BackgroundBack pain is one of the most frequent complaints in the nursing profession. Thus, the 12-month prevalence of pain in the lumbar spine in nursing staff is as high as 76%. Only a few representative studies have assessed the prevalence rates of back pain and its risk factors among nursing staff in nursing homes in comparison to staff in home-based care facilities. The present study accordingly investigates the prevalence in the lumbar and cervical spine and determines the physical workload to lifting and caring in geriatric care.Methods1390 health care workers in nursing homes and home care participated in this cross sectional survey. The nursing staff members were examined by occupational physicians according to the principals of the multistep diagnosis of musculoskeletal disorders. Occupational exposure to daily care activities with patient transfers was measured by a standardised questionnaire. The lumbar load was calculated with the Mainz-Dortmund dose model. Information on ergonomic conditions were recorded from the management of the nursing homes. Comparisons of all outcome variables were made between both care settings.ResultsComplete documentation, including the findings from the occupational physicians and the questionnaire, was available for 41%. Staff in nursing homes had more often positive orthopaedic findings than staff in home care. At the same time the values calculated for lumbar load were found to be significant higher in staff in nursing homes than in home-based care: 45% vs. 6% were above the reference value. Nursing homes were well equipped with technical lifting aids, though their provision with assistive advices is unsatisfactory. Situation in home care seems worse, especially as the staff often has to get by without assistance.ConclusionsFuture interventions should focus on counteracting work-related lumbar load among staff in nursing homes. Equipment and training in handling of assistive devices should be improved especially for staff working in home care.
ObjectiveThe quality of life (QOL) and work ability of health care workers allergic to natural rubber latex (NRL) were assessed after implementation of regulations on powder-free NRL gloves in Germany.Methods196 HCW with reported NRL allergy answered a questionnaire (response rate 58%) containing the Work Ability Index (WAI), Mini Asthma Quality of Life Questionnaire (MiniAQLQ), and Dermatology Life Quality Index (DLQI).Results63.2% still had NRL-related symptoms during the last 6 month. However on a scale from 0 to 10, the intensity of NRL-related symptoms decreased from 8.5 before to 2.3 after implementation of regulations on powder-free NRL gloves. A higher number of subjects were able to avoid NRL in the private than in the work environment (85% vs. 61%). NRL-related symptoms decreased and WAI increased with successful avoidance of NRL at workplace (b = 0.23, p = 0.003). QOL was only little affected by NRL allergy (mean: MiniAQLQ = 6.0; DLQI = 4.1).ConclusionsAlthough there was improvement after implementation of powder-free NRL gloves, there is still a considerable number of HCW with NRL-related symptoms. Further investigations on latex avoidance and the cause of persisiting allergic symptoms in HCW with NRL allergy are therefore needed.
Although most subjects had only mild disease, ongoing work-related symptoms of the eyes, nose or airways in a substantial number of subjects with latex allergy suggest the need for further secondary preventive measures in German healthcare.
This study investigated the career preferences of medical graduates in Germany with regard to discipline, place and position after the completion of postgraduate training. We also investigated differences in career options according to gender and region of study (former German Federal Republic vs. former German Democratic Republic).The study is based on a standardised postal survey among all last year medical students in the medical faculties of Erlangen, Giessen, Hamburg, Heidelberg, Cologne, Leipzig and Magdeburg in 2009. 2 107 persons were contacted and 1 012 (48%) participated in the survey.96% of participants stated their intention to pursue a postgraduate training in a medical discipline, and only 0.4% denied such an objective. 7% of the graduates preferred a career towards general practice, and a similar percentage preferred general internal medicine which usually also leads to a primary care activity. 84% aimed at becoming a medical specialist. In total, 28% intended to work in a specialist practice, and 10% in a general practice. Only one-fifth of the latter aimed at working in a countryside setting. 7% aimed at starting postgraduate training outside of Germany, and 8% preferred to work outside Germany after completion of the postgraduate training. In both cases, Switzerland was by far the most preferred country.The results contradict the thesis that young graduates are reluctant to enter clinical medicine. Working abroad is within the scope of less than 10% of the graduates. A dramatic difference between the demand for general practitioners and the career intentions of medical graduates is observed. Measures to increase the attractiveness of primary care, especially in the countryside, are urgently needed.
Geriatric nurses with a health- and occupation-related impairment require intensive measures to support their health and to prevent health damage and to stop them from leaving work prematurely. If at all possible, these measures should not be restricted to a single social insurance agency. The individual preventive behaviour to avoid occupational back symptoms is not dependent on age. An age effect was observed for individual measures to protect the skin. Nevertheless, these had no effect on the risk of disease. The results indicate that more attention should be given to older employees during occupational training.
The results indicate that current work on equipment with aids and training in their use must be optimised and must also incorporate recent advances in scientific knowledge. Implementation of specific risk assessment analyses of stress at work and regular training in dealing with aids could help to support the use of aids for geriatric in-patients.
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