Cognitive on Prevention of Work-Related Musculoskeletal Disorders among Nurses in Shandong Province of China: A cross- sectional study

Cognitive on Prevention of Work-Related Musculoskeletal Disorders among Nurses in Shandong Province of China: A cross- sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Cognitive on Prevention of Work-Related Musculoskeletal Disorders among Nurses in Shandong Province of China: A cross- sectional study Hailing Yang, Yuepeng Cheng, Xu Zhang, Hui Lin, Pia Vanessa Basilio, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5518939/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Work-related musculoskeletal disorders (WMSDs) have become major occupational health problems worldwide. Last year, 91.2% of nurses reported experiencing WMSDs in at least one region of their body. However, this issue has not received adequate attention among nurses. This study aims to determine the frequency of WMSDs and assess nurses' knowledge, attitudes, and practices regarding self-protective behaviors. Methods A cross-sectional study was conducted in March 2024 among full-time registered nurses from various departments in hospitals across Shandong Province, China. Demographic data, the Nordic Standardized Musculoskeletal Questionnaire, and questionnaires on knowledge, attitudes, and behaviors related to protection were used. Results A total of 697 nurses participated, 93.7% of whom were female and 87.7% who held a bachelor's degree or higher. The prevalence rates of WMSDs were 94.98% (historical), 93.11% (annual), and 87.37% (weekly), which are higher than those reported in relevant studies from Xinjiang. The top five affected body parts were the waist, neck, shoulders, back, and wrist. The WMSD prevalence was higher in women (96.02%) than in men (20.45%) and was highest among nurses aged ≥ 41 years and those with 16–20 years of experience (98.01% and 98.90%, respectively). Married nurses and those with a BMI ≥ 32.0 kg/m2 had prevalence rates of 95.85% and 100%, respectively. The factors significantly associated with WMSDs included sex, age, years of work, marital status, educational background, BMI, working hours, knowledge, and protective behaviors. The study revealed that 31.3% of nurses lacked knowledge about WMSDs, 65.1% reported no relevant training in their hospitals, and 90.7% were willing to participate in such training. Conclusion The prevalence of WMSDs among nurses in Shandong Province is high, with multiple body parts affected. Binary logistic regression analysis identified long periods of standing and lifting weights with one hand as risk factors. Strong protective behavioral abilities serve as a protective factor. This study highlights the need for increased attention and timely interventions from nursing managers. Work-related musculoskeletal disorders (WMSDs) Chinese nurses Cognitive self-protecting behaviors Occupational health Cross-sectional study 1. INTRODUCTION The increasing awareness of professional self-protection has led to a greater focus on work-related illnesses among practitioners and managers ( 1 ). WMSDs typically contribute to a significant portion of occupational morbidity ( 2 ). Nurses are more often to report to be vulnerable to sustaining occupational health including WMSDs during the shift ( 3 ). Because WMSDs are among the major work-related illnesses that threaten the occupational health of nurses; impair not only the health of nurses but also their capacity to work, their quality of life, and, eventually, their work efficiency, further potentially hurting patient care and safety( 4 , 5 ). Nurses are a significant part of health, and the nurse team is an important force on the health front, thus, more attention should be given to this topic by managers and nurses ( 6 ). A meta-analysis of 42 articles with a total sample size of 36,934 nurses revealed that nurses' overall understanding of WMSD knowledge and protective practices was not promising internationally( 7 ).Chinese nurses lack knowledge and behaviors related to WMSDS protection and have a high demand for knowledge and skills related to WMSDS protection but lack systematic training, which further increases the risk among nurses( 8 , 9 ) . In summary, this study will assess the factors and work-related outcomes of having WMSDs among nurses and evaluate their knowledge, attitudes, and practices toward self-protection behaviors toward WMSDs. The impact of the study will increase awareness not only of hospital administration but also of public health. 2. STUDY OBJECTIVES 2.1 To describe the study participants' characteristics as follows: a) demographic profile, b) work-related characteristics, c) lifestyle-related characteristics. 2.2 Identifying the area/s of discomfort about WMSD profiles of the study participants. 2.3 Determining nurses' knowledge, attitudes, and practices regarding self-protecting behaviors toward WMSD prevention. 3. METHODS 3.1. Study Design and Study Locale A cross-sectional research design was selected. The convenience sampling method was used to recruit eligible participants from tertiary and secondary hospitals in Shandong Province, and the nursing staff of the hospital were contacted to solicit their consent and cooperation to confirm the feasibility of this study. An online questionnaire is generated online which is then pushed to the nurses through WeChat, they can fill in the questionnaire online by phone. 