The prevalence and cause of occupational back pain in Hong Kong registered nurses

Journal of Advanced Nursing, 1997, 26, 380–388

The prevalence and cause of occupational backpain in Hong Kong registered nurses

Peter French RGN PhD

Project Manager, The Institute of Advanced Nursing Studies, Hospital Authority,Hong Kong

Lee Fung Wah Flora RN BN(Hons)

Yan Chai Hospital

Liu Sum Ping RN BN(Hons)Yan Chai Hospital

Luk Kar Bo RN BN(Hons)

Pamela Youde Nethersole Eastern Hospital

and Wong Heung Yee Rita RN BN(Hons)

Yan Chai Hospital, Hong Kong

Accepted for publication 5 July 1996

FRENCH P., LEE F.W.F., LIU S.P., LUK K.B. & WONG H.Y.R. (1997) Journal of AdvancedNursing 26, 380–388The prevalence and cause of occupational back pain in Hong Kong registerednursesIt is well known that many patient-oriented tasks contribute to occupational backpain in nurses and this is borne out by previous studies. In order to know whetherthe incidence of back pain and the contributing factors are the same in Hong Kong, adescriptive study was adopted to investigate the situation locally. This studyexplored the prevalence and perceived contributing factors of back pain, utilizing anon-experimental survey approach. Baseline data for this study were gathered bymeans of a questionnaire. The questionnaire elicited characteristics of the subjects’history and contributing factors to back pain. Of 47 nursing sta� at an acute carehospital, the reported occurrence of some form of back pain during their career wasfound to be 80·9%. Approximately one-third of nurses with back pain experiencedpain at least once a month. The top two dynamic factors contributing to back painwere lifting patients and transferring patients. Meanwhile, stooping was identifiedas the most common static factor contributing to back pain. In addition of those whohad experienced some form of back pain, 92·1% stated that they have neverreported their back pain to their employers. Contributing factors such as transferringpatients from bed to chair and lifting patients within bed without assistanceindicate poor practice which should be eliminated by the existence of continuingin-service education.

Keywords: occupational health, back pain, nursing

Correspondence: Dr H.P. French, Project Manager, The Institute of

Advanced Nursing Studies, Queen Elizabeth Hospital, 30 Gascoigne Road,Kowloon, Hong Kong.

380 © 1997 Blackwell Science Ltd

Occupational back pain

78% of nurses did not report back pain to management.INTRODUCTION

Both episodic and chronic back pain are infrequentlyreported to the nurses’ employer (Bulaitis 1992, HarberThe authors’ experience of nursing in Hong Kong indicated

that there was a serious problem with occupationally et al. 1985).It has been estimated that around 3% of nurses changeinduced lower back pain. The issue did not seem to be

acknowledged as a serious problem. their jobs due to back pain (Harber et al. 1985, Stubbs et al.1986, Owen 1989). These studies raised the issue of theBecause of the potential health risks to nurses, the

danger to patients and the costs to the service which may cost to the service of losing experienced sta�. Such costsincluded recruitment, retraining, compensation, and poss-be involved, it was thought necessary to look at the size

and nature of the problem in Hong Kong. ible e�ect of low morale in wards experiencing high sta�turnover. With wastage such as this occurring, patientsand taxpayers clearly pay a price, too. Nurse wastage

LITERATURE REVIEWfigures combined with the sickness absence rates indicatedthe possible magnitude of the problem.The prevalence of back pain and its occupational signifi-

cance has been documented thoroughly. Nurses are in anoccupational group which experiences more serious back

Preventive strategiesinjuries and occupational back pain than most other pro-fessions. A number of studies have compared the back pain An understanding of the activities associated with back

pain is necessary for the development of appropriate pre-rates of nurses with those of other occupations. Studies inthe United Kingdom have demonstrated that the incidence ventive strategies. The unique nature of the job is probably

the major cause of the high prevalence of back pain amongof back pain among nurses is as great as that among indus-trial manual workers (Reed 1980). It has been found to be nurses. Many of the factors identified are postural in

nature. Direct patient contact activities, particularlymore frequently due to occupational factors in nurses thanin, for instance, a control group of teachers (Cust et al. patient lifting and transferring, are most frequently men-

tioned as causes of occupational back pain (Stubbs et al.1972). Others have confirmed the work relatedness ofoccupational back pain (Harber et al. 1985). 1983, Harber et al. 1985, 1988, Cato et al. 1989, Owen

1989). These two tasks accounted for 79% of low backThe e�ects on nurses and the service have also beenindicated in this study which found that 29% of nurses pain among nurses.

