Study On Influencing Factors And Prevention And Control Countermeasure Of Neck And Low Back Pain Among Military Flight Crews Based On KAP Theory

【Objectives】(1)To investigate the epidemiological situation,knowledge-attitude-practice(KAP)and requirement in the prevention and control of neck and low back pain in military flight crews,analyze the influencing factors.(2)Through the above investigation,provide theoretical and empirical basis for the aviation health support department to promote the prevention and control of neck and low back pain of military flight crews,and put forward countermeasures and suggestions.【Methods】(1)Development of KAP questionnaire for prevention and control of neck and low back pain in military flight crewsTake the KAP theory as the theoretical framework,construct the item pool by combining the methods of qualitative interview of the target population and brainstorming of the members of the research group,preliminarily screen and modify the items by Delphi method experts,and the pre-test items are analyzed to form a formal questionnaire.The reliability and validity of the questionnaire were evaluated.(2)Current situation and influencing factors of neck and low back pain in military pilotsFrom October to November 2021,a questionnaire survey was conducted on the epidemiology of neck and low back pain,KAP and needs of neck and low back pain prevention and control of 607 military flight crews from 10 flight forces by multistage sampling method.Spearman correlation analysis,x~2test,Fisher exact test,Mann Whitney U test or Kruskal Wallis H test,Logistic regression analysis,multiple linear regression analysis and other statistical analysis methods were used for population comparison or influencing factor analysis.【Results】(1)This study developed the KAP questionnaire for the prevention and control of neck and low back pain in military flight crews,which contains 3 dimensions and 35 items.The reliability and validity test showed that the Cronbach’sαcoefficients of the whole questionnaire and each dimension were 0.884,0.689,0.948 and 0.753.The structure of the questionnaire basically conforms to the theoretical framework.Each dimension of the questionnaire has good independence,and each dimension has good correlation with the questionnaire as a whole.Each item’s I-CVI of the questionnaire is between 0.83 to 1,S-CVI=0.886 and S-CVI/ave=0.981.(2)In military flight crews,the point prevalence rate of neck pain was43.82%(95%CI:39.87%～47.77%),the period prevalence rate of neck pain was55.35%(95%CI:51.40%～59.31%),the point prevalence rate of low back pain was47.45%(95%CI:43.47%～51.42%),the period prevalence rate of low back pain was61.12%(95%CI:57.24%～65.00%).Only 20.43%had no neck pain or low back pain.62.77%of the respondents had neck and low back pain of grade I,showing mild disability-mild pain.16.80%of the respondents still had neck and low back pain of grade II or above,showing severe pain or severe disability.Aerobic exercise,sitting upright in flight with neck and waist support and stretching after flight were the protective factors of neck pain and low back pain within six months in military flight crews(P<0.05).(3)The total score of KAP of neck and low back pain prevention and control of military flight crews is 70.00(62.50,75.83),which is at a medium level.The score of knowledge dimension is 79.17(66.67,87.50),which is at the medium level.The score of attitude dimension is 80.00(75.00,95.00),which is at the medium level.The score of behavior dimension is 46.67(40.00,56.67).The knowledge level,attitude level,health education frequency,military service and aircraft type are the influencing factors of the behavior level.(4)98.52%of the respondents were willing to carry out self-management of neck and low back pain prevention and control.The most desired knowledge of neck and low back pain prevention and control is neck and waist muscle exercise(80.72%),and the most desired way for pilots to obtain knowledge is expert lectures(62.27%),The most needed support for the prevention and control of neck and low back pain for pilots is to equip massage chairs to the aircrew dormitory(84.18%).【Conclusions】(1)The KAP questionnaire of neck and low back pain prevention and control of military flight crews compiled in this study meets the development process and requirements,has good reliability and validity,and can be used as an evaluation tool to investigate the knowledge,attitude and behavior level of neck and low back pain prevention and control of military flight crews.(2)The epidemiology of neck and low back pain in military flight crews is not optimistic.The knowledge,attitude and behavior level of neck and low back pain prevention and control need to be further improved.Military flight crews have a high willingness to self-management of neck and low back pain prevention and control,and the needs for neck and low back pain prevention and control are diverse.(3)The influencing factors of neck and low back pain are multifaceted,so multi factor treatment methods are needed,and the top-level design is needed to solve any systematic problem.It is suggested to take measures from the three levels of system,organization and individual to promote the prevention and control of neck and low back pain in military pilots,so as to reduce the prevalence of neck and low back pain in pilots.