3.2. Study participants 3.2.1. Sample size According to the requirement of sample size for multivariate factor analysis, the sample size should be 5–10 times the study variable ( 7 ). This study included demographic information, the WMSD discomfort form, questionnaires on knowledge, attitudes, and practices related to self-protection behavior toward WMSDs, lifestyle-related characteristics, health education service profiles; etc. and a total of 46 variables. A sample size of 575 was ultimately determined by taking 10 study variables and a 20% invalid questionnaire rate into consideration. A total of 697 valid questionnaires were collected in this study. 3.2.2. Inclusion and exclusion criteria The eligible study participants were selected on the basis of the inclusion and exclusion criteria. Those who quit, became pregnant, or could not participate for other reasons were excluded. The inclusion criteria were as follows nurse practitioners who obtained the nurse's license issued by the Ministry of Health, worked for 1 year or more, worked in clinical nursing wards in selected hospitals of Shandong Province, and volunteered to participate in this study. The exclusion criteria were as follows: nurses with musculoskeletal disorders caused by nonoccupational factors such as spinal diseases, gynecological diseases, or tumors; patients with a history of joint musculoskeletal injuries; nurses on leave; and trained nurses from other hospitals via self-reports. 3.3 Research instruments In this study, the questionnaires, including demographic information, the WMSD discomfort form, a questionnaire on knowledge, attitudes, and practices for self-protection behavior toward WMSDs. The online questionnaire was generated through the website ( www.wenjuanxing.com ) and was pushed to the nurses online so that the nurses could answer via a smartphone. This form is convenient, and is popular, widely used before. Nurses were able to self-manage by completing and submitting online questionnaires during the survey, and researchers could receive feedback in real time. 3.3.1 Demographic Questionnaire A self-administered questionnaire consisting of 45 items on socio-demographic characteristics, self-reported medical conditions, work-related characteristics, lifestyle-related characteristics, and health education service profiles was administered. Data such as sex, age, highest education level, locality, marital status, height, weight, number of children, personal monthly income, family monthly income, etc. Work-related information (including title, years of nursing, department, weekly working hours, shifts, daily work steps, and perceived work stress), and physiological and psychological characteristics, including working time/shifts and exercise time per week. Organizational environment characteristics, such as working environment, temperature, humidity, working table and chair height, ward bed height, artificial mechanical auxiliary equipment configuration, pressure, etc.,, were collected as demographic variables. 3.3.2 WMSD discomfort form The questionnaire used was prepared by Yan Ping, a scholar from Xinjiang ( 10 ), to measure the area of discomfort and work-related outcomes due to WMSDs. With the consent of the original authors of the questionnaire, Yang Lei et al. consulted the Nordic Musculoskeletal Disorders Questionnaire (NMQ) ( 11 ). This paper combines the Dutch Musculoskeletal Questionnaire (DMQ) and takes into account the actual situation in China and the experiences of previous investigations and studies. The overall Cronbach's α coefficient was 0.81. The Cronbach's α coefficients of each dimension ranged from 0.52–0.92. The questionnaire has high structural validity, discriminative validity, and prediction validity( 12 ) and has high retest reliability in a nurse group study, which is suitable for the nurse population ( 13 ). The participants were evaluated for pain or discomfort in 9 parts of the neck, shoulder, back, waist, elbow, wrist, hip/hip, knee, and ankle/foot by self-reports at three points since starting work, in the past year, and in the past week via self-reports. The questionnaire provides a schematic diagram of human body parts to clarify the range of the above 9 parts and to facilitate the choice of respondents. The scoring guidelines include the following( 10 ): Previous WMSD prevalence = Number of people with WMSDs in any part of the body since work/number of respondents (%). "Since working" refers to the period from the time of participation in nursing work to the time of participation in this survey. WMSD Weekly prevalence = Number of people with WMSDs in any part of the body/number of responders in the last week (%). "Within the last week" refers to a period of seven days calculated from the time of the survey. Annual prevalence of WMSDs in the neck, shoulder, back, waist, elbow, wrist, hip/hip, knee, and ankle/foot = Number of patients with WMSDs in the neck, shoulder, back, waist, elbow, wrist, hip/hip, knee, and ankle/foot/number of respondents (%). Body part WMSD prevalence = Number of patients with n sites/number of respondents (%) Nursing absence rate due to WMSDs = Number of absences due to WMSDs of any body part/number of responders (%) In addition, the questionnaire surveyed whether they had taken time off work due to pain and/or discomfort in any of the above areas since they