However, Harber et al. (1988) argue that nurses are socia-take medication for low back pain, and 9% regularly misswork due to low back pain. Back pain among nurses is a lized in nursing training with some set of beliefs which

they retained throughout their professional career, suchmajor cause of days lost due to sickness, and this exactsa huge drain on health service resources. Back pain as: patient contact tasks cause back pain. To some extent,

these beliefs might bias the understanding of actual injuryaccounted for 16·2% of all sick leave in a sample studiedby Stubbs et al. (1983). A number of studies indicate that experiences when recalling such activities related to

back pain.around 43% of subjects report recent back pain and up to79% report episodes of work-related back pain during their One observational study on 63 nurses found that non-

patient contact actions occurred more frequently thancareer (Stubbs et al. 1983, Videman et al. 1984, Skovronet al. 1987, Cato et al. 1989). patient contact activities per shift, and that static actions

were common. Such static action, especially in a nonup-right position, further increased biomechanical stress on

Regular su�eringthe lower back (Harber et al. 1987b). Other studies havereported that back pain in nurses might be related to factorsAccording to one survey, one in four nurses su�ered back

pain regularly either at work or at the end of the working other than direct patient care. These included carrying andpushing, previous back injury, headache, and frequentday (Bulaitis 1992). Videman et al. (1984) found that low

back pain which led to unfitness for daily tasks in the exercise (Harber et al. 1987a, Mandel & Lohman 1987).previous 5 years was reported by 18% of qualified nursesand 29% of nursing aides.

Hong Kong nursesA number of studies have found that the majority of

nurses continued to work despite their discomfort. A Occupational back pain in Hong Kong nurses is poorlyunderstood in terms of its frequency, cost and cause.survey conducted by Mandel & Lohman (1987) indicated

that nurses who missed work comprised only 13% of those According to employees’ compensation legislation, theprescribed occupational diseases that were entitled toreporting painful episodes lasting at least 2 days. Owen

(1989) estimated that over one-third of nurses had episodes receive compensation for health care workers were onlytuberculosis and viral hepatitis (Hong Kong Labourof back pain related to work, yet only 13% of these nurses

had reported the episode. Cato et al. (1989) also found that Department 1994). Hence, the Department of Health in

381© 1997 Blackwell Science Ltd, Journal of Advanced Nursing, 26, 380–388

P. French et al.

Hong Kong does not seem to collect statistics on occu- self-developed tool addressed the incidence of work-related back pain and the perceived contributing factorspational back pain in nurses. The prevalence, morbidity,

lost work time, and poor work performance due to back to back pain (see Appendix). The questionnaire was div-ided into three sections. The first sought demographic datapain is largely unreported in Hong Kong nurses.including age, working experience and present workingarea of the subjects. The second gathered information on

THE STUDYthe first episode, usual sites of back pain, current practicesand consequences associated with back pain. QuestionsAfter reviewing the literature, it can be concluded that

occupational back pain is regarded as a common conse- about dynamic and static patient-oriented tasks whichcontributed to back pain were included in the final section.quence of nursing work in other parts of the world. In

order to discover whether similar phenomena occur in A pilot study was conducted in order to test and evaluatethe self-developed questionnaire. Ten volunteers withHong Kong and which factors are most significant, a

descriptive study was designed and conducted. The con- similar characteristics of the study sample were recruitedto answer the questionnaire and were interviewed aftertributing factors to back pain were explored.

The specific objectives of this study were to determine completion. Therefore, face validity of the self-developedquestionnaire was plausible.the prevalence of occupational back pain in Hong Kong

registered nurses, and to ascertain which patient-orientedtasks were the most significant in the genesis of occu-

Samplepational back pain.

