ارزيابي خطر ابتلا به اختلالات اسكلتي-عضلاني ناشي از جابجايي بيمار در پرسنل بيمارستاني به روش DINO و PTAI در بيمارستان‌هاي منتخب وابسته به دانشگاه علوم پزشكي شهيد بهشتي

Risk Assessment of Musculoskeletal Disorders in Hospital Personnel due to Patient Transfer by DINO and PTAI in Selected Hospitals Affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran

زﻣﯿﻨﻪ و ﻫﺪف: اﺧﺘﻠﺎﻟﺎت اﺳﮑﻠﺘﯽ-ﻋﻀﻠﺎﻧﯽ ﻣﺮﺗﺒﻂ ﺑﺎ ﮐﺎر )Work-related Musculoskeletal Disorders( از ﻣﻬﻢﺗﺮﯾﻦ ﻋﻮاﻣﻞ ﺗﻬﺪﯾﺪﮐﻨﻨﺪه ﺳﻠﺎﻣﺖ ﭘﺮﺳﻨﻞ ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ داراي وﻇﯿﻔﻪ ﺟﺎﺑﺠﺎﯾﯽ ﺑﯿﻤﺎر در ﺑﯿﻤﺎرﺳﺘﺎن ﺑﻮده و از ﺷﯿﻮع ﺑﺎﻟﺎﯾﯽ ﺑﺮﺧﻮردار اﺳﺖ. ﺑﻪ ﻫﻤﯿﻦ ﻣﻨﻈﻮر اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎﻫﺪف ارزﯾﺎﺑﯽ ارﮔﻮﻧﻮﻣﯿﮑﯽ ﺧﻄﺮ اﺑﺘﻠﺎ ﺑﻪ اﺧﺘﻠﺎﻟﺎت اﺳﮑﻠﺘﯽ-ﻋﻀﻠﺎﻧﯽ در ﭘﺮﺳﻨﻞ ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ داراي وﻇﯿﻔﻪ ﺟﺎﺑﺠﺎﯾﯽ ﺑﯿﻤﺎر ﺷﺎﻏﻞ در ﺑﺨﺶﻫﺎي ﻣﺨﺘﻠﻒ ﺑﯿﻤﺎرﺳﺘﺎنﻫﺎي ﻣﻨﺘﺨﺐ واﺑﺴﺘﻪ ﺑﻪ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ ﺷﻬﯿﺪ ﺑﻬﺸﺘﯽ ﺗﻬﺮان ﺑﻪ روش DINO و PTAI اﻧﺠﺎم ﮔﺮﻓﺖ. روشﻫﺎ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﻘﻄﻌﯽ-ﺗﺤﻠﯿﻠﯽ در ﺑﯿﻦ 245 ﻧﻔﺮ از ﭘﺮﺳﻨﻞ ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ داراي وﻇﯿﻔﻪ ﺟﺎﺑﺠﺎﯾﯽ ﺑﯿﻤﺎر در ﺑﺨﺶﻫﺎي ﻣﺨﺘﻠﻒ 4 ﺑﯿﻤﺎرﺳﺘﺎن ﻣﻨﺘﺨﺐ واﺑﺴﺘﻪ ﺑﻪ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ ﺷﻬﯿﺪ ﺑﻬﺸﺘﯽ ﺷﻬﺮ ﺗﻬﺮان در ﺳﺎل 1398 اﻧﺠﺎم ﮔﺮدﯾﺪه اﺳﺖ. در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻧﻮع ﻧﻤﻮﻧﻪﮔﯿﺮي دو ﻣﺮﺣﻠﻪاي ﺗﺼﺎدﻓﯽ ﺧﻮﺷﻪاي ﺑﻮد. دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از ﭘﺮﺳﺸﻨﺎﻣﻪ Body map و ﭘﺮﺳﺸﻨﺎﻣﻪﻫﺎي PTAI و DINO ﮔﺮدآوري ﮔﺮدﯾﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻣﯿﺎﻧﮕﯿﻦ و اﻧﺤﺮاف ﻣﻌﯿﺎر ﺳﻦ اﻓﺮاد ﻣﻮرد ﻣﻄﺎﻟﻌﻪ 37/7±9/6 ﺳﺎل ﺑﻪ دﺳﺖ آﻣﺪ. 72/2 درﺻﺪ )177 ﻧﻔﺮ( اﻓﺮاد ﻣﻮرد ﻣﻄﺎﻟﻌﻪ را ﻣﺮدان و 27/8 درﺻﺪ )68 ﻧﻔﺮ( را زﻧﺎن ﺗﺸﮑﯿﻞ دادﻧﺪ. ﻧﺘﺎﯾﺞ ﻧﺸﺎن داد ﮐﻪ 88/6 درﺻﺪ )217 ﻧﻔﺮ( از اﻓﺮاد ﻣﻮرد ﻣﻄﺎﻟﻌﻪ در ﻃﯽ 12 ﻣﺎه ﮔﺬﺷﺘﻪ ﺣﺪاﻗﻞ در ﯾﮑﯽ از اﻧﺪامﻫﺎي ﺧﻮد اﺣﺴﺎس درد و ﻧﺎراﺣﺘﯽ داﺷﺘﻨﺪ. ﮐﻤﺮدرد ﺑﺎ 71 درﺻﺪ )174 ﻧﻔﺮ(، ﺷﺎﯾﻊﺗﺮﯾﻦ ﻧﺎراﺣﺘﯽ اﺳﮑﻠﺘﯽ-ﻋﻀﻠﺎﻧﯽ در ﭘﺮﺳﻨﻞ ﻣﻮرد ﻣﻄﺎﻟﻌﻪ ﺑﻮده اﺳﺖ. ﺑﯿﺶﺗﺮﯾﻦ ﻧﻤﺮه PTAI ﺑﺎ 69/8 درﺻﺪ )171 ﻧﻔﺮ( در ﺳﻄﺢ دو )ﻧﺎﺣﯿﻪ زرد: ﻧﯿﺎزﻣﻨﺪ اﻗﺪاﻣﺎت ارﮔﻮﻧﻮﻣﯿﮑﯽ( ﺑﻮد. ﻫﻤﭽﻨﯿﻦ 27/8 درﺻﺪ )68 ﻧﻔﺮ( در ﺳﻄﺢ ﺳﻪ )ﻧﺎﺣﯿﻪ ﻗﺮﻣﺰ: ﺳﻄﺢ ارﮔﻮﻧﻮﻣﯿﮑﯽ ﺿﻌﯿﻒ( ﻗﺮار داﺷﺖ. ﺑﯿﺶﺗﺮﯾﻦ ﻧﻤﺮه DINO ﺑﺎ 57/6 درﺻﺪ )141 ﻧﻔﺮ( در ﺳﻄﺢ دو )ﻧﺎﺣﯿﻪ زرد( و 41/6 درﺻﺪ )102 ﻧﻔﺮ( در ﺳﻄﺢ ﺳﻪ )ﻧﺎﺣﯿﻪ ﻗﺮﻣﺰ( ﻗﺮار داﺷﺖ. ﺑﯿﻦ ﻧﺘﺎﯾﺞ ﺣﺎﺻﻞ از ﻫﺮ ﯾﮏ از ﺷﺎﺧﺺﻫﺎي PTAI و DINO ﺑﺎ ﺷﯿﻮع اﺧﺘﻠﺎﻟﺎت اﺳﮑﻠﺘﯽ-ﻋﻀﻠﺎﻧﯽ ارﺗﺒﺎط ﻣﻌﻨﺎداري وﺟﻮد ﻧﺪارد )0/05>p(. ﻫﻤﭽﻨﯿﻦ ﺑﯿﻦ ﺳﻄﻮح ﻣﺨﺘﻠﻒ ﺷﺎﺧﺺ DINO ﺑﺎ PTAI ارﺗﺒﺎط ﻣﻌﻨﺎداري وﺟﻮد دارد )0/05

