A study of work stress, patient handling activities and the risk of low back pain among nurses in Hong Kong

J Adv Nurs. 2001 Dec;36(6):794-804. doi: 10.1046/j.1365-2648.2001.02037.x.


Rationale: Low back pain (LBP) remains a common and costly problem among the nursing profession. Several studies have indicated that LBP is attributed to mentally straining or demanding work, fatigue or exhaustion or general work satisfaction.

Aims: This study aims to measure the magnitude of LBP among Hong Kong nurses and its association with the work-related psychological strain and patients handling activities. RESEARCH METHODS AND MEASURES: A cross-sectional study of Hong Kong hospital nurses was conducted. Three hundred and seventy-seven nurses were recruited from six district hospitals. They were registered nurses or enrolled nurses working full-time for at least 1 month in the current ward. One hundred and seventy-eight (47.2%) study subjects were randomly selected from two district hospitals and 199 (52.8%) study nurses made up the convenience sample. Possible bias from psychological distress, socio-demographics and lifestyle factors was controlled for. Data were collected by face-to-face interviews. The data included work factors (both psychological stress and patient handling activities related to work), demographics, psychological distress and lifestyle factors and the occurrence of LBP.

Results: Of the 377 nurses interviewed, 153 (40.6%) reported having LBP within the last 12 months. With symptoms of LBP as the outcome, risks were increased where nurses self-reported that they only occasionally or never enjoyed their work [adjusted odds ratio (OR) 2.07], where frequent manual repositioning of patients on the bed was required (adjusted OR 1.84) and where they were required to assist patients while walking (adjusted OR 2.11) after adjustment for other potential confounders.

Conclusion: The results indicate that an association exists between work stress, manual lifting and LBP prevalence. The main route to prevention of LBP among nurses is likely to lie in improved ergonomics and psychological health in their work place. Good posture and correct transferring techniques in ward situations should be reinforced with hands-on practice performed on nurses' common types of clients.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Hong Kong / epidemiology
  • Humans
  • Lifting / adverse effects*
  • Low Back Pain / epidemiology
  • Low Back Pain / etiology*
  • Male
  • Middle Aged
  • Nursing Staff, Hospital*
  • Occupational Diseases / epidemiology
  • Occupational Diseases / etiology*
  • Odds Ratio
  • Posture
  • Prevalence
  • Random Allocation
  • Risk Factors
  • Stress, Psychological / complications*