腰背痛(low back pain ,LBP) 是一种职业相关性疾病,人群中LBP 发生率约85% ,[1]LBP 与肩、颈、臂及腿痛统称为肌肉骨骼疾患( musculoskeletal disorder ,MSD) ,其最基本的特点就是疼痛和运动功能障碍。[2-3] 随着科学技术的发展,职业病的构成发生了明显的变化,在许多国家LBP 已位于职业病的榜首,成为人群就诊、住院或手术的最常见病因。[1] 为此,美国国家安全与健康机构(NIOSH) 从1989 年起把MSD 列为研究和预防的重点。众多研究表明,护士是患LBP 的高危人群,[4-6]护士和辅助护士患LBP 的危险性是其他职业女性的2. 5 倍,[4]有10 %的护士每年因LBP 缺勤累计超过4 周。[7]LBP 作为影响护理人员健康和工作的一个严重的职业卫生问题,在欧美国家已受到广泛的重视。为引起我国广大护理人员的重视,本文就国外近年来护士职业性LBP 的研究概况作一个简要综述。
1 LBP 在护士人群中的分布
1. 1 LBP 的概念及其在护士人群中的发病情况
1. 2 护士职业性LBP 的分布特点
2 护士发生LBP 的危险因素分析
2. 1 个体因素
2. 2 职业因素
2. 2. 1 抬、搬病人
2. 2. 2 不良的工作姿势
2. 2. 3 体力负荷
2. 3 社会心理因素
2. 4 组织管理因素
3 LBP 的自然病程及其影响因素
4 LBP 的治疗与预防
4. 1 初级预防
总之,LBP 已是影响护士健康问题的一个严重问题,借鉴国外的经验对我国护士人群的LBP 的流行现况及危险因素进行研究,并依此制定适合我国国情的干预措施,减少国内护理人员LBP 发生,将具有重要的现实意义。
参 考 文 献
1 Gunnar B , Andersson J . Epidemiological features of chronic low - back pain. The lancet ,1999 , 354( 14) :581 - 585.
2 杨磊. 职业下背痛的病因学研究进展. 工业卫生与职业病,1993 ,19(3) :190 - 192.
3 金克峙. 职业性腰背痛的流行病学研究. 劳动医学,1993 ,16 (1) :53 - 54.
4 Johanning. E. Evalution and management of occupational low back disor2ders. American Journal of Industrial Medicine ,2000 ,37 :94 - 111.
5 Higmett - S . Work - related back pain in nurses. J - Adv Nurs , 1996 ,23(6) :1238 - 1246.
6 Knibhe JJ , Friele PD. Prevalence of back pain and characteristics of the physical workload of community nurses. Ergonomics ,1996 ,39 (2) :186 -
198.
7 Smedley J , Egger P , Cooper C , et al . Manual handling activities and risk of low back pain in nurses. Occup Environ Med ,1995 ,52 :160 - 163.
8 Stanlley JB ,Richard RB , Brean GR , et al . Acute low back problems in adults U S. Department of Health and Human Services ,1994 ,1.
9 Stubbs DA , Buckle PW, Hudson MP ,et al Back pain in the nursing pro2 fession. I. Epidemiology and pilot study. Ergonomics , 1983 ,26 :755 -765.
10 Leighton DJ , Reilly T. Epidemiological aspects of back pain :the ince2 dence and prevalence of back pain in nurses compared to the general pop2 ulation. Occup. Med ,1995 ,45(5) : 263 - 267.
11 刘建平,任辉,周玲. 护理人员腰背痛现状调查与危险因素初步分析. 工业卫生与职业病,1999 ,25(3) :166 - 167.
12 Chiou WK, Wong MK ,Lee YH. Epidemiology of low back pain in Chi2 nese nurses. Int . Nurs Stud ,1994 , 31 (4) : 361 - 368.
13 Omokhodion FO , Umar US , Ogunnowo BE. Prevalence of low back pain among staff in a rural hospital in Nigeria. Occup Med , 2000 , 50 (2) :107 - 110.
14 Yassi A , Khokhar J , Tate R , et al . The epidemiology of back injuries in nurses at a large Canadian tertiary care hospital : implications for pre2 vention. Occup. Med ,1995 , 45 (4) :215 - 220.
15 Vasiliadou A , Soumilas A , Roumeliotis D , et al . J . Adv. Nurs ,1995 , 21(1) :125 - 130.
16 Cohen - Mansfield J , Culpepper WJ , Carter P. Nursing staff back in2 juries : prevalence and cost in long term care facilities. AAOHNJ ,1996 ,44(1) : 9 - 17.
17 Vwen BD , Damron CF. Personal characteristics and back injury among hospital nursing personnel . Res. Nursing Health , 1984 ,7 : 305 - 313.
18 Vasiliadou A , Karvountqis G, Roumeliotis D ,et al . Factors associated with back pain in nursing staff : a survey in Athens , Greece. Int . J .Nurs. Pract , 1997 ,3(1) :15 - 20.
19 Engels. JA , van der Gulden. JWJ , Senden. TF , et al . Work related risk factors for musculoskeletal complaints in the nursing profession : results of a questionaire survey. Occup. and Envirn Med ,1996 , 53 :636 - 641.
20 Heap DC. Low back injuries in nursing staff . J Soc Occup Med ,1987 , 37 :66 - 70.
21 Svensson HO , Andnersson JS , Hazel - I ,et al . Natural history of low - back pain : a longitudinal study in nurses. Spine , 1998 ,23(22) :2422 -2426.
22 Biering - Sorenson F , Thomsen C.Medial , social and occupational history as risk indicators for low back trouble in a general populatiom . Spine ,1983 ,8 :277 - 285.
23 Kul DJ I , Coggon D. Mann S , et al . Height , occupational and back pain in a national prospective study. Br J Rheumatol ,1993 ,32 :911 -916.
24 Smedley J , Egger P , Cooper C , et al . Prospective cohort study of pre2 dictors of nicedent low back pain in nurses. Bri . Med , J , 1997 , 314(26) : 1225 - 1228.
25 Alex B , Cary S. Positive and negative evidence of risk factors for back disorders. Scan J . Work Environ. Health , 1997 ,23 : 243.
26 Chiou WK,Wong MK. Epidemiology of low back pain in the nurses of Chang Gung memorial hospital . Chang - Keng - 1 - Hsuch , 1992 , 15(2) :64 - 71.
27 Burton Ak , Erg E. Back injury and work loss : Biomechanical and psy2 chosocial influences. Spine ,1997 ,22 (21) : 2575 - 2580.
28 Kendall NA. Psychosocial approaches to the prevention of chronic pain : the low back paradigm. Baillieres - Best - Pract - Res - Clin - rheuma2tol ,1999 ,13(3) : 545 - 554.
29 Josephson M , lagerstrom M , Hagberg M , et al . Musculoskeletal symptoms and job strain among nursing personnel :a study over a threeyear period. Occup Environ Med ,1997 ,54(9) :681 - 685.
30 Svensson HD , Andersson GBJ . The relationship of low back pain , work history ,work environment and stress. Spine ,1989 ,14(5) :517 - 522.
31 Larese F , Fiorito A. Musculoskeletal disorders in hospital nurses : a comparison between hospitals . Ergonomics ,1994 ,37(7) : 1205 - 1211.
32 骆永华. 有关职业性腰背痛诊治问题的再认识. 职业医学,1995 ,22 (2) : 21 - 23.
33 Yassi A ,Tate R , Cooper Je ,et al . Early intervention for back injuried nurses at a large canadian tertiary of a two - year pilot project . Occup Med ,1995 ,45 (4) :209 - 214.
|
