| Abstract [eng] |
The Author: Ada Petrauskaitė, 2nd year student of the Rehabilitation study program of the Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Sciences, Faculty of Medicine, Vilnius University. Academic supervisor: Doc. Dr. Aušra Adomavičienė, Department of Rehabilitation, Physical and Sports Medicine, Institute of Health Sciences, Faculty of Medicine, Vilnius University. Keywords: Nurses, patient transfer, biomechanical loads, a systematic review of the literature. Aim of the study: to assess the factors influencing the biomechanical loads on the musculoskeletal system of nurses in different body segments, such as the nature of the nurses' physical load, the working position, the movements performed, and the aids used for patient transfer. Tasks of work: 1. To identify and analyze research studies that provide information on the biomechanical loads experienced by nurses in different body segments during patient transfer, depending on the nature of the physical load, the working position, the movements performed, and the transfer aids used. 2. To collect data on the effects of the positions, movements, and assistive devices used by nurses in transferring patients on the biomechanical loads experienced in different body segments. Methodology and investigation: To write a systematic literature review, the PRISMA (Preferred Reporting Item for Systematic Review and Meta-Analyses) requirements were followed. The search for scientific articles was carried out by one researcher in PubMed and Web of Science databases, according to the adapted search strategy. Articles were searched based on the first studies publication date, which had to correspond to the years 2015-2024. According to the keywords combinations, 2240 publications were obtained, which participated in the selection of articles according to the inclusion and exclusion criteria of the systematic literature review, and of which 13 publications were included in the systematic literature review. Results: In order to provide analysis of the obtained results, a table was created, which contains information about the analyzed indicators, the averages and standard deviations, median or coefficients of the evaluation indicators presented in the studies comparing the groups before and after of a certain intervention. Statistical significance was assessed both within and between groups. The analysis of the scientific literature showed that the high weight of the nurse during the transfer of the patient puts the greatest strain on the back muscles and the arms. In relation to the results obtained, it was observed that the analysis of biomechanical loads on the nurse during patient transfers showed statistically significant decreases in muscle performance, arm strength, and trunk flexion angle loads compared to unassisted patient transfers (p-values of 0.000*, 0.005*, <0.001*). Conclusions: 1. According to a systematic literature review, the most commonly loaded segment in nurses' work is the trunk during patient lifting (wheelchair-to-bed/bed-to-wheelchair) and lateral transfer (bed-to-bed), where the nurse has to bend to take the patient's weight, thereby increasing the trunk compressive force (N), the torque and joint angles. These results were obtained from 16 articles included in the systematic review. 2. The synthesis of the research data showed that the highest loads on the musculoskeletal system in the trunk and shoulder region are caused by the level of physical training of the caregivers, the adaptation of the correct environment, and the use of assistive devices. Recent research shows that mechanical lifts are effective in reducing biomechanical loads in all types of patient care: lifting/transferring, repositioning (lateral, bedside), and lateral transfers. |
