Journal of Nursing Research Vol. 14, No.

3, 2006

Risk Factors for Musculoskeletal Discomfort

in Nurses
Jui-Yeh Hou · Judith Shu-Chu Shiao*

ABSTRACT: Although musculoskeletal problems are commonly reported among the working population, including
nurses, the prevalence and risk factors for musculoskeletal discomfort in nurses have not been
extensively studied in Taiwan. To understand the risk factors and prevalence of musculoskeletal
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discomfort in different body parts among nurses in Taiwan, we performed a cross-sectional study using
a self-administered questionnaire to collect data. A total of 5,269 (93%) nurses completed the
questionnaire survey. Musculoskeletal discomfort was found to be prevalent in this group. In terms of
location, the lower back was the most commonly reported site of discomfort, followed by lower legs,
shoulders and neck. Considering limitation of motion as an indicator of musculoskeletal discomfort
severity, the highest levels of prevalence were reported, respectively, in the lower back, shoulder,
lower leg, and wrist. Numbness was most commonly reported in lower legs, hands, thighs, and lower
back. Risk factors for pain in shoulders/neck included waist-bending and waist-twisting, while those
for lower back pain included duration of standing, waist-bending, and weight-lifting. Risk factors for
lower leg pain included duration of standing and weight-lifting. Musculoskeletal discomfort was
prevalent among nurses (91.6%). Pain in different body parts was related to different ergonomic risk
factors while at work, namely, bending and twisting of the waist, and standing for extended periods of
time. The development and testing of interventions to minimize these risk factors is warranted in future
studies.
Key Words: musculoskeletal discomfort, occupational disease, nurses.

Introduction decisions to leave the nursing profession (Fochsen et al.,

Musculoskeletal discomfort has been frequently re-
ported among the working population, including health
care workers (Goldman, Jarrard, Kim, Loomis, & Atkins,
2000; Shiao, Chen, Du, & Guo, 1996; Stockstill, Harn,
Strickland, & Hruska, 1993). Nursing is recognized as a
physically demanding profession, with nurses and nursing
aides reported as facing the highest risk of back pain in
many countries (Anonymous, 1997; Cooper, Tate, & Yassi,
1998; Diaz, 2001; Engels, van der Gulden, Senden, & van’t
Hof, 1996; Engels, van der Beek, & van der Gulden, 1998;
Lagerstrom, Hansson, & Hagberg, 1998; Josephson &
Vingard, 1998; Smedley et al., 1995; Trinkoff et al., 2002).
A previous study identified that back pain contributed to
2006). Musculoskeletal discomfort in body areas other
than the back was less frequently reported in the literature.
In addition, most studies have been focused on pain, al-
though other musculoskeletal conditions, e.g., soreness
and numbness, may also affect work performance and
result in loss of workdays and productivity (Burton et al.,
1997; Josephson & Vingard, 1997; Leighton & Reilly,
1995). To assess the prevalence of musculoskeletal dis-
comfort in various body areas among nurses, we conducted
a survey in accredited hospitals in Taiwan. Potential per-
sonal and job risk factors were analyzed as predictors for
pain in the affected body parts. Limitation of motion was
used as an indicator of musculoskeletal condition severity.
We asked participants to evaluate the association between

RN, MS, Instructor, Department of Nursing, Chang Hwa College of Medical Technology; *RN, PhD, Assistant Professor, School and
Graduate Institute of Nursing, National Taiwan University.
Received: April 17, 2006 Revised: June 12, 2006 Accepted: June 26, 2006
Address correspondence to: Judith Shu-Chu Shiao, No. 1, Jen-Ai Rd. Sec. 1, Taipei 10051, Taiwan, ROC.
Tel: 886(2)2394-7740; Fax: 886(2)2394-7998; Email: scshiao@ha.mc.ntu.edu.tw

