Data were collected using a self-administered questionnaire to determine the prevalence of low back pain among nurses in the hospital. Bivariate analyzes and logistic regressions were performed to determine the risk factors associated with low back pain.
I NTRODUCTION
The risk factors for low back pain at Edendale Hospital remain unclear and it is not clear whether low back pain is more prevalent in certain wards. Knowing the risk factors that contribute to the prevalence of low back pain will help nursing and hospital managers plan appropriate interventions to minimize the occurrence.
S IGNIFICANCE OF THE STUDY
It is estimated that in the UK each year 12% of nursing staff will consider a job transfer to reduce the risk of low back pain, and a further 12% to 18% will actually leave the nursing profession due to chronic back pain. At Edendale Hospital, the number of nurse physiotherapy treatments related to the treatment of low back pain has increased from 30% to 45% over the past three years.
A IM
O BJECTIVES
O VERVIEW OF DISSERTATION
Furthermore, the predisposing factors and the impact of low back pain in nurses and health workers are described. The following keywords were used in the search strategy: low back pain, risk factors, prevalence, nurses and health workers.
This chapter provides a critical review of studies describing the prevalence of low back pain in developing and developed countries. They research preventive measures in the workplace to reduce the incidence and impact of work-related injuries.
Research that has been conducted in South Africa has focused on low back pain among steelworkers. Compensation costs for low back pain in South Africa resulted in the equivalent of approx. 20 million US dollars in 2000 [15].
P ERSONAL F ACTORS A SSOCIATED WITH L OW B ACK P AIN
Conflicting evidence was found in the literature regarding the impact of smoking and low back pain. However, there is a lack of well-designed studies on the effect of alcohol on low back pain.
O CCUPATIONAL AND E NVIRONMENTAL F ACTORS
A systematic review of nine original research reports published between 1987 and 1995 concluded that alcohol consumption did not appear to be associated with low back pain [37]. The association between night shift and low back pain has been established in some studies [41, 43].
P SYCHOLOGICAL F ACTORS
Lack of staff, work pressure, and unexpected and stressful events that are common in hospitals can influence the development of low back pain. The relationship between psychosocial factors and low back pain has been recognized in most studies in different parts of the world, but the exact physiological mechanism behind this relationship remains to be established.
I NTERVENTIONS TO R EDUCE L OW B ACK P AIN
Low back pain is a serious problem caused by a multitude of factors in the general population as well as among nursing professionals. These actions were found to improve low back pain injuries among nurses in England [46].
C ONCEPTUAL F RAMEWORK : F ACTORS C ONTRIBUTING TO
Nurses are often required to perform heavy lifting tasks such as moving patients in bed, transferring patients between bed and chair, and lifting patients from the floor [46]. There are a number of possible strategies that can be adopted to help reduce the prevalence of low back pain and help eliminate risk factors. Intervention strategies deal with preventive practices such as proper lifting techniques, back care, exercise, building healthy public policies, and creating supportive environments.
In conclusion, the literature review shows that the risk factors for low back pain are different in different contexts. Determining the risk factors among nurses in a specific setting is important to identify the most appropriate interventions.
R ESEARCH S ETTING
The discussion includes the study setting, study period, study design, source population, sample population and sampling, data collection and analysis, and measures taken to ensure the validity of the study.
S TUDY P ERIOD
S TUDY D ESIGN
S OURCE P OPULATION
S AMPLE P OPULATION
S AMPLING S TRATEGY AND S IZE
On an average day, 450 nurses are on duty day and night at the Hospital. The expected prevalence of low back pain in the sampled population was estimated at 60%. The score was based on the number of nurses who reported low back pain during Back Care Awareness Week in 2008.
D ATA S OURCES
It was determined how many days respondents were absent from work in the past year due to low back pain. Respondents were also asked about the activities that cause low back pain to return. Information about history of current low back pain included asking whether respondents were currently experiencing low back pain and whether they believe the low back pain is due to their occupation.
They were asked what type of department they worked in when the current low back pain occurred. They were also asked whether the low back pain is worsened by nursing activities and what effect the pain has on daily activities.
D ATA C OLLECTION
D ATA A NALYSIS
The group with the lowest risk was selected as the reference group, but in cases where the group with the lowest risk had very small numbers, the next group was selected.
D ATA M ANAGEMENT AND S TORAGE
E THICS A PPROVAL
C ONCLUSION
This chapter begins by presenting the sample size, prevalence of low back pain, and occupational back pain. In addition, risk factors associated with low back pain among nurses at Edendale Hospital were documented.
