Approximately one-third of all cases of sick leave for health care workers are related to musculoskeletal disorders (MSDs) originating in the neck, shoulders, and back. A cross-sectional multicenter survey based on the Nordic Questionnaire for Analysis of Musculoskeletal Symptoms investigated the nature and scope of MSDs among Dutch OR personnel. The three-month prevalence rates for MSDs in OR personnel were found to be high compared to MSDs in the general population and comparable to rates in other strenuous professions in health care, industry, and construction. The causes of MSDs that participants mentioned were summarized into four main categories: prolonged standing, awkward postures, lifting and pushing; and climactic conditions.

In wards in nursing homes with a higher number of staff less awkward back postures as well as forceful lifting were observed during patient handling activities. The use of ergonomic devices was high and associated with less forceful movements and awkward back postures. Both aspects will most likely contribute to the prevention of low back pain among nurses.

Prolonged standing is considered to be an occupational risk factor for musculoskeletal disorders. This cross-sectional, multicenter study examined whether Dutch perioperative personnel exceeded ergonomic guidelines for standing in the workplace (ie, not more than one hour of continuous standing and not more than four hours of standing in total per day). Perioperative personnel in 16 hospitals recorded their standing times on a daily basis. The average standing time in the OR was 2.5 hours per work day; however, participants exceeded the ergonomic guidelines on two out of three work days.A reduction in the source of the strain is considered to be the most effective way to prevent occupational health problems. Taking "microbreaks" to relax or move and job duty rotation could help reduce excessive physical stress.

The objective of this research project was to study the effectiveness of a training program for the enhancement of patient education skills in physical therapy. In this paper the improvement of five of these skills is tested. These skills are aimed at a better monitoring of adherence problems during the treatment and at enhancing self-efficacy of the patient after treatment. In order to test the effectiveness of the program, complete treatments of 19 physiotherapists have been assessed before (1142 sessions, 130 patients) and after (775 sessions, 88 patients) the training program. Information on the instructions and solutions given to the patients was obtained with a registration form, completed after each session by the physiotherapist. The patient's perception of the effectiveness and feasibility of instructions was obtained from questionnaires, completed by the patient on three occasions. After the training only a minority of the trained skills appeared to be improved. All in all, the training program was not very effective. More effort is needed to develop training programs aimed at promoting patients' self-efficacy as well as measurement instruments to assess the effects of such programs.

No abstract