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PROFORMA FOR REGISTRATION OF SUBJECT

FOR DISSERTATION

MINU JOY

1st YEAR M.Sc. (NURSING)

MEDICAL-SURGICAL NURSING

YEAR 2012-2014.

ST.PHILOMENA’S COLLEGE OF NURSING

#4 CAMPBELL ROAD, VIVEKNAGAR P. O

BANGALORE 560047


RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1 / NAME OF THE CANDIDATE / MINU JOY
1ST YEAR MSC NURSING
ST. PHILOMENA’S COLLEGE OF NURSING
BANGALORE -47
2 / NAME OF THE INSTITUTION / ST.PHILOMENA’S COLLEGE OF NURSING
3 / COURSE OF STUDY AND SUBJECT / M.SC NURSING MEDICAL AND SURGICAL NURSING
4 / DATE OF ADMISSION / 04.06.2012
5 / TITLE OF THE TOPIC / A STUDY TO ASSESS THE KNOWLEDE REGARDING POSTURAL HEALTH PROBLEMS AMONG EMPLOYEES WORKING IN SELECTED BANKS , BANGALORE WITH A VIEW TO DEVELOP AN INFORMATIONAL BOOKLET.

BRIEF RESUME OF THE INTENDED WORK

6.1. NEED FOR THE STUDY

“A good stance and posture reflect a proper state of mind”.

[MORIHEI UESHIBA]

Posture istherelativearrangements of parts of the body. Good posture will protect the supporting structures of the body against injury or progressive deformity. Poor posture is a common cause for low back pain and neck pain. Back support is especially important for persons who spend many hours sitting in an office chair or standing throughout the day. Majority of the software engineers and bank employees suffer from low back pain and neck pain because of poor posture. Improper posture and inadequate back support can add strain to muscles and put stress on the spine1.

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Over time poor posture can change the anatomical characteristics of the spine, leading to the possibility of constricted blood vessels and nerves, as well as problems with muscles, discs and joints. All of these can be major contributors to low back and neck pain, as well as headaches and fatigue. Most people will experience musculoskeletal pain at some stage during their life1.

The incidence of musculoskeletal injuries especially low back pain occur due to an increase in computer use.Bank employees spend majority of their working days using the computer. Education has been advocated as a Prevention method for reducing the incidence and severity of these injuries. Many corporations, unions and businesses are recognizing the potential value of programmes aimed at preventing musculoskeletal injuries.2

Globally there are increased number of people suffering with musculoskeletal associated disorder in recent times due to lack of exercises, sedentary jobs, imbalanced diet etc. The pain experienced may be mild, transient or chronic and in capacitating. Musculoskeletal disorders are the most common causes of long-term disability. They also utilize a considerable proportion of healthcare resources.2

About 75% to 85% of all people will experience low back pain at some time during their life and the yearly prevalence is estimated to 15% to 20% in the US and 25% to 45% in Europe. In US, low-back pain is ranked as the most frequent reason for activity limitation in people below the age of 45, second for physician’s visit, third for hospitalization and fourth for surgical procedures3.

A study was conducted in India on a sample of 650 computer-workers (average age was 27 years and ratio of males to females was4:1).The study revealed that 55% develop symptoms within a year of their careers, 76% reported atleast one symptom and 6 of them between 25 and 35 years of age reported computer related injury. The researcher concluded that 75% of them reported the computer related disorders duringtheir life time4.

A survey was conducted in North India among bank employeesrevealed that 23.09% had low back pain, 57% had shoulder and neck pain ,26% had to change or leave their profession and 38% did not enjoy their present job. The incidence of low back pain has increased rapidly due to ignorance and failure to take precautionary measures at the earliest. Changes in the lifestyle with ignorance towards the sitting posture and strenuous activities have led to the problem. Since it is a harmless problem, nearly 90% of the cases can be tackled by taking appropriate preventive measures. The remaining 10% need to go for proper treatment.5

A prospective study on musculoskeletal symptoms in the shoulder, elbow, and low-back regions was conducted in Denmark(2000) using questionnaire on ergonomics, work pauses, work techniques, psychosocial and work factors and delivered to 5033 office workers at baseline in early 1999 (response rate 69%) and to 3361 respondents at the time of the follow-up in later.(response rate 77%). The result revealed that in the follow-up, 10%, 18%, and 23% had intense symptoms of pain more often in the elbow, shoulder, and lower back, respectively.6

