Prevention management program of musculoskeletal diseases using the participatory action oriented training (PAOT) in the health care workers
Keywords
Musculoskeletal disease, health care workers, prevention management program, PAOT (participatory action oriented training)
GPA Objective
GPA Objective 1: To devise and implement policy instruments on workers’ health
Action 1.10
CC or NGO Name
Catholic Industrial Medical Centre (CIMC), Korea
Project leader
Email address
Jung-Wan Koo, M.D., Prof.
jwkoo@catholic.ac.kr
Partners (of the CC Network)
Toshiaki Higashi, Japan ; Kazutaka Kogi, Japan
Other partners
Funding
- Research and grant proposal
- Contracts with companies
Objective of the project
The objectives are to find out for themselves the improvement opinion of health care workers for prevention of work-related musculoskeletal diseases (WRMSDs) by participatory action oriented training (PAOT).
Project outcome(s) and deadline(s) for completion of the project
The participants accomplish the real action plans for improvement of their own hospitals by PAOT. And they have positive thinking for improvement of their wards and become good facilitators to be able to perform PAOT. – J Science of Labour 2006; 82(4): 151-156, Application of Action-Oriented Approach Programs (PAOAP) for Preventing Musculoskeletal Disorders in Health Care Workers
Target group and/or beneficiaries
Health care workers
Summary of the project
PAOT workshop consists of 6 technical sessions. In the first session, each action checklist item is explained and an on-site checklist exercise is carried out. In sessions two to six, good example pictures on five principles – treatment and management of medicines, medical instrument and equipment / patient care, work environment safety and job management, ward design, welfare facilities – and group discussions are carried out by the participants. In the sixth session in implementation of improvement, each participant is asked to present two to three short-term and long-term action plans for their own ward improvement.
This study is assured that the PAOT program shows high potentials as an intervention program to prevent WRMSDs in hospitals.
Dissemination
- Results will be submit to relevant journals for publication
- Presentation at relevant conferences and meetings
- Reports
Impact (global or regional)
Global
Progress on Project
After participating in PAOAP workshop, work improvements have been achieved on the basis of their own ideas. A lot of improvements were helpful to prevent musculoskeletal disorders. This study so far has shown that the PAOAP had high potential as a useful program to prevent work-related musculoskeletal disorders (WRMSD) in hospitals.
Now that the first stage of PAOT program at Uijeongbu St. Mary's Hospital is complete, the second stage is in preparation within the same hospital. This may also be applied to other hospitals in the future.
Nurses; patient handling tasks; ergonomic risk factors; work related musculoskeletal disorders
GPA Objective
Objective 1: To devise and implement policy instruments on workers’ health
Action 1.10
CC or NGO Name
National Institute for Occupational Health (NIOH), SA
Project leader
Email address
Ms Busisiwe Nyantumbu (previously Ms S Dyosi)
busisiwe.nyantumbu@nioh.nhls.ac.za
Partners (of the CC Network)
National Institute for Occupational Health, South Africa
Other partners
Center of Ergonomics for Developing Countries, Sweden
Funding
The study will be funded by the NIOH
Objective of the project
To prevent occurrence of musculoskeletal problems among nurses
Project outcome(s) and deadline(s) for completion of the project
To conduct a pilot project in one of the public hospitals (by June 2006)
To conduct this project among public hospitals in all South African provinces (by end 2009)
To develop a database with statistics on prevalence of musculoskeletal pain among South African nurses (by 2009)
To develop guidelines for prevention of work related musculoskeletal disorders associated with patient handling tasks for nurses working among public hospitals in developing countries (by end 2010)
Target group and/or beneficiaries
Health care workers and managers
Summary of the project (max 100 words)
Musculoskeletal disorders (MSDs) may develop from exposure to ergonomic hazards. However, symptoms are multi-factorial. They include pain and numbness. Disability may arise if these disorders are not diagnosed at an early stage because they may remain asymptomatic for years before the symptoms manifest. Nurses are not exceptions. Tasks that involve manual handling of patients have been identified as the leading causes of MSDs among nurses but not in South Africa. This project aim is to determine the prevalence of musculoskeletal pain among nurses working in public hospitals and associated ergonomic risk factors in order to develop guidelines on their prevention.