Background and Aim: Work-related musculoskeletal disorders are one of the most prevalent health hazards of hospital personnel with the task of patient transfer. Therefore, the aim of this study is ergonomic risk assessment of musculoskeletal disorders in hospital personnel with the task of patient transfer working in different sections of selected hospitals affiliated to Shahid Beheshti University of Medical Sciences using DINO and PTAI methods. Methods: This cross-sectional study was performed on 245 hospital personnel with the task of patient transfer in different sections of 4 selected hospitals, affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran, in 2019. In this study two-stage cluster random sampling was used. Data were collected by using Body map, PTAI and DINO questionnaires. Results: The mean and standard deviation of age were 37.7±9.6 years. 72.2% (n=177) of the subjects were men and 27.8% (n=68) were women. Results showed 88.6% (n=217) of the subjects had pain in at least one of the body organs during the past 12 months. Low back pain with 71% (n=174) was the most common musculoskeletal discomfort between subjects. The highest PTAI score was 69.8% (n=171) at second level (yellow area) and 27.8% (n=68) in third level (red area). The highest DINO score was 57.6% (n=141) at second level (yellow area: Requires Ergonomic Measures) and 41.6% (n=102) at third level (red area: weak ergonomic surface). Relationship between the results of PTAI and DINO indexes and prevalence of musculoskeletal disorders were not found significant (p>0.05). There is a significant relationship between different levels of DINO index with PTAI index (p<0.05). Conclusion: Both PTAI and DINO methods can be a useful tool for evaluating patient displacement. Other risk factors such as inappropriate body postures, prolonged standing and high work pressure in nursing job, indicate that ergonomic interventions and improvement of working conditions are necessary.