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Musculoskeletal Discomfort in Nurses
their musculoskeletal conditions and their jobs as nurses,
as well as whether they have taken sick leave due to mu-
sculoskeletal discomfort.
Methods
A total of 16 hospitals were randomly selected from
Taiwan’s accredited hospital list, including four hospitals
each in the following categories: more than 1,000, 500-
999, 200-499, and less than 200 employees. Nurses were
identified from the personnel department of each hospital
as the study participants. This was a cross-sectional study
design. An anonymous structured self-administered, modi-
fied Chinese version of the Nordic musculoskeletal ques-
tionnaire (NMQ) was used for data collection. All partici-
pants were given one week to fill out the questionnaire and
assured that their participation was entirely voluntary. The
questionnaire included a series of questions on muscu-
loskeletal complaints and began with the question “Since
entering your current job, have you suffered from muscu-
loskeletal discomfort such as pain, numbness, or limited
motion? [yes or no]” If the answer was “yes,” the partici-
pant would be further asked to identify the nature of the
condition [pain, soreness, numbness, or limited motion;
multiple choices allowed]. For each condition, the ques-
tionnaire requested identification of the body parts in-
volved [neck, shoulder, upper back, elbow, lower back,
wrist, hand, hip, upper leg, knee, lower leg, ankle, or oth-
ers; multiple choices allowed]. A sketch of a human body
was printed on the questionnaire to ensure that all partici-
pants used the same definitions of the body parts. Partici-
pants were also asked “Have you ever lost any workdays in
the past 12 months because of musculoskeletal discomfort
in your current job? [yes or no]” If the answer was “yes,”
the participant was then asked to report the number of
workdays lost. Nurses were also asked whether they
thought their musculoskeletal discomfort was related to
their current job. We also asked the duration and frequency
that they stood, twisted and bent their waist, and lifted
heavy objects at work on a typical day. Information on
demographic variables, such as age and gender, and other
work-related variables, such as duration of employment,
were also collected.
This questionnaire had been used in studies of other
occupations (Shiao, Chen, Du, & Guo, 1996). Prior to data
collection, a total of five focus groups were held to improve
questionnaire face and content validity. Members of focus
J. Nursing Research Vol. 14, No. 3, 2006
groups included experts in occupational health and safety;
public health and health care workers from various profes-
sional fields; surgical, internal and emergency medicine
physicians; nurses in various specialties; technicians; and
support personnel, including laundry workers, janitors,
porters and central supply workers. The test-retest reliabil-
ity of the questionnaire was evaluated for 44 health care
workers from all job categories at a 2-week interval. The
correlation coefficient of the two tails was 0.902.
Data were coded and stored in a personal computer
running Microsoft Excel. The statistical analysis was per-
formed using JMP 5.0 (SAS Company, 2002). Prevalence
of musculoskeletal discomfort was analyzed using de-
scriptive statistics. Chi-square tests were used to examine
variations in musculoskeletal discomfort prevalence be-
tween different age groups, durations of tenure, and dura-
tions of employment. Logistic regression was performed
to determine risk factors related to musculoskeletal dis-
comfort. Odds ratios were calculated to determine the
contribution of each job-related risk factor (tenure, work
hour per week, hours of standing, frequency of bending
waist, twisting waist, and weight lifting at work) to pain
and the contribution of musculoskeletal complaints to
sick leave requests. Backward stepwise logistic regres-
sion was used to determine the most important muscu-
loskeletal conditions resulting in employees taking sick
leave. For this, we used sick leave (yes/no) as the depend-
ent variable and presence (yes/no) of pain, numbness, or
difficulty in movement of each body part as independent
variables.
Results
Of a total 5,668 eligible nurses at randomly selected
hospitals, 5,271 (93.0%) completed and returned question-
naires. Due to their small number (n = 2) in the sample,
male nurses were excluded from analysis, which left 5,269
questionnaires available for content review. Among these,
1,319 had at least one item left blank in the following areas:
age, duration of employment, weekly work hours, mu-
sculoskeletal discomfort, and sick leave during the past 12
months. Therefore, researchers were able to effectively uti-
lize the content of 3,950 (69.7%) valid questionnaires in
this study. The majority of participants were aged between
25 and 34. Tenures averaged longer than 8 years and work-
ing hours averaged in the range of 40-48 hours per week
(see Table 1 for details).
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J. Nursing Research Vol. 14, No. 3, 2006 Jui-Yeh Hou et al.

Table 1.
Demographic Characteristics and Working Conditions
of Nurses Participating in This Study
Variable n %
Age (years)
< 25 1,496 37.9
25-34 1,995 50.5
35-44 336 08.5
³ 45 123 03.1

Tenure (years)
<1 663 16.8
1 to < 2 666 16.9
2 to < 4 807 20.4
4 to < 8 845 21.4 Figure 1. Prevalence of pain, numbness, and difficulty of
>8 969 24.5 movement in the neck, shoulders, upper back and lower back.