Dissemination
Workshops and seminars; conferences; brochures and booklets
Impact (global or regional)
SADC Region
Progress on Project
The project has completed its first phase of the "Pilot". A protocol is currently being prepared for the full study, which is scheduled to be completed by end of 2009.
The title of this project is due to change to account for development of an intervention tool in the form of guidelines for the healthcare workers.
There are intentions to form project links with regard to data collecting tools, which will aim to allow us to generalize the findings worldwide.
Area 3: Psychosocial hazards and work organization / Workplace violence
2009-2012 Work Plan Number
GPA1.9g
Formerly AA3:H1
Project title
Job stress surveillance in health care workers
Keywords
Job stress, surveillance, work organization, health workers
GPA Objective
GPA Objective 1: To devise and implement policy instruments on workers’ health
To develop a surveillance system in health care workers
Project outcome(s)
and deadline(s) for
completion of the
project
A validated surveillance system for health care workers to be available one year from the starting point.
Target group and/or
beneficiaries
Health care workers
Summary of the
project (max 100
words)
To develop a surveillance system based on self-administered questionnaires and organization data among others. Sensitivity and specificity of the system will be calculated. Data collection validation will be carried out in a sample of health workers. We will develop a quantitative scale to identify different degrees of stress in health workers. According to the workers stress level derivation to interventions will be carried out. Impact of the interventions will be evaluated using quantitative and qualitative methods. Identification and selection of interventions using evidence-based medicine will be carried out.
Dissemination
Government, mutual, meeting, Labour and Health Ministries
Impact (global or
regional)
Regional
Progress on Project (max 100 words)
A literature review (general and specific) has been concluded and at the moment work is being carried out on the surveillance system design. The proposal, based on the bibliography, consists on a two-step survey system applied as a panel study at selected occupational sites. The instruments correspond to: a) short self- administered survey of high sensibility and b) interview survey of high specificity. The surveys will be administered sequentially at working places recognized for being stressors, in the literature. The proposal will be completed (first draft) in September.
2009-2012 Work Plan Number
GPA1.9t
Formerly AA4:TM1e
Project title
Countries in Transition: How to promote health at work in health organizations
Keywords
Health care workers, health workforce, stress at work, burnout, mobbing, work ability index, human working index, risk assessment
GPA Objective
GPA Objective 1: To devise and implement policy instruments on workers’ health
Action 1.9
CC or NGO Name
Andrija Stampar School of Public Health, School of Medicine University of Zagreb, Zagreb, Croatia
Institute of Occupational Health, WHO Collaborating Center, Skopje, Macedonia
School of Medicine University of Tuzla, Department of Occupational and Environmental Health, Bosnia & Herzegovina
Funding
Croatian and Macedonian Ministry of Science; Croatian and Macedonian Ministry of Health; Institute of Occupational Health, WHO CC, Skopje Macedonia; Croatian and Macedonian Medical Chamber; Social partners.
Objective of the project
To spread awareness, knowledge and skills in work-related stress within health care workers in tackling work-related stress
To co-ordinate stress risk assessment
To educate workers and management in health organizations on how to work in partnership to address work-related stress throughout the organization
To provide some solutions and directions
To develop train the trainer materials and documents
Project outcome(s) and deadline(s) for completion of the project
To develop curriculum and toolkit to tackle work-related stress (by 2007)
To list the mayor stressors in healthcare workers (by 2008)
To assess stress and Work Ability Index (WAI) in the representative sample of health care workers (by 2009) for international application or adaptation
To create the stress guidance pack – curriculum for training and education (by 2010)
Target group and/or beneficiaries
All workers in health organizations, especially health workers and health managers
Summary of the project
Globalization, processes of transition, and high rate of unemployment have emphasized the problem of work-related stress in transitional countries. Stress, mobbing and burnout are believed to be due to bad work organization in health care services.
Activities are designed to explore the major determinants of work-related stress in health care workers using European Foundation for Living and Working Environment methodology for workplace surveys.
Develop common set of indicators and develop national plans of action on work-related stress. Inter-country collaboration could take the form of regional fora: conferences, workshops in the particular area of stress at work with participation of the social partners.
