CHAPTER ONE
1.1 Background of the Study
Musculoskeletal disorders are serious health issues that can contribute to disability, have a significant effect on quality of life, and place a financial burden on society in the form of compensation costs, lost wages, and reduced productivity. It is the primary source of pain that the majority of people complain about and an indication that there is a chance of tissue damage. It has the second-largest influence on disability globally and the fourth-greatest effect on health.
Musculoskeletal disorders, which cause chronic pain and physical disability and have significant negative effects on employees’ health and productivity, affect hundreds of millions of people worldwide. (Kebede et al., 2019). Musculoskeletal disorders are illnesses of the muscles, tendons, joints, intervertebral discs, peripheral nerves, and vascular systems that don’t immediately result from an acute or immediate incident but instead develop gradually and chronically (Sanders et al., 2013; Kebede et al., 2019).
One of the most prevalent musculoskeletal diseases is low back pain (LBP), also referred to as “lumbago”. Low back pain is characterized as posterior trunk discomfort that extends from the horizontal gluteal crease to the lower ribs. It also encompasses lower extremity pain, whether or not there is trunk pain, that is brought on by a low back disorder (such as sciatica or radiating low back pain) (Chiodo et al., 2020).
Low back pain is typically classified into 3 subtypes: acute, sub-acute and chronic low back pain. This classification is made based on how long the back pain persist. A low back pain incident that lasts less than six weeks is considered acute, one that lasts between six and twelve weeks is subacute, and one that lasts for twelve weeks or longer is chronic. (Burton and Balagué, 2004).
Low back pain, which many authors refer to as “social ill/evil,” truly has serious negative effects because of a variety of factors, particularly the sheer number of affected people, the high socioeconomic cost, and the severity of the effects on socio-professional life (Boughattas et al., 2017). In the industrialized world, low back pain (LBP) is a well-known cause of morbidity. Several studies have documented the prevalence of LBP in both the general population and workplace contexts. LBP is a frequent contributor to mortality in healthcare professionals. One occupational group within the health sector that is susceptible to LBP is nurses (Sikiru and Hanifa, 2010).
In most healthcare facilities, nurses perform a wide range of duties, making them undoubtedly the most crucial frontline healthcare professionals. Such duties are widely believed to increase workload. These and other factors make nursing one of the professions with the highest risk of LBP. This is supported by the fact that among the top ten occupations with a high risk of LBP, the nursing field is ranked (Kasa et al., 2020).
According to the literature review, the prevalence of LBP among Italian nurses varies from 33% to 86%, with an annual prevalence of 73.5% for Nigerian nurses (Sikiru & Hanifa, 2010). The low back was the most frequently reported painful body part by the nurses in a research by Madani et al. (2014). 87.5%, 65%, 72%, and 40% of nurses in the research by Al-Samawi and Awad (2015) in Sudan, Rusten (2016) in Nepal, Shieh et al. (2016) in Taiwan, and Roupa et al. (2008) in Greece reported having LBP on a regular basis. According to Budhrani-Shani et al. (2016), 50–80% of nurses globally experience LBP on a regular basis.
In the research by Petersan and Marziale (2014) and Ovayolu et al. (2014) on intensive care nurses, it was discovered that 67% and 84.2% of intensive care nurses, respectively, have LBP, and In the study performed by Akinci et al., the ratio was 75.8% (2014). According to Altinel et al.’s research from 2007, nurses experience chronic LBP the most frequently, with a ratio of 55.8%, compared to doctors, who experience it two times less frequently. In a research by Pinar (2010) on occupational musculoskeletal conditions affecting nurses in Turkey, it was discovered that LBPs had the highest prevalence, with a 49.7% rate, and that 70% of nurses sought medical attention as a result.
Numerous influencing factors frequently determine how LBP is experienced in connection to the inherent nature of the nursing profession. Researches have shown that workplace risk factors, including overtime work, extended working hours, poor posture, and rotating shifts, are important predictors of LBP (Almaghrabi and Alsharif, 2021). Therefore, it is crucial for employers to understand the occupational risk factors linked to low back pain in nurses and take the required precautions to avoid injury.
