The purpose of this study was to investigate musculoskeletal symptom prevalence in university hospital nurses and explore the relation between musculoskeletal symptom prevalence and work related factors. A structured questionnaire was conducted with nurses in a university hospital to look into the characters of responsibility and musculoskeletal symptom prevalence. The questionnaire respondents numbered , so the response rate was Among the respondents, three who gave insincere answers were excluded. The final study population was respondents. In the case of the whole body, symptom prevalence amounted to
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The purpose of this study was to investigate musculoskeletal symptom prevalence in university hospital nurses and explore the relation between musculoskeletal symptom prevalence and work related factors. A structured questionnaire was conducted with nurses in a university hospital to look into the characters of responsibility and musculoskeletal symptom prevalence.
The questionnaire respondents numbered , so the response rate was Among the respondents, three who gave insincere answers were excluded. The final study population was respondents. In the case of the whole body, symptom prevalence amounted to Regarding each body region, shoulder symptom prevalence accounted for the highest, or According to multiple logistic regression analysis, in the case of the whole body, the group with a high ANSI checklist grade had odds ratio of 3. Regarding the occupational factors related to musculoskeletal symptoms of university hospital nurses, it was found that ANSI Z checklist high risk group, total job tenure, department, shiftworks, and job stress had high relation with musculoskeletal symptoms.
It is necessary to find an ergonomic solution and a stress reduction plan to prevent musculoskeletal disease. Work-related musculoskeletal disease is one of occupational diseases recently increased by a new industrial structure and a changed social environment.
It is a health problem caused by something related to repetitive motion, improper work posture, excessive use of force, the sharp side of the body contact, and vibration and temperature factor. It refers to a disease appearing in the nerves and muscles of the neck, the shoulder, the waist, and the upper and lower limbs, and in surrounding body tissues. In the US, it was said that musculoskeletal disease is the main cause of the absence from work induced by occupational injuries and diseases [ 1 ].
According to the 2nd Korean working condition survey the 2nd KWCS with Korean workers, the absence from work induced by musculoskeletal disease accounted for 1.
It is known that, among risk factors of work related musculoskeletal disease, ergonomic factors are important. According to National Institutes of Safety and Health NIOSH , however, psychosocial factors, such as workload dissatisfaction, monotonous works, limited job autonomy, low job clarity, tedious work, and low social support, have something to do with a variety of work-related musculoskeletal disease [ 3 ].
The tasks of medical care workers in hospital vary. The risk factors of work-related disease are categorized into biological factors, physical factor, chemical factor, ergonomic factor, psychiatric factor, and psychological factors by task [ 4 ].
Of medical care workers, nurses, according to Occupational Safety and Health Agency OSHA , are in the 10 major occupations which have the high risk of work-related musculoskeletal disease [ 5 ]. Another one is the character of their jobs requiring the postures damaging the waist and the body, such as bending, twisting hands, and dealing with patients [ 11 , 12 ]. Domestic nurses do repetitive jobs mainly using their upper limbs, like writing medical records and test records, and have the character of works requiring the frequent use of their lower body part in stations, which need improper and atypical postures, such as injection and medical care for patients.
Also it is known that they receive psycho-social stress because of their job character of giving assistance for patient treatment, and experience severe conflict on account of the different work scope of occupations in hospital, where there are many different occupations [ 13 ].
The previous Korean studies of musculoskeletal disease focused on relevant factors. Most of them looked into only the relation between the disease and ergonomic factors or between the disease and psycho-social factors, or investigated work-related musculoskeletal disease of operation room nurses. There is few research on the risk factors of the disease by body region. The study on medical care workers in one university hospital published in this journal in , which mentioned the issue partially, is the only case.
In other words, there is no study on nurses related musculoskeletal disease. Therefore these author investigated musculoskeletal symptom prevalence in nurses in one university hospital, and looked into ergonomic factors, job stress, work-related factor, and risk factors by body region.
This study conducted a structured questionnaire survey in a self-record type with nurses in a university hospital located in Busan in The study subjects were those who heard the purpose of this study before their participation and agreed on the survey.
The questionnaire respondents numbered , and the response rate was Among them, three respondents gave insincere answers.
As a result, respondents were selected as a study population. The questionnaire includes personal history information, such as age, martial status, and house, and work-related factors, including occupation, department, position, total job tenure, works types, and character of works.
Their age is classified into 20 something, 30 something, 40 something, and over 50 something. Their work department is classified into station, operation room, ICU, and other departments. Their work position is divided into temporary position and permanent position, and their work type into day works and shiftworks.
Their position is classified into general nurse, responsibility nurse, and head nurse and over. Operation room includes operation room nurses. ICU room includes internal medicine part, surgery part, neurology part, and Intensive care units. Other departments include referral center, proper care center, clinical trials centre, outpatient, occupational health centers, infection control room, recovery room, artificial endoscopy laboratory, emergency department, supply chamber, cardiac laboratory, and nursery.
For the questionnaire about musculoskeletal symptom prevalence, this study employed the burden of musculoskeletal research work instructions of Korea occupation safety health agency KOSHA code H The KOSS consists of such sub-elements as job demands, job autonomy, interpersonal conflict, job insecurity, inadequate compensation, organizational structure, and workplace culture. Job stress sub part and total job stress score were based on the 50th percentile reference value suggested by Chang et al.