started working, in the past year and in the past week. 3.3.3 Questionnaire on Knowledge, Attitudes, and Practices for Self-Protecting Behavior toward WMSDs A tool developed by Chinese researcher ( 7 ) was adopted in this study to measure knowledge, attitudes, and practices related to self-protecting behavior and organizational support toward WMSDs. The questionnaire consists of 45 items with 4 dimensions: protection-related knowledge with 13 items, protection attitudes with 8 items, protection practices with 14 items, and organizational support with 10 items, which were previously used at the Hospital of Xinjiang Medical University. The reliability of the questionnaire's broken half ranged from 0.751–0.975, its Cronbach's α ranged from 0.833–0.977, and its retest reliability ranged from 0.725–0.954. The content validity indices of knowledge, attitudes, behavior, and organizational support linked to protection were 0.940, 0.963, 0.919, and 0.852, respectively. Through exploratory factor analysis, eight common variables were identified, with a cumulative contribution rate of 73.715%. The questionnaire satisfies psychometric standards in terms of validity and reliability, making it a useful instrument for assessing nurses' WMSD status. The scoring method of the questionnaire: The questionnaire consists of 4 parts. All the items are scored via the Likert 5-level scoring method, and each dimension of the questionnaire is scored. The questionnaire on knowledge related to the protection of WMSDs of nurses includes 13 items and adopts a 5-part Likert scale, with 1 point for "do not know", 2 points for "understand", 3 points for "general", 4 points for "familiar" and 5 points for "master". The highest score is 65, whereas the lowest score is 13. The higher the score is, the better the knowledge of WMSD protection. The questionnaire on the protective attitudes toward occupational musculoskeletal diseases of nursing staff includes 8 items: a 5-part Likert scale, "strongly disagree", "disagree", "general", "agree", "strongly agree", and "strongly agree". The highest score is 40, the lowest score is 8, and the higher the score is, the more positive the attitude of the nursing staff toward the protection of WMSDs. The questionnaire on the prevention practices of WMSDs, which includes 14 items, uses a 5-part Likert scale: "never" is 1 point, "occasionally" is 2 points, "general" is 3 points, "often" is 4 points, and "always" is 5 points. The highest score is 70, while the lowest score is 14. The higher the score is, the more the nurse focuses on taking the right actions to protect WMSDs( 10 , 14 ). The organizational support questionnaire for WMSDs in nurses includes 10 items answered with "yes" or "no." These items are used to determine organizational support status. One multiple-choice question was added to the scale to understand the sources of knowledge related to WMSDs among nurses. This item is not included in the scale rating. 3.4 Research procedure Online questionnaires were selected to carry out the survey for free through the online collection system by researchers, and information was hidden and protected and sent to the research participants through WeChat. The questionnaires used included demographic questionnaires, discomfort questionnaires, questionnaires on knowledge, attitudes, and practices for protection, etc. 3.4.3 Quality control of the intervention implementation process Good communication and assistance should be ensured before implementation should be organized( 15 ). Nurses were contacted to elaborate on the purpose of the study, the requirements for completing the questionnaire, and their cooperation, and they were invited to complete the questionnaire online and submit it after completion. In this process, the researchers monitored the completion of the questionnaire in a timely manner, contacted the head nurse in time, and communicated on relevant precautions( 16 ). The respondents were encouraged to fill out the questionnaire carefully, truthfully, and completely. In the collation, export, and analysis stage of the data collection, a two-person system was adopted for verification. First, the collected questionnaires were cleaned, and those with less than 80% of the questionnaire content and those with large and consistent answers to the questionnaire were excluded. The valid questionnaires are numbered uniformly. 4. STATISTICAL ANALYSIS OF DATA Data analysis involved both descriptive and inferential statistics. Descriptive statistics include frequency, mean, value, median, mode, range, quartile, standard deviation, etc. Furthermore, inferential statistical tests include the chi-square test and t test for the assessment of relationships between demographic variables; the ANOVA and ANCOVA tests; and logistic regression to compare and identify relationships between the research variables. P < 0.05 was considered statistically significant. 