A Survey of perceived disability and contributing risk factors to work-related low back pain amongst nurses in Rwanda
Ndagijimana, Pierre Claver
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Nursing is worldwide regarded as a high risk occupation for the development of work-related low back pain (WRLBP). LBP is one of the most common causes of disability, creating an important socio-economic problem in modern society. Studies report that more than 80% of workers suffer from WRLBP once in their occupational lives. Among nurses, the lifetime prevalence has been found to be higher, varying up to 90% of a nursing population. The current study aimed at determining the prevalence, perceived disability and contributing/risk factors to WRLBP among nurses in Rwanda, identifying the perceived contributing risk factors of WRLBP and intervention strategies received by those nurses. A descriptive quantitative cross-sectional survey using convenience sampling was used to gather data with a self-administered questionnaire on a sample of 226 nurses. The study population included all registered nurses of Kabgayi District Hospital and Nyanza District Hospitals and their respective health centers. To be included, the nurses had to have suffered from WRLBP during the previous 6 months before data collection. The Nordic Back Pain Questionnaire, the Oswestry Disability Index and an open-ended questionnaire regarding perceived risk factors have been used. Descriptive statistics to summarize data and inferential statistics such as chisquare test to test the relationship between different variables of the study have been studied at 5% levels. Correlation coefficients in terms of cross-tabulation were also studied at 1% level of significance. The current study highlights one-month prevalent rates of 70.4%, and one-week prevalent rates of 54.4%. WRLBP among nurses has been found to be significantly associated with gender according to the p-value of 0.007 among the studied variables, and good correlation coefficients between disability scores, together with the length of WRLBP and BMI with 0.0001, 0.0030 respectively. Nurses in the current study reported WRLBP as a result of a wide range of factors related to their work, manual handling being the major physical work activity exposing them to WRLBP. The perceived risk factors for WRLBP reported in this study were classified into 4 categories. The first category included work positional factors such as standing, sitting, bending, and awkward work postures. The second group included work-related nursing tasks such as lifting patients and items at work, repositioning and transferring patients, bed making, washing patients, and many others. In the third group, psychosocial factors like poor relationship with colleagues, work pressure and reduced job satisfaction have been listed. Finally, some non-occupational factors such as aging, pregnancy, menstruation, history of back pain, being female and body built have also been perceived as contributing factors to WRLBP. The Oswestry Disability Index demonstrated a mild to moderate disability due to WRLBP in this group of nurses. WRLBP has a negative impact in health services due to activity limitation, lost time and lowered productivity. The study concludes that nurses must be protected from ergonomic work stressors, and improvement of awareness of urses with regards to ergonomic stressors seems to be crucial. However, an effort by different parties concerned with the problem at all levels in Rwanda is needed. The government of Rwanda, through the Ministry of Health in particular, will be recommended to put strategies in place for the management, reduction and prevention of WRLBP amongst health workers, especially in the nursing population.