Multifaceted intervention for the prevention and management of musculoskeletal pain in nursing staff: Results of a cluster randomized controlled trial

Autoři: Mercè Soler-Font aff001;  José Maria Ramada aff001;  Sander K. R. van Zon aff004;  Josué Almansa aff004;  Ute Bültmann aff004;  Consol Serra aff001
Působiště autorů: Center for Research in Occupational Health, University Pompeu Fabra/ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain aff001;  CIBER of Epidemiology and Public Health, Madrid, Spain aff002;  Occupational Health Service, Parc de Salut Mar, Barcelona, Spain aff003;  Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands aff004
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225198



Nurses and nursing aides are at high risk of developing musculoskeletal pain (MSP). This study aimed to evaluate a multifaceted intervention to prevent and manage MSP in two hospitals.

Material and methods

We performed a two-armed cluster randomized controlled trial, with a late intervention control group. Clusters were independent hospital units with nursing staff as participants. The intervention comprised three evidence-based components: participatory ergonomics, health promotion activities and case management. Both the intervention and the control group received usual occupational health care. The intervention lasted one year. MSP and work functioning data was collected at baseline, six and 12-month follow-up. Odds ratios (OR) and their 95% confidence intervals (95%CI) were calculated for MSP risk in the intervention group compared to the control group using logistic regression through GEE. Differences in work functioning between the intervention and control group were analyzed using linear regression through GEE. The incidence of sickness absence was calculated through logistic regression and Cox proportional hazard modeling was used to analyze the effect of the intervention on sickness absence duration.


Eight clusters were randomized including 473 nurses and nursing aides. At 12 months, the intervention group showed a statistically significant decrease of the risk in neck, shoulders and upper back pain, compared to the control group (OR = 0.37; 95%CI = 0.14–0.96). A reduction of low back pain was also observed, though non statistically significant. We found no differences regarding work functioning and the incidence and duration of sickness absence.


The intervention was effective to reduce neck, shoulder and upper back pain. Our results, though modest, suggests that interventions to prevent and manage MSP need a multifactorial approach including the three levels of prevention, and framed within the biopsychosocial model.

Klíčová slova:

Allied health care professionals – Lower back pain – Myalgia – Nurses – Public and occupational health – Questionnaires – Shoulders – Ergonomics


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