Back disorders and lumbar load in nursing staff in geriatric care: a comparison of home-based care and nursing homes

Abstract

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.

Uncovering the care setting–turnover intention relationship of geriatric nurses

“…time pressure) (Hasson and Arnetz 2007;Kromark et al 2009;Tummers et al 2013). Moreover, nurses in nursing homes have more social interrelations at work (Nübling et al 2010), yielding more social support (Kromark et al 2009) but also more social conflicts (Simon et al 2005;Tummers et al 2013; but see Nübling et al 2010). Notably, the abovementioned factors have all been confirmed to be antecedents of nurses' turnover attitudes and behaviour (Flinkman et al 2010;Hayes et al 2012;Nei et al 2015).…”

“…For example, nurses in home care experience more autonomy as well as less physical and psychological demands (e.g. time pressure) (Hasson and Arnetz 2007;Kromark et al 2009;Tummers et al 2013). Moreover, nurses in nursing homes have more social interrelations at work (Nübling et al 2010), yielding more social support (Kromark et al 2009) but also more social conflicts (Simon et al 2005;Tummers et al 2013; but see Nübling et al 2010).…”

“…On the other hand, beneficial job resources (e.g. social support and collective rest breaks; Kromark et al 2009;Wendsche et al 2014) in nursing homes might attenuate the relationship of job stressors and turnover in this field.…”

“…Previous studies not only showed that there are more nursing aides working in nursing homes (Kromark et al 2009), but that there are differences in the perception of job demands and resources (Morgan et al 2002) as well as leaving intentions (Hasselhorn et al 2003). In our sample, we found only few significant, mostly small relationships of job status and variables in the model, that is: age (r = .21), weekly working time (r = .26), time pressure (r = -.17), and task identity (r = .12) (see Table 1).…”

Factors That Influence the Use of Safe Patient Transfer Technique in Home Care Service

“…In a cross-sectional survey, Kromark, Dulon, Beck, et al stated the need to improve facilitating equipment and training in handling these assistive devices for staff working in home care [34]. This is in concordance with Hasson and Arnetz, who compared the nursing staff's competence, work strain, stress and satisfaction between home care and nursing homes [35].…”