Prevalence of musculoskeletal symptoms in hospital nurse technicians and licensed practical nurses: associations with demographic factors

Objective : This cross-sectional study aimed at analyzing: 1. the main musculoskeletal symptoms (MSS) presented by hospital nursing workers and; 2. personal, occupational, and health factors related to MSS among them. Method : Two questionnaires were filled in by 245 nurse technicians (NTs) and licensed practical nurses (LPNs) (response rate 95%) associated with direct patient care sectors from a hospital. These questionnaires were: the standardized version of the Nordic Musculoskeletal Questionnaire (NMQ) and one including questions on 15 demographic independent variables potentially related to outcomes from the NMQ. Univariate analyses and binary logistic regression analyses were performed to identify which variables would explain the occurrence of MSS in different body regions. Results: The low back (57%), shoulder (52%), and neck (48%) were identified as the most affected regions. The logistic regression analysis showed that low back symptoms in the last 12 months were significantly associated with LPN activities (OR=2.36; CI=1.24-4.5) and previous sick leave due to MSS (OR=5.97; CI=1.2-29.1). Smoking was significantly associated with symptoms in the low back (OR=2.77; CI=1.13-6.8) and thoracic spine (OR=2.37; CI=1.04-5.40). Physical exercise showed a protective effect on the cervical spine (OR=0.42; CI=0.23-0.77). Previous sick leave was significantly associated with pain in the knees (OR=4.24; CI=1.33-13.5) and in the upper limbs (OR=5.36; CI=1.07-26.7). Conclusions: The nursing workers who were evaluated presented a high prevalence of MSS. Previous history of sick leave was strongly associated with the presence of symptoms in various body regions. These results indicate the need for preventive programs in the hospital environment in order to control more severe MSS in nursing professionals. .

The perceptions of Unified Health System (Sistema Asnico de Saude) users about including undergraduate students in Family Health Units (Unidades de Saude da Familia) / Percepcao dos usuarios do Sistema Unico de Saude sobre a insercao discente nas Unidades de Saude da Familia

BACKGROUND: Curriculum guidelines for health professionals in training recommend including health students in different levels of service in the Unified Health System (Sistema Único de Saúde - SUS). Thus, there is a need to investigate the perceptions of SUS users with regard to the students' participation. OBJECTIVE: To evaluate the perceptions of SUS users about the participation of health students in Family Health Units (Unidades de Saúde da Família - USF). METHOD: A total of 518 people were interviewed in the waiting room of eight USFs in São Carlos/São Paulo. The interviews were conducted by students using a semi-structured questionnaire, and the data were analyzed descriptively. RESULTS: A total of 391 (75.5%) women and 127 (24.5%) men, with a mean age of 42.0±17.5 years, were interviewed. Among these users, 33.1% had encountered students in the USF, mainly while receiving clinical care (52.1%) or during home visits (20.1%); 55.3% considered the student's performance very good, and 0.6% considered it very bad. Most of the interviewees (58.2%) evaluated the activity performed by the student as effective, whereas 8.2% considered it ineffective. CONCLUSIONS: The students were included primarily in individual assistance activities, and the care provided by the students was well accepted. Both the users' satisfaction scores and their reported expectations were positive. .

CONTEXTUALIZAÇÃO: As diretrizes curriculares preconizam a inserção dos alunos das áreas de saúde nos diferentes níveis assistenciais do Sistema Único de Saúde (SUS), surgindo a necessidade de se investigar a percepção dos usuários do SUS a respeito da atuação discente. OBJETIVO: Avaliar a percepção dos usuários do SUS sobre a inserção e atuação de estudantes dos cursos da área de saúde nas Unidades de Saúde da Família (USF). MÉTODO: Foram entrevistadas 518 pessoas em sala de espera de oito USF do município de São Carlos/São Paulo. As entrevistas foram realizadas pelos estudantes por meio de questionário semiestruturado. Os dados foram analisados descritivamente. RESULTADOS: Foram entrevistadas 391 (75,5%) mulheres e 127 (24,5%) homens, com média de idade de 42,0 ± 17,5 anos. Entre os usuários, 33,1% haviam realizado alguma atividade com alunos nas USF, principalmente atendimento clínico (52,1%) e visita domiciliar (20,1%); 55,3% consideraram a atividade como muito boa e 0,6%, como péssima. A maioria (58,2%) avaliou a atividade realizada pelo aluno como resolutiva e 8,2%, como não resolutiva. CONCLUSÃO: A inserção discente se deu, prioritariamente, na forma de atividades assistenciais individuais, e houve boa aceitação do atendimento realizado pelos alunos, já que tanto a satisfação quanto as expectativas relatadas foram positivas. .

Wrist electrogoniometry: are current mathematical correction procedures effective in reducing crosstalk in functional assessment? / Eletrogoniometria de punho: procedimentos matemáticos usuais de correção são eficazes para reduzir crosstalk em avaliação funcional?

BACKGROUND: The recording of human movement is an essential requirement for biomechanical, clinical, and occupational analysis, allowing assessment of postural variation, occupational risks, and preventive programs in physical therapy and rehabilitation. The flexible electrogoniometer (EGM), considered a reliable and accurate device, is used for dynamic recordings of different joints. Despite these advantages, the EGM is susceptible to measurement errors, known as crosstalk. There are two known types of crosstalk: crosstalk due to sensor rotation and inherent crosstalk. Correction procedures have been proposed to correct these errors; however no study has used both procedures in clinical measures for wrist movements with the aim to optimize the correction. OBJECTIVE: To evaluate the effects of mathematical correction procedures on: 1) crosstalk due to forearm rotation, 2) inherent sensor crosstalk; and 3) the combination of these two procedures. METHOD: 43 healthy subjects had their maximum range of motion of wrist flexion/extension and ulnar/radials deviation recorded by EGM. The results were analyzed descriptively, and procedures were compared by differences. RESULTS: There was no significant difference in measurements before and after the application of correction procedures (P<0.05). Furthermore, the differences between the correction procedures were less than 5° in most cases, having little impact on the measurements. CONCLUSIONS: Considering the time-consuming data analysis, the specific technical knowledge involved, and the inefficient results, the correction procedures are not recommended for wrist recordings by EGM.

