| Background and ObjectiveOccupational musculoskeletal injury(OMSI)is an occupational disease caused by occupational factors causing multiple site injuries or movement disorders.In recent years,domestic and foreign studies have shown that OMSI occurs in many occupational groups and ranks second in the incidence of occupational diseases.The incidence of OMSI in nursing industry is the highest in all industries,and OMSI in delivery room is the second in related departments.The service group of midwives is the mother and child group,which is related to the life safety of mother and child.The skill operation of midwives has its own professional characteristics,but at present,there are few researches on OMSI of midwives at home and abroad.The influencing factors of OMSI of midwives can be divided into occupational factors and non-occupational factors.At present,domestic and foreign researches on the influencing factors of OMSI of midwives mainly focus on macro aspects such as occupational exposure,while there are few researches on micro aspects such as occupational injury caused by body posture of midwives.At present,midwifery methods used by midwives in China are mainly divided into traditional midwifery methods and improved midwifery methods.Investigation and research show that traditional midwifery methods can increase the incidence of OMSI,but there are few studies on the effect of improved midwifery methods on OMSI.Therefore,this study aims to investigate the current situation of OMSI of midwives,explore its influencing factors,and explore the intervention effect of improved midwifery on OMSI of midwives on the basis of the influencing factors,so as to provide references for scientific protection of OMSI of midwives.Methods1.Study on status quo and influencing factors of occupational musculoskeletal injury of midwivesA total of 328 midwives were randomly selected from 33 eligible hospitals in Suzhou from October 2020 to September 2021 to conduct a questionnaire survey.The contents of the questionnaire included:(1)Questionnaire on the general situation of midwives;(2)Midwife occupational Musculoskeletal Injury self-rating scale;(3)Questionnaire of influencing factors of occupational musculoskeletal injury of midwives;(4)Questionnaire of postural factors affecting occupational musculoskeletal injury of midwives.SPSS 22.0software was used for data analysis.The frequency and composition ratio were used to describe the basic situation of midwives and the incidence of OMSI.The influencing factors of OMSI were analyzed by univariate Logistic regression and multiple Logistic regression.2.Study on the effect of improved midwifery on OMSI intervention of midwivesBased on the results of the first part of the study on influencing factors,taking into account the factors of working posture,occupation and knowledge mastery,the idea of exploring the effect of improved midwifery on OMSI of midwives was further formed.A total of 50 midwives from 2 hospitals in Suzhou were selected as the study objects from September 2021 to December 2021,and the improved midwifery method was trained and guided for them,and the effect was evaluated after 3 months of clinical application.The Chi-square test was used to statistically analyze OMSI score and knowledge mastery of midwives before and after the application.Results1.Current situation of OMSI midwives(1)The incidence,annual incidence and weekly incidence of occupational musculoskeletal injury of midwives were 80.5%,78.7% and 38.3%,respectively.In order of annual incidence,the lower back(66.1%),neck(65.1%),shoulders(59.9%),back(51.9%)and wrists(48.0%)were the most common.(2)Occupational musculoskeletal injury of midwives resulted in 20.4%,22.7% and6.3% absenteeism of midwives since working,respectively.In descending order of annual absenteeism,the incidence was lower back(13.2%),neck(8.9%),wrists(8.2%),shoulders(5.3%)and back(3.3%).(3)The annual incidence of OMSI was different among midwives with different personality characteristics(except ethnic group)and different among midwives with different working positions,and the difference was statistically significant(P<0.05).(4)The OMSI treatment rate of midwives(33.8%)was low;According to the analysis of the annual incidence of OMSI in midwives,the pain degree of OMSI in different parts of midwives is different.The pain degree of OMSI in waist and neck is moderate and severe,the pain degree of OMSI in shoulder,back and wrist is mild and moderate,and the pain degree of OMSI in other parts is mild.2.Analysis results of influencing factors of OMSI of midwives(1)Univariate Logistic analysis: individual factors(age,working years,BMI>24.0,job title,etc.);Working posture factors(neck,back,wrist working posture factors);Occupational factors(cumulative working time >4h per day);Organization and management factors(shift to night shift,overtime work times >3 times per month,etc.);Psychological factors(work fatigue is very tired,work tension is very tense,etc.);Lifestyle factors(insomnia more than once a week,very tired housework,etc.);The factors of knowledge mastery are all influencing factors of OMSI.(2)Multivariate Logistic regression analysis: age of service,job title,BMI,working posture factors of neck,back and wrist,insomnia,side standing position for delivery in the past year,and application of human mechanics knowledge to midwifery/nursing operations were the influencing factors of OMSI.3.Effect analysis of improved midwifery method on OMSI intervention of midwives(1)The comparative analysis of the OMSI self-assessment table of midwives before and after the intervention with the improved midwifery method showed that the incidence of midwives’ injuries in the waist,neck,shoulder,back,wrist and other parts was reduced after the intervention,and the differences were statistically significant.(2)Comparative analysis of self-evaluation of OMSI pain performance of midwives before and after intervention with improved midwifery method showed that the pain performance of midwives in waist,neck,shoulder,back,wrist and other parts were improved after intervention,and the differences were statistically significant.(3)The comparative analysis of the questionnaire on midwives’ knowledge mastery before and after the intervention with improved midwifery method showed that midwives’ understanding of human mechanics and OMSI knowledge increased after the intervention,and the differences were statistically significant.Conclusions1.The incidence of OMSI among hospital midwives is high and will increase with time;In addition to the common waist,back,neck,shoulders,etc.,there are wrists and elbows related to midwifery occupational characteristics;Midwives have high rates of absenteeism and low rates of medical treatment due to OMSI.2.The influencing factors of occupational musculoskeletal injury of midwives include individual factors,working posture factors,occupational factors,organizational factors,psychological factors,lifestyle factors and knowledge mastery factors,among which the working posture factors,occupational factors and knowledge mastery factors lay the foundation for the subsequent research on improving midwifery.3.The improved midwifery method adopted in this study can reduce the occurrence of midwives’ injuries in the waist,neck,shoulder,back,wrist and other parts;During midwifery and nursing operations,it can relieve pain in the waist,neck,shoulder,back,wrist and other parts,and improve the understanding and attention of midwives on human mechanics and OMSI knowledge. |
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