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Patient Handling Methods and Musculoskeletal Disorders among Nurses
No full text護理工作是肌肉骨骼不適（musculoskeletal disorders, MSDs）盛行率最高的職業之一，造成護理人力流失及影響照護品質。過去研究顯示：協助病患轉移位是造成護理人員肌肉骨骼傷害的主因，使用不同的方式協助病患轉移位對肌肉骨骼系統之風險程度不同，但過去比較不同轉移位方式對MSDs風險之研究多在實驗情境進行，缺乏對護理人員日常協助病患轉移位方式及其對MSDs影響之探究。因此，本研究目的為瞭解國內醫院護理人員MSDs概況（包含：各科別護理人員MSDs之盛行率、不適部位、嚴重程度、影響工作程度等），及協助病患執行各項轉移位活動之情形（包含：頻率、費力程度、使用輔具類型、執行人數），以探討協助病患轉移位方式與身體各部位MSDs之關係；並進一步探討護理人員MSDs（部位數目）之相關因子（包含：人口學資料、工作特性、及協助病患轉移位之變項），作為未來職業災害預防之參考。
本研究採橫斷面研究設計，以自填問卷蒐集資料，收案對象為北部醫學中心、區域醫院、地區醫院及醫院附設護理之家中年滿二十歲之護理人員。問卷包含三部分：人口學與工作環境之基本資料、身體各部位MSDs概況，及協助病患轉移位概況。問卷分送至科別護理站，填完後回收，有效問卷共470份。
問卷調查結果顯示，88.3%護理人員最近六個月有一個部位以上之MSDs，約五成有四個部位以上之MSDs。各部位盛行率以下背部（77.2%）、頸部（64.2%）及肩部（58.7%）最高。各部位MSDs者中，手/手腕（21.6%）不適者因MSDs嚴重影響工作及請假之比例最高，下背部（20%）次之。不同病房單位之肩膀、上背、手/手腕、及足踝/足部不適比例達顯著差異，各部位MSDs盛行率普遍以綜合外科、加護病房、長期照護單位較高，內科及急診較低，下背部之盛行率於神經內外科高達92~95.7%，且在各病房單位均高，值得關注。
協助病患轉移位概況部分，全數轉移位活動需執行之比例皆高於六成，其中四個與床相關之活動（移動床上位置、床上翻身、床上平躺坐起、床到床）需執行比例高達九成，且為執行頻率及負荷程度（頻率乘以費力程度）最高的活動，另外，協助無法坐起者從床到椅、協助從地上起身兩活動則為單次執行自覺費力程度及自覺造成MSDs程度最高之活動，此六項活動需優先注意。十項轉移位活動中，國內護理人員僅有約四項常執行的方式為使用輔具，其他仍以徒手操作為主，以四個與床相關之活動較常使用輔具來執行的比例最高（55.4~93.8%）。使用之輔具以非動力輔具為主，最常使用之輔具為床單/布中單、轉位滑墊/滑板、及電動床。
迴歸分析結果顯示：護理人員MSDs部位數較多的相關危險因子，包含年齡較大、已婚、教育程度在研究所以上、某些病房單位（長期照護、綜合外科及骨科、加護病房）、負荷程度總分較高、轉移位活動方式之平均負重分數較高（較常使用徒手操作）。
本研究之結果顯示協助病患轉移位之負荷程度及執行方式皆為國內護理人員MSDs之相關因子，建議醫療單位需提供適切輔具並教導正確使用方式，以降低協助病患轉移位對護理人員之負荷程度，減少協助病患轉移位對其MSDs之風險。Nurses have one of the highest prevalence of musculoskeletal disorders （MSDs） among all the occupations and healthcare practitioners, resulting in nursing shortage and decreasing the quality of healthcare. The main cause of musculoskeletal injuries in nurses is showed to be patient handling. Patient handling can be carried out in different methods and may have varied risks for musculoskeletal system. However, previous research to compare the risks of MSDs by different patient handling methods was mostly done in laboratory context. Until now few studies examined nurses'' patient handling methods in working situation and its impact on MSDs. Thus, the purposes of this study include: 1) To survey MSDs (prevalence, affected body parts, pain intensity, and functional impact on work) among nurses in Taiwan. 2) To examined patient handling tasks (frequency, perceived exertion, and patient handling methods such as types of assistive technology and number of executors) executed by hospital nurses in Taiwan. 3) To identify potential risk factors including demographic and workplace characteristics and variables of patient handling tasks for number of prevalent body parts among hospital nurses in Taiwan. The results may provide the strategies for preventing MSDs among nurses in Taiwan.
In this cross-sectional study, a questionnaire survey was carried out among nurses in one medical center, four metropolitan hospitals and belonging nursing homes in northern Taiwan. A self-reported questionnaire was used to investigate 1) demographic and workplace characteristics. 2) MSDs of neck, shoulder, upper back, lower back, elbow, wrist/hand, hip, knee, ankle/foot. 3) Nurses'' performance of 10 patient handling tasks. Questionnaires were distributed by nursing stations, and 470 valid questionnaires were collected.
The 6-month prevalence of MSDs at any body parts was 88.3%, and half of the participants reported at least MSDs of four body parts. Lower back (77.2%）, neck (64.2%）and shoulder (58.7%） were the most prevalent body parts. Nurses with wrist/hand complaints had the highest proportion (21.6%) of severe functional impact on work and absence from work due to MSDs, followed by nurses with lower back complaint s (20%). There''s a significant difference of MSDs prevalence of shoulder, upper back, wrist/hand, and ankle/foot among different wards. In general, surgical, intensive care, and long-term care units had higher prevalence of MSDs, contrary to internal medical and emergency units. The prevalence of lower back MSDs is high among all units, and up to 92~95.7% in neurosurgical and neurology units, implicating the common issue of lower back pain.
All surveyed patient handling tasks were executed by at least 60% of nurses in Taiwan. Four patient handling tasks in bed (moving in the bed, turning or rolling over in bed, from lying to sitting in bed, from bed to bed）were performed by at least 90% of surveyed nurses, and these four tasks were with the highest frequency and patient handling burden (defined as frequency multiply by scores of perceived exertion）. In addition, "from bed to chair/wheelchair with patients unable to sit up " and "up from floor" were two tasks that had the highest perceived exertion and highest perceived extent to cause MSDs. These six tasks mentioned above had high priority to pay attention for. In average, nurses in Taiwan preferred to use transfer equipment in four out of ten patient handling tasks, and the other tasks were mostly carried out manually. Four tasks in bed had the highest proportion to use transfer equipment, ranging from 55.4% to 93.8%. The equipment most often used was bed sheets, slide boards/ slippery sheets, and electric beds.
Ordinal regression analysis showed that older age, married, graduate school, certain wards (long-term care, surgical, intensive care), higher patient handling burden, and higher loads due to manual patient handling were the risk factors for more body parts with MSDs.
In conclusion, the burden and methods of patient handling were both risk factors for MSDs among nurses in Taiwan. Appropriate transfer equipment and education on how to properly handle patients is needed to decrease the burden of patient handling and its unhealthy impact on MSDs among nurses
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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