Background
The Back College - a measure for secondary individual prevention
Questions to be answered
Methods
Study design and data collection
Statistical evaluation
Results
Description of the cohort
Frequency | Percent | Pain development T1-T3* | |||||
---|---|---|---|---|---|---|---|
Total group N = 1394 | Not employed in nursing | 112 |
8%
| ||||
Employed in nursing | 1282 |
92%
| |||||
Median T1
|
Median T3
|
Test (p)
| |||||
Employed in nursing
| 1282 |
100%
| 6 | 4 | < 0.001 | ||
Year of Back College
| 2009 | 425 | 33.2% | 6 | 4 | < 0.001 | |
2010 | 388 | 30.3% | 6 | 4 | < 0.001 | ||
2011 | 469 | 36.6% | 6 | 4 | < 0.001 | ||
Missing | 0 | 0% | |||||
Gender
| Female | 1141 | 89% | 6 | 4 | < 0.001 | |
Male | 140 | 10.9% | 5 | 4 | < 0.001 | ||
Missing | 1 | 0.1% | |||||
Age at Survey
| 20-29 | 25 | 2% | 6 | 2.5 | < 0.001 | |
30-39 | 95 | 7.4% | 6 | 4 | < 0.001 | ||
40-49 | 406 | 31.7% | 6 | 4 | < 0.001 | ||
50-59 | 601 | 46.9% | 6 | 4 | < 0.001 | ||
≥ 60 | 145 | 11.3% | 6 | 5 | < 0.001 | ||
Missing | 10 | 0.8% | |||||
Year in nursing
| 0-9 | 203 | 15.8% | 6 | 4 | < 0.001 | |
10-19 | 443 | 34.6% | 6 | 4 | < 0.001 | ||
20-29 | 395 | 30.8% | 6 | 4 | < 0.001 | ||
≥ 30 | 233 | 18.2% | 6 | 4 | < 0.001 | ||
Missing | 8 | 0.6% | |||||
Qualification
| Nursing | 646 | 50.4% | 6 | 4 | < 0.001 | |
Nursing assistant | 233 | 18.2% | 7 | 5 | < 0.001 | ||
Paediatric nursing/Obstetrics | 18 | 1.4% | 6 | 5 | 0.015 | ||
Geriatrics | 289 | 22.5% | 6 | 5 | < 0.001 | ||
Nursing management | 9 | 0.7% | 5 | 3 | 0.039 | ||
Intensive care/OP/anaesthetics | 87 | 6.8% | 6 | 4 | < 0.001 | ||
Missing | 0 | 0% | |||||
Institution
| Outpatient nursing | 181 | 14.1% | 6 | 4 | < 0.001 | |
Hospital | 630 | 49.1% | 6 | 4 | < 0.001 | ||
Old people’s home | 425 | 33.2% | 6 | 5 | < 0.001 | ||
Other | 46 | 3.6% | 6 | 4 | < 0.001 | ||
Missing | 0 | 0% | |||||
Employment
| Yes | 1100 | 85.8% | 6 | 4 | < 0.001 | |
No | 179 | 14% | 7 | 5 | < 0.001 | ||
Missing | 3 | 0.2% | |||||
BGW services
| Refresher course | 514 | 40.1% | 6 | 3 | < 0.001 | |
Personal advice | 197 | 15.4% | 6 | 4 | < 0.001 | ||
Workplace support | 376 | 29.3% | 6 | 4 | < 0.001 | ||
Outpatient rehabilitation measures | 40 | 3.1% | 7 | 5 | < 0.001 | ||
Aids for patient transfer | 74 | 5.8% | 6 | 4 | < 0.001 | ||
Other | 38 | 3% | 7 | 4 | 0.002 | ||
No services | 38 | 3% | 6 | 4.5 | 0.007 | ||
Missing | 4 | 0.3% | |||||
Applicability of working techniques in occupation
| Yes | 1044 | 81.4% | 6 | 4 | < 0.001 | |
No | 216 | 16.8% | 7 | 5 | < 0.001 | ||
Missing | 22 | 1.7% | |||||
If yes: reduction in stress to the lumbar spine with working techniques | Yes | 911 | 87.3% | 6 | 4 | < 0.001 | |
No | 108 | 10.3% | 7 | 6 | 0.046 | ||
Missing | 25 | 2.4% |
Other BGW services used
Applicability of the working techniques
Satisfaction with the components of the Back College
Periods of inability to work and working ability
Current inability to work | Frequency | Percent |
---|---|---|
Yes | 195 | 15.2% |