A Study on Occurrence of Musculoskeletal Discomfort among Computer Operators was conducted in two Talukasof Anand districtnamely, Anandand Petlad - from May 2004to January 2006.The sample size was 440 selected randomly, and pre-tested questionnaire was given. Musculoskeletal discomfort (MSD) was considered when one or more of the following symptoms were reported by the respondents such as neck or shoulder stiffness, neck or shoulder pain, tingling/numbness in hands, thumbs or fingers during work or many hours after stopping work, hand and wrist pain, backache, headache, leg cramps, leg stiffness, numbness and swelling in ankles and feet, reduction in strength of hand and difficulty in grasping objects. The age ranges from 18-55 years. Three-fourths of the subjects wereyoung (18-25 years). Majority (65.4%) of the respondents started using computers at a young age (16-20 years), and 236 (56.3%) individuals had been using computers for less than 5 years. About 41% of the respondentsused to work on computers for about 21 to 40 hours in a week. The study revealed that prevalence of symptoms related to MSD was higher among the young age (16-20).7

A cross-sectional survey was conducted in 2008 in IT companies of Mangalore, Manipal and Bangalore, to investigate the awareness of Computer Related Injuries (CRI) among computer users and their health behaviors related to computer usage. 200 computer users were interviewed using a questionnaire, 58.5% were aware of CRI. Among the various symptoms under study, the perceived pain among keyboard users is 40%, mouse users is 33%.Among this,69% participants were aware that CRI is preventable andalso found that Computer users' awareness of CRI appears to be fragmented and recommended emphasis of education programs on the appropriate health behaviors, cautious use of computers for leisure, and encourage an active lifestyle for effective prevention of CRI.8

A Cohort Study was conducted among Computer Office Workers in Sudan regarding Complaints of the arms, neck, and shoulders in general and computer-related disorders. Data was collected from 250 computer office workers using the Arabic version of the Maastricht Upper Extremity Questionnaire. Prevalence rates for symptoms were calculated and the categories of risk factors being evaluated consisted of physical, psychological, and individual risk factors. The 1-year follow-up prevalence rate was 0.63 (95% CI: 0.58-0.70) for neck symptoms, 0.56 (95% CI: 0.45-0.66) for shoulder symptoms, and 0.46 (95% CI: 0.42-0.59) for symptoms of the forearms/hands. Work-related psychological factors such as stress, personality traits predicted more significantly the presence of symptoms in the targeted population.9

A cross sectional study wasconducted in 2002 onprevalenceof low back pain and sciatica among clerical workers in German .A sampleof 1,720 clerical workers were investigated by a questionnaireand the result revealed that 70 % of the workers complained oflow back pain and sciatica.10

A study was conducted in Chennai 2009 to identify the health problems of employeesinbusiness process outsourcing (BPO) and data were collected from 50 respondents with the help of a questionnaire. The results showed that 28 % of the respondents suffer from Eye Problem, Back Pain (24%), Weight loss (16%); Tiredness (12%); Skin Irritation (16%) and Nerve Problem (4%)10.

The researcher’s informal discussion with bank employees revealed that 80% of them had consulted physician more than 3 times in a year due to postural health problems. Hence the researcher decided to conduct a study to assess the knowledge regarding postural health problems among bank employees.

6.2. REVIEW OF LITERATURE

The review of literature has been organized under the following headings

6.2.1  Literature related to postural health problems among bank employees.

6.2.2 Literature related to educational programmes regarding postural health problems among bank employees.

6.2.1. Literature related to postural health problems among bank employees

A cross-sectional survey was conducted using a descriptive questionnaire, which was distributed to 2000 office workers in 54 workplaces, in Bangkok to investigate the relationship between the self-reported prevalence of musculoskeletal symptoms in the neck, upper and lower back and certain individual, work-related physical and psychosocial factors. Findings revealed that frequently working in an uncomfortable posture increased the risk of experiencing head/neckmusculoskeletal symptoms like low back pain neck pain, headache and shoulder pain. The study concluded that some bio psychosocial factors were associated with the prevalence of musculoskeletal symptoms in the spineamong officeworkers.11