Nurses' productivity in the clinical setting may be impacted by low back discomfort. Considering that nurses make up about one-third of the workforce at any hospital and play a significant part in the health care system, it is likely that LBP directly affects the limitations on their ability to perform their duties and attendance (Almaghrabi and Alsharif, 2021). Hence, the present study was designed to determine the prevalence of LBP and the associated risk factors among nurses.
1.2 Statement of the Problem
Nurses are one of the most significant members of the medical team because they have the necessary scientific and practical knowledge to provide nursing care at various levels of prevention (Halcomb et al., 2020). As a result of the nature of their job nurses frequently carry out duties that demand lifting heavy loads, lifting patients, working in uncomfortable postures, moving patients out of bed and from the floor, transporting medical equipment of different weights and sizes and arranging beds of various dimensions (Járomi et al., 2018; Asadi et al., 2016).
Owing to the frequent overuse of tendons, ligaments, and muscles, static muscle loading, and fatigue associated with these activities, nurses are at a high risk of developing work-related musculoskeletal disorders (WMSDs), such as low back pain (LBP), which has a lifetime prevalence ranging from 35 to 80% and accompanied by significant socioeconomic expenses and health risks to society (Pakbaz et al., 2019; Ovayolu et al., 2014; Moreira et al., 2014).
Additionally, carrying out tasks without assistance or any tools for support has been linked to LBP, according to reports. (Yilmaz et al., 2006). Long working hours, an excessive workload, a lack of staff and tools, inadequate breaks, prolonged standing, and irregular eating and sleeping schedules as a result of shift work are additional occupational risk factors that can cause LBP in nurses. (Ovayolu et al., 2014; Selvi et al., 2010). Also, due to a lack of equipment and work-related designs, nurses in developing nations experience a greater incidence of job-related back pain (Sanjoy et al., 2017).
Low back pain is a workplace hazard that reduces nurses’ productivity (El-Soud et al. 2014). Finding and keeping nurses is difficult, and the weight of occupational injuries like LBP and associated disabilities has made the nursing shortage worse. (Munabi et al. 2014; Tinubu et al. 2010). An estimated 12% of nursing staff in the UK contemplate changing jobs to lessen their LBP, and another 12% to 18% ultimately quit their jobs as nurses as a result of persistent back pain (Burdorf & Jansen 2006). The cost of occupational musculoskeletal conditions in nursing staff is high, and this includes indirect costs such as hiring temporary or replacement staff, working extra to cover an injured worker’s responsibilities, paying legal fees, processing delay for claims, decreased productivity after traumatic events, and training expenses for temporary or replacement staff (Abuadas 2005).
As a result, precise data on prevalence and occupational risk factors in nurses are required for preventive action.
1.3 Aim of the Study
The study aims to estimate the prevalence of low back pain among nurses and to look for associations between low back pain and occupational risk factors
1.4 Objectives of the Study
The study had the following specific objectives:
- To determine the prevalence of low back pain among nurses
- To identify the various occupational risk factors that contribute to the prevalence of low back pain among nurses
- To investigate the strategies for reducing the prevalence of low back pain among nurses
1.5 Research Questions
The following research questions were asked and answered in the process of study of this work:
- How prevalent is low back pain among nurses?
- What are the occupational risk factors that contribute to the prevalence of low back pain among nurses?
- What preventive measures can be implemented to reduce the prevalence of low back pain among nurses?
1.6 Research Hypothesis
Ho: There is no statistically significant relationship between the prevalence of low back pain amongst nurses and associated occupational-risk factors
Ha: There is a statistically significant relationship between the prevalence of low back pain amongst nurses and associated occupational-risk factors
1.7 Justification of the Study
It is critical to understand the prevalence of LBP and its related occupational risk factors among nurses. Knowing this will aid nursing staff and hospital managers in developing efficient LBP prevention plans. Furthermore, identifying risk factors for low back pain provides important information for decision-makers and hospital administrative authorities to use when planning and implementing preventive measures designed to mitigate the problem and the resulting decline in nursing care quality.
The analysis presented in this study will assist nurses in changing the behaviours that predispose them to low back pain in order to reduce unnecessary personal and medical expenses. Ultimately this findings from this study will convey valuable information for future research.
1.8 Scope of the Study
The scope of the study covers the prevalence of low back pain amongst nurses and occupational risk factors. Data for the study will be obtained from nurses in intensive care unit of a multi-specialist hospital in Nigeria.
