Predictors of work-related musculoskeletal symptoms in shoulders among nursing assistants working in nursing homes.
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SUBMITTER: Cheung K
PROVIDER: S-EPMC8101459 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background/objectivesCertified nursing assistants (CNAs) who work in nursing homes (NHs) face significant work and personal stress. Self-compassion training has been shown to decrease stress postintervention in previous studies among healthcare providers and those in helping professions. This study examines the feasibility, acceptability, and preliminary outcomes of self-compassion training to address CNA stress and well-being.DesignPre-post intervention.SettingThree mid-size, nonprofit NHs in North Carolina.ParticipantsThirty CNAs, with a mean age of 49, 96% of whom were female, and 83% black/African American.InterventionIn one NH, participants received an 8-week, 2.5-h/session (20 h total) group intervention. At the time of recruitment for NHs 2 and 3, a briefer format (6-week, 1-h/session; 6 h total) became available and was preferred by CNAs, thus both NHs 2 and 3 participants received a 6-h group intervention. All interventions occurred in meeting rooms within participating NHs during shift changes.MeasurementsIntervention attendance, retention, and acceptability; self-compassion, stress, burnout, depression, and attitudes toward residents with dementia, and job satisfaction pre-, post-, 3-month post-, and 6-month postintervention were assessed.ResultsAttendance and program satisfaction were high, and attrition was low for both training formats. Self-compassion was significantly improved at all time periods (p < 0.001), and stress and depression improved significantly through 3 months (p < 0.05), but not 6 months. No statistically significant change in job satisfaction was noted.ConclusionSelf-compassion interventions are feasible and acceptable for CNAs working in NHs and show promise for managing stress and improving well-being and compassion toward residents. The briefer 6-h format may maximize participation, while still providing benefits.
| S-EPMC8273132 | biostudies-literature
Project description:ObjectivesWe examined the relationship between nursing assistant (NA) retention and a measure capturing nursing home leadership and staff empowerment.DesignCross-sectional study using nationally representative survey data.Setting and participantsData from the Nursing Home Culture Change 2016-2017 Survey with nursing home administrator respondents (N = 1386) were merged with facility-level indicators.MethodsThe leadership and staff empowerment practice score is an index derived from responses to 23 survey items and categorized as low, medium, and high. Multinomial logistic regression weighted for sample design and to address culture-change selection bias identified factors associated with 4 categories of 1-year NA retention: 0% to 50%, 51% to 75%, 76% to 90%, and 91% to 100%.ResultsIn an adjusted model, greater leadership and staff empowerment levels were consistently associated with high (76%-90% and 91%-100%) relative to low (0%-50%) NA retention. Occupancy rate, chain status, licensed practical nurse and certified nursing assistant hours per day per resident, nursing home administrator turnover, and the presence of a union were also significantly associated with higher categories of retention (vs low retention).Conclusions and implicationsModifiable leadership and staff empowerment practices are associated with NA retention. Associations are most significant when examining the highest practice scores and retention categories. Nursing homes seeking to improve NA retention might look to leadership and staff empowerment practice changes common to culture change.
