O7C.3 Effectiveness of a multi-faceted intervention to prevent musculoskeletal pain in nurses and aides: results of a cluster-randomized controlled trial

Abstract

BackgroundHealth workers are at high risk of developing musculoskeletal pain (MSP). This study aimed to evaluate a multi-faceted intervention in two public tertiary hospitals, encompassing three levels of prevention and health promotion to prevent and manage MSP.MethodsA two-armed cluster randomized controlled trial, with a late intervention control group was performed. Clusters were independent hospital units, and participants were the nursing staff. The intervention comprised three components: participatory ergonomics, case management, and health promotion. The control group received usual occupational health care. The intervention lasted one year and data were collected at baseline, 6 and 12 months follow-up. Primary outcomes were self-perceived MSP and its associated sickness absence. The process evaluation included recruitment, context, reach, dose administered and received, fidelity, satisfaction, implementation strategy, and discussion groups of experts and participants.ResultsEight clusters, including 445 participants, were randomized. In the intervention group a 20% statistically significant reduction of neck, shoulders and upper back pain compared to the control group (OR=0.37; 95% CI=0.14–0.96) was observed at 12 months follow-up. We found no significant differences in incidence and duration of sickness absence. Organizational culture (secondary outcome) improved significantly in the intervention group in the domains of ‘formal safety audits’, ‘availability of information for safety at work’, and ‘involvement of workers in decisions that affect their safety and health’ compared to the control group. The intervention was implemented with 96.6% fidelity, and participants’ adherence was 75.5%. Participant’s satisfaction was 9.1/10.ConclusionsThis intervention showed effectiveness to reduce MSP and improve organizational culture, through to an integral management of MSP. Although our results are modest, strategies should focus on multi-faceted interventions, and occupational health services might be excellent opportunity for.

Methods of engagement and levels of involvement of stakeholders in the management of work-related musculoskeletal disorders: A systematic scoping review

“…A total of 17 unique methods of SE were identified across the 32 included studies. The predominant method of engagement used was education (n=18), in the form of noninteractive group sessions (Ludewig 2003, Rivilis 2006, Speklé 2010, Mahmud 2011, Mongini 2012, Lowe 2017, interactive group sessions (Haldorsen 1997, Bohr 2000, Haukka 2008, Bernaards 2011, Motamedzade 2011, Dale 2016, Rasmussen 2016, Font 2019, pamphlets (Hazard 2000, Soares 2012, Murray 2017, web education (Murray 2017) and oneone sessions (de Jong 2012). Educational sessions were mostly one session, however, the length of sessions varied from one hour to one day.…”

“…Collaboratively led meetings only focused on identification and management of workplace risk factors (Bohr 2000, Loisel 2001, Anema 2007, Haukka 2008, Driessen 2011, Jensen 2011, Jensen 2012, Dale 2016, Rasmussen 2016, Hansen 2019, Bird 2020. The remaining methods used were worker led: graded workplace exposure; (Steensra 2006), workplace alteration (Bohr 2000, Rivilis 2006, Font 2019) exercise following education (Murray 2017) and feedback on management options (Loisel 2001).…”