No | 1070 | 83.5% |
Missing | 17 | 1.3% |
If yes: reasons for inability (multiple answers allowed):
| ||
Lumbar spine symptoms | 102 | 52.3% |
Thoracic spine symptoms | 32 | 16.4% |
Cervical spine symptoms | 41 | 21.0% |
Other health problems | 128 | 65.6% |
Missing | 8 | 4.1% |
Inability to work during the last 12 months | Outpatient nursing N = 181 | Hospital N = 630 | Old people’s home N = 425 | Other N = 46 | Total N = 1,282 |
---|---|---|---|---|---|
< 2 weeks | 40.0% (22) | 29.0% (62) | 19.1% (27) | 43.8% (7) | 27.7% (118) |
2-4 weeks | 16.4% (9) | 29.0% (62) | 25.5% (36) | 31.3% (5) | 26.3% (112) |
4-6 weeks | 5.5% (3) | 8.9% (19) | 15.6% (22) | 6.3% (1) | 10.6% (45) |
6 weeks-3 months | 16.4% (9) | 14.0% (30) | 13.5% (19) | 0.0% (0) | 13.6% (58) |
3-12 months | 21.8% (12) | 19.2% (41) | 26.2% (37) | 18.8% (3) | 21.8% (93) |
Total
|
30.3% (55)
|
34% (214)
|
33.2% (141)
|
34.8% (16)
|
33.2% (426)
|
Current working ability | Frequency | Percent |
---|---|---|
Slight (0–3) | 209 | 16.3% |
Moderate (4–6) | 390 | 30.4% |
High (7–10) | 641 | 50% |
Missing | 42 | 3.3% |
Performing current work in 2 years
| ||
Improbable | 161 | 12.6% |
Uncertain | 455 | 35.5% |
Fairly certain | 635 | 49.5% |
Missing | 31 | 2.4% |
Pain development
Pain | Before the Back College T1 | At time of survey T3 | Test T1-T3 (p) | ||
---|---|---|---|---|---|
Frequency | Percent | Frequency | Percent | ||
Slight pain (1–4)
| 310 | 24.2% | 657 | 51.2% | p < 0.001 |
Moderate pain (5–7)
| 620 | 48.4% | 390 | 30.4% | |
Intense pain (8–10)
| 210 | 24.2% | 171 | 13.3% | |
Missing
| 42 | 3.3% | 64 | 5% | |
Total
| 1,282 | 100% | 1,282 | 100% |
Target variable | Frequency | Percent | Median T1 | Median T3 | Test (p) |
---|---|---|---|---|---|
Pain relief
| 576 | 44.9% | 7 | 3 | <0.001 |
No pain relief
| 627 | 48.9% | 5 | 6 | <0.001 |
Missing
| 79 | 6.2% | |||
Total
| 1282 | 100% | |||
Leaving nursing due to back pain
| 132 | 11.5% | 7 | 6 | <0.001 |
Currently employed in nursing
| 949 | 82.6% | 6 | 4 | <0.001 |
Missing
| 68 | 5.9% | |||
Total
| 1149 | 100% |
Factors influencing unfavourable pain development
Variable | Pain relief | p* | Final model OR (95% CI) | ||
---|---|---|---|---|---|
No% (n) | Yes% (n) | ||||
Age
| 20-39 | 41.9%% (49) | 58.1% (68) |
0.005
| 1 |
40-49 | 51% (198) | 49% (190) | 1.4 (0.85-2.17) | ||
50-59 | 52% (294) | 48% (271) | 1.5 (0.98-2.41) | ||
≥ 60 | 64.5 (80) | 35.5% (44) |
2.2 (1.24-3.94)
| ||
Years in nursing
| 0-9 | 42% (78) | 58% (108) |
0.017
| - |
10-19 | 53% (218) | 47% (196) | |||
20-29 | 56% (211) | 44% (165) | |||
≥ 30 | 53% (116) | 47% (103) | |||
Qualification
| Nursing | 48% (305) | 52% (331) |
0.012
| |
Nursing assistant | 54.5% (116) | 45.5% (97) | |||
Geriatric nursing | 56.8% (150) | 43.2% (114) | |||
Intensive care/OP/anaesthetics | 62.2% (56) | 37.8% (34) | |||
Institution
| Outpatient nursing | 45% (77) | 55% (94) | 0.072 | 1 |
Hospital | 51.2% (308) | 48.8% (294) | 1.3 (0.88-1.90) | ||
