INTRODUCTION:

Body mechanics term is define as the way we walk, move and lift objects. It includes how a person holds the body. Proper body mechanics are vitally important for keeping spine healthy. Body coordinates with muscles and nerves balance the posture and body alignment while lifting objects, bending forward, to perform activities of daily living. The use of proper body mechanics reduces the risk of injuries and allows physical mobility without straining major muscles and also reducing excessive use of muscular energy.¹

Health care professionals should have thorough scientific knowledge of body mechanics and its proper use in their daily practices. Gravity plays an important role in body mechanics. There is a constant pull exerted by earth on every object towards its center part, which helps to maintain the good posture and balance of whole body.² The proper functioning of the body relates to the posture also and correct use must be implicated during shifting the bedridden or immobilized patients. Walking, moving, lifting and are some essential components needed in transferring the patients in the hospital.³

Patient’s safety is one of the major aspects for each patient. Although it is impossible to prevent accidents occurred in hospitals completely, but we can make an arrangements that those injuries could be prevented. There are many cases had happened all over the world which may causes harm and severe injuries to the patient during shifting and lifting and some of cases were happened in which healthcare workers and their family members does not paid attention. Safety measure is the ways through which we can prevent and make the patient safe from accidental falls.⁴

Health care providers often provide care for immobilized patients where position must be changed, who must be moved in the bed or who must be transferred from a bed to chair or bed to a stretcher. Moving includes lifting the patient in and out of the bed. Ambulation of an individual needs knowledge and implementation of proper body mechanics so that the individual could lift or transfer the patients.⁵

Nurses are among the occupational groups within the health service that are vulnerable to lower back pain. Among nurses the prevalence of lower back pain was varying between 50% and 90%. Nurses frequently have to lift or transfer patients who may move suddenly and carry out repetitive procedure with incorrect are poor body posture, which subsequently cause lower back pain.⁶

A study conducted in the rural hospital of Maharashtra on 25 nurses to assess the work load musculoskeletal disorder. Result showed that 84.1% nurses had experienced work related musculoskeletal pain or discomfort.⁷ Harbor in his study revealed that work related back injury among hospital nurses were because of lifting and helping the client in and out of bed (78%). Some health care workers used improper body mechanics while handling and transferring the immobilized patients due to lack of knowledge and its can leads complications.⁸

In a study nursing helpers, ward attendants, had the highest rate of injuries because of improper use of body mechanics.Study conducted in India; on occupational musculoskeletal injuries showed 62% injuries included lower back and upper back, caused while lifting or shifting the patients. There were 65% of nurses working in orthopedic department and 58% nurses from ICU had low back pain.⁴ This problem was reduced by the use of manual lifting and transferring of patient replaced by with modern, battery operated, portable and other patient transfer assisted devices.⁹

Results of this the number of injuries from patient transfers decreased by 62%. Occupational injuries in the back are considered, the second leading occupational injury in America. Health care personnel, including nurses have the highest prevalence rate of back pain. The annual prevalence was 40% to 50%, and 35% to 80% is the occurrence of lifetime prevalence. Spending prolonged time, in one or in an awkward position causes excessive stress to the muscles and their ligaments, causing muscular contraction, fatigue, strain, and discomfort in the body.¹⁰ On the basis of review of literature and observation of researchers the following topic had been selected.

METHODOLOGY:

In present study the researchers had used Quantitative, non- experimental approach and Cross sectional survey design. The sample comprised of ward attendants working in selected hospital and was involved in lifting and shifting of immobilized patients. Purpose sampling technique was used to select the setting and simple random sampling technique was used to select the 100 ward attendants from 29 wards who met the inclusion criteria of the study. Tool used for the study were Demographic profile, Knowledge Questionnaire which had TWO sections, Knowledge Questionnaire on Body Mechanics and Knowledge Questionnaire on Safety Measures. The prepared tool was given to five nursing experts to ensure content validity. The 100% agreement was there for each section of tool by all the validators. Data for the main study was collected in moth of April 2016. Informed and written consent was taken before the data collection.

ANALYSIS AND INTERPRETATION:

The result of the data analysis were organized and presented under the following sections:

Section A: Socio-demographic characteristics of study participants

Table no.1. Frequency and percentage distribution of Socio-demographic profile of study participants (n=100)

S.NO.