| S-EPMC7483198 | biostudies-literature
Project description:BackgroundCertified nursing assistants (CNAs) in palliative care units often encounter the death of patients and undergo emotional burdens because of their altruistic practices. However, the influences of altruism and perceptions of death on the work morale of CNAs remain unclear. The fact that morale can be improved by modifying related factors justifies the necessity of a theoretical model of morale for CNAs. However, such a model is currently absent. Based on relevant literature, factors including altruism, social support, perceptions of death, and job satisfaction are related to morale through the mediation of job stress.AimThis study was aimed toward determining the influencing factors and developing a structural model of morale with regard to CNAs working in palliative care units.DesignThe hypothesized model was tested in a cross-sectional design with structural equation modeling using AMOS 23.Setting/participantsA total of 413 CNAs from five hospice units in Taiwan participated in the survey.ResultsGoodness-of-fit indexes, including ?2/DF = 2.187, PGFI = 0.461, and PNFI = 0.462, among others, confirmed the modified model fit the data well. Altruism, social support, perceptions of death, and job satisfaction were negatively related to job stress (-0.238, -0.196, -0.204, and -0.131, respectively). Altruism and social support positively affected job satisfaction (0.635 and 0.553). Factors directly affecting morale included altruism, social support, job stress, and job satisfaction (0.837, 0.711, -0.244, and 0.540, respectively). The relationship between altruism and morale was the strongest among all the direct paths toward morale. Job stress was the major mediator in these relationships.ConclusionAltruism is imperative for morale. The confirmed model is called the Five Constructs to Morale (5CM) model. These findings indicate the need to assess the levels of altruism and perceptions of death during the recruitment of CNAs. From the perspective of human resource management and organizational behavior, CNAs with a high level of altruism and a positive attitude toward death assure the well-being of end of life patients because of work involvement and commitment to the challenging work of hospice care. The cultivation of a supportive environment and coping strategies are suggested for the management of CNAs facing patient death. Hospice care decision makers should carefully assess morale levels among health professionals by applying the 5CM model. Identifying modifiable factors that can improve morale among nursing staff in hospice care to ensure work fulfillment and quality care merits emphasis in clinical practice. The establishment of effective strategies to facilitate the work morale of nursing staff is suggested for palliative care units. Morale improvement related task should be a global public health priority.
| S-EPMC6203351 | biostudies-literature
Project description:PurposeWe aimed to investigate variations in the risk of low back pain (LBP), lower extremity muscle pain, and whole body fatigue according to differences in prolonged standing work hours in relation to risk factor exposure and rest frequency.Materials and methodsFrom the fifth Korean Working Conditions Survey data collected in 2017, data for 32970 full-time workers who worked for more than 1 year at their present job were analyzed. We classified the workers according to exposure to fatigue or painful postures, carrying heavy objects, performance of repetitive movements that burden the musculoskeletal system, and how often they took a break. Relationships between time spent in a standing posture at work and risks of LBP, lower extremity muscle pain, and whole body fatigue were analyzed by multivariate logistic regression.ResultsOf the full-time workers in the survey, 48.7% worked in a standing position for more than half of their total working hours. A higher odds ratio (OR) value for lower extremity muscle pain was observed in female not exposed to carrying heavy objects [OR: 3.551, 95% confidence interval (CI): 3.038-4.150] and not exposed to performing repetitive movements (OR: 3.555, 95% CI: 2.761-4.557).ConclusionChanges in work methodologies are needed to lower the number of hours spent in a prolonged standing posture at work, including being able to rest when workers want to do so, to reduce pain and fatigue.
| S-EPMC8149936 | biostudies-literature
Project description:To investigate the status of work-related musculoskeletal disorders (WMSDs) in nurses working in the hospitals in Xinjiang Uygur Autonomous Region.The prevalence of WMSDs since working and in the previous 12 months was evaluated using self-administrated modified musculoskeletal questionnaire based on North European questionnaire. In this cross-sectional study, 6674 nurses involved in the nursing profession were selected from 16 hospitals using the stratified cluster sampling method.The most commonly affected regions by WMSDs were lower back, neck, shoulder, and back, with an annual prevalence of 62.71%, 59.77%, 49.66%, and 39.50%, respectively. Statistical differences were noticed in the annual prevalence of WMSDs in those with different ages (P < 0.01) and working durations (P < 0.01). Logistic regression analysis indicated that the following risk factors were associated with the prevalence of WMSDs: working duration of ≥6 years; working in the Emergency Department, Department of Anesthesia, or Supply Room; night shift of more than once, working duration of >40 hrs per week; poor health status; and feeling of fatigue. Rest time of >10 min and no history of WMSDs were the protective factors of WMSDs.Shift and working/rest duration was closely related to WMSDs.