Dissemination
Meetings and workshops of health care workers, health managers, health and labour administration; WHO/ILO documents
Impact (global or regional)
Regional (countries)
Progress on Project
A cross-sectional study was conducted in four clinical hospitals in Zagreb, over 6 months, ending January 2007. Self-reporting questionnaires about work-related stressors and WAI were completed by 395 physicians and 1086 nurses. Factor analysis classified the stressors into 7 groups: Work management and financial issues, public criticism, shift work, professional demands, interpersonal communication, professional health hazards, and job dissatisfaction. Physicians reported organization of work, financial issues, public criticism, law suits, shift work, professional and intellectual demands as very stressful. Nurses with secondary school education perceive all of the 7 groups of stressors more stressful than nurses with higher education. Hazard perception and dissatisfaction with jobs contribute to low (WAI<37), while professional and intellectual demands, and job satisfaction cause higher chance for a good and excellent work ability (WAI>37).
List of outcomes already achieved by this project
Development and evaluation of the measuring tool for perceived workplace stressors among hospital workers was done and published in the PhD thesis which presents the factor structure, reliability, validity and calibration of the Occupational Stress Questionnaire for Hospital Health Care Workers (OSQ-HHCW). The study included 2380 participants aged between 18 and 65 years who were employed as healthcare workers in 5 hospitals in Zagreb, Croatia. Factor analysis yielded six factors of relatively high reliability of inner consistency (all values of Cronbach α exceeded 0.7): Workplace Organization and Financial Issues, Public Criticism, Hazards at Workplace, Conflicts and Communication at Work, Shift Work, Professional and Intellectual Demands. The OSQ-HHCW is a suitable instrument for the recognition and quantification of occupational stress, thus having an important role in the development of evidence-based strategies that target at improving health and safety among hospitals healthcare workers.
The 4th Symposium of Croatian Medical Chamber, organized together with WHO CC in Occupational Health in Croatia, held in March 2010, focused on the stress at work and quality of life of medical doctors
Results of this work are recognized in the Region and the researchers are in the FP7 project- Call identifier: FP7-HEALTH-2009-single-stage, Proposal No: 242084, Acronym: ORCAB, “Improving quality and safety in the hospital: The link between organisational culture, burnout, and quality of care", has been favourably evaluated.
Publications:
Golubić, Rajna; Milošević, Milan; Knežević, Bojana; Mustajbegović, Jadranka.
Work-related stress, education and work ability among hospital nurses. // Journal of Advanced Nursing. 65 (2009)
Knežević, Bojana; Milošević, Milan; Golubić, Rajna; Belošević, Ljiljana; Russo, Andrea; Mustajbegović, Jadranka. Work-related stress and work ability among Croatian university hospital midwives (2009).
Milošević, Milan; Knežević, Bojana; Golubić, Rajna; Mustajbegović, Jadranka; Matec, Lana; Debeljak, Maja. Differences in stress perceptions between physicians in surgical and non-surgical specialities // Budapest Meeting Abstract. 2007. Cell Stress Chaperones online 12.
List of additional outcomes expected from this project by 2012
To apply for perceived workplace stressors among other health workforce
To list the major stressors in healthcare sector
List of additional outcomes expected by 2016
To develop program in the community under draft title: “I care for my healthcare givers” trying to sensitize community for the work conditions of health workforce.
