الفهرس | Only 14 pages are availabe for public view |
Abstract Low back pain is a public cause of morbidity in hospital among health care staffs and is associated with major social and economic influence worldwide. Nurses are one of the few occupational groups who have to work in shifts during their jobs. Work shift either long-term night work or work including rotation between day, evening, and night shifts. Work shifts influence nurse’s well-being and performance because of disturbance the circadian circulation. This may result in sleep disturbances, fatigue, and decreased work performance and safety alertness. The use of correct body mechanics is important to decrease the risk of musculoskeletal system problems and also to assist physical mobility without muscle tension and undue use of muscles energy. In addition, correct body alignment enhances lung expansion and promotes effective circulatory renal and gastrointestinal function. Orthopedic nurses at risk every day to low back damages while providing patient care, as nursing care may hold strenuous physical exertion such as patient transferring in and out of bed during daily care. Moreover, LBP is costly for both the nurse and health care setting. Costly, for the nurse as it results in pain, disability and hinder effective nursing performance, and costly for the health care setting because the injured nurse is not able to provide the obligatory level of nursing care and the treatment is costly. The aim of this study was: To identify the relationship between utilization of body mechanics and exposure to low back pain among nurses working in orthopedic department. Materials and method Research Design: A descriptive correlational research design was utilized for this study. Setting: This study was conducted at at three places: orthopedic department at Benha University Hospital in Egypt, orthopedic department at Toukh Central Hospital and orthopedic department at Benha Teaching Hospital. Subject: The sample of this study comprised convenience sample from all nurses working at the orthopedic department (70 nurses) were considered eligible to participate in the study, if they meet the following criteria: All nurses who are responsible for providing direct patient care for orthopedic patient for more than one year. Works for three different shifts. Willing to participate in the study. Tools of the study: Three tools were used for the purpose of data collection: Tool I: Nurses’ Socio demographic and Clinical data Structured Questionnaire: The tool consisted of two parts as the following: Part I: sociodemographic data; which consisted of nurses’sociodemographic characteristics. Part II: clinical data; which consisted of two subcategories: health history and anthropometric measurements. Tool II: Nurses’ Utilization of Body Mechanics: Observational Checklist The tool consisted of two parts as the following: Part I: nurses’ practice regarding body mechanics during practice of general physical tasks. Part II: nurses’ practice regarding body mechanics during patients handling. Tool III: Low Back Pain Assessment: The tool consisted of four parts as the following: Part I: pain history Part II: behavioral responses of pain Part III: physiologic responses of pain Part IV: Nurses’ Pain Numeric Rating Scale Method: • Study tools number I, II, and III part I, II, III was developed by researchers after reviewing the related literatures, and tool III part IV was adopted by the researcher. • Study tools number I and III was translated into Arabic language and tool II will be used in English.. • All tools was tested for content validity by three experts in the Medical Surgical Nursing field and two experts in orthopedic field, to assure the content validity, completeness and clarity of items and appropriateness. Every jury member was informed about the aim and method of the study. Comments and suggestions of the jury were considered, and the tools were modified accordingly. • All tools were tested for its Reliability and ascertained using the appropriate statistical test. The data was analyzed; the correlation coefficient for tool II (Nurses’ utilization of body mechanics observational checklist) was 0.972 and tool III (Low Back Pain Assessment) was 0.903, which means that the tools were reliable. • A pilot study was carried out on 7 staff nurses from Benha university hospital to assess clarity, feasibility and applicability of the tools and to identify obstacles that may be faced during data collection. The necessary modifications were done accordingly. These nurses were excluded from the current study. • Study tools number I, III was distributed to nurses during their break time and asked to fill them in the presence of the researcher and return them back. The duration of data collection for each nurse was about 20-30 minutes to complete the tools in the nurse’s room. Data were collected throughout a period of six months from the beginning of September 2021 to the end of February 2022. • Body Mass Index was calculated by measuring weight and height. BMI = weight (Kg) /height (m)² (WHO. 2020). It was asserted as the following: Underweight if BMI < 18.5 Normal weight if BMI 18.5 – 24.9 Over weight if BMI 25 – 29.9 Obese if BMI >30. • Nurses’ utilization of body Mechanics observational checklist (Tool II) was used to assess utilization of body mechanics. Every nurse will be observed three times in the morning, afternoon and evening shifts at the selected orthopedic departments using tool II from Saturday to Thursday on daily basis from 9 A.m. to 2 P.m, 2 P.M to 8 P.m and 8 P.m to 8A.m; around one to two nurses were observed daily by the researcher through concealed observations. The main results of this study were: 2. Findings of this study revealed that nearly half of the studied nurses were in the age group of 30 > 45years, also the majority of them were females, married, had bachelor degree, had five years or more of work experience, and didn’t attend attended training about body mechanics. 3. More than half of the studied nurses 55.7% had no previous hospitalization, 37.5% of them were suffering from arthritis, and only 10% of the studied nurses took medication. Also the majority of the studied nurses had previous pregnancy and non-smoker (93.3%, 97.1 % respectively). Two thirds of the studied nurses 67.2% were sleeping on the side and the majority of the studied nurses 88.6 % wear low heel shoes. Highest percentages 44.3% of nurses were overweight and 37.1% of them were obese. 4. Highest percentage of the studied nurses75.7 %had low back pain. nearly one quarter of them had intermittent pain and 41.5% had pain on both sides of the lower back. 39.6% of the nurses had pain radiates below the knee; Also, 66% of the nurses had pain starts gradually and had constant pain rhythmicity respectively. More than half of the nurses 52.8% had pain as pricking. 5. LBP had accelerated pain by the end of their shift, 47.2% of them when lifting a heavy object. Moreover, more than half of the nurses with LBP 52.8% were relieving their pain by having a warm bath. In addition, only 26.4% of the nurses with LBP visited a health care unit related to pain. 6. The highest percentage of the studied nurses (41.5%) had moderate low back pain, while only (39.6%) of them had mild low back pain. 7. Almost 100% of the studied nurses possess an unsatisfactory practice level in relation to nurses’ utilization of body mechanics. 8. Although there is no statistically significant relation between the nurse’s level of education and their pain severity. 9. The more years of experience the nurses had, the more pain severity level they achieved. 10. Furthermore that there is no statistically significant relation between the nurse’s attendance training about body mechanics and their pain severity level. 11. While there is no significant difference between nurse’s clinical data characteristic and their pain severity. 12. There are statistical significant difference between nurses age and overall body mechanics. 13. There are statistical significant relationship between nurses’ overall practices and their qualifications. 14. There are statistical significant relationship between nurses’ overall practices and their years of experience. 15. There is no significant difference between nurse’s socio demographic characteristic (as gender, marital status and attendee course related body mechanics) and their utilization of body mechanics. 16. There are statistical significant difference between medical history and gait (walking) at (p=0.06*) which indicates that nurses’ with presence of diseases had the highest practices scores in walking. 17. There are statistical significant difference between smoking and sitting position. 18. There are statistical significant difference between sleeping and moving patient to sitting position 19. Additionally, there is no significant difference between nurse’s socio demographic characteristic (as previous hospitalization, taking medication, previous pregnancy, kind of shoes and body mass index) and their utilization of body mechanics. 20. Although there is no significant difference between nurse’s utilization of body mechanics and their pain severity and their pain severity. 21. There are statistical significant difference between pulling and pushing, and pain severity. |