Work Hours/Week
< 32 81 02.1
32 to < 40 389 09.8
40 to < 48 2,910 73.7
> 48 570 14.4

Every participant was counted only once, even when

he/she had multiple complaints. The combined preva-
lence of all four musculoskeletal complaints during he-
althcare worker careers totaled 91.6% among nurses. Of
the 3,618 nurses who noted experiencing musculoskeletal
discomfort, 2,559 (71%) considered the discomfort to be
work-related, while 21% considered it possibly work- Figure 2. Prevalence of pain, numbness, and difficulty of
related. movement in shoulders, elbows, wrists, and hands.
In terms of pain location, the lower back (32.9%) was
the most commonly reported affected area, followed by the
lower legs (22.3%), shoulders (17.1%) and neck (12.2%)
(Figures 1-3). If limitation of motion was taken as an indi-
cator for severity of musculoskeletal discomfort, the high-
est prevalence was reported in the lower back (6.7%), fol-
lowed by the shoulders (4.1%), lower legs (3.8%), and
wrists (3.4%). Numbness was most commonly reported in
lower legs (12.8%), hands (5.3%), lower back (4.7%), and
thighs (4.6%).
Frequency of pain in the most frequently affected
body parts (e.g., shoulders/neck, lower back, and lower
legs) was compared between different age, tenure, and
duration of employment groups using Chi-square tests.
Pain frequency was significantly different between differ-
ent age groups (segmented as “< 25 years,” “25 to 34
years,” “35 to 44 years,” and “> 45 years”) and employ- Figure 3. Prevalence of pain, numbness, and difficulty of
ment duration (segmented as “<1 year,” “1 to 2 years,” “2 movement in buttocks, thighs, knees, lower legs, and feet.

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Musculoskeletal Discomfort in Nurses J. Nursing Research Vol. 14, No. 3, 2006

Table 2.
Neck/Should Pain, Lower Back Pain, and Lower Leg Pain in Nurses Across Different Age Groups, Tenure, and
Weekly Work Hours
Variable Neck/shoulder pain (%) Lower back pain (%) Leg pain (%)
Age (years) (p < .001) (p = .01) (p < .001)
< 25 18.1 30.6 25.7
25-34 24.7 35.4 22.1
35-44 30.1 31.0 13.1
³ 45 35.0 26.0 08.9

Tenure (years) (p < .001) (p < .001) (p < .001)

<1 15.8 25.9 23.5
1 to < 2 19.2 31.1 25.5
2 to < 4 22.7 36.7 25.2
4 to < 8 25.7 37.3 22.3
>8 28.4 32.0 16.9

Work Hours/Week (p = .15) (p = .19) (p = .001)

< 32 24.7 25.9 11.1
32 to < 40 22.9 31.4 19.0
40 to < 48 22.2 32.7 22.2
> 48 26.7 36.0 26.8
Note. p values were obtained by Chi-square test.

Table 3. Table 4.
Risk Factors for Neck/Shoulder Pain in Nurses - Including Risk Factors for Lower Back Pain in Nurses - Including
Hours Spent Standing, Frequency of Bending and Hours Spent Standing, Frequency of Bending and
Twisting, and Amount of Weight Lifted per Day Twisting, and Amount of Weight Lifted per Day

95% CI of 95% CI of
Item Odds ratio odds ratio p-value Item Odds ratio odds ratio p-value

Bending Waist Standing

£ 10 times/day 1.00 < 4 hr/day 1.00
11-20 times/day 1.14 (0.92-1.40) .240 4-6 hr/day 1.31 (1.10-1.55) .003
> 20 times/day 1.38 (1.11-1.70) .003 > 6 hr/day 1.51 (1.24-1.85) < .001

Bending Waist
Twisting Waist
£ 10 times/day 1.00
£ 5 times/day 1.00
11-20 times/day 1.23 (1.02-1.49) .034
6-10 times/day 1.26 (1.03-1.55) .025
> 20 times/day 1.56 (1.29-1.89) < .001
> 10 times/day 1.14 (0.92-1.41) .240
Amount of Weight
Note. Adjusted for age and tenure; hours spent standing and amount
Lifted at Work
of weight lifted were excluded due to lack of statistically significant
< 50 Kg/day 1.00
association.
50-100 Kg/day 1.45 (1.24-1.70) < .001
> 100 Kg/day 1.69 (1.38-2.07) < .001
to 4 years,” “4 to 8 years,” and “> 8 years”) (Table 2). Note. Adjusted for age and tenure; frequency of waist twisting
Job-related risk factors’ (tenure, work hours per week, was excluded due to lack of statistically significant association.
hours spent standing, frequency of bending waist, fre-
quency of twisting waist, and weight lifting requirement at in shoulders/neck included waist-bending and waist-
work) were entered into a logistic regression formula to twisting (Table 3). Risk factors for lower back pain in-
identify the potential risk factors of pain in the shoul- cluded longer hours of standing, waist-bending, and the
ders/neck, lower back, and lower legs. Risk factors for pain amount of weight lifted per day (Table 4). Finally, risk fac-

