ผลของโปรแกรมส่งเสริมการดูแลตนเองด้านการยศาสตร์ร่วมกับการบริหารร่างกายแบบมณีเวชต่ออาการปวดหลังส่วนล่างและความสามารถในการทำกิจกรรมของพยาบาลห้องผ่าตัด

Abstract

This one-group quasi-experimental research aimed to evaluate the effect of ergonomic self-care enhancement with Maneevej exercise program on lower back pain and functional ability in operating room (OR) nurses. Twenty-five female subjects were purposively selected based on predetermined criteria from OR nurses in one super-tertiary hospital. Subjects received the program which was developed based on self-care ability according to Orem's nursing theory, using the knowledge of ergonomics along with the 6-step risk management and the concept of Maneevej exercise for 8 weeks. All instruments were validated for content validity by 3 experts and evaluated for reliability using Cronbach's alpha, including 1) Self-care of Ergonomics questionnaire (α=0.88); 2) Short-form McGill Pain questionnaire (α=0.85); and 3) the Modified Oswestry Disability Index questionnaire (α=0.86). The questionnaires were applied before the program and at the 1st week, 5th week, and 8th week after starting the program. Data were analyzed using descriptive statistics, and the hypotheses were tested by one-way repeated measures ANOVA and Wilcoxon signed rank test. The findings showed that the mean age was 27.6 years (SD-4.0), mean working age 4.8 years (SD=4.1), and mean working hours per day 8.9 hours (SD=1.1). Most of the subjects (60%) had experience of lower back pain during their work which was caused by long-term working hours. A majority (68%) had no exercise activities. After the program the mean score of lower back pain (1st week: mean=11.84, SD=4.469, 5th week: mean=9.36, SD-4.572, and 8th week: mean=9.60, SD=4.481) was significantly lower than before the program (F1,24=177.537, p<.01). The mean score of the ability to perform functional activities, which was assessed by the limitation of activities, was higher after the program than before but without statistical significance. The mean score of self-care ergonomics at the 1st week, 5th week, and 8th week was higher than that before the program (1st week: mean=74.88, SD=12.34, 5th week: mean=90.28, SD=9.30, and 8th week: mean-90.32, SD=9.36). This study findings reveal that the developed program resulted in decreased lower back pain scores during the 1-5 week and slightly increased during the 5-8 week, whereas the ability to function scores were not different from before the program. These findings suggest that the effectiveness of the program should be tested and confirmed using a comparison group and a randomized controlled trial. Other clinical outcomes, such as strength of the back muscles, should be evaluated to confirm the persistence of self-care in ergonomics and Maneevej exercise for relief and prevention of acute lower back pain.