2009-2012 Work Plan Number
GPA1.9u
CONTRIBUTING PROJECT Title
How to maintain health care workers workability and quality of life
GPA Objective and Action
GPA Objective 1: To devise and implement policy instruments on workers’ health
Action 1.9
Priority Initiative
Priority 1.4: Conduct studies and develop evidence-based tools and information materials for the comprehensive protection and promotion of health for health care workers, emphasizing HBV immunization
Responsible CC or NGO Name
Andrija Stampar School of Public Health, School of Medicine University of Zagreb, Zagreb, Croatia
Project leader
Professor Jadranka Mustajbegovic, MD, PhD
jmustajb@snz.hr
Network partners
Institute of Occupational and Radiological Health, Beograd, Serbia; bulatp@eunet.yu
Institute of Occupational Health, Republic of Macedonia, WHO CC; bislimovska_j@yahoo.com
School of Medicine University of Tuzla, Bosnia and Herzegovina; pranicnurka@hotmail.com
WHO Regions involved in this CONTRIBUTING project
WHO/Regional/HQ lead: Dr Ivan Ivanov, ivanovi@who.int
WHO/EURO Centre for Environment and Health: Dr Rokho Kim, rki@ecehbonn.euro.who.int
WHO Liaison Officer in Croatia: Dr Antoinette Kaic-Rak, a.kaic-rak@wholo.hr
Country ministries involved in this CONTRIBUTING project
Croatian Ministry of Health and social Welfare: Dr Dunja Skoko-Poljak,
dunja.skoko-poljak@mzss.hr
External partners for this CONTRIBUTING project
IBG Institut für Humanökologische Unternehmensführung GmbH, Dr Rudolf Karazman, r.karazman@chello.at
Summary of the project
Research into workplace stress, work ability and quality of life indicates worryingly high levels of poor psychosocial health in the health care population as a vulnerable group which is recognised by WHO. There is a need to build a health care system compatible with the psychological, social and physical characteristics of human beings, be they patients or health care professionals, in order to improve work ability, quality of life and quality of patient care. To achieve this goal we need to determine factors that are associated with changes and preservation of health care professionals’ work ability, quality of life and to what extent.
Target group and/or beneficiaries
All workers in health organizations, especially health care workers / providers and health managers
Events-opportunities for furthering the project
Inter-country collaboration could take the form of regional cooperation, e.g. conferences and workshops in a particular area with participation of the social partners. Recognising these priorities on national and regional levels can have a significant impact on the promotion of health care workers’ mental health and on healthy workplaces, quality of patient care and patient safety.
Expected results of this project by 2012 (outcomes)
The project will produce a guidance document which includes a range of successful initiatives adopted by the Croatian Ministry of Health and Social Welfare in order to improve health care workers’ work ability and quality of life.
Indicators of achievement (impact)
Expected direct outputs will be a developed toolbox of workplace-related indicator system for adequate assessing of hospital healthcare providers’ work ability and quality of life. Concept of educational contents and programmes for sustainable work ability and quality of life, strategic hospital management and health care providers will be developed.
Major Milestones (list up to three dates and milestones)
2009 - 2010: Developing toolkit, action plan and regional cooperation network, reaching hospitals, conducting surveys
2010 - 2011: Analyzing collected data, publication of results, developing a prevention plan
2011 – 2012: Reaching hospital management (meetings, workshops) and developing final guidance document on national and regional levels
Public health impact
Health of health care providers, personal development and life quality represent a high value not only for employers but also for the health care system, for countries’ democratic sustainability and social coherence based on human sustainable development. Recognising these priorities on regional and national levels can have great positive public health impact not only on health workers mental health preservation, but also on the improvement of patient safety.
Funding source(s)
Croatian Ministry of Science, Education and Sports; Croatian Ministry of Health and Social Welfare; Croatian Medical Chamber, Social partners.
To develop toolkit which intention is to assess and to maintain health care workers quality of life and their workability, research was done and results were presented as PhD thesis. This dissertation analyzes work ability, quality of life and salutogenic productivity of hospital health care workers employed in seven hospitals in Croatia. A cross-sectional study was conducted. The study population consisted of 1633 participants (267 men, 1366), aged 19-64 years. Different types of hospitals were included: 2 clinical, 4 general and 1 specialized hospital. The study was carried out in 2007 and 2008. Despite the methodological limitations, this study clearly shows the descriptive details of work ability, QoL and salutogenic productivity of hospital health care workers and points to the need to formulate and implement a workplace health promotion program that aims at maintaining work ability.
The 4th Symposium of Croatian Medical Chamber, organized together with WHO CC in Occupational Health in Croatia, held in March 2010, focused on the stress at work and quality of life of medical doctors.
Results of this work are recognized in the Region and the researchers are in the FP7 project- Call identifier: FP7-HEALTH-2009-single-stage, Proposal No: 242084, Acronym: ORCAB, “Improving quality and safety in the hospital: The link between organisational culture, burnout, and quality of care", has been favourably evaluated.
Publications:
Golubić, Rajna; Milošević, Milan; Knežević, Bojana; Mustajbegović, Jadranka.