The subjects were registered general nurses drawn fromone acute general hospital in Hong Kong. As the aim of

Concept clarificationthe study focused on patient-oriented tasks in relation tooccupational back pain, nurses in clinical areas whoA common di�culty in the study of back pain is its highly

variable and subjective nature (Stubbs et al. 1983). engaged in direct patient contact were selected for thestudy. Nursing o�cers (sister/head nurse), ward managersIndividuals might have di�erent conceptions of the term

‘back pain’. Accordingly, key terms in this study were and departmental operation managers were excluded fromthis study.defined so as to make explicit the nature of the concept to

be studied. Occupational back pain was defined as all con- Simple random sampling was used to select the subjects.A nursing sta� duty list for the period 26.12.1994 toditions of pain, ache, sti�ness or fatigue localized to the back

related to nursing practice (Svensson & Andersson 1983). 22.1.1995 was obtained from the hospital as a basis for thesampling frame. Subjects were selected by drawing namesPatient-oriented tasks were those nursing activities that

involved direct patient contact (Harber et al. 1988). They from a box. Sixty out of 590 nurses, approximately 10%of the target population, were selected for the study.were mainly divided into two types of actions, dynamic

and static. Dynamic patient-oriented tasks were thosepatient contact activities involving motion, while static

Data collectionpatient-oriented tasks were those patient contact activitiesin which the nurse maintained a static antigravity posture The selected subjects were contacted by the researchers

individually in their wards. Each subject received a self-for at least 30 seconds, and in which there was no transferof the patient (Harber et al. 1987b). administered questionnaire with instructions on how to

complete and return the questionnaire. Meanwhile, writ-ten information was also provided which included the

Designpurpose, importance, anonymity and confidentiality of thestudy. All subjects were invited to participate and the sub-This study aimed to describe phenomena and identify fac-

tors that contributed to prevalence of occupational back ject’s consent was indicated by the return of the completedquestionnaire.pain in registered nurses in Hong Kong. The design was

based on the approach of descriptive study. Forty-nine out of 60 questionnaires were returned whichgave an overall response rate of 81·7%. Two questionnairesAs proposed by Wilson-Barnett & Batehup (1988), a

descriptive survey was necessary to identify relevant fac- were excluded in the analysis as they were incomplete.Thus, the results are based on 47 responses.tors in a given area, to report the frequency of events, and

to provide maps or a matrix from which to do more work.

Data analysisQuestionnaire

The data analysis used a quantitative method. All collecteddata were organized and summarized by descriptiveA 13-item questionnaire was developed after a review of

the literature (Stubbs et al. 1983, Harber et al. 1987b). This statistics.

382 © 1997 Blackwell Science Ltd, Journal of Advanced Nursing, 26, 380–388


reported back pain, while 11 (78·6%) had back pain in theRESULTS

category ‘more than 8 years’.The ages of the subjects ranged from 22 to 45 years. All ofthem were equally selected from di�erent clinical areas of Incidents associated with the first episode of back

painthe hospital.Twenty-seven (71%) respondents who had su�ered backpain reported that their first episode of back pain hap-

Frequency of back painpened during the day. Most incidents of back pain hadoccurred in an orthopaedic ward, closely followed in fre-Of the 47 respondents 38 (80·9%) respondents reported

that they had su�ered from back pain during their nursing quency by elderly care and medical wards. Incidentsassociated with the first episode of back pain are showncareer. The frequency of their back pain was categorized

as ‘daily’, ‘once a week’, ‘once a month’, ‘a few times a in Table 2.When asked how the first episode happened, 11 out ofyear’ and ‘less than once a year’, and ‘others’.

Figure 1 summarizes the frequency of back pain reported 27 subjects indicated that it occurred ‘after lifting a heavypatient’. The second most frequently identified situationby subjects. Two respondents (5%) reported that their back

pain occurred twice a week, within the category of others. was the ‘transfer of a patient from stretcher to bed’. Bothof them were dynamic patient-oriented tasks. In view ofIt can be seen that about 4 out of 10 subjects who had

experienced back pain in their career experienced it at all the described situations, only one ‘after prolongedstanding for surgery’ was a static patient-oriented task.least once a month or more frequently. This represents

one-third of the original 47 respondents. In total seven outof the respondents had experienced back pain at least a Factors contributing to back pain

Subjects were asked to identify patient contact activitiesfew times a year.which they believed ‘could’ contribute to their back pain.The number of responses was not restricted; an average of

Experience of back painfour activities were selected by subjects. These activitieswere categorized into dynamic and static. Results are pre-All of the following results are based on responses from

the 38 subjects who had reported experience of back pain. sented separately in Tables 3 and 4. Of the dynamic factors,‘transferring the patient’ was most frequently chosen,followed by ‘lifting the patient within bed without assist-Relationship between years of working experience

and back pain ance’. The results demonstrate that the static factors arealso important in contributing to back pain. ‘Stooping’ wasAs shown in Table 1, the category of less than 2 years’

working experience had the highest prevalence; all sub- most frequently chosen; 31 out of 38 subjects believed thatit was a contributing factor to back pain.jects in this category reported back pain. The second high-

est prevalence appeared in the category concerning workexperience of 2 to less than 5 years; 14 (87·5%) respon- Usual sites of back pain