CONTEXTUALIZAÇÃO: O registro do movimento humano é requisito fundamental para análises biomecânicas, clínicas e ocupacionais, permitindo avaliar variações posturais, riscos e aprimoramento de programas preventivos e de reabilitação em Fisioterapia. O eletrogoniômetro flexível (EGM), considerado um equipamento confiável e acurado, é utilizado para o registro dinâmico de diferentes articulações. Apesar das vantagens, o EGM é suscetível de erros de medida, denominados crosstalk. Atualmente, são conhecidos dois tipos de crosstalk, o crosstalk devido à rotação do sensor e o crosstalk inerente. Procedimentos de correção foram propostos para a correção desses erros, no entanto nenhum estudo utilizou ambos os procedimentos em medidas clínicas dos movimentos do punho, visando otimizar a correção. OBJETIVO: Avaliar o efeito de procedimentos matemáticos atualmente empregados para correção do: 1) crosstalk devido à rotação do antebraço; 2) crosstalk inerente aos sensores e 3) combinação desses dois procedimentos. MÉTODO: Quarenta e três indivíduos saudáveis tiveram as amplitudes máximas dos movimentos de flexão/extensão e desvios ulnar/radial do punho registrados pelos EGM. Os resultados foram analisados de forma descritiva, e os procedimentos foram comparados por diferenças. RESULTADOS: Não houve alteração significativa nas medidas após a aplicação dos procedimentos de correção (P<0,05). Além disso, as diferenças entre os procedimentos de correção foram inferiores a 5° para a maioria dos casos, indicando pouco impacto sobre as medidas. CONCLUSÕES: Considerando o tempo de processamento, o conhecimento técnico específico exigido e os ineficazes resultados obtidos, desaconselha-se a aplicação desses procedimentos na correção de registros eletrogoniométricos do punho.

Effects of an educational back care program on Brazilian schoolchildren's knowledge regarding back pain prevention / Efeitos de um programa educacional de cuidados com a coluna sobre o nível de conhecimento de escolares brasileiros quanto à prevenção de dor na coluna vertebral

BACKGROUND: Children are often exposed to ergonomic risk factors at school. Thus, the school is a potential environment for developing musculoskeletal disorders and implementing back care programs. OBJECTIVES: To evaluate the effect of an educational program on schoolchildren's knowledge regarding back pain prevention. METHODS: 392 students from 4th to 8th grade from a Brazilian state school took part in the study; 114 students (30%) were evaluated at follow-up. The back care program included pre- and post-intervention assessments and a follow-up assessment, as well as theoretical and practical lessons. The time interval between the pre- and post-intervention assessments was 9 weeks, and between the post-intervention and follow-up assessments, it was 2 years. Statistical analysis included non-parametric ANOVA tests. Significance level was set at 5% (p<0.05). RESULTS: There was a significant increase (p<0.001) between pre- (3.6±2.9) and postintervention (7.5±2.2) scores and a significant decrease in the follow-up score (5.1±2.5). However, the follow-up score was still significantly higher (p<0.001) than the pre-intervention score. The rate of correct answers in the post-intervention assessment increased for all questions, and some of them were still high at follow-up. Significant differences were identified for the comparison between grades, with the 8th grade being significantly different from the other grades. CONCLUSION: The back care program showed an increase in the level of knowledge of Brazilian schoolchildren. Two years after the intervention, students still retained ergonomic concepts. Although the program has limitations, theoretical knowledge acquisition is the first step towards adopting healthy postural habits to prevent back pain.

CONTEXTUALIZAÇÃO: As crianças estão expostas a um conjunto de fatores de risco ergonômicos na fase escolar. Tais fatores tornam a escola um ambiente propício ao desenvolvimento de alterações musculoesqueléticas, assim como para a implementação de programas de cuidados com a coluna vertebral. OBJETIVO: Avaliar os efeitos de um programa educacional de cuidados com a coluna sobre o nível de conhecimento de escolares brasileiros quanto à prevenção de dor na coluna vertebral. MÉTODOS: Trezentos e noventa e dois estudantes da 4ª à 8ª série de uma escola estadual participaram do estudo, sendo que 114 deles (30%) foram avaliados no follow up. O programa foi composto por avaliações pré, pós-intervenção e follow up, por aulas teóricas e práticas. O intervalo entre as avaliações pré e pós-intervenção foi de nove semanas e, entre a avaliação pré e o follow up, foi de dois anos. A análise estatística incluiu ANOVA não-paramétrica e o nível de significância foi de 5%. RESULTADOS: Houve diferença significativa no nível de conhecimento (pfollow up (5,1±2,5), sendo que a pontuação no follow up foi significativamente superior à do pré-teste. Foi encontrada diferença significativa entre as séries, sendo que a 8ª série atingiu pontuação maior que as demais (p CONCLUSÃO: O programa preventivo proporcionou aumento no nível de conhecimento dos estudantes, mesmo após dois anos de sua implementação. Embora o programa tenha limitações, a aquisição de conhecimento é o primeiro passo para a adoção de hábitos posturais saudáveis para a prevenção de dores na coluna vertebral.