AIMS AND OBJECTIVES: The aim of this study was to describe the prevalence of low back pain (LBP) and the use of lifting aids and ergonomics among Czech registered nurses. BACKGROUND: Low back pain is the most common occupational health problem affecting nurses. Frequent manual lifting of heavy loads, including patients, is one of the main duties of nursing staff, which causes compressive and shear forces on the vertebrae of the lower spine. Training in manual handling and lifting aids reduce the physical burden on the musculoskeletal system, thus decreasing work-related back injuries and further back problems. DESIGN: A cross-sectional survey. METHODS: The online survey was distributed to 1460 randomly selected nurses involved in caring for patients. The survey comprised the extended version of the Nordic Musculoskeletal Questionnaire and a self-structured questionnaire. Data were analysed using STATA 15 at a significance level of 0.05. RESULTS: Of the 569 respondents, 84.7% reported high occurrence of LBP over the previous 12-month period. The lower back was the most commonly reported body region for pain, followed by the neck, shoulders and upper back. LBP was found to occur significantly less among nursing staff who used mechanical lifting aids. Nurses with a higher level of education were found significantly more likely to use mechanical patient-lifting equipment in their clinical practice. CONCLUSIONS: The study findings show that LBP is a frequent problem among nurses and has highlighted a lack of organisational safety practices and culture in clinical nursing practice. RELEVANCE TO CLINICAL PRACTICE: This study provides valuable information about the extent of LBP among nurses with insufficient preventive measures or health and safety practices at work. The results provide useful baseline data for the Czech Republic, that may lead to increased awareness and therefore implementation of preventative strategies, and thus enable a reduction in the risk of back injuries among nursing professionals.

Department of Nursing and Midwifery Faculty of Medicine Masaryk University Brno Czech Republic

Department of Nursing and Midwifery Faculty of Medicine University of Ostrava Ostrava Czech Republic

Practice Development and Education John Radcliffe Hospital Oxford University Hospitals NHS Foundation Trust Oxford UK

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Andersen, L. L., Vinstrup, J., Villadsen, E., Jay, K., & Jakobsen, M. D. (2019). Physical and psychosocial work environmental risk factors for back injury among healthcare workers: Prospective cohort study. International Journal of Environmental Research and Public Health, 16(22), 4528.

Bernal, D., Campos-Serna, J., Tobias, A., Vargas-Prada, S., Benavides, F. G., & Serra, C. (2015). Work-related psychosocial risk factors and musculoskeletal disorders in hospital nurses and nursing aides: A systematic review and meta-analysis. International Journal of Nursing Studies, 52(2), 635-648.

Berthelette, D., Leduc, N., Bilodeau, H., Durand, M. J., & Faye, C. (2012). Evaluation of the implementation fidelity of an ergonomic training program designed to prevent back pain. Applied Ergonomics, 43(1), 239-245.

Bos, E., Krol, B., van der Star, L., & Groothoff, J. (2007). Risk factors and musculoskeletal complaints in non-specialized nurses, IC nurses, operation room nurses, and X-ray technologists. International Archives of Occupational and Environmental Health, 80(3), 198-206.

Cunningham, C., Flynn, T., & Blake, C. (2006). Low back pain and occupation among Irish health service workers. Occupational Medicine, 56(7), 447-454.

D'Agostin, F., & Negro, C. (2017). Symptoms and musculoskeletal diseases in hospital nurses and in a group of university employees: A cross-sectional study. International Journal of Occupational Safety and Ergonomics, 23(2), 274-284.

Edlich, R. F., Hudson, M. A., Buschbacher, R. M., Winters, K. L., Britt, L. D., Cox, M. J., Becker, D. G., McLaughlin, J. K., Gubler, K. D., Zomerschoe, T. S. P., Latimer, M. F., Zura, R. D., Paulsen, N. S., Long, W. B. III, Brodie, B. M., Berenson, S., Langenburg, S. E., Borel, L., Jenson, D. B., … Falwell, R. J. (2005). Devastating injuries in healthcare workers: Description of the crisis and legislative solution to the epidemic of back injury from patient lifting. Journal of Long-term Effects of Medical Implants, 15(2), 225-241.

European Agency for Safety and Health at Work (1990). Directive 90/269/EEC - Manual handling of loads. European Agency for Safety and Health at Work. Retrieved from https://osha.europa.eu/en/legislation/directives/6

Fiter, J., Werdhani, R. A., & Wahyuni, S. (2018). Effect of back-exercise on the level of pain and disability among hospital ward nurses with subacute and chronic nonspecific low back pain. Journal of Physics: Conference Series, 1073(6), 1-8. https://doi.org/10.1088/1742-6596/1073/6/062027

Hartvigsen, J., Lauritzen, S., Lings, S., & Lauritzen, T. (2005). Intensive education combined with low tech ergonomic intervention does not prevent low back pain in nurses. Occupational and Environmental Medicine, 62(1), 13-17.

Hegewald, J., Berge, W., Heinrich, P., Staudte, R., Freiberg, A., Scharfe, J., Girbig, M., Nienhaus, A., & Seidler, A. (2018). Do technical aids for patient handling prevent musculoskeletal complaints in health care workers? A systematic review of intervention studies. International Journal of Environmental Research and Public Health, 15(3), 476.