5. RESULTS and DISCUSSION 5.1 General information about the participants There were 697 nurses from 53 different specialty departments, 53 hospitals, and 11 cities, with an average age of 34.61 ± 7.694 years from 19–59 years. The average length of nursing was 12.55 ± 8.471 years, ranging from 1–42 years. The BMI ranged from 11.53 kg/m 2 ~ 32.39 kg/m 2 , with an average of 22.45 ± 3.33 kg/m 2 ; there were 653 females (93.7%) and 44 males (6.3%). The working environment temperature and humidity accounted for 91.4% and 91.8%, respectively. There were 86 college level (12.4%), 596 bachelor’s level (85.5%), and 15 master’s level (2.2%). Among the ways of commuting, 38% were by car, 50.1% by motorcycle or electric car, 3.6% by bicycle, 6.7% by bus and 21.1% by foot. A total of 98% of the nurses did not smoke. The working hours ranged from 40–120 hours per week, with an average of 46.36 ± 12.11 hours. Table 1 General information about the participants ( N =697) Variables Minimum Maximum Standard Standard Deviation Age 19 59 34.61 7.69 Gender Height 150 192 163.47 5.79 Weight 40.0 85.0 59.974 9.36 BMI (kg/m2) 11.53 32.39 22.45 3.33 Work years 1 42 12.55 8.471 Monthly income(RMB) 2000 120000 6296.87 5117.199 Monthly household income(RMB) 2000 300000 15477.56 23463.307 Working hours per week(h) 40.0 140.0 46.36 12.11 Screen exposure time min per week (min) 60 24000 1204.52 2002.49 Exercise time min per week 0 2100 81.23 191.29 Commuting time 3 70 15.98 9.10 How many breaks can you take during your work shift? 0 10 1.42 1.02 How many breaks do you have per shift (min) 0 2880 55.82 149.84 In terms of protective equipment for nurses, 94.5% indicated that there were nurse shoes, 13.5% indicated that there were protective objects (such as waist support, wrist guards, etc.), 19.1% indicated that there was patient mobility AIDS (such as turning AIDS), and 20.9% indicated that there was ergonomic equipment (such as ergonomic chairs and ergonomic keyboard/mouse). In the past 6 months, patients have engaged mainly in shift work; direct nursing patients (day) account for 52.2%, and direct nursing patients (night) account for 16.4%. In the past 6 months, they have received relevant treatments such as acupuncture, massage, cupping, moxibustion, hot compress, drug treatment and surgical treatment, accounting for 10.6%, 32.4%, 12.5%, 16.9%, 32.9% and 2.3%, respectively. Only 12.2% of nurses were absent from work due to illness or accidents within six months. In terms of the understanding of occupation-related skeletal and muscular diseases among the nursing staff, 31.3% said that they did not know WMSDs, and 5.6% and 4.0% were familiar with WMSDSs. Table 2 Work-related information and hospital occupational protection training information within 6 months ( N = 697) Item Number Frequency In the past 6 months, I have been mainly engaged in shift work 1 Direct patient care (day) 364 52.2 2 Direct patient Care (night) 114 16.4 3 Drug Class 23 3.3 4 General duty/watch 54 7.7 5 Others 142 20.4 Related treatment in the last 6 months Acupuncture Yes 74 10.6 No 623 89.4 Massage Yes 226 32.4 No 471 67.6 Cupping glass Yes 87 12.5 No 610 87.5 Moxibustion Yes 118 16.9 No 579 83.1 Apply hot compress Yes 251 36.0 No 446 64.0 Drug therapy Yes 229 32.9 No 468 67.1 Surgical treatment Yes 16 2.3 No 681 97.7 Absence from work in the last 6 months due to illness or accident Yes 85 12.2 No 612 87.8 Understanding of occupationally related skeletal and muscular diseases in nursing staff Never heard of 218 31.3 Know a little 412 59.1 More familiar with 39 5.6 Know well 28 4.0 Does the hospital carry out relevant WMSDs occupational protection training? Yes 243 34.9 No 454 65.1 Are you willing to participate in WMSDs occupational protection training organized by the hospital? Yes 632 90.7 No 65 9.3 Interested training content 1WSMDs Definition, symptoms, hazards 35 5.0 2 How can caregivers prevent WMSDs? How to configure and use WMSDs-related protective equipment and objects? 309 44.3 3. Application of artificial mechanics in clinical nursing work 95 13.6 4. What should caregivers pay attention to if they suffer from WMSDs? 78 11.2 5. Others 131 18.8 A total of 65.1% said that their work units had not carried out occupational protection training for work-related skeletal and muscular diseases, and 90.7% said that they were willing to participate in such training. 5.2 Analysis of influencing factors for the participants Among nurses, the prevalence rate in women was higher than that in men (96.02% vs 20.45%). The prevalence rate in nurses aged ≥ 41 years and those with 16–20 years of working experience was the highest (98.01%, 98.90%), the prevalence rate in married nurses was 95.85%, and the prevalence in nurses with a BMI ≥ 32.0 kg/m 2 (obesity) was the highest (100%). P < 0.05. The results of single factor analysis revealed that WMSDs were correlated with nurses' gender, age, years of work, marital status, educational background, BMI, working hours, knowledge related to protection, behaviors related to protection, feeling tired, work tasks, being equipped with protective equipment (shoes, waist guards, wrist guards, etc.), hot packs, absence due to illness, etc. Whether the unit carries out occupational protection training for work-related skeletal and muscular diseases, smoking, job changes, bending and turning when lifting weights at work, leaning forward of the neck and holding it for a long time at work, standing for a long time at work, and using force of the upper limbs or hands at work was not related to the number of children, personal monthly income, family monthly income, department, screen exposure time, weekly exercise time, work commuting time, number of work breaks, work breaks, main work shift, disease awareness, work environment satisfaction, work transportation, or willingness to participate in training. 