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J. Nursing Research Vol. 14, No. 3, 2006 Jui-Yeh Hou et al.

Table 5. ble with those of many other studies (Anonymous, 1997;

Risk Factors for Lower Leg Pain in Nurses - Including Burton, 1997). We found a high prevalence (91.6%) of
Hours Spent Standing, Frequency of Bending and
musculoskeletal complaints among nursing staff. Our study
Twisting, and Amount of Weight Lifted per Day (Adjusted
for Age and Tenure) found levels of musculoskeletal symptom prevalence among
nursing personnel similar to those identified by Engels et al.
95% CI of
(1996 & 1998). Such prevalence levels included: 17.1% for
Item Odds ratio odds ratio p-value
shoulders (19-22% for shoulders/upper arms in Engels’) and
Standing
3.4% for wrist (6% for wrists or hands in Engels’). However,
< 4 hr/day 1.00
4-6 hr/day 1.59 (1.30-1.95) < .001
while our study found 22.3% of nurses reportedly suffering
> 6 hr/day 1.73 (1.38-2.18) < .001 from pain in their lower legs, Engels reported a prevalence of
only 10-13% for knee or lower leg problems.
Amount of Weight
In our study, personal risk factors were found to be
Lifted at Work
< 50 kg/day 1.00 associated with pain in the shoulders/neck, back and lower
50-100 kg/day 1.16 (0.97-1.38) .095 legs to different extents. Shoulder/neck pain appears to be
>100 kg/day 1.28 (1.02-1.60) .031 affected by the aging process. On the other hand, leg pain
Note. Adjusted for age, tenure, and weekly work hours; correlated most closely with the number of working hours
frequency of twisting/bending waist was excluded due to lack of per week (Table 2). This result is compatible with Engels
statistically significant association. and coworkers’ (1998) study findings that occurrences of
musculoskeletal problems correlate to the length of time
spent working. Older nurses had less leg pain, probably due
tors for lower leg pain included hours of standing and the to having less primary care loading. The results of linear
amount of weight lifted per day (Table 5). regression analysis showed that increased age was associ-
Among the 3,950 participants, 180 (4.6%) reported tak- ated with shorter durations spent standing per day (p <
ing sick leave during the past 12 month due to musculo- .001) as well as less bending (p < .001), twisting (p < .001),
skeletal discomfort. Among these individuals, pain was most and lifting (p < .001). Longer tenure was significantly
frequently reported in the lower back (58.3%), shoulders/ related to older age (p < .001) and shorter duration of stand-
neck (32.2%), lower legs (26.7%), wrists (24.4%), knees ing per working day (p < .001). Since nursing aides are not
(16.1%), and ankles/feet (14.4%); numbness was most fre- counted as formal members of the nursing staff at most
quently reported occurring in lower legs (19.4%), lower back hospitals in Taiwan, nurses must perform all nursing care
(13.3%), shoulders/neck (12.8%), thighs (11.1%), and hands for patients and usually stand for most of the working day.
(9.4%); and limitation of motion occurred most often in the In this study, participants reported standing on average 5.5
lower back (16.7%), shoulders/neck (13.9%), knees (9.4%), hours per working day. This might be a reason why mu-
wrists (8.3%), and lower legs (7.8%). However, the adjusted sculoskeletal discomfort in lower legs is relatively high
odds ratio showed only pain in the lower back, wrists, and among nursing staffs in Taiwan.
ankles/feet, and difficulty in movement in shoulders/neck, Most previous studies did not distinguish between
lower back, and knees were associated with taking sick leave, “pain”, “soreness” and “numbness”, and many cases of
for which these complaints were mutually adjusted (Table 6). “soreness” and “numbness” could be categorized as cases
of “pain”. Therefore, the prevalence of “pain” might be
Discussion overestimated. Although numbness and soreness might not
be as serious as “pain” in terms of taking time away from
Nurses usually represent the largest group of hospital work, they often cause limitation of motion in affected
employees and provide most of the direct care to patients. body parts and may interfere with work activities and result
Nurses have been reported as having comparatively more in loss of productivity. In our study, cases of numbness in
musculoskeletal system problems than other health care the knees had the highest correlation with limitation of
workers (Cooper et al., 1998; Gunnarsdottir, Rafnsdottir, motion. Although the case number was small, the finding
Helgadottir, & Tomasson, 2003). In terms of occupational was quite consistent across job categories. This supports
musculoskeletal complaints, our study results were compati- our argument that musculoskeletal conditions other than