The job stress was measured in the categories of the group with low total job stress and the group with high stress. This study was reviewed for private information protection and approved by the Institutional Review Board of the Kosin university hospital. Analysis of frequency was applied to the general characters, work-related characters, and psycho-social factor of all study subjects. And analysis of frequency was conducted on symptom prevalence in the categories of the whole body and body regions.
Ergonomic characters, work related characters, and job stress were set to independent variables, and musculoskeletal symptom prevalence and positive symptom according to the whole body and each body region were set to dependent variables. With these variables, linear logistic regression analysis was performed. With significant independent variables, age was adjusted first and then multiple logistic regression analysis was conducted.
The assumptions of multiple regression analysis were verified. As a result, tolerance was less than 1. For statistical analysis, Regarding the age distribution of study subjects, those in their 20s accounted for the highest or Regarding total job stress, they were in 25th to 50th percentile.
In the case of age, those in their 30s had the highest percentage of symptom prevalence, and those in their 50s the lowest. Unmarried study subjects had a higher percentage of symptom prevalence than married ones.
Regarding house-working hours per day, those with more than six hours had the highest percentage of symptom prevalence. With regard to department, operation room nurses had the highest Regarding total job tenure, those with less than four years had the highest percentage Regarding position, general nurses had the highest According to linear logistic regression analysis, ANSI checklist grade, department, total job tenure, shiftworks, and total job stress had relation.
According to multiple logistic regression analysis, in the case of the whole body, the group with high ANSI checklist grade had odds ratio of 3.
In the case of the neck, those with 5 to 10 work years had odds ratio of 1. In the case of the shoulder, those with more than 10 work years had odds ratio of 1. Those with high job stress had odds ratio of 3.
Other body part had odds ratio of 2. Odds ratios of work-related factors for musculoskeletal symptoms by multivariate analysis. This study tried to investigate the relation with ergonomic risk factors, job stress, and work-related factor of nurses according to body regions.
In the case of the whole body, ANSI checklist grade had relation. In the case of each body region, work tenure, department, shiftworks, and job stress had relation. The results were similar to the prevalence According to the study of male and female workers in the main shipbuilding industry by bakjeongseon, the musculoskeletal symptom prevalence of male manufacturing workers was The results were not higher than the musculoskeletal symptom prevalence of university hospital nurses in this study.
This study was compared with previous studies on hospital nurses. In the study by Woh [ 17 ] et al. In the study by Woh et al. In this study, symptom prevalence was high in the order of the shoulder, the waist, the neck, and the knee. Depending on studies, there were differences in the order of body regions and symptom prevalence.
It is considered that the causes are different working conditions and different labor grades. Another critical cause is the difference in the definition of symptom prevalence and diagnosis method depending on surveyors.
Nevertheless, the result that each study showed symptom prevalence in the almost same body regions indicates that the work types of nurses are reflected well.
The relation between the body symptom prevalence and wok-related factor relation was analyzed. As a result, in the case of the whole body, as an ANSI checklist grade went up, odds ratio of symptom prevalence significantly increased to 3. A previous study observed neck symptom according to the total score, and revealed that high risk group increased relative risk of musculoskeletal symptom more than low risk group [ 19 ].
According to the study of Choi et al. The result is presumed to be related to the characteristics of hospital work described earlier, and supports the conclusion that ergonomic work environment improvement is necessary. In the cases of the neck and the shoulder, a rise in total job tenure had significant relation with odds ratio of symptom prevalence.
According to Kurumatani, the longer the tenure was, the higher the perception symptom prevalence for body regions, such as the shoulder, the neck, and the arms became [ 21 ]. The study by Park revealed that the group of workers with more than five work years had statistically significant higher musculoskeletal symptom prevalence than the group with less than five work years [ 22 ].
The pains on the neck and the shoulder, and lethargy of the arms had relation with tenure, and the pain on the waist had significant relation with a rise in tenure [ 22 ]. Kourinka and Forcier proved that a level of exposure per day or in lifetime increased the strength of the relation between exposure and work-related musculoskeletal disease [ 23 ]. Operation room nurses need to make a quick and accurate judgment, repeatedly use one arm, lift or move a heavy object, and take a fixed posture and tension for a long time in the process of surgical operation.
Therefore, they have a lower level of health conditions than other workers [ 24 ]. The scrub work of operation room nurses is to prepare operation tools and hand over the prepared tools to operating surgeons. It requires a fixed standing posture for a long time and a posture of keeping a certain distance. As a result, it causes unnatural postures.
Risk factors of musculoskeletal symptoms in university hospital nurses
Thomas J. Armstrong, chairman of the ANSI Accredited Standards Committee Z committee developing a voluntary consensus standard for ergonomics and professor of Industrial Engineering at the University of Michigan, commented on the OSHA proposal: "The proposed formation of a steering committee, the development of guidelines and enforcement application regulations regarding ergonomics are all positive steps. However, the committee composition, program funding and how seriously OSHA takes enforcement will determine the effectiveness of this initiative. We will have to wait and see.