5.3 The presence of WMSDs and work-related outcomes of discomfort The nurses experienced pain or discomfort in any of the following body parts since you started working. The prevalence of lower back pain was the highest, at 92.3%. Table 3 Previous WMSD prevalence(since started working) Parts Ratio% CL95% Neck 86.5 [84.0-89.1] Shoulders 83.6 [80.9–86.4] Upper Back 80.8 [77.8–83.7] Elbows 52.4 [48.7–56.1] Lower Back 92.3 [90.3–94.2] Wrists/Hands 68.3 [64.8–71.8] Hips/Thighs 62.3 [58.7–65.9] Knees 66.0 [62.5–69.5] Ankles/Feet 60.5 [56.9–64.2] The nurses experienced pain or discomfort in any of the following areas of their bodies in the past year: Table 4 Prevalence of WMSDs in the past year Parts Ratio% CL95% Neck 83.4 [80.6–86.1] Shoulders 81.3 [78.4–84.2] Upper Back 76.3 [73.2–79.5] Elbows 49.1 [45.3–52.8] Lower Back 90.0 [87.7–92.2] Wrists/Hands 62.4 [58.8–66.0] Hips/Thighs 58.8 [55.2–62.5] Knees 63.7 [60.1–67.3] Ankles/Feet 55.2 [51.5–58.9] The nurses experienced pain or discomfort in any of the following areas of their bodies in the past week (weekly prevalence): Table 5 Weekly prevalence of WMSDs Parts Ratio% CL95% Neck 73.3 [70.0-76.6] Shoulders 70.0 [66.6–73.4] Upper Back 64.6 [61.0-68.1] Elbows 38.0 [34.4–41.6] Lower Back 79.2 [76.2–82.2] Wrists/Hands 51.9 [48.2–55.7] Hips/Thighs 48.8 [45.1–52.5] Knees 51.8 [48.1–55.5] Ankles/Feet 45.1 [41.3–48.8] In this study, the prevalence of WMSDs among nurses at three time points was 94.98% (past prevalence: 662/697), 93.11% (past year prevalence: 649/697) and 87.37% (weekly prevalence: 609/697). The results were higher than those of Xinjiang scholars (81.15%, 76.94%, 23.19%). Among the 9 body parts of the nursing staff, the top 5 WMSD prevalence were lower back, neck, shoulder, upper back and wrist, which were similar to the results of Xinjiang scholars. Among the patients, 2.87% had one body part involved, 3.30% had two body parts involved, and 88.81% had three or more body parts involved, among which the percentage of patients with three or more body parts was greater than that reported by Xinjiang scholars (71.96%). 5.4 Nurses' knowledge, attitudes, and practices regarding self-protecting behaviors toward WMSD prevention The survey results revealed that the WMSD protection-related knowledge score of the nursing staff was 47.29 ± 12.51 points, and the average score of each item was above 3.55 points. The highest score for "correct posture for turning a bedridden patient" was 4.16 ± 1.092, the lowest score was 3.55 ± 1.293 for "Training methods for health care and protection of limbs and joints" and 3.85 ± 0.86 for "Learning human mechanics knowledge is very important for nursing work". The score of protective attitudes was 36.67 ± 5.36 points, the average score of each item was above 4.55 points, and the score of protective behavior was 56.44 ± 11.97 points, which was higher than the research results of Xinjiang scholars; that is, the total score of protective knowledge of Xinjiang nursing staff was 36.35 ± 12.88 points, and the average score of each item was below 3.0 points. The total score of the protective attitudes of the nursing staff was 31.04 ± 6.44, and the total score of the protective behavior of the nursing staff was 41.26 ± 4.83. Table 6 Scores of WMSD protection-related knowledge, attitudes and practices among nurses (x ± s)(N = 697) Item x s K1. Correct posture during intravenous infusion 4.03 1.211 K2. Proper posture for intramuscular injections 4.09 1.176 K3. Correct posture for bedridden patients 4.14 1.113 K4. Correct posture for turning a bedridden patient 4.16 1.092 K5. Correct posture for lifting the patient 4.13 1.092 K6. Change the correct position of the drainage device 4.07 1.118 K7. Correct posture when working in a seated position 4.10 1.098 K8. Proper posture when working standing 4.13 1.085 K9. Method of expanding the support surface during operation 3.85 1.195 K10. Method of lowering center of gravity during operation 3.87 1.185 K11. Health care and protective training methods of lumbar and back muscles 3.60 1.281 K12. Training methods for health care and protection of the neck 3.58 1.268 K13. Training methods for health care and protection of limbs and joints 3.55 1.293 A1. Learning human mechanics is very important for nursing work 4.55 0.717 A2. The correct posture of human mechanics in nursing operations should be actively learned 4.56 0.705 A3. Knowledge of human mechanics should be applied in nursing operations 4.58 0.709 A4. You should do exercises to exercise the muscles in the corresponding parts 4.57 0.716 A5. Weight should be assessed before handling patients or heavy objects 4.59 0.688 A6. Help should be sought when carrying heavy patients or objects 4.61 0.673 A7. The hospital environment should be improved to reduce the incidence of occupational musculoskeletal disorders 4.60 0.685 A8. Departments should actively allocate labor-saving workers for nurses according to specialty characteristics 4.61 0.689 P1. Lunge of both legs and knee flexion for bedridden patients 3.91 1.082 P2. Assess the patient's weight before lifting 4.15 0.989 P3. Knee flexion while lifting patient 3.98 1.059 P4. Keep your arms close to your sides when lifting the patient 4.02 1.040 P5. The handling of overweight patients will take a collaborative approach 4.35 0.839 P6. Squat while observing drainage fluid 4.16 0.954 P7. When bending over to pick up items, place your feet front and back