Institute of Health Information and Statistics of the Czech Republic (2013). Terminated cases of incapacity for work for disease or injury 2012. Institute of Health Information and Statistics of the Czech Republic. Retrieved from https://uzis.cz/sites/default/files/knihovna/uppn2012.pdf

June, K. J., & Cho, S. H. (2011). Low back pain and work-related factors among nurses in intensive care units. Journal of Clinical Nursing, 20(3/4), 479-487. https://doi.org/10.1111/j.1365-2702.2010.03210.x

Karahan, A., & Bayraktar, N. (2013). Effectiveness of an education program to prevent nurses' low back pain. Workplace Health & Safety, 61(2), 73-78. https://doi.org/10.1177/216507991306100205

Karahan, A., Kav, S., Abbasoglu, A., & Dogan, N. (2009). Low back pain: Prevalence and associated risk factors among hospital staff. Journal of Advanced Nursing, 65(3), 516-524. https://doi.org/10.1111/j.1365-2648.2008.04905.x

Kneafsey, R., Clifford, C., & Greenfield, S. (2015). Perceptions of hospital manual handling policy and impact on nursing team involvement in promoting patients' mobility. Journal of Clinical Nursing, 24(1/2), 289-299.

Kuorinka, I., Jonsson, B., Kilbom, A., Vinterberg, H., Biering-Sørensen, F., Andersson, G., & Jørgensen, K. (1987). Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Applied Ergonomics, 18(3), 233-237.

Laštovková, A., Nakládalová, M., Fenclová, Z., Urban, P., Gaďourek, P., Lebeda, T., Ehler, E., Ridzon, P., Hlávková, J., Boriková, A., Kuijer, P. P. F. M., Bátora, I., Scholz-Odermatt, S. M., Moldovan, H., Godderis, L., Leijon, O., Campo, G., Vaneckova, M., Bonneterre, V., … Pelclova, D. (2015). Low-back pain disorders as occupational diseases in the Czech Republic and 22 European countries: Comparison of national systems, related diagnoses and evaluation criteria. Central European Journal of Public Health, 23(3), 244-251.

Lee, S. J., & Lee, J. H. (2017). Safe patient handling behaviors and lift use among hospital nurses: A cross-sectional study. International Journal of Nursing Studies, 74(June), 53-60.

Mirmohammadi, S., Yazdani, J., Etemadinejad, S., & Asgarinejad, H. (2015). A cross-sectional study on work-related musculoskeletal disorders and associated risk factors among hospital health cares. Procedia Manufacturing, 3, 4528-4534.

Nelson, A. (2005). Safe patient handling and movement: A guide for nurses and other health care professionals. Springer Publishing Company.

Occupational Safety Research Institute (Czech Republic) (2016). System prevention of risks in health and safety at work handling patients in health care. Occupational Safety Research Institute (Czech Republic). Retrieved from https://zsbozp.vubp.cz/pracovni-sprostredi/odvetvi/zdravotnictvi/284-manipulace-s-pacienty-ve-zdravotnictvi

Pugh, J. D., Gelder, L., Williams, A. M., Twigg, D. E., Wilkinson, A. M., & Blazevich, A. J. (2015). Validity and reliability of an online extended version of the Nordic Musculoskeletal Questionnaire (NMQ-E2) to measure nurses' fitness. Journal of Clinical Nursing, 24(23/24), 3550-3563. https://doi.org/10.1111/jocn.12971

Rahman, H. A., Abdul-Mumin, K., & Naing, L. (2017). Psychosocial work stressors, work fatigue, and musculoskeletal disorders: Comparison between emergency and critical care nurses in Brunei Public Hospitals. Asian Nursing Research, 11(1), 13-18.

Ratzon, N. Z., Bar-Niv, N. A., & Froom, P. (2016). The effect of a structured personalized ergonomic intervention program for hospital nurses with reported musculoskeletal pain: An assigned randomized control trial. Work, 54(2), 367-377.

Royal College of Nursing (2002). Compliance with manual handling policies. Royal College of Nursing. Retrieved from https://www.nhsemployers.org/~/media/Employers/Publications/Manual%20handling.pdf

Samaei, S. E., Mostafaee, M., Jafarpoor, H., & Hosseinabadi, M. B. (2017). Effects of patient-handling and individual factors on the prevalence of low back pain among nursing personnel. Work, 56(4), 551-561.

Serranheira, F., Sousa-Uva, M., & Sousa-Uva, A. (2015). Hospital nurses tasks and work-related musculoskeletal disorders symptoms: A detailed analysis. Work, 51(3), 401-409.

Shieh, S. H., Sung, F. C., Su, C. H., Tsai, Y., & Hsieh, V. C. (2016). Increased low back pain risk in nurses with high workload for patient care: A questionnaire survey. Taiwanese Journal of Obstetrics and Gynecology, 55(4), 525-529.

Simon, M., Tackenberg, P., Nienhaus, A., Estryn-Behar, M., Conway, P. M., & Hasselhorn, H. M. (2008). Back or neck-pain-related disability of nursing staff in hospitals, nursing homes and home care in seven countries. Results from the European NEXT study. International Journal of Nursing Studies, 45(1), 24-34.

Skela-Savič, B., Pesjak, K., & Hvalič-Touzery, S. (2017). Low back pain among nurses in Slovenian hospitals: Cross-sectional study. International Nursing Review, 64(4), 544-551. https://doi.org/10.1111/inr.12376

Smith, D. R., Mihashi, M., Adachi, Y., Koga, H., & Ishitake, T. (2006). Detailed analysis of musculoskeletal disorder risk factors among Japanese nurses. Journal of Safety Research, 37(2), 195-200.

Suliman, M. (2018). Prevalence of low back pain and associated factors among nurses in Jordan. Nursing Forum, 53(4), 425-431. https://doi.org/10.1111/nuf.12269

Cross-cultural comparison of low back pain in the nursing workforce: A pilot study