Subjects who had su�ered back pain were asked todents reported back pain and two (12·5%) did not. In thecategory ‘5 to less than 8 years’, eight (66·7%) subjects identify their usual sites of pain on a diagram in the

dailyonce a weekonce a montha few times a yearless than once a yearothers

45%

5%

16%13%

8%

13%

Figure 1 Frequency of back pain.


P. French et al.

Table 3 Number of subjects who reported the following dynamic low back pain, and the other four (10·5%) had low back,factors contributing to their back pain (n=38) buttock and leg pain. Therefore, it was indicated that ‘low

back’ was the most usual site of back pain in nurses.Number of

Dynamic factor responsesE�ects of back pain

Lifting patient within bed with assistance 22In responding to question 11 ‘Have you ever reported the

Lifting patient within bed without assistance 27incidence of back pain?’ in the questionnaire (seeLifting patient from floor with assistance 21Appendix), 35 (92·1%) subjects stated they had notLifting patient from floor without assistance 20reported their back pain to the ward in-charge, nursingTransferring patient (bed to chair; bed to bed) 31o�cer or ward manager. Twenty-six (68·7%) respondentsAmbulating patient 8stated the back pain had restricted their activities, andRestraining struggling patient 19

Giving assistance when patient starts to fall 12 three (7·9%) had been transferred to another nursing postbecause of their back pain.

Table 4 Number of subjects who reported the following staticDISCUSSIONfactors contributing to their back pain (n=38)

The findings of this study demonstrated a high prevalenceStatic factor Number of responses

of back pain (80·9%) in this sample of registered nursesand compare with other worst reports in similar studiesLeaning over patient 17reported in other countries. These studies demonstratedStooping 31that the prevalence of back pain ranged from 43 to 79%Squatting 12(Cato et al. 1989, Harber et al. back pain. Although thisstudy showed a high prevalence in that particular groupof nurses, the small number of subjects (n=5) may makethe observation unreliable.questionnaire. The distribution of back pain by site is

shown in Figure 2. When comparing the two working groups, ‘2 to less than5 years’ and ‘5 to less than 8 years’, the result showed aSubjects had neither upper back nor neck pain. The larg-

est single category was ‘low back’, with 63·2% of the 38 decrease in percentage of back pain from 87·5% to 66·7%(Table 1). One could argue that this reduction was due toanalysable responses. The second largest category was ‘mul-

tiple sites’, with 29% of the responses; the majority of which increased skill due to experience. A more likely expla-nation is that it is possible that more of the nurses in theincluded ‘low back’. Four (10·5%) subjects had mid and

Figure 2 Usual sites of back pain(n=38). Site of pain n %

1. Upper back & neck 0 0

2. Mid back 1 2·63

3. Low back 24 63·16

4. Buttocks & legs 2 5·26

5. Multiple sites:

– Mid back & low back 4 10·53– Low back, buttocks & legs 4 10·53– Upper back, neck & low back 1 2·63– Mid back, buttocks & legs 1 2·63– Mid back, low back, buttocks & legs 1 2·63

Total 38 100



category of ‘5 to less than 8 years’ were married and had is part of the work of the nurse (Whitehead 1984, Harberet al. 1988). Nurses seem to view back pain as a ‘normal’had children.phenomenon in the profession.

It has been found that complaints of back pain and injuryChildbirth

amongst junior nurses in particular are often ignored(Bulaitis 1992). Given the idea that back pain is a com-Earlier studies have found a marked increase in back pain

with number of childbirths (Videman et al. 1984, Stubbs monly abused excuse for taking sick leave, it is possibleto understand that many nurses do not want to be seen toet al. 1986, Buckle 1987, Skovron et al. 1987). This sup-

ports the assertion that nurses may be leaving to take up be malingering and that this and/or the actual existence ofchronic back pain will lead to dismissal.less strenuous work after experiencing a period of chronic

back pain which may be induced by nursing activities orchildbirth and exacerbated by the other (Field et al. 1982).

