International Orthopaedics (SICOT) DOI 10.1007/s00264-015-2900-x

ORIGINAL PAPER

Prevalence, consequences and predictors of low back pain among nurses in a tertiary care setting Sameh M. Abolfotouh 1 & Karim Mahmoud 1 & Khaled Faraj 1 & Gemeh Moammer 1 & Abir ElSayed 2 & Mostafa A. Abolfotouh 1

Received: 9 April 2015 / Accepted: 22 June 2015 # SICOT aisbl 2015

Abstract Purpose Nursing is a profession with high incidence and prevalence of low back pain (LBP), with its medical and professional consequences. These prevalence rates vary among countries, and with various measurements have been used to determine LBP. Individual and work-related factors are regarded as causal factors for many back injuries. The aims of study this were: (1) to estimate the prevalence of LBP using different measures, (2) to determine medical and professional consequences of LBP, and (3) to determine the associated factors and significant predictors of LBP. Methods A cross-sectional study was conducted among 254 nurses from different departments/wards at Hamad General Hospital (HGH), Doha, Qatar over two months (February and March, 2015). A self-administered modified Nordic questionnaire was used to collect data regarding five different measures of LBP, its medical and occupational consequences and individual/lifestyle and work-related risk factors of LBP. Descriptive and analytic statistical analyses were done using chisquare and multivariate logistic regression techniques. Significance was considered at p≤0.05. Results The findings of this study broadly confirm the high levels of back pain in nursing, with a one-year prevalence of LBP of 54.3 % for LBP of at least one day, 26.8 % for chronic LBP, 18.1 % for sick leave seeking LBP, and 34.3 % for medical treatment seeking LBP. Difficult or impossible

* Sameh M. Abolfotouh [email protected] 1

Orthopaedics Department, Hamad Medical Corporation, Doha, Qatar

2

King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

activities of daily living were reported due to LBP in climbing stairs (50.7 %), walking (42.8 %), standing up (39.9 %), sleeping (33.3 %), getting out of bed (30.4 %) and wearing clothes (20.3 %). Work stop due to LBP was reported by 76.8 % of nurses, with 2.03±3.09 days within the last year. Treatment was sought in 58.7 % by medical care, and 15.9 % by physiotherapy, while seeking rest days and/or sick leave was sought in 50.8 % of nurses with LBP. Sports practice (p= 0.003), office work (p15 m/day Running >15 m/day Others >15 m/day Smoking

162.86 26.57 n 204 21 10 9

±9.67 ±4.70 % 80.3 16.8 7.9 7.1

Factors associated with low back pain Individual factors for LBP were being a female nurse (p= 0.011) and those with arthritis (p=0.025). The practice of running for more than 15 min/day was rather LBP protective (p=0.003). Professional factors associated with LBP include office work (p30 years Marital status Single Married B. Cormorbidities Obesity Yes No Diabetes Yes No Arthritis Yes No Spine problem Yes No C. Lifestyles Walking >15 min/day Yes No Running >15 min/day Yes No Other sports >15 min/day Yes No Smoking Yes No D. Work-related characteristics Work nature Direct contact Office Shift hours 8 hours 12 hours Shift nature Day work Shift work Physical patient assistance Yes No

Number, n

Percent, %

χ2

P-value

Odds ratio (OR)

26 112

40.6 58.9

6.48

0.011

1 1.45 (1.06–2.0)

66 70

62.3 50

3.67

0.055

1 1.25 (0.99–1.56)

34 104

60.7 52.5

1.180

0.28

1.40 (−0.76 to 2.56) 1

78 42

56.5 45.7

2.614

0.106

1.54 (0.91–2.63) 1

8 130

44.4 55.1

0.76

0.382

1 1.24 (0.73–2.10)

15 123

78.9 52.3

5.015

0.025

3.42 (1.10–10.59) 1

12 126

54.5 54.3

0.005

0.945

1.01 (0.42–2.43) 1

110 28

53.9 56

0.07

0.79

1 1.04 (0.79–1.37)