Variables

Frequency(f)

Age (in years)

· 21-30

· 31-40

· 41-50

Gender

· Male

· Female

Education status

· Illiterate

· Secondary

· Senior secondary

· Bachelor

· Post Graduate

2 4

Working Experience

· 4months- 7years

· 8years-16years

· 17years-25years

Back pain

· Yes

· No

Causes of back pain

· Heavy lifting

· Others

Body built

· Thin built

· Average

Data in Table no.1 depicts that out of total number of sample 53% participants were between the age group of 21-30years. Majority 79% of the study participants were male and about 45% participants were having bachelor education. Most of 74% participants were experience between 4months- 7years. Majority 79% of the study participants were no back pain rest of the 21% were suffering from back pain due to heavy lifting 62% with thin body built 77%

Section B. Level of knowledge score

Graph no1. Frequency and percentage distribution of level of knowledge score according to Arbitory scoring by gained score (n=100)

Graph no 1. Shows the Arbitory distribution of knowledge score among the study participants the main gained score was 6 and the maximum score was 21. Most of the study participants had an average level of knowledge 70% and 5% had good and 25% had poor level of knowledge on use of body mechanics and safety measures.

Section C: Item Analysis of participant’s response

Table no.2 (a) Percentage distribution of responses level of knowledge on uses of body mechanics (n=100)

S.No	Items	Yes %	No%
1.	Good posture good body	20	80
2.	One must have good body mechanics	35	65
3.	Largest and strongest muscles in arms and legs	33	67
4.	Human's base of support are feet	41	59
5.	Do not bending at waist lifting a heavy patient	26	74
6.	Abdomen muscles used to lift a patient	23	77
7.	Posture exercises can help muscles flexibility	42	58
8.	Feet apart and slight one foot forward to stand	28	72
9.	Keep back straight and squat to lift a patient	27	73
10.	Hold the patient close to you while lifting	37	63
11.	Push and slide the patient from bed to trolley	8	92
12.	Count three and lift the patient	78	22
13.	Never lift a patient if you can’t handle him	38	62
14.	Saving money not helps using body mechanics	90	10
15.	Asses the weight before lift a patient	44	56
16.	Alignment, body posture, call for helps are ABC	24	76

Table no. 2. (a) Depicts that 80% participants said no that good postures helps to maintain good body, almost 65% said that good body mechanics are not necessary while transferring the patient. 67% of participants said that arms and legs muscles are not the strongest and largest muscles. Half of 59% participants said that feet are not the human’s base of support, most of 74% participants said that bending at waist while lifting a heavy patient and 77% of participants said abdominal muscles are not helpful for the support while lift a patient.

Half of 58% participants said no that posture exercises helps in flexibility. most of 72% participants said that feet apart and one foot forward not helpful in stand for longer period and 73% said that do not keep your back straight while lift an patient. Almost 63% participants said do not close the patient to you while lifting the patient and majority of 92% participants said that do not push and slide the patient while shifting from bed to trolley.

Most of 78% said yes that count three and lift the patient while shifting and 62% said that do attempt to lift the patient if you can’t handle him. Majority of 90% participants said that saving money is not used for proper body mechanics and half of 56% said that do not assess the patient’s weight before lifting. Most of 76% said that alignment, body posture and call for help are not the ABC of body mechanics.

Table no.2 (b) Percentage distribution of responses level of knowledge on uses of safety measures

S.No	Items	Yes%	No%
1.	Twist upper body and lift quickly are the best	64	36
2.	Do not lift the patient while moving from bed	38	62
3.	Patient stretch himself before lift him	25	75
4.	Hand muscles are used to lift heavy patient	2	98
5.	Good body position helps in range of motion	77	23
6.	Turn towards patient while transferring	50	50
7.	Communication is important during shifting	50	50
8.	Tighten abdominal muscles while lifting patient	74	36
9.	Move whole body while turning the patient	85	15
10.	Lock wheel chair when transferring patient	35	65
11.	Don't brace patient knees to prevent buckling	59	41
12.	Contract and tighten muscles to decrease strain	72	28
13.	Inappropriate work can cause injury	87	13
14.	Use one hand to lift and shift	70	30
15.	Turn upper waist and twist at waist while lifting	27	73
16.	Back muscles helps to lift properly	7	93

Table no. 2. (b) Depicts that 64% study participants said that twist your body and lift quickly while lifting heavy patient, 62% said that lift the patient rather than moving out of bed. Most of 75% said that patient should not stretch himself before lifting and majority of 98% participants said hand muscles are not useful for lifting a patient.