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Musculoskeletal Discomfort in Nurses J. Nursing Research Vol. 14, No. 3, 2006

Table 6.
Crude and Adjusted Odds Ratios (OR) for Taking Sick Leave (180/3, 950; 4.6%) During the Past 12 Months,
According to Presence of Musculoskeletal Complaints
Item (-) Sick leave (+) Sick leave Crude OR (95% CI) Adjusted OR (95% CI)*
Pain
Shoulders/neck 22.6 32.2 1.63 (1.18-2.24)
Upper back 08.0 13.3 1.76 (1.10-2.70)
Lower back 31.7 58.3 3.02 (2.22-4.10) 2.54 (1.84-3.52)
Elbows 02.7 05.0 1.93 (0.89-3.68)
Wrists 09.8 24.4 2.96 (2.06-4.20) 2.36 (1.60-3.42)
Hands 02.9 05.6 1.99 (0.96-3.70)
Buttocks 04.1 07.8 1.97 (1.07-3.36)
Thighs 06.9 09.4 1.40 (0.81-2.80)
Knees 06.0 16.1 3.01 (1.95-4.52)
Lower legs 22.1 26.7 1.28 (0.91-1.79)
Ankles/feet 06.0 14.4 2.64 (1.67-4.01) 1.83 (1.12-2.87)

Numbness
Shoulders/neck 05.9 12.8 2.34 (1.45-3.63)
Upper back 01.5 03.9 2.68 (1.10-5.59)
Lower back 04.3 13.3 3.40 (2.11-5.29)
Elbows 01.4 05.0 3.69 (1.68-7.25)
Wrists 03.8 06.1 1.64 (0.82-2.95)
Hands 05.2 09.4 1.92( 1.10-3.14)
Buttocks 01.4 06.1 4.56 (2.23-8.57)
Thighs 04.3 11.1 2.78 (1.66-4.45)
Knees 01.1 05.6 05.22 (2.44-10.18)
Lower legs 12.5 19.4 1.69 (1.14-2.45)
Ankles/feet 02.9 05.6 1.98 (0.95-3.66)

Difficult Moving
Shoulders/neck 06.2 13.9 2.46 (1.55-3.76) 1.72 (1.04-2.71)
Upper back 01.3 02.8 2.17 (0.75-5.02)
Lower back 06.2 16.7 3.01 (1.96-4.49) 1.87 (1.18-2.88)
Elbows 00.7 01.1 1.50 (0.24-5.04)
Wrists 03.2 08.3 2.74 (1.51-4.65)
Hands 01.1 03.3 3.14 (1.18-6.95)
Buttocks 00.8 01.7 2.11 (0.50-6.00)
Thighs 02.2 06.7 3.17 (1.62-5.71)
Knees 02.1 09.4 4.94 (2.77-8.34) 3.43 (1.84-6.05)
Lower legs 03.6 07.8 2.24 (1.21-3.83)
Ankles/feet 01.7 03.9 2.38 (0.98-4.93)
Note. The adjusted odds ratio was obtained by logistic regression using sick leave (yes/no) as the dependent variable, and presence
(yes/no) of pain, numbness, or difficulty in movement in each body part as independent variables. *Only those with significant
(p < .05) adjusted odds ratios are shown.

pain should be studied more extensively. In fact, when all
job categories and body parts are taken into account, cases
of “numbness” had the highest association with limitation
of motion (20.3%), even higher than that of “pain” (13.6%).
Musculoskeletal disorders were found to be a main
cause of taking sick leave among female hospital workers.
Among those who took sick leave due to musculoskeletal
problems, 28% required medical treatment (Leighton &
Reilly, 1995). In our study, sick leave was taken as an indi-
cator of musculoskeletal discomfort severity. As com-
plaints with regard to almost all body parts were related to
requests for sick leave (Table 6), a backward stepwise

