 2.364 and 3.463 in nurses who perceived their workloads to be heavy or moderate. Nurses who did not exercised regularly were less likely (OR 0.24) to experience discomfort in hand/wrist than those who exercise regularly. Nurses who did not perform stretching exercise were less likely (OR 0.415) to have upper back syndrome than those who stretched regularly. Nurses working at ward units were significantly more likely (OR 1.889) to experience shoulder and neck syndrome than those working in intensive care units or operating rooms. (p＜0.05)Conclusion: The prevalence rate of MSDs in nurses was high in this study, suggesting a need for the hospital to consider ergonomic issues and a need to provide assistance instruments for nurses. In order to reduce MSDs symptoms from workload and working area, it is also important to consider shift rotation. Managers in the hospitals should provide stress management programs and health promotional activities to help nurses do stretch exercises regularly. These measures may help eliminate key risk factors for MSDs in nurses and hence improve the work efficient.