Most of 77% participants said yes that good body position will help a patient to maintain a range of motion and half of 50% said that always turn towards the patient while transferring and half of 50% said no that communication are not important between two person while shifting. Most of 74% participants said that tighten abdominal muscles and close to patient while lifting and 85% said that move your whole body and support the joints while turning the patient. Almost 65% participants said that lock the wheel chair while transferring the immobilized patient and 59% said that use knees braces against patient’s knees to prevent from buckling.

Most of 72% participants said that contracting and tightening the abdominal muscles can decrease the strain while lifting an patient and majority of 87% said that if inappropriate work is done back injury can happen. Most of 70% said yes use one hand while lifting and pushing the patient and 73% participants said no twist and turn upper body while lifting heavy patient. Majority 93% participants said no back muscles enable to lift properly.

Table no.3. Mean Standard Deviation, Median and Mode of obtained score (n=100)

Maxim.

possible score

Range of obtained score

Mean± SD

Median

Mode

Knowledge score

6-21

13.45± 2.85

Table no. 3. Shows that the maximum possible score was 32 and the range of obtained score was 6-21. The Mean± SD of the level of knowledge score was 13.45± 2.85 and the median was 14. The mode of the collected data was 15 which equals to the mean of the obtained score which shows that data was equally distributed and the group was homogenous.

Section D: Association between the levels of knowledge score with their selected demographic data.

Table no.4. Association between the levels of knowledge score with Selected demographic data (n=100)

S.NO.

Variables

Median and above median

Below median

Chi- square

Age (in years)

· 21-35

· 36-50

0.245

Gender

· Male

· Female

1.0448

Working Experience

· 4months- 15years

· 16years-25years

1.620#

Back pain

· Yes

· No

0.49

Causes of back pain

· Heavy lifting

· Others

0.822#

Body built

· Thin built

· Average

0.208

Education status

· Literate

· Illiterate

N/A

Df₁= 3.84 at p< 0.05; # Yate’s correction

The table no.4 Shows that no association between level of knowledge with their selected demographic variables, such as age 0.245, gender 1.0448, working experience 1.620, back pain 0.49, causes of back pain 0.822, body built 0.208 and education status.

DISCUSSION:

Age group (53%) of the participants was between 21-30 years. 79% of the participants were males. literate 98% and 45% had done bachelors. Working experience of participants between 4months- 7years was (74%). Back ache were common among 21% of the study participants out of which 13% participants stated that the back pain is caused by heavy lifting. Age group of 21-30 years was supported by Reda Abd Eslam Ibrahim. Kochitty Anisha and Devi Sita had conducted a study which contradicts the present study in gender, as most of the participants were females.

This study was also contradicted by GH Mahmoodi Rad, M Nakhaei and N Ali Abadi. 74% of the study participants had experience between 4 months to 7 years and 8% participants had experience between 17years-25years. This study results were supported by N Jafar, Ghazali Mohd. 21% of the study participants had low back pain and 53% participants were between the age group of 21-30 years this study results were supported by Sandhya R V, M J Kumari, Dr. Gopisankar, Angeline Mary Sheela. Male participants and age group result were supported by Mwilila Chandeu Mary.

The present study result shows most of the participants had an average level of knowledge regarding safety measures and body mechanics. This study result were supported by V.P. Vidya, D’souza Freeda Vineeta on usage of body mechanics and this study also supported by Sandhya R V, M J Kumari, Dr. Gopisankar, Angeline Mary Sheela on knowledge on body mechanics. In the present study no association were found between the level of knowledge score with the demographic variable. This study results are supported by the studies conducted by Ms. Vidya, Ms. Freeda Vinita, Ms. Vinyamol T.O, Mr. Vivian Machado, Ms Juicy Francis, G.R. Gireesh et al in the year of 2014.

RECOMMENDATIONS

· A similar study can be done or larger sample along with practice on body mechanics.

· An interventional study can be done to increase the knowledge and improve the practice.

CONCLUSION:

The heath care workers often experience musculoskeletal disorders due to patient handling activities, heavy manual lifting associated with transferring. Occupational back pain in nurses constitutes major sources of morbidity in the health care environment. Knowledge of body mechanics help in maintaining good body posture as well as it prevents from injury too. Although there was no correlation found between level of knowledge and study variables like age gender, working experience, back pain, causes of back pain, body built and education status.

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Received on 01.06.2017 Modified on 20.08.2017

Int. J. Adv. Nur. Management. 2017; 5(4):288-292.

DOI: 10.5958/2454-2652.2017.00062.2