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J. Nursing Research Vol. 14, No. 3, 2006
logistic regression was used to determine which body part
pains played the most significant roles in such leave re-
quests. Adjusted odds ratios showed that pain in the lower
back, wrists, and ankles/feet and difficulties in movement
in shoulders/neck, lower back, and knees were the most
significant contributors to sick leave requests.
A limitation of this study is that it did not consider
the influence on self-reported musculoskeletal com-
plaints of participants’ psychological states. Psychosocial
factors are known to associate with musculoskeletal com-
plaints (Josephson et al., 1997). However, to avoid a low
response rate due to a lengthy questionnaire, psychosocial
questions were not included in our study questionnaire.
This limitation may result in an unintended inflation of the
number of musculoskeletal complaints due to depression,
anxiety or other psychological problems among study par-
ticipants. In addition, we did not validate the reported rela-
tionship between musculoskeletal discomfort and work.
Nevertheless, such relationships are generally very diffi-
cult to validate. Another limitation is that, due to its seg-
mentation by body part, many conditions were reflected in
only a few cases or had no cases at all. Extrapolations based
on the small number of cases covered in this report would
be less reliable. Further studies focused on specific condi-
tions will be needed to confirm our findings.
Although in 1995 the Taiwanese government estab-
lished a reporting system for occupational diseases, few
cases with musculoskeletal problems have actually been
reported. As of 2004, very few workers in Taiwan had
received compensation for occupational musculoskeletal
problems. This is probably due to most workers not per-
ceiving such problems as related to their job. Therefore,
education of all relevant parties is very important. We hope
this study can increase awareness among healthcare practi-
tioners, administrators of hospitals and other healthcare
facilities, and government agencies regarding the high
prevalence of musculoskeletal discomfort among nurses,
especially with regard to levels of expression other than
“pain” and involving parts of the body other than the back.
Our survey showed musculoskeletal discomfort to be prev-
alent among nurses in accredited medical institutions. Hos-
pital administrators should be aware of the risk factors for
musculoskeletal discomfort in nurses, which include bend-
ing and twisting at the waist and standing for long periods
of time. Developing and testing interventions to prevent
these risk factors are warranted in future studies. Preven-
tive measures and equipment should be provided to reduce
234
Jui-Yeh Hou et al.
such exposure. In addition, we recommend that muscu-
loskeletal conditions be included in routine health exami-
nation for nurses in order to monitor and detect muscu-
loskeletal problems.
Acknowledgment
This research was partially sponsored by the Na-
tional Science Council, Executive Yuan, Taiwan, R.O.C.
(NSC91-2320-B-010079).
References
Anonymous. (1997). Watch your back! Lamp, 54(3), 21-22.
Burton, A. K., Symonds, T. L., Zinzen, E., Tillotson, K. M.,
Caboor, D., & Van Roy, P., et al. (1997). Is ergonomic
intervention alone sufficient to limit musculoskeletal
problems in nurses? Occupational Medicine, 47(1), 25-
32.
Cooper, J. E., Tate, R. B., & Yassi, A. (1998). Components of
initial and residual disability after back injury in nurses.
Spine, 23(19), 2118-2122.
Diaz, J. H. (2001). Carpal tunnel syndrome in female nurse
anesthetists versus operating room nurses: Prevalence, la-
terality, and impact of handedness. Anesthesia & Anal-
gesia, 93(4), 975-980.
Engels, J. A., van der Beek, A. J., & van der Gulden, J. W. J.
(1998). A LISREL analysis of work-related risk factors
and health complaints in the nursing profession. Inter-
national Arch Occupational & Environmental Medicine,
71, 537-542.
Engels, J. A., van der Gulden, J. W. J., Senden, T. F., & van’t
Hof, B. (1996). Work related risk factors for musculo-
skeletal complaints in the nursing profession: Results of
a questionnaire survey. Occupational & Environmental
Medicine, 53, 636-641.
Fochsen, G., Josephson, M., Hagberg, M., Toomingas, A., &
Lagerstro¨m, M. (2006). Predictors of leaving nursing
care: A longitudinal study among Swedish nursing per-
sonnel. Occupational & Environmental Medicine, 63,
198-201.
Goldman, R. H., Jarrard, M. R., Kim, R., Loomis, S., &
Atkins, E. H. (2000). Prioritizing back injury risk in hos-
pital employees: Application and comparison of differ-
ent injury rates. Journal of Occupational & Environ-
mental Medicine, 42(6), 645-652.
Gunnarsdottir, H. K., Rafnsdottir, G. L., Helgadottir, B., &
Tomasson, K. (2003). Psychosocial risk factors for mu-
sculoskeletal symptoms among women working in geri-
Musculoskeletal Discomfort in Nurses
atric care. American Journal of Industrial Medicine,
44(6), 679-684.
Josephson, M., Lagerstrom, M., Hagberg, M., & Wigaeus
Hjelm, E. (1997). Musculoskeletal symptoms and job
strain among nursing personnel: A study over a three year
period. Occupational & Environmental Medicine, 54(9),
681-685.
Josephson, M., & Vingard, E. (1998). Workplace factors and
care seeking for low-back pain among female nursing
personnel. MUSIC-Norrtalje Study Group. Scandinavian
Journal of Work, Environment & Health, 24(6), 465-
472.
Lagerstrom, M., Hansson, T., & Hagberg, M. (1998). Work-
related low-back problems in nursing. Scandinavian
Journal of Work, Environment & Health, 24(6), 449-
464.
Leighton, D. J., & Reilly, T. (1995). Epidemiological aspects
of back pain the incidence and prevalence of back pain
J. Nursing Research Vol. 14, No. 3, 2006
in nurses compared to the general population. Occupa-
tional Medicine, 45, 263-267.
Shiao, J. S. C., Chen, C. J., Du, D., & Guo, Y. L. (1996).
Prevalence and risk factors for occupational musculo-
skeletal problems in electronics workers. Chinese Jour-
nal Occupational Medicine, 3, 111-118. (In Chinese.)
Smedley, J., Egger, P., Cooper, C., & Coggon, D. (1995).
Manual handling activities and risk of lower back pain
in nurses. Occupational & Environmental Medicine, 52,
160-163.
Stockstill, J. W., Harn, S. D., Strickland, D., & Hruska, R.
(1993). Prevalence of upper extremity neuropathy in a
clinical dentist population. Journal of American Dental
Association, 124, 67-72.
Trinkoff, A. M., Lipscomb, J. A., Geiger-Brown, J., & Brady,
B. (2002). Musculoskeletal problems of the neck, shoulder,
and back and functional consequences in nurses. American
Journal of Industrial Medicine, 41(3), 170-178.
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護理人員肌肉骨骼不適 J. Nursing Research Vol. 14, No. 3