Lower back painChildbirth may also explain the high incidence in sub-

jects in the ‘more than 8 years’ group. This group is more The finding that 63% of the back pain su�erers wereexperiencing lower back pain, and another 26% of painlikely to consist of nurses who are compelled to return to

nursing after multiple childbirth for economic reasons was related to multiple sites which included the lowerback, is not surprising given that the lower back is theregardless of the health consequences. This may provide

further support for the assertion that childbirth and nurs- most susceptible site. The lower lumbar discs, L4–L5 andL5–S1, are subject to the greatest mechanical stress, com-ing activities are implicated in the causation of chronic

back pain. This encourages the economically self-su�cient pression force and the greatest degenerative changes(Deede 1987, Smeltzer & Bare 1992). These compressionto leave nursing but the less well o� to stay or return to

nursing and endure the pain. This explanation is plausible forces are generated by heavy physical work, manual lift-ing and prolonged static work posture. This explains whygiven the finding that 92·1% of the back pain su�erers did

not report the problem to their employers. most subjects report stooping as the most likely staticfactor contributing to their back pain.Given that the high prevalence of back pain has been

confirmed in this study, the frequency of back pain Given that stooping is warned against in almost all train-ing scenarios, there is some indication here that eitherbecomes a crucial factor when considering the nurses’

health and working performance. inadequate training or personal neglect is contributing tothe problem. There is other evidence that inappropriatepractices are taking place. Given that ‘transferring the

Chronic painpatient’ was the top dynamic factor contributing to theback pain and that ‘lifting a heavy patient’ came closeThe finding that one-third of the sample experience pain

more than once a month and that over-two thirds experi- second, there is some indication that suitable techniquesfor lifting and carrying are not being adopted in practice.enced it at least twice a year indicates a serious chronic

back pain problem among nurses in Hong Kong. Acute The second most common finding that ‘lifting a patientwithout assistance’ contributed to most nurses’ back painpain serves as a warning that something somewhere in the

body is amiss and requires immediate attention, whereas indicates that nurses are taking risks either necessarily orunnecessarily. If they are taking risks unnecessarily thenchronic pain might never fully cease (Tollison 1987).

When pain lasts for 6 months or more in periodic or unre- they are guilty of neglect which puts themselves and thepatient at risk of injury. If it is necessarily incurred becausemitting episodes, it can be defined as chronic in nature

(Bond 1984, Landan 1986, Burckhardt 1990, Keane 1992). of sta� shortages then the health service management isputting nurses and patients at risk of injury.The findings indicate that there is a great deal of physical

and psychological ill health associated with chronic backpain in Hong Kong nurses.

Other factorsDepression usually accompanies chronic pain, and this

has an adverse e�ect on the nurses’ morale and job per- The free responses at the end of the questionnaire givesome interesting insights into other contributing factors.formance (Skevington 1983, Tollison 1987). The impact on

the nursing service should be taken seriously when one Some subjects mentioned that inadequate manpower andinadequate education were the possible causes of backconsiders that back pain is the leading cause of disability

and absenteeism in the working population (Haber 1971, injury. Two respondents thought that their uniform restric-ted movement in the handling of patients. It has beenGoldberg et al. 1980). This is all the more worrying when

one considers that the size of the problem is being mini- found that constricting uniforms place nurses at a higherrisk of back pain because they limit movement, propermized by the tendency for nurses not to report the inci-

dence of back pain to their employers. Some argue that position and proper alignment of the spine (Marchette &Marchette 1985).this is because nurses are socialized into the belief that it


P. French et al.

Harber P., Billet E., Lew M. & Horan M. (1987a) Importance ofCONCLUSION non-patient transfer activities in nursing-related back pain:

questionnaire survey. Journal of Occupational MedicineIt is apparent from this study that nurses in Hong Kong29(12), 967–970.demonstrate one of the highest incidences of back pain

Harber P., Shimozaki S., Gardner G., Billet E., Vojtecky M. &when compared with other studies. The incidence isKanim L. (1987b) Importance of non-patient transfer activities

largely hidden and ignored because nurses in Hong Kongin nursing-related back pain: observational study and impli-

seem to be more reluctant to report their back pain than cations. Journal of Occupational Medicine 29(12), 971–974.subjects in previously reported studies. Even if statistics Harber P., Billet E., Vojtecky M., Rosenthal E., Shimozaki S. &were collected in Hong Kong they would not give a true Horan M. (1988) Nurses’ beliefs about cause and prevention ofindication of the size of the problem. occupational back pain. Journal of Occupational Medicine

30(10), 797–800.The high incidence of back pain is brought aboutHong Kong Labour Department (1994) Guide to Occupationalby factors which seem to be entirely preventable. It is

Diseases Prescribed for Compensation Purposes. Governmentapparent that nurses are taking risks or are pursuingPrinter, Hong Kong.questionable practices.

