臺灣博碩士論文加值系統

下背痛是醫療人員中最常見的健康問題之一。其中護理人員為最易罹患下背痛者，因護理工作內容的多變性，加上護理人員在彎腰與搬運病人時發生下背痛之機率最高，其已成為促使護理人員轉業的重要因素之一。基於此，為了解研究單位之護理人員下背痛情形與相關因子，並能提供適當的預防措施。本研究以橫斷性問卷調查某醫學中心副護理長以下所有護理人員（740位）之下背痛盛行率及下背痛相關因子，自90年3月2日至3月15日以兩週時間收集問卷，將回收721份問卷中，去除85位從事護理工作前曾有下背痛護理人員後，有636位護理人員資料以SPSS 統計軟體處理與分析，統計方法包括：平均值、百分比、標準差、卡方檢定、羅吉斯迴歸分析與獨立樣本t檢定。
研究結果：從事護理工作後，護理人員下背痛終生盛行率為65.3﹪，週盛行率為28.6﹪，週發生率為2.7﹪。研究對象以問卷結果分為---以前曾經有過下背痛護理人員398位（第一組）、以前曾經有過下背痛、問卷調查當週（90.3.2-90.3.8）亦有下背痛護理人員165位（第二組）及問卷調查當週新發生下背痛護理人員17位（第三組）。第一組與第二組護理人員各科別之間下背痛發生率無顯著差異。第一組護理人員的下背痛與基本屬性相關因子中之“有子女、三個月體重變化、工作之科別年資”有正相關。第二組護理人員的下背痛與“有子女”有正相關。第二組護理人員的下背痛與“白班工作、無就醫情形”有正相關。第三組護理人員下背痛發生與“小夜班工作”有正相關。另三組護理人員的下背痛與休閒活動相關因子無相關。第一組護理人員的下背痛與家事活動相關因子中“替小孩換尿片”（彎腰姿勢）有正相關。另三組護理人員之下背痛與工作項目之相關性方面：一、工作項目中，第一組之下背痛與平時工作項目無關，第二組有四項工作項目包含“搬運重物（抬舉）、打點滴（彎腰）、推床（大量用背力）、幫病人做復健（彎腰、扭腰）”與下背痛有正相關。第三組則與“鋪床（彎腰），打電腦（彎腰）”有正相關。二、三個組別之下背痛與平時工作項目姿勢之相關性方面；第一組護理人員下背痛與四項工作姿勢有正相關，其姿勢為“幫病人上下輪椅或推床；翻身姿勢；扶病人站立姿勢；抽痰姿勢”有正相關。第二與第三組護理人員下背痛與工作姿勢均無相關。
工作項目次/時數方面第一組與第二組之下背痛與平時工作項目次數/時數有相關的項目為“每週幫病人做復健之時數”有正相關。第三組之下背痛與“鋪床工作項目之次數”有正相關。
根據以上結果，研究單位之護理人員下背痛盛行率相當嚴重，危險因子方面以彎腰與抬舉為最重要之原因。針對相關因子醫院應提供護理人員衛生保健課程訓練、有症狀儘早就醫、全面改用床套、增購符合人體工學之輔助器材（電動床、自動治療車），使護理人員養成規律之運動習慣。以降低下背痛之盛行率與再復發之情形。
關鍵字:下背痛、盛行率、相關因子

Low back pain（LBP）has been described as one of the main health problems among healthcare workers, especially for nursing staffs。Their works usually have to bending and lifting patients ,it induced nurses have to transfer other work and early retire。According to this view , to investigate the prevalence of LBP and risk factors in all of nursing assistant and staffs（N=740）,a cross sectional study was carried out in a medical center in Taipei .From 2001/03/01 to2001/03/15 during two weeks period;(721)cases completed questionnaires .We delete（85）cases because their LBP were suffered before working ,It was left (N=636)cases selected for analysis with SPSS soft ware include descriptive data ,chi-square ,Logistic regression model and 2 independent t test。
Results :after nursing working, life prevalence of LBP was 65.3﹪,point prevalence and incidence were28.6﹪and 2.7﹪.there was no significant between any nursing working department。According to data analyzed ,it described in three groups ; groupⅠ.is nurses who ever suffered LBP but not response on the survey week；groupⅡ is nurses who ever suffered LBP and also response on the survey week；groupⅢ.is nurses who only suffered LBP on the survey week（new） .GroupⅠnurses were significant with “have baby, three months bodyweight change and working professional years”. GroupⅡnurses were significant with “have baby”, also significant with “day shift duty and not to see a doctor”. GroupⅢ nurses were significant with “evening shift duty.” All of the three groups nurses were not significant with leisure times activities .Only groupⅠnurses were significant with “change napkin for baby”（homework）,the other two groups were not significant with homework activities.
Working activities：groupⅠnurses were not significant with working activities. groupⅡnurses were significant with “lifting heavy objects, inject IV, push rolled bed and help patient rehabilitation”. GroupⅢ nurses were significant with “made bed and using computer”.
Working posture：groupⅠnurses were significant with “lifting patients onto trolleys or in bed posture, change positions posture ,help patients standup posture and suction posture”。 The other two groups were not significant with working posture.
Working activities times：groupⅠand groupⅡnurses were significant with “help patient rehabilitation hours”. groupⅢnurses were significant with “made bed times”。
Based upon those results from research, prevalence of nursing staffs was high and severe .The main risk factor was “banding and lifting”. For these view, we suggest to arrange training ,educate lifting and prevent handling program；training nurses have a good exercise habit ,early to see doctor ,use bed suit（save time and less to banding ）, purchase more automatic bed and working table. It can decrease prevalence of LBP and recurrence.
Key words：low back pain； prevalence； associated factors

第一章 緒論 頁次
第一節 研究動機與重要性……………………………………01
第二節 研究目的………………………………………………04
第三節 名詞界定………………………………………………04
第二章 文獻查證
第一節 下背痛的定義與分類………………………………… 08
第二節 下背痛的盛行率……………………………………… 09
第三節 下背痛的相關因子
（基本屬性、相關因子、工作情形）…………………12
第四節 下背痛相關因子之相關研究………………………………24
第五節 研究架構……………………………………………………33
第六節 研究假設……………………………………………………34
第三章 研究方法
第一節 研究設計……………………………………………………34
第二節 研究對象……………………………………………………35
第三節 研究工具……………………………………………………36
第四節 資料收集過程………………………………………………42
第五節 資料統計與分析……………………………………………44
第四章 研究結果
第一節 研究個案之基本屬性與分佈………………………………45
第二節 護理人員下背痛盛行率與組別……………………………49
第三節 不同組別之護理人員基本屬性與其之的相關性…………52
第五章 討論
第一節 護理人員下背痛盛行率與各單位之間發生率的比較………89
第二節 不同組別之護理人員基本屬性與其之間的相關性…………91
第三節 不同組別之下背痛與休閒、家事活動相關因子之相關性…97
第四節 不同組別之下背痛與平時工作姿勢、工作項目、
工作項目姿勢、工作項目次數之間的相關性…………98
第六章 結論與建議
第一節 結論…………………………………………………………105
第二節 研究貢獻……………………………………………………107
第三節 建議…………………………………………………………108
第四節 研究限制……………………………………………………110
參考資料
英文部份……………………………………………………………111
中文部份……………………………………………………………122

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