apart, and then squat 3.98 1.094 P8. Use ladders, footstools, and other items when taking high objects 4.19 0.951 P9. When rotating the body, the whole body is rotated instead of the trunk rotation 3.96 1.064 P10. Stand, walk, squat, and stand with at least one foot between them A distance of 15 cm 3.94 1.059 P11. Feel comfortable at work 3.76 1.093 P12. Can maintain an optimistic and positive mental state 4.13 0.901 P13. Focus on physical exercise 3.70 1.198 P14. When turning over a patient who is awake or allowed to cooperate, ask the patient to exert force Coordinate turning 4.22 0.893 6. CONCLUSION AND RECOMMENDATIONS 6.1 Conclusion 6.1.1 Knowledge, attitudes and behavior related to WMSDs protection among nursing staff WMSDs is not optimal This study investigated the knowledge, attitudes and behavior of nurses with respect to WMSDs protection to provide a basis for further changes in their behavior. According to the study, the scores of WMSDs protection-related knowledge, protective attitudes and protective behavior were 47.29 ± 12.51, 36.67 ± 5.36 and 56.44 ± 11.97, respectively, all of which were higher than the results of similar studies by Xinjiang scholars ( 10 ). A total of 31.3% said that they did not know about WMSDs, 65.1% said that their hospitals had not carried out relevant occupational protection training for work-related skeletal and muscular diseases, and 90.7% said that they were willing to participate in relevant occupational protection training. This finding is consistent with the research results of the other Chinese researchers ( 7 , 17 – 20 ); however, 31.3% of the nursing staff had never been exposed to WMSDs knowledge, and 90.7% were willing to participate in the training organized by the hospital, which showed that the government, the relevant hospital departments and the nursing staff themselves had not paid enough attention to WMSDs( 9 , 19 ). It is suggested that starting with school training, WMSDs-related courses should be added, occupational protection content should be increased, and nurses' awareness and ability to protect WMSDs should be fully improved ( 16 , 21 , 22 ). This study revealed that nursing staff have a good protective attitude toward WMSDs, which is related to the high prevalence rate of WMSDs among nursing staff, which not only affects their normal physiological function but also reduces their normal working ability and their own quality of life( 6 , 23 ). A survey revealed that many professionals lacked awareness of WMSDs protection, believed that WMSDs caused by work were inevitable, and did not believe that changing the nature of work could prevent the occurrence of pain( 6 , 24 ) . Therefore, there is an urgent need to carry out WMSDs-related training and improve awareness of WMSDs protection among nurses. 6.2 Recommendations WMSD prevention is a long-term process. The occurrence of WMSDs is related to many factors( 15 ). Many preemptive measures have been used to reduce its occurrence and development, but the lack of administrative intervention has not been effective( 25 ). Improving the nurse practice environment requires strong support from the management department( 8 , 26 ). For example, the state should provide policy support, including monitoring quality evaluation indicators, improving public awareness, updating nurse regulations for nurse legislation, and incorporating the professional protection of nurses into legal content( 6 ). Hospital managers do not pay enough attention, and support measures need to be further strengthened. A small nurse‒patient ratio in a hospital means that the workload of nurses will increase significantly, and the nurse‒patient ratio is closely related to the decisions of management decision-making departments( 27 ). More organizational support, such as improving the bed-to-nurse ratio, carrying out more forms of mixed training, carrying out more health science popularization and evaluation, incorporating WMSDSs into the nursing quality evaluation duty system for regular evaluation, and distributing professional protective gear, protective shoes, insoles, belts, etc., in key departments to provide humanistic care to nurses, should be provided( 28 ). Preventive sports playgrounds, facilities, training courses, positive nurses who meet the correction to massage Chinese medicine, acupuncture and other health care treatment should be provided( 29 ). In terms of the working environment, the logistics support of the ward environment and the office equipment and facilities should take into account the principles of economy and ergonomics( 30 ). It is recommended to set up a work break room and work break time every day. The notice of the General Office of the National Health Commission on work related to May 12, 2024, Nurses' Day clearly requires hospitals at all levels to implement the relevant provisions of the "Regulations on Nurses" and protect the legitimate rights and interests of nurses in accordance with the law, such as salary, welfare benefits, social insurance, health protection, and safety practices( 6 ). There are 31 nursing quality evaluation indicators in hospitals, among which 5 are structural indicators, which are related to nurse manpower allocation, and 18 are outcome indicators. Only the number of sharp instrument injuries of nurses is related to nursing occupational protection, and the remaining nurses have no WMSD