護理人員肌肉骨骼不適的危險因子
侯瑞葉 蕭淑銖*

摘 要： 國際間之研究顯示，肌肉骨骼不適常見於各職業族群 (包括護理人員在內)，但在台
灣針對護理人員肌肉骨骼疾病盛行率與發生原因的相關研究並不多見。為了解台灣
護理人員肌肉骨骼不適的部位、原因及盛行率，我們進行一項橫斷性研究並以自填
式問卷進行資料的蒐集。總共有 5,269 位 (93%) 護理人員完成有效問卷，且出現肌
肉骨骼不適的人相當多。最容易發生肌肉骨骼疼痛的部位為下背部、腿、肩膀和脖
子；若以「行動受限」為肌骨骨骼不適之嚴重度的指標，最常發生的部位依序為下
背、肩膀、腿和手腕；麻木則最常發生在腿、手、大腿和下背等部位。造成頸肩疼
痛的危險因子包含彎腰及扭腰；下背痛則是因長期站立、彎腰、和提重物所致；腿
部的肌骨疼痛則是因為長期站立和提重物所造成的。肌肉骨骼不適在受訪之護理人
員中有很高的盛行率 (91.6%)，且疼痛部位與工作內容有關。我們認為有必要更進
一步地瞭解工作環境中可能引起肌肉骨骼不適的人體工學因素以為防範之據。

關鍵詞： 肌肉骨骼不適、職業疾病、護理人員。

中華醫事學院護理系講師 *國立台灣大學醫學院護理學系所助理教授
受文日期：95 年 4 月 17 日 修改日期：95 年 6 月 12 日 接受刊載：95 年 6 月 26 日
通訊作者地址：蕭淑銖 10051 台北市仁愛路一段 1 號

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