일 대학병원 중환자실 간호사의 요통에 관한 연구

Abstract

[한글]

요통은 전체 인구의 80% 이상이 일생 중 한번 이상 경험하는 것으로써 어느 한 질환을 지칭하는 용어가 아니라 요추부위에 나타날 수 있는 동통 증후군을 광범위하게 표현하는 용어로 요통의 위험요인중 직업적 요인이 개인적인 요인보다 더 의미가 있으며, 간호직은 직업성 요통이 빈발하는 20개 직종 중 하나로 알려져 있다. 또한 중환자실은 간호업무가 허리에 부담을 주는 자세가 많고 신체역학원리를 적용하지 않을 경우 요통 유병률이 높고, 주로 서서 일하면서 누워있는 환자를 대상으로 처치를 행하므로 해서 요통 발생가능성이 더 높다고 할 수 있다. 이에 본 연구는 중환자실 간호사의 요통경험과 관련된 간호업무활동과 작업환경 등을 파악하고, 신체역학원리실천정도와 기능장애정도를 파악하여 요통 예방을 위한 기초자료를 제공하기 위한 조사연구이다.

연구기간은 2003년 5월 16일에서 26일까지였으며, 연구장소는 일 대학병원 내외과, 신경외과, 심혈관계, 신생아 중환자실 4곳이었으며, 간호사 125명에게 설문지를 배부하여 조사하였다.

질문지의 구성은 간호업무활동 9문항, 작업환경 4문항, 요통특성 3문항, 신체역학원리실천 7문항, 기능장애 10문항, 일반적 특성 10문항으로 총 33문항으로 구성하였으며 자료는 SPSS WIN 10.0프로그램을 이용하여 통계처리 하였다.

요통경험정도는 요통이 있는 군과 없는 군으로 나누어 실수, 백분율, 평균, 표준편차의 서술적 통계방법과, Chi-square검정, Fisher 검정법을 실시하였으며 연구의 결과는 다음과 같다.

1. 전체 대상자의 요통 유병률은 80%였다.

2. 일반적 특성과 요통경험정도에는 연령, 결혼상태, 직위, 비만도, 근무 경력, 건강상태, 가족력의 유의성은 없었으나, 부서별로 유의성이 있었다(P=.005).

3. 대상자의 간호업무활동과 요통경험정도에서는 서서 일하는 시간, 의자에 앉아 있는 시간, 체위변경횟수, 부축횟수, 밤근무 일수, 환의교환 횟수,위생간호 횟수, 침상 만드는 횟수의 유의성은 없었으나, 환자이동횟수에는 유의성이 있었다(P=.018).

4. 대상자의 작업환경과 요통경험정도와는 통계적인 유의성이 없었다.

5. 신체역학원리적용의 요통경험정도와는 통계적인 유의성이 없었으나, 기능 장애정도에는 통계적인 유의성이 있었다(P=.001).

본 연구를 통해서 중환자실 간호사 80%가 요통경험이 있는 것으로 나타났으며, 일부 작업환경과 간호업무활동요인이 요통의 위험요인의 가능성을 시사한다고 본다. 따라서 연구자는 중환자실 간호사 요통의 총체적인 예방 대책 마련을 위해서 적절한 운반기구 사용 및 요통 예방교육을 실시하고, 인간 공학적 작업 시설을 마련해 줄 것과 간호사의 적성 배치를 제안하였다.

[영문]

80 percent of the whole population go through low back pains at lease once a life. The pains don''t relate to a certain disease but to a wide range of pain syndromes in the lumbar. Occupational factors have a more meaning than individual factors. The profession of nursing is known as one of the 20 jobs causing occupational low-back pains. The work of nursing at intensive care units involves a number of postures which impose a heavy burden on the loins. In case of not applying kinematics, nurses are exposed to a high rate of low-back pains for they tend the sick while they are lying in bed. In this context, this study is designed to determine the experiences of nurses at intensive care units going through low back paints and their working environment and so on, to grasp the degrees to which they abide by kinematics and to which they are exposed to functional disabilities and to present basic materials necessary for the prevention of low back pains.

The period of research ranged from May 16, 2003 to May 26, 2003. The researcher worked with 125 nurses at medical and surgical ward, neurosurgery, cardiovascular department and new-born baby intensive units with the aid of questionnaires.

The questionnaires consisted of a total of 33 questions: 9 questions related to the work of nursing, 4 questions concerning the working environment, 3 questions in regard to low back pains, 7 questions in respect to practicing kinematics, 10 questions as to functional disability and 10 questions to general features. The researcher relied on SPSS WIN 10.0 program for statistic treatment.

The subjects were divided into two groups; One didn''t have low back pains; The other had low back pains. The researcher depended on such descriptive statistic methods as real numbers, percentage, average and standard deviation as well as Chi-square and Fisher test. The followig are the findings of research.

1. The rate of the subjects having low back pains stood at 80%.

2. The survey on general features and the extent of experiencing low back pains shows that there was no significant difference in age, marital status, positions, BMI, working career, health status and family disease background but that there was a significant difference by department(P=.005).

3. The research on the activities of the subjects'' practice and the experience of their low back pains reveals that there was no significant difference in hours when the subject had to stand and work, hours when they had to sit and work, the frequency of changing physical postures, the frequency of helping patients by holding their arms, the days when they had to work at night, the frequency of changing the patients'' clothes, the frequency of hygienic nursing, and the frequency of making bed but that there was a significant difference in the frequency of moving the patients(P=.018).

4. There was no statistic difference between the subjects'' working environment and the degree of their experience low back pains.

5. There was no statistic difference between the application of kinematics and the degree of experiencing low back pains. But there was a statistically significant difference in functional disability(P=.00).

This study indicates that 80 percent of nurses at intensive care units are exposed to low back pains. As some working environment and the factors of nursing activities act as dangerous factors, the researcher would, for the purpose of preventing nurses at intensive care units as a whole, like to suggest that proper carrying equipment should be used, and that preventative education should be conducted and that working facilities should be ironed out on the basis of biomechanics and that the aptitude of nurses should be taken into account.