Other | 60.5% (26) | 39.5% (17) | 1.9 (0.86-4.12) | ||
Old people’s home | 55.8% (216) | 44.2% (171) |
1.9 (1.29-2.93)
| ||
Employment
| Yes | 51% (526) | 49% (510) |
0.028
| - |
No | 60% (99) | 40% (66) | |||
Refresher course
| Yes | 47.8% (223) | 53.2% (254) |
0.003
| 1 |
No | 55.5% (402) | 44.5 (322) |
1.4 (1.07-1.82)
| ||
Applicability of working techniques
| Yes | 49.1% (479) | 50.9% (497) |
< 0.001
| - |
No | 67.6% (140) | 32.4% (67) | |||
Relief of lumbar spine with working techniques
| Yes | 45% (383) | 55% (468) |
< 0.001
| 1 |
No | 70.9% (219) | 29.1% (90) |
3.7 (2.73-5.06)
| ||
Pain before the Back College
| Intense | 39.5% (120) | 60.5% (184) |
< 0.001
| 1 |
Moderate | 47.9% (289) | 52.1% (314) |
1.8 (1.30-2.45)
| ||
Slight | 73.6% (218) | 26.4% (78) |
7.2 (4.83-10.61)
| ||
*χ2 (Pearson) | R2: 0.21 |
Leaving nursing due to back pain
Variable
|
Leaving nursing
| p* | Final model OR (95% CI) | ||
---|---|---|---|---|---|
Yes
|
No
| ||||
Age
|
20-39
|
9.0%(9)
|
91%(91)
|
<0.001
| 1 |
40-49
|
8.2%(31)
|
91.8%(345)
| 0.82 (0.35-1.96) | ||
50-59
|
11.2%(61)
|
88.8%(484)
| 0.98 (0.43-2.24) | ||
≥ 60
|
31.1%(37)
|
68.9%(82)
|
3.39 (1.38-8.31)
| ||
Qualification
|
Nursing
|
7.9%(48)
|
92.1%(557)
|
<0.001
| 1 |
Nursing assistant
|
13.7%(28)
|
86.3%(176)
| 1.2 (0.65-2.16) | ||
Geriatric nursing
|
18.8%(47)
|
81.2%(203)
|
2.5 (1.53-4.21)
| ||
Intensive care /OP/anaesthetics
|
16.7%(15)
|
83.3%(75)
|
2.5 (1.22-5.52)
| ||
Years in nursing
|
0-9
|
8.1%(14)
|
91.9%(159)
|
0.002
| - |
10-19
|
16.5%(65)
|
83.5%(329)
| |||
20-29
|
8.5%(31)
|
91.5%(334)
| |||
≥ 30
|
13.3%(28)
|
86.7%(182)
| |||
Institution
|
Outpatient nursing
|
17.5%(28)
|
82.5%(132)
|
0.026
| - |
Hospital
|
9.7%(56)
|
90.3%(520)
| |||
Other
|
7.3%(3)
|
92.7%(38)
| |||
Old people’s home
|
13.7%(51)
|
86.3%(321)
| |||
Workplace inspection
|
Yes
|
4.9%(17)
|
95.1%(329)
|
<0.001
| 1 |
No
|
15.1%(121)
|
84.9%(681)
|
2.9 (1.55-5.31)
| ||
New aids
|
Yes
|
3%(2)
|
97%(65)
|
0.019
| - |
No
|
12.6%(136)
|
87.4%(945)
| |||
Number of sites of symptoms
|
One
|
9.9%(68)
|
90.1%(618)
|
0.013
| - |
Two
|
14.9%(47)
|
85.1%(269)
| |||
Three
|
17.3%(23)
|
82.7%(110)
| |||
Applicability of working techniques in occupation
|
Yes
|
7.6%(71)
|
92.4%(866)
|
<0.001
| - |
No
|
31.9%(61)
|
68.1%(130)
| |||
Reduction in stress on lumbar spine from working techniques
|
Yes
|
5.7%(47)
|
94.3%(771)
|
<0.001
| 1 |
No
|
28.6%(82)
|
71.4%(205)
|
5.3 (3.48-8.14)
| ||
Adequate training in implementing working techniques
|
Yes
|
8.8%(56)
|
91.2%(580)
|
0.021
| - |
No
|
13.2%(60)
|
86.8%(396)
| |||
Time since Back College
|
1 year
|
9.9% (42)
|
90.1% (381)
| 0.241 | 1 |
2 years
|
13.6% (49)
|
86.4% (311)
| 1.6 (0.93-2.69) | ||
3 years
|
12.8% (47)
|
87.2% (319)
| 1.1 (0.65-1.88) | ||
Pain before Back College
|
Slight
|
4.3%(12)
|
95.7%(268)
|
<0.001
| 1 |
Moderate
|
10.8%(60)
|
89.2%493)
|
2.3 (1.15-4.74)
| ||
Intense
|
22.9%(64)
|
77.1%(216)
|
5.1 (2.45-10.52)
| ||
χ2 (Pearson) | R2 : 0.31 |