S AMPLE S IZE
O CCUPATIONAL L OW B ACK P AIN
D EMOGRAPHIC C HARACTERISTICS OF THE R ESPONDENTS
R ELATIONSHIP BETWEEN P ERSONAL F ACTORS AND
R ELATIONSHIP BETWEEN E MPLOYMENT H ISTORY AND THE
O CCUPATIONAL F ACTORS AND C URRENT L OW B ACK P AIN
R ELATIONSHIP BETWEEN E NVIRONMENTAL F ACTORS AND
R ELATIONSHIP BETWEEN P SYCHOLOGICAL F ACTORS AND
R ELATIONSHIP BETWEEN P ERSONAL F ACTORS AND
R ELATIONSHIP BETWEEN E MPLOYMENT H ISTORY AND
O CCUPATIONAL F ACTORS AND C HRONIC L OW B ACK P AIN
R ELATIONSHIP BETWEEN E NVIRONMENTAL F ACTORS AND
T HE R ELATIONSHIP BETWEEN P SYCHOLOGICAL F ACTORS
L OGISTIC R EGRESSION
C ONCLUSION
Findings will be discussed in relation to the aim and objectives of the study and in relation to similar studies. The objectives of the study were (1) to measure the prevalence of low back pain among nurses at Edendale Hospital and (2) to ascertain the risk factors associated with low back pain among nurses at Edendale Hospital. The results showed that the risk factors associated with current and chronic back are similar.
Therefore, the discussion of the findings of acute, chronic and occupational low back pain will be related.
Nursing category may be a confounder regarding the relationship between age and low back pain. The present study concluded that there was a relationship between age and chronic low back pain. The prevalence of current low back pain was higher among respondents who were overweight (57%) and obese (62%) compared to respondents who were of normal weight and underweight (25%).
Similarly, obese respondents were found to have a higher prevalence of chronic low back pain in the study. The effect of high BMI on back pain has been reported in other studies [28, 29].
Work in medical, outpatient, paediatrics, obstetrics and gynaecology, orthopedics and surgery was positively associated with current low back pain, and the association was found to be statistically significant. Respondents working in obstetrics and gynaecology, orthopedics and surgery reported a higher incidence of low back pain with an odds ratio of 6.30 and 6.09, respectively. Similarly, the nurses who worked in surgical and orthopedic wards showed the highest prevalence of chronic low back pain.
This results in great biomechanical strain, which can ultimately lead to the development of low back pain [15]. Another study is needed to investigate the impact of ergonomic interventions on low back pain at Edendale Hospital.
Further research needs to be conducted to investigate the influence of cumulative effects of different manual handling activities on the lower back. The current study also found that 81% of respondents who suffered from current low back pain reported that their work surfaces were too low. While the majority of respondents who reported that the work surface and chair height were too high suffered from chronic low back pain.
The relationship between body height, chair height, work surface has been established in other studies [11, 20]. The current study did not explore this relationship, but further study is required to determine whether this contributes to the high prevalence in the Hospital.
P SYCHOSOCIAL F ACTORS AND THEIR R ELATIONSHIP TO L OW
Insomnia and anxiety, which can be a manifestation of depression, are common complaints in people suffering from low back pain [1]. A significant effect of work-related stress on low back pain was also found in a study conducted among hospital workers in Gauteng, South Africa [1]. The effect of staff shortages on the development of low back pain was not investigated in the present study, future research is needed to assess whether the lack of human resources has any effect on the incidence of low back pain among nurses in the Hospital.
It was not possible to determine from this study whether psychosocial factors were present before the onset of low back pain and whether psychological factors are influenced by demographic factors [1]. A longitudinal study involving nurses who do not have pain at baseline should be conducted to obtain more scientific evidence on the influence of psychological factors on low back pain.
L OGISTIC R EGRESSION
Over a period of time, psychosocial and behavioral factors exacerbate the level of pain and thus contribute to severe disability. Unexpected and stressful events are also an integral part of daily patient care and the effect can be exacerbated by the lack of human resources. These results support the studies that found that surgery, obstetrics and gynecology reported a higher incidence of nurses suffering from low back pain.
Therefore, occupational interventions at Edendale Hospital are most likely to reduce low back pain and the associated loss of productivity.
L IMITATION OF THE STUDY
The aim of the study was to determine the prevalence of low back pain among nurses at Edendale hospital and risk factors associated with low back pain. The prevalence of low back pain was high among employed nurses, respondents aged 30 to 39, over 50 years, women and obese respondents. Bending, turning and shifting, working in awkward positions were strongly associated with low back pain.
The greater the level of depression, anxiety and stress, the greater the risk of low back pain. Bending and working in pediatrics, administration, orthopedics, surgery, obstetrics and gynecology were all statistically significantly associated with low back pain among hospital nurses.
R ECOMMENDATIONS
Sikiru L, Hanifa S. Prevalence and risk factors for low back pain among nurses in a typical Nigerian hospital. Low back pain prevalence and association with body fat, fat distribution and height. The study will investigate the prevalence of low back pain among nurses at Edendale Hospital.
Study title: A survey of the prevalence of low back pain among nurses at Edendale. Introduction: I, Thembelihle Dlungwane, am researching the prevalence of low back pain among nurses at Edendale.
