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Leena Tamminen-Peter:
The physical strain when assisting a patient to move -
An ergonomic evaluation of three transfer methods.
University of Turku, Faculty of Medicine, Occupational Health.
Ser. C 228. Scripta lingua Fennica edita_0082-6995. Turku 2005
ABSTRACT
The aim of the study was to find out if the new
transfer methods, Durewall and Kinaesthetics, were less strenuous than the
presently used method, and to find the least strenuous method which should, at
the same time, be safe and comfortable for the patient and allow her/him to take
part in the transfer to the limit of her/his capacity.
The study included twelve female nurses and 18 patients. Patients’ functional
independence measure was low; one or two. The nurses were assigned to two
groups and they received training in both new methods, but in different order.
Nurses assisted a patient from the wheelchair to the bed and vice versa in three
test sessions: before the training, after learning one method and after learning
the other method. The nurses' skill in assisting a patient to move was evaluated
with a new observation instrument, SOPMAS. The lower back and trapetzius muscle
activity of the nurses was measured by video EMG. The nurses rated their
perceived physical exertion in lower back and shoulders on Borg’s CR-10 scale.
The patients rated their feeling of security, control and comfort on a bipolar
rating scale, and their muscle activity was measured in the knee extensor
muscles.
The nurses learned the new methods to assist a patient well, their skills
developed from the lowest level to the second highest level after the first
training session. After both training sessions, the group receiving the last
Kinaesthetics training reached the highest level of skill. Applying both new
methods their measured and perceived physical strain was significantly less than
when applying the presently used method. The muscle activity and perceived
physical exertion was reduced by 60–75 % in the lower back and 27–57 % in the
neck and shoulder area. The patients' feeling of control in the trans¬fer
situation and their measured activity was higher when the new methods were
applied. Patients also rated the new methods as safer and more comfortable than
the presently used methods. The better the nurse's skill, the greater comfort,
safety and control patients experienced when being transferred. However, there
was no significant differ¬ence between the new methods. This study shows that
the patients' support from somewhere other than the nurse is an important factor
in decreasing the physical load of the nurse. Another factor is that the
patients are better able to participate in their transfer, when the nurses
learned to activate them more effectively and gave them more time and space to
do so. The results can be exploited in making nursing physically less heavy and
in improving the quality of nursing. The most important is to apply the new
evidence in the professional training of nursing staff.
Keywords: physical strain, nurse, elderly patient, transfer skill, lifting,
training-intervention, Durewall-method, Kinaesthetics
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