A cross sectional study was conducted on low back pain at work regarding knowledge and attitude of sectional heads at the University college hospital, Ibadan. The purpose of this study was to assess the knowledge and attitude of sectional heads towards managing low back pain at work and also aimed at identifying the difficulties encountered and organizational needs required in the management of low back pain at work. Twenty-nine (29) sectional heads (16 males and 13 females) participated in the study. Participants completed a self-administered questionnaire, for managing low back pain. Twenty-six (89.7%) of the participants reported no difficulty in managing staff members with low back pain. Seventeen (58.6%) participants had poor knowledge, while 37.9% had fair to good knowledge of managing low back pain. Twenty-two participants had a positive attitude towards managing staff members with low back pain. There was no significant association (p=0.307) between respondents’ knowledge and attitude towards managing workers with low back pain. The study concluded that the sectional heads had poor knowledge but a positive attitude towards managing workers with low back pain.12

Across sectional study was conducted on low back pain among Iranian industrial workers in Sweden. The objectives of the study were to determine the prevalence of low back pain and to explore associations between low back pain and physical and psychosocial factors at work, as well as life style factors. The prevalence of low back pain, work exposures and life style factors were recorded using the standardized Nordic questionnaire for analysis of musculoskeletal symptoms. Demographic data and life style factors (age, sex, education, weight, work experience, smoking and fitness training) were also collected. Of the 18031 employees, 78% participated. The 1-year prevalence of self-reported low back pain was 21% (20% males and 27% females). The prevalence rate of absence due to low back pain was 5% per annum. The multiple logistic regression models indicated that the following remained risk factors for low back pain in the previous 12 months: increasing age, no regular exercise, repetitive work and monotonous work. The study concluded that age and gender as well as certain work-related physical and psychosocial factors influenced the prevalence of low back pain.13

Astudy wasconducted inKolkataamong100 VDT workersto measure the outcome of epidemiological studies on musculoskeletal disorders. Samples wereselected randomly comprising 50 male and 50 female. A detailed study with modified questionnaire was performed among these VDT workers suffering with pain in neck, shoulder, fore arm, wrist, elbow and the different parts of the upper extremities.Study revealed that the female VDT workers suffer more discomfort than male VDT workers due to prolonged period of work in anawkward posture, and the study concluded that both male and female workers suffering from visual stress due to prolonged period of work and without using of antiglare screen.14

A cross sectional study was conducted to find the prevalence of visual and musculoskeletal disorders among computer professionals in Delhi. A total of 200 computer professionals were selected for the study using convenient sampling technique. The data was collected by using a questionnaire. The study result showed that the prevalence of visual problems in the study group was 76% (152/200), and musculoskeletal problems were reported by 76.5% (153/200). It was found that there was a gradual increase in visual complaints as the number of hours spent for working on computers daily increased and the same relation was found to be true for musculoskeletal problems as well. The study concluded that significant proportion of the computer professionals were found to be having health problems and this denotes that the occupational health of the people working in the computer field needs to be emphasized as a field of concern in occupational health.15

A cross-sectional observationalstudy assessed the pattern of musculoskeletal disorders (MSDs) suffered by bank office employees in Kuwait. A self-administered validated questionnaire which included the Nordic musculoskeletal questionnaire and 12-item general health questionnaire (GHQ12) were distributed to both employees. Of 750 employees, 80% suffered at least 1 episode of MSD during the previous year and 42% suffered at least 1 disabling episode. The study concluded that most affected body parts were the neck (53.5%), lower back (51.1%), shoulders (49.2%) and upper back (38.4%).16

A study was conducted among office worker in Singapore General Hospital (SGH) on the prevalence of musculoskeletal disorders and it was found that 73.4% of the 324 respondents reported experiencing pain in at least one of the body parts. The body parts with the highest report of pain were neck (46%), shoulder (42%) and low back (42%). There was a higher prevalence of MSD in females (78.8%) compared to males (63.9%) and this was statistically significant (p=0.003).17

A Cross-sectional descriptive study of 4 months duration from January 2011 to April 2011 was conducted among software professionals, working since 6 months on computer for at least 4 h/day is selected for the study and participants were then interviewed face to face using a pre-tested semi-structured questionnaire after taking their informed consent. Statistical Analysis was done by using the chi-square test. The prevalence of any type of computer-related morbidity in software professionals was 178 (89%). The proportion of visual, musculoskeletal, and stress was found to be 67%, 63%, and 44%, respectively. Ocular discomfort, musculo-skeletal disorders and psycho-social problems forms key category of health problems found among constant computer users18.