Work-related stress, education and work ability among hospital nurses. // Journal of Advanced Nursing. 65 (2009)
Knežević, Bojana; Milošević, Milan; Golubić, Rajna; Belošević, Ljiljana; Russo, Andrea; Mustajbegović, Jadranka. Work-related stress and work ability among Croatian university hospital midwives (2009).
Milošević, Milan; Knežević, Bojana; Golubić, Rajna; Mustajbegović, Jadranka; Matec, Lana; Debeljak, Maja. Differences in stress perceptions between physicians in surgical and non-surgical specialities // Budapest Meeting Abstract. 2007. Cell Stress Chaperones online 12.
List of additional outcomes expected from this project by 2012
To develop toolkit for other health care workers.
List of additional outcomes expected by 2016
To develop program in the community under draft title: “I care for my healthcare givers” trying to sensitize community for the work conditions of health workforce.
2009-2012 Work Plan Number
GPA1.9aa
CONTRIBUTING PROJECT Title
Changing world of work in nursing sector and migration: developing preventive strategies
GPA Objective and Action
GPA Objective 1: To devise and implement policy instruments on workers’ health
Action 1.10
Priority Initiative
Priority 1.4: Conduct studies and develop evidence-based tools and information materials for the comprehensive protection and promotion of health for health care workers, emphasizing HBV immunization
Responsible CC or NGO Name
ISPESL – Dept. of Occupational Medicine ITALY
Project leader
Dr Sergio Iavicoli (sergio.iavicoli@ispesl.it)
Dr Antonio Valenti (antonio.valenti@ispesl.it)
Network partners
European Agency for Safety and Health at Work, Spain FIOH, Finland
Swedish Work Environment Authority, Sweden
WHO Regions involved in this CONTRIBUTING project
WHO - EURO
Country ministries involved in this CONTRIBUTING project
External partners for this CONTRIBUTING project
Summary of the project
Nursing shortage is reported to be an increasing problem worldwide due mainly to early retirement from work and insufficient turnover of nurses coming from educational programmes. The shortage of nurses in Italy is 99.000 (OECD). Work flexibility by acquiring professionals through outsourcing (social cooperatives and work supply) and facilitation of migration flow of foreign nurses have been introduced to tackle the problem. In Italy, their presence in hospitals has tripled in the period 2002 – 2005. The project is aimed at identifying key priorities for developing strategies and tools for better work organization in the nursing sector with special focus on migration.
Target group and/or beneficiaries
Health care sector (nurses and migrant workers)
Events-opportunities for furthering the project
International congresses (e.g. ICOH 2009 Cape Town, 22-27 March 2009)
9th Conference of the European Academy of Occupational Health Psychology, Pontifical Urbaniana University, Rome, 29 – 31 March 2010
Expected results of this project by 2012 (outcomes)
Questionnaire to identify gaps and needs in OSH for nursing sector
Publication of results
Tools for information and prevention in nursing sector
Indicators of achievement (impact)
Major Milestones (list up to three dates and milestones)
2009: Analysis of scientific literature on the subject, census of the sources and regulatory context. Identification of a representative sample of the population under study
2010: Production of a survey and critical analysis of results
2011: Dissemination of results by targeted tools and events
Public health impact
Regional
Funding source(s)
Self-funding
Dissemination
Documents, guidelines, workshops
List of outcomes already achieved by this project
Developed fact-sheet for prevention of burnout in Latin American Countries “Etrés y burnout en profesionales de la salud”. ISPESL (National Institute for Occupational Safety and Prevention) – Department of Occupational Medicine, Rome, 2009 (ISBN 978–88–6230–060-5).
Disseminated booklet “Stress and Burnout” (second edition) edited by Marta Petyx, Patrizia Deitinger, Benedetta Persechino, Antonio Valenti, Sergio Iavicoli. ISPESL (National Institute for Occupational Safety and Prevention) – Department of Occupational Medicine, Rome, 2009 (ISBN 88-978-88-6230-043-8)
List of additional outcomes expected from this project by 2012
Questionnaire to identify gaps and needs in OSH for nursing sector;
Dissemination of results;
Tools for information and prevention in nursing sector