14 122

33.3 58.7

9.031

0.003

1 1.76 (1.13–2.74)

8 130

40 55.6

1.80

0.18

1 1.39 (0.80–2.41)

6 132

33.3 55.9

3.44

0.064

1 1.68 (0.87–3.26)

86 52

45.3 81.3

24.987

0.000

1 5.24 (2.63–10.44)

124 14

52.5 77.8

4.292

0.038

1 3.16 (1.01–9.89)

54 84

57.4 52.5

0.58

0.445

1.22 (0.73–2.04) 1

112 26

53.3 59.1

0.486

0.486

1 1.11 (0.84–1.46)

International Orthopaedics (SICOT) Table 4 (continued) Characteristic

Number, n

Percent, %

χ2

P-value

Odds ratio (OR)

Heavy objects Yes No

106 32

57.6 45.7

2.891

0.089

1.61 (0.93–2.81) 1

6 116 16

60 52.7 66.7

1.829

0.401

1 0.74 1.33

110 28

59.8 40

7.998

0.005

2.23 (1.27–3.91) 1

2 98 38

50 53.8 55.9

0.113

0.945

1 1.17 (0.79–3.25) 1.27 (0.46–2.93)

Workload Light Moderate/heavy Overwhelming Physical stress Yes No Working days/week 3–4 5 >5

a work stop in our survey is higher than figures in previous studies [23, 41], yet still lower than the rate of 93 % reported in a previous study [49]. In our investigation, mean work stop duration was 2.8 days per year, as compared to 4.5 days by Bejia et al. [23] and 15 days by Lallahom et al. [41]. In terms of absence from work, 16.2 % of total days lost to sickness have been attributed to back pain, with the loss of 764,000 working days annually [6, 50]. However, in the present study, the majority of nurses stopped their work for less than a week, denoting the fact that LBP was not a major cause of sick leave. This was in agreement with the findings of a previous study on nurses in Saudi Arabia [51]. This might be attributed to the possible fear of premature retirement or termination of appointment by employers on the presence of ill health, especially that nearly all nurses in these settings are expatriate employees. Risk factors of LBP Professional risk factors Several risk factors are associated with the prevalence of common LBP. Several studies [52, 53] showed that administrative staffs and workers were more affected by LBP than nurses. Table 5 Significant predictors of low back pain among nurses

Studies involving nurses found that fixed low back postures [54] and prolonged standing and sitting [55] were significant predictors for perceived risk of musculoskeletal injury or illness. In our study, nurses with direct contact showed significantly lower prevalence of LBP than those who are enrolled in office work. Nurses in office work are five times more likely to suffer from LBP as compared to those with direct patient contact. This could be explained by the seated position and the sedentary nature of their activities [52]. However, other studies did not find any interrelationship between professional categories and the likelihood of suffering from LBP [23]. The seat quality is reported to be associated to LBP among administrative staffs [52]. Vibrations exposure studied more in industrial environments has been found to be a risk factor of LBP in the literature [23]. However, this issue was not investigated in our study. Some authors found a meaningful association between heavy load handling and LBP prevalence [23, 34, 41]. A heavy load handling was observed in 69.9 % [23] of the cases of LBP. This is in accordance with our survey. In the present study, workload was perceived as heavy and overwhelming by 36.3 % of all nurses. This workload was reported by the majority of nurses in terms of heavy objects (72.4 %), physical

Independent variable

β

SE

p-value

Odds ratio (OR)

95 % CI

Gender Arthritis Running practice Office work Physical stress Shift hours (12 hrs) Constant

−0.52 0.05 −1.35 2.00 1.03 1.13 −0.75

0.36 0.65 0.45 0.40 0.33 0.62 0.30

0.15 0.94 0.003

Prevalence, consequences and predictors of low back pain among nurses in a tertiary care setting.

Nursing is a profession with high incidence and prevalence of low back pain (LBP), with its medical and professional consequences. These prevalence ra...
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