Keane M. (1992) Encyclopedia and Dictionary of Medicine, Nurs-In this situation, initial nurse education will never being and Allied Health 5th edn. W.B. Saunders, Philadelphia.su�cient and the most obvious course of action seems to

Landan S.I. (1986) International Dictionary of Medicine andbe periodic and continuous in-service training. The costs

Biology Vol. 1. Wiley Medical, New York.of training are easily justifiable in terms of savings made Mandel J.H. & Lohman W. (1987) Low back pain in nurses: theby avoiding loss of nurses to the profession, absenteeism relative importance of medical history, work factors, exercise,and potential danger to the patient. and demographics. Research in Nursing and Health 10,

165–170.Marchette L. & Marchette B. (1985) Back injury: a preventable

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night . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 2APPENDIX: QUESTIONNAIRE which type of ward . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .

Please circle the appropriate number which matches yourQ7answer.*How did it happen?. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .

Section I . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .*Only choose one answer from each question.

Q8Q1Have you experienced back pain recently?Age at 1 Jan. 1995 yearsYes . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 1No. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 2

Q2Experience in nursing after registration: Q9Less than 2 years. . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 1

What frequency of back pain do you experience?2 to less than 5 years . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 2Daily . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 15 to less than 8 years . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 3Once a week . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . 2More than 8 years. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 4Once a month . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . 3A few times a year . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . 4

Q3 Less than once a year. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 5Which area do you presently work in? Other. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 6Medical . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 1 (please specify)Surgical. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 2Intensive care unit . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 3 Q10Neonatal intensive care unit. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 4

Where was the usual site(s) of your back pain?Renal unit . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 5A&E Department . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 6Geriatric . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 7Paediatric. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 8Operation theatre . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . 9Obstetrics . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .10Gynaecology . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .11Orthopaedic. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .12Other. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .13(please specify)

Section II

Upper back & neck... 1

Mid back................... 2Low back.................. 3Buttocks & legs......... 4

*You can choose more than one answer which is appro-priate to your feelings.

Q11Have you ever reported the incidence of back pain?Q4No. . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 1Have you su�ered back pain before 1995?Yes (e.g. report to ward in-charge, nursing o�cer, wardYes . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . 1manager, etc.) . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . 2No . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . 2

If ‘yes’, please continue.If ‘no’, you have finished this questionnaire. Thank you. Q12

Has your back pain caused you to:Q5 leave nursing? . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . 1

transfer to another nursing position?. . . . . . . . . . . . . . . . . . . .. . . 2When did you experience your first episode of back pain?restrict your activities? . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 3Before commencing nursing . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 1Other. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . 4After commencing nursing . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 2(please specify)If your answer is ‘1’, you have finished this questionnaire.

If your answer is ‘2’, please continue.

Section IIIQ6Did the first episode occur on: *You can choose more than one answer which is appro-

priate to your feelings.day duty?. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 1


P. French et al.

a. leaning over patient (e.g. suctioning or adjusting dripQ13rate) . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . 9What precipitated your back pain?

b. stooping (e.g. performing dressing, giving injection orDynamic patient-oriented taskstidying beds) . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .10a. lifting patient within bed

c. squatting (e.g. measuring urine output or observing bub-$ with assistance . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . 1bling of chest drain). .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .11$ without assistance. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . 2

b. lifting patient from floor If you have any comments related to your back pain, please$ with assistance . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . 3

feel free to write them below.$ without assistance. . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . 4

. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .c. transferring patient (e.g. from bed to chair, chair to bed,

. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .bed to bed) . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 5

. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .d.ambulating patient . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . 6

You have now finished the questionnaire.e. restraining struggling patient . . . . . . . . . . . .. . . . . . . . . . . . . . . . . 7

Please use the enclosed envelope for returning the finishedf. giving assistance when patient starts to fall . . . . . . . . . . . . 8

questionnaire.Thank you for contributing to this study.Static patient-oriented tasks


The prevalence and cause of occupational back pain in Hong Kong registered nurses

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