| 摘要: | 背景與動機：在臨床護理領域裡，因應照護病人及業務需求，護理工作是體力需求高的工作，其長時間生理負荷常常造成護理人員因工作引起有關肌肉骨骼不適問題。而手術室護理人員的作業細項繁多且需要長時間久站，及搬運病人，加上搬運過重的儀器設備，手術中需不斷重複及快速的傳遞器械，容易在工作中產生累積性的肌肉骨骼傷害。
目的：本研究旨在探討手術室護理人員肌肉骨骼傷害預防行為及其相關因素，並依據健康信念模式來探討南部某醫學中心手術室護理人員肌肉骨骼傷害預防行為與其相關因素之間的關係。
方法：研究為橫斷式描述性相關研究設計，採普查並利用結構式問卷進行調查，以南部某醫學中心手術室之全體護理人員為研究對象，共有215人納為收案對象，於 2017年 9 月施測。實得有效問卷210份，有效回收率為97.6%。
結果：一、研究對象過去一年肌肉骨骼傷害盛行率為74.8%，身體各部位肌肉骨骼傷害盛行率以肩部77.6%最高。二、研究對象自覺肌肉骨骼威脅性是屬於中上程度，普遍認同工作中採取肌肉骨骼傷害預防行為是必要的，同時認為若自我效能越多越有把握完成肌肉骨骼預防行為。三、本研究結果顯示，社會人口學變項中的性別、年齡、教育程度、過去病史、每週工時、是否生育、手術年資、輪班、科別、肌肉骨骼傷害經驗、肌肉骨骼傷害生活障礙，與健康信念變項對影響護理人員採取「肌肉骨骼傷害預防行為」有統計上顯著差異。
結論與建議：若要提升手術室護理人員肌肉骨骼傷害預防行為，宜降低護理人員自覺行動障礙，且提升自我效能，未來預擬定職場安全衛生教育訓練活動如講授、問答、小組討論、演練訓練，運用引導、討論、反思多元教學法並採取教學前後之對照方式以評值其成效。加強宣導造成肌肉骨骼傷害的原因及預防方法、使用防護用具的重要性，並提供相關內容單張、手冊、光碟、海報及警語，增加行動線索及提升自我效能、減少行動障礙，以預防、減少護理人員肌肉骨骼傷害發生，促進其身心健康。
Background and motivation: In the field of clinical care, nursing care work is a physically demanding work due to the need to care for the patients and the business. The prolonged physiological load often causes the caregiver to cause musculoskeletal discomfort due to work. On the other hand, operating room nurses have a lot of detailed tasks and need to stand for a long time, carry the patient, to carry over heavy equipment and repeated and rapid delivery of the instruments during the operation. This makes it easy to produce cumulative musculoskeletal injury in work.
Objectives: The purpose of this study was to investigate the musculoskeletal injury prevention behaviors and related factors of nursing staff in operating rooms, and to explore the relationship between the musculoskeletal injury prevention behaviors and the related factors of nurses in operating rooms of a medical center in the south Taiwan.
Methods: The study was designed for a cross-sectional related descriptive research, taking census and structured questionnaires to conduct the surveys. All nurses in the operating room of a medical center in southern Taiwan were the subjects of the study. A total of 215 people were included in the study. A total of 215 questionnaires were issued and filled in by the clinical nursing staff in the operating room in Septemper 2017. There were 210 effective questionnaires and the effective recovery rate was 97.6%.
Results: 1.The prevalence of musculoskeletal injuries in the study population was 74.8% in the past year, and the prevalence of musculoskeletal injuries in all parts of the body was the highest in the shoulders with 77.6%. 2.The subjects felt that the musculoskeletal threat was of a medium to high degree, and it was generally accepted that it was necessary to take musculoskeletal injury prevention at work. At the same time, if more self-efficacy was achieved, the musculoskeletal prevention behavior would be more assured. 3. The results of this study show that gender, age, education level, past medical history, weekly working hours, childbirth, years of surgery, shifts, divisions, musculoskeletal injury experience, and health beliefs in sociodemographic variants have a statistically significant difference in affecting the nursing staff in taking “musculoskeletal injury prevention behavior”.
Conclusion and suggestion: To improve the musculoskeletal injury prevention behavior of nursing staff in operating rooms, it is desirable to reduce the conscious movement barriers of nursing staff and improve self-efficacy. In the future, pre-planned workplace health and safety education and training activities such as lectures, question and answer, group discussions, drills training, and using guidance, discussion, reverse thinking multiple teaching methods and adopting comparative methods before and after teaching to evaluate their effectiveness. To strengthen the causes of musculoskeletal injuries and prevention methods, and the importance of using protective equipment and to provide relevant leaflets, manuals, CDs, posters and warnings to increase clues and promote self-efficacy and reduce mobility barriers to prevent might reduce the occurrence of musculoskeletal injuries in nursing staff and promote their physical and mental health. |