evaluation or monitoring indicators( 16 , 19 , 23 ). Nurses should continue to strengthen their disease understanding, build good health literacy in terms of knowledge, attitudes and practice, and prevent disease( 12 ). Improving working conditions is the most basic measure for preventing and controlling WMSDs. The reasonable organization and arrangement of work is an important means to prevent and control WMSDs. Health education and training are important measures for preventing and controlling WMSDs( 30 ). The prevalence rates of WMSDs at the three time points were 94.98% (historical prevalence: 662/697), 93.11% (past year prevalence: 649/697) and 87.37% (weekly prevalence: 609/697), which were higher than the results of relevant studies by Xinjiang scholars( 12 ). Among the 9 body parts of nurses, the top 5 WMSD prevalence rates were waist, neck, shoulder, back and wrist. Among the patients, 2.87% had 1 body part involved, 3.30% had 2 body parts involved, and 88.81% had 3 or more body parts involved. Among nurses, the prevalence rate in women was higher than that in men (96.02% vs 20.45%). The prevalence rate in nurses aged ≥ 41 years and those with 16–20 years of working experience was the highest (98.01%, 98.90%), the prevalence rate in married nurses was 95.85%, and the prevalence rate in nurses with a BMI ≥ 32.0 kg/m 2 was the highest (100%). P < 0.05. The results of single factor analysis revealed that WMSDs were correlated with nurses' gender, age, years of work, marital status, educational background, BMI, working hours, knowledge related to protection, behaviors related to protection, feeling tired, work tasks, being equipped with protective equipment (shoes, waist guards, wrist guards, etc.), hot packs, absence due to illness, etc. Whether the unit carries out occupational protection training for work-related skeletal and muscular diseases, smoking, job changes, bending and turning when lifting weights at work, leaning forward of the neck and holding it for a long time at work, standing for a long time at work, and using force of the upper limbs or hands at work was not related to the number of children, personal monthly income, family monthly income, department, screen exposure time, weekly exercise time, work commuting time, number of work breaks, work breaks, main work shift, disease awareness, work environment satisfaction, work transportation, or willingness to participate in training. The prevalence of WMSDs among nursing staff in Shandong Province was greater than that among those in Xinjiang( 31 ),China, and the prevalence of WMSDs in multiple parts of the body was greater( 18 , 26 ),especially in lower back. Binary logistic regression analysis revealed that female sex, standing for a long time and lifting weights with one hand were risk factors for WMSDs. Strong defense-related behavior is a protective factor for WMSDs. The scores of knowledge and behavior related to protection are low, and the attitude of protection is good, which deserves high attention from nursing managers at all levels and timely intervention measures( 15 , 32 ). Abbreviations WMSDs, Work-related musculoskeletal disorders NMQ, the standardized Nordic Questionnaire BMI, Body Mass Index Declarations Ethics approval and consent to participate The study was approved from the Ethic Committee of the selected hospital (Ethic No. KYLL-2024001-004-1) and the University of Angeles University Foundation (ERC code: 2024-DPH-Student-040). Consent for publication Not applicable. Availability of data and materials The data used to support the findings of this study are available from the corresponding author upon request. Competing interests The authors have no conflicts of interest to disclose. Funding The authors have no funding by others to declare. Author `s c ontributions YHL, CYP conceived and designed the study. YHL,ZX LX and CYP collected and analyzed the data. YHL, CYP wrote the paper. Mylene S.Calibjo did the review of data analytics,MAX communicated with those nurses,YHL, Pia Vanessa Basilio reviewed and edited the manuscript. All authors read and approved the manuscript and agree to be accountable for all aspects of the research in ensuring that the accuracy or integrity of any part of the work are appropriately investigated and resolved. Acknowledgements: We acknowledgement the participants in this study of the hospitals,also give thanks for the managers of those nursing department from Shandong Province for their support and assistance. References Khodayarimotlagh Z, Ahmadi F, Sadooghiasl A, Vaismoradi M. Professional protection as the strategy of nurse managers to deal with nursing negligence. Int Nurs Rev. 2022;69(4):442–9. Occupational health. health workers [Internet]. [cited 2024 Nov 30]. https://www.who.int/news-room/fact-sheets/detail/occupational-health%2D%2Dhealth-workers Le TTT, Jalayondeja W, Mekhora K, Bhuuanantanondh P, Jalayondeja C. Prevalence and risk factors of work-related musculoskeletal disorders among physical therapists in Ho Chi Minh City, Vietnam. BMC Public Health. 2024;24(1):6. Mailutha J. Prevalence of Musculoskeletal Disorders among Nurses in Kenya: Part 1, Anthropometric Data and MSDS. 2020;10:158–63. Bernal D, Campos-Serna J, Tobias A, Vargas-Prada S, Benavides FG, Serra C. Work-related psychosocial risk factors and musculoskeletal disorders in hospital nurses and nursing aides: a systematic review and meta-analysis. Int J Nurs Stud. 2015;52(2):635–48. National Health Commission of China. Further promoting occupational health protection action to improve the level of occupational health literacy of workers [Internet]. 