| S-EPMC5530439 | biostudies-other
Project description:ObjectivesThis study aimed to gain insight into how substitution of elderly care physicians (ECPs) by nurse practitioners (NPs), physician assistants (PAs) or registered nurses (RNs) in nursing homes is modelled in different contexts and what model in what context contributes to perceived quality of healthcare. Second, this study aimed to provide insight into elements that contribute to an optimal model of substitution of ECPs by NPs, PAs or RNs.DesignA multiple-case study was conducted that draws on realist evaluation principles.SettingSeven nursing homes in the Netherlands PARTICIPANTS: The primary participants were NPs (n=3), PAs (n=2) and RNs (n=2), working in seven different nursing homes and secondary participants were included; ECPs (n=15), medical doctors (MDs) (n=2), managing directors/managers/supervisors (n=11), nursing team members (n=33) and residents/relatives (n=78).Data collectionData collection consisted of: (1) observations of the NP/PA/RN and an ECP/MD, (2) interviews with all participants, (3) questionnaires filled out by the NP/PA/RN, ECPs/MDs and managing directors/managers and (4) collecting internal policy documents.ResultsAn optimal model of substitution of ECPs seems to be one in which the professional substitutes for the ECP largely autonomously, well-balanced collaboration occurs between the ECP and the substitute, and quality of healthcare is maintained. This model was seen in two NP cases and one PA case. Elements that enabled NPs and PAs to work according to this optimal model were among others: collaborating with the ECP based on trust; being proactive, decisive and communicative and being empowered by organisational leaders to work as an independent professional.ConclusionsCollaboration based on trust between the ECP and the NP or PA is a key element of successful substitution of ECPs. NPs, PAs and RNs in nursing homes may all be valuable in their own unique way, matching their profession, education and competences.
| S-EPMC6538050 | biostudies-literature
Project description:To describe the proportions of workers with upper extremity (UE) symptoms and work limitations because of symptoms in a newly hired working population over a 3-year study period and to describe transitions between various outcome states.A total of 827 subjects completed repeat self-reported questionnaires including demographics, medical and work history, symptoms, and work status. Outcomes of interest were UE symptoms and work limitations because of symptoms.Up to 72% of workers reported symptoms at least once during the study, with 12% reporting persistent symptoms and 27% reporting fluctuating symptoms; 31% reported work limitations at least once, with 3% reporting consistent work limitations and 8% reporting fluctuating limitations.UE symptoms and work limitations are common among workers and dynamic in their course. A better understanding of the natural course of symptoms is necessary for targeted interventions.
| S-EPMC4049189 | biostudies-literature
Project description:BACKGROUND: Physiotherapists are known to be prone to Work- related musculoskeletal disorders (WRMDs) but its prevalence among physiotherapists in Nigeria has not been reported. This study investigated the prevalence and work factors of WRMDs among physiotherapists in Nigeria. METHODS: A cross- sectional survey was administered to physiotherapists in different parts of Nigeria using a 2- part questionnaire with items adopted from questionnaires used for similar studies around the world. Two hundred and seventeen copies of the questionnaire were distributed for self administration but 126 physiotherapists returned completed surveys for a 58.1% response. The data were analyzed using SPPS version 10 at alpha level of 0.05. Descriptive statistics of frequency and percentages and inferential statistics of chi2 were used as appropriate for data analysis. RESULTS: Reported 12- month prevalence of WRMDs among Nigerian physiotherapists was 91.3%. Prevalence of WRMDs was significantly higher in female physiotherapists (p = 0.007) and those with lower body mass index (p = 0.045). The low back (69.8%) was the most commonly affected body part, followed by the neck (34.1%). Fifty percent of the physiotherapists first experienced their WRMDs within five years of graduation and the highest prevalence (61.7%) was found among physiotherapists younger than 30 years. Treating large number of patients in a day was cited by most (83.5%) of the respondents as the most important work factor for their WRMDs. The most commonly adopted coping strategy identified was for the therapists to modify their position and/or the patient's position (64.3%). Majority of the respondents (87.0%) did not leave the profession but 62.6% changed and/or modified their treatment because of their WRMDs. CONCLUSION: The prevalence of WRMDs among physiotherapists in Nigeria is higher than most values reported for their counterparts around the world. The coping strategies and work factors of WRMDs among Nigerian physiotherapists are mostly similar to those of their counterparts elsewhere.
