| Objective: Construct a scientific and theoretical remote intervention program for clinical nurses’ neck,shoulder and low back pain,and evaluate the effects of the remote intervention program.Method:1.The construction of a remote intervention plan for clinical nurses’ neck,shoulder and low back pain based on the Omaha system(1)Literature review method:Systematic retrieval of documents related to neck,shoulder and low back pain,the retrieval period is from the establishment of the database to February 10,2020(2)Qualitative interview method: Using descriptive research methods,from March to May 2020,the purpose is to sample 12 nurses suffering from neck,shoulder and low back pain in a tertiary hospital for semi-structured interviews.Revise the intervention draft with reference to the nurses’ neck,shoulder and low back pain management needs.(3)Experts consultation method: From June to July 2020,10 experts from the fields of nursing management,nurse occupational protection,human anatomy and rehabilitation are invited to consult,and the entries of the remote intervention draft are sent by email.For experts,the evaluation method is electronic questionnaire.After two rounds of expert consultation,the intervention plan was determined.2.Evaluate the effect of the clinical nurses’ remote intervention program for neck,shoulder and back pain based on the Omaha systemA total of 89 nurses with neck,shoulder and low back pain in a third-level hospital were selected by convenience sampling method from July to October 2020,and randomly divided into the intervention group(46)and the control group(43)by the envelope method.The intervention group used We Chat and Dingding APP to provide remote intervention programs,and the control group was given regular guidance,using compliance scale,cognitive-behavioral-symptom score(KBS score),VAS score scale and rapid exposure test method to evaluate the effect.Result:1.The construction of a remote intervention plan for clinical nurses’ neck,shoulder and low back pain based on the Omaha system(1)Literature review: A total of 11 randomized controlled trials were included.The intervention draft included basic knowledge of neck,shoulder and low back pain,common bad posture of nursing operation,principles of human mechanics,reasonable posture of ten nursing operations,reasonable posture of nurses’ daily living habits,self-relief methods of neck,shoulder and low back pain,and physical exercise.(2)Qualitative interview results: The health management needs of nurses with neck,shoulder and back pain include four themes: training content requirements,training methods requirements,exercise requirements and training duration requirements.The intervention draft is revised based on the interview results:(1)The self-relief method adds TCM methods and the use of protective equipment;(2)In the dimension of reasonable posture of nursing operation,the reasonable posture of working at a desk and taking objects from a low position were added;(3)The training method is online APP,and the implementation of the intervention draft consists of two modules.The first module is information module,once a week,20-30min/ time,a total of six weeks;the second module is exercise module,5 times a week,15-20min/ time,a total of six weeks.(3)The positive coefficient of experts in the two rounds of consultation was 100%,and the expert authority coefficient was 0.803.According to the results of expert consultation,the intervention draft was revised as follows:(1)The expression form of the intervention draft was modified;(2)In order to increase the nurse’s compliance,an in-class quiz was added;(3)Every Sunday morning,the class watching time list and quiz results will be published in time to encourage nurses to learn;(4)Daily exercise health exercises removed the standing posture small swallow fly and calm two movements.Mean value of each intervention item>4,and the coefficient of variation was<0.25.2.Evaluate the effect of the clinical nurses’ remote intervention program for neck,shoulder and back pain based on the Omaha system(1)A total of 89 clinical nurses with neck,shoulder and low back pain were included in this study,with an age of(31.85 ± 5.19)years,including 68 women.The exercise compliance of nurses in the intervention group was78.48%,and that of the control group was 38.93%.(2)There was no statistical difference in baseline data between the two groups before intervention(P>0.05),the cognitive and behavioral scores of the intervention group were significantly higher than those of the control group after 6 weeks(P<0.001),there was no significant difference in symptom scores between the two groups(P=0.116);VAS score was significantly lower than that of control group(P=0.027);The pain frequency of neck,shoulder and waist was significantly lower than that of the control group,and the P value was 0.036、0.013、0.029,respectively.(3)After 6 weeks of intervention,the ergonomic load levels of back,neck,shoulder/arm and hand/wrist in the intervention group were significantly lower than those in the control group(P<0.05)There was no difference in working rhythm and working pressure between the two groups(P>0.05).(4)After six weeks of intervention,the incidence of bad postures in the intervention group was significantly lower than that in the control group(P<0.05).Conclusion:Based on the Omaha system of clinical nurses neck shoulder waist pain remote intervention scheme has good security,scientific and theoretical,give full consideration to the needs of clinical nurses,nurse’s exercise adherence is higher,can significantly improve the nurses the intervention plan implement the knowledge and behavior of neck shoulder waist pain,reduce neck and shoulder pain in waist in frequency and intensity,reduce ergonomic load,can be further widely applied in clinic. |
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