| S-EPMC2535595 | biostudies-literature
Project description:ObjectivesStudies from western countries show that dentists are vulnerable to work-related musculoskeletal disorders (WMSDs) of the neck and upper extremities, but little is known about their epidemiology among members of this rapidly growing profession in China. This study aims to investigate the prevalence of WMSDs and identify potential risk factors associated with their occurrence in the dental profession in China.Setting and participantsA cross-sectional survey was carried out in 52 different hospitals in a large metropolitan city in China. A total of 304 questionnaires were distributed to respondents identified via stratified random sampling and 272 dentists (121 females and 151 males) completed the survey. The response rate was 89.5%.OutcomesVisual analogue score was used to record neck and upper limb musculoskeletal symptoms on a body chart. Work-related risk factors, including physical and psychosocial factors, were accounted for in the regression analysis.Results88% of the dentists reported at least one musculoskeletal disorder and 83.8% suffered from neck pain. In the multivariate analyses, working hours per day were associated with neck pain (OR=1.43; 95% CI 1.03 to 1.98). Inability to select the appropriate size of dental instrument was associated with shoulder (OR=2.07; 95% CI 1.00 to 4.32) and wrist/hand (OR=2.47; 95% CI 1.15 to 5.32) pain. As for psychosocial factors, high job demand was associated with symptoms in the shoulder (OR=1.09; 95% CI 1.00 to 1.18), elbow (OR=1.11; 95% CI 1.03 to 1.19) and wrist/hand (OR=1.09; 95% CI 1.02 to 1.17). Regular physical exercise was associated with decreased neck pain (OR=0.37; 95% CI 0.14 to 1.00).ConclusionsThe prevalence of WMSDs among Chinese dentists is high. Specifically, long working hours, inability to select the appropriate size of dental instrument and high job demand are the most significant risk factors.
| S-EPMC4275663 | biostudies-literature
Project description:IntroductionWork-related musculoskeletal disorder (WMSD) is a leading causes of occupational injury and disability among drivers and workers in the transport industry. This study evaluated the ergonomically assessed WMSD and its determinants among Nigerian commercial mini bus drivers (BD) and mini bus conductors (BC).MethodA total of 379 participants (BD = 200, BC = 179) were purposively sampled for this exploratory cross-sectional study. Participants' WMSD and work related variables were respectively assessed using the standardized Nordic questionnaire and a content-validated, Driving Work Station Assessment (DWSA) form. Data were analyzed descriptively and inferentially using chi-square and logistic regression. The level of significance was set at α = 0.05.ResultsThe participants were aged between 20 and 66 years, with a mean age of 33.26±10.76years (BD = 38.42±10.22years, BC = 27.50±8.13years); most of whom consumed alcohol (84.4%) and experienced severe job stress (73.4%). There was a high prevalence (95.8%; BD = 94.5%, BC = 97.8%) of WMSDs, the lower back (66.8%) and upper back (54.1%) had the highest regional prevalence of WMSD. The BC (BC vs BD) had significantly (p<0.05) higher prevalence of Neck (47.7% vs 21.5%) and upper back (80.4% vs 30.5%) WMSDs. Conversely, the BD (BD vs BC) had significantly (p<0.05) higher prevalence of low-back (85.0% vs 46.4%), knee (25.0% vs 9.5%), elbow (11.5% vs 3.9%), and wrist (10.5% vs 3.4%) WMSD. There was a significant association between WMSD and each of work duration (X2 = 11.634, p = 0.009), work frequency (X2 = 8.394, p = 0.039), job dissatisfaction (X2 = 10.620, p = 0.001) and job stress (X2 = 16.879, p = 0.001). Working beyond 4days/week (OR = 10.019, p = 0.001), job dissatisfaction (OR = 1.990, p = 0.031), constrained working postures (OR = 5.324, p = 0.003) and fatigue (OR = 4.719, p = 0.002) were the predictors of WMSD.ConclusionJob stress, work duration and work frequency, posture and fatigue are important determinants of WMSDs among mini bus drivers and their assistants in Nigeria. Ergonomics training intervention for this population is recommended.
| S-EPMC8651118 | biostudies-literature