2024 [cited 2024 Feb 2]. http://www.nhc.gov.cn/zyjks/s7824k/202401/4637c5d73ff34a538f90d1b098a3a2ae.shtml Zhang C, Yang Z, Zhang H. Psychometric Evaluation of the Chinese Version of Occupational LowBack Pain Prevention Behaviors Questionnaire Among Clinical Nurses: A Validation Study. Front Public Health. 2022;10:827604. Zhang T, Tian Y, Yin Y, Sun W, Tang L, Tang R, et al. Efficacy of an Omaha system-based remote ergonomic intervention program on self-reported work-related musculoskeletal disorders (WMSDs) - A randomized controlled study. Heliyon. 2024;10(2):e24514. Athanasakis E. A meta-synthesis of how registered nurses make sense of their lived experiences of medication errors. J Clin Nurs. 2019;28(17–18):3077–95. Yan P. Research on prevalence status of work-related musculoskeletal disorders and intervention among nursing staff in Xinjiang [Thesis of Doctor Degree]. [xinjiang]: Xin Jiang Medical University; 2017. Hildebrandt VH, Bongers PM, van Dijk FJ, Kemper HC, Dul J. Dutch Musculoskeletal Questionnaire: description and basic qualities. Ergonomics. 2001;44(12):1038–55. Yan P, Li F, Zhang L, Yang Y, Huang A, Wang Y, et al. Prevalence of Work-Related Musculoskeletal Disorders in the Nurses Working in Hospitals of Xinjiang Uygur Autonomous Region. Pain Res Manag. 2017;2017:5757108. Lee J. Understanding nurses’ experiences with near-miss error reporting omissions in large hospitals. Nurs Open. 2021;8(5):2696–704. Zhang L, Yan P, Dai YL, Li FY, Yang Y, HE. Construction of Questionnaire of Occupation Musculoskeletal Disorders on Protective Knowledge, Attitude, Behavior and Organizational Support in Nursing Staff and its reliability and validity. Chin J Mod Nurs. 2018;24(15):1806–10. Altus I. Nurse Musculoskeletal Disorders (MSDs) Guide. [cited 2024 Jun 26]. Nurse Musculoskeletal Disorders (MSDs) Guide. https://www.altus-inc.com/insight/blog/nurse-musculoskeletal-disorders-msds-guide Kezhi DSHYJ, Zhou Yingfeng. Clinical practice guideline of Chinese nurses’ occupational low back pain prevention and care - CNKI. J Nurses Train. 2021;13:1227–36. Dong H, Zhang Q, Liu G, Shao T, Xu Y. Prevalence and associated factors of musculoskeletal disorders among Chinese healthcare professionals working in tertiary hospitals: a cross-sectional study. BMC Musculoskelet Disord. 2019;20:175. Liu Jingyun W, Aiping L. Meta-analysis of the prevalence rate of work-related musculoskeletal disorders in operation room nurses in China. Chin J Mod Nurs. 2018;24(33):4036–41. He X, Xiao B, Wu J, Chen C, Li W, Yan M. Prevalence of work-related musculoskeletal disorders among workers in the automobile manufacturing industry in China: a systematic review and meta-analysis. BMC Public Health. 2023;23(1):2042. Gan L, Li XE, Lu Q, Zhang LC. [The prevalence and influence factors of work-related musculoskeletal disorders of dental nurse]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi Zhonghua Laodong Weisheng Zhiyebing Zazhi Chin. J Ind Hyg Occup Dis. 2022;40(10):756–60. International Labor Organization, World Health Organization. HealthWISE-Work Improvement in Health Services Trainers’ Guide. Beijing: Science; 2015. Sun W, Yin L, Zhang T, Zhang H, Zhang R, Cai W. Prevalence of Work-Related Musculoskeletal Disorders among Nurses: A Meta-Analysis. Iran J Public Health. 2023;52(3):463–75. China Health Supervision Association. Ergonomic principle for the prevention of work-related musculoskeletal disorders. 2021. Alzghoul BI, Abdullah NAC. Pain Management Practices by Nurses: An Application of the Knowledge, Attitude and Practices (KAP) Model. Glob J Health Sci. 2015;8(6):154–60. Yu Z, Zhang J, Lu Y, Zhang N, Wei B, He R, et al. Musculoskeletal Disorder Burden and Its Attributable Risk Factors in China: Estimates and Predicts from 1990 to 2044. Int J Environ Res Public Health. 2023;20(1):840. Kazemi SS, Tavafian SS, Hiller CE, Hidarnia A, Montazeri A. Promoting behavior-related low back health in nurses by in-person and social media interventions in the workplace. BMC Nurs. 2022;21(1):271. The third Hospital of Peking University. A Guide for the Prevention of Work-related Musculoskeletal Disorders. 2023. A Guide for the Prevention of Work-related Musculoskeletal Disorders. https://www.puh3.net.cn/zybk/info/1008/3191.htm National Health Commission of China. Transcript of the press conference of the National Health Commission [Internet]. 2022 [cited 2023 Nov 7]. http://www.nhc.gov.cn/xcs/s3574/202205/521fc41948544e00a9ffe886eaac1496.shtml Office of Healthy China Action Promotion Committee. Healthy China Action [Internet]. [cited 2023 Nov 7]. https://www.jkzgxd.cn/ Moradi Z, Tavafian SS, Kazemi SS. Educational intervention program based on health belief model and neck pain prevention behaviors in school teachers in Tehran. BMC Public Health. 2022;22(1):1501. Yan P, Li F, Zhang L, Yang Y, Huang A, Wang Y, et al. Prevalence of Work-Related Musculoskeletal Disorders in the Nurses Working in Hospitals of Xinjiang Uygur Autonomous Region. Pain Res Manag. 2017;2017:5757108. Liu Q, Liu X, Lin H, Sun Y, Geng L, Lyu Y, et al. Occupational low back pain prevention capacity of nurses in China: A multicenter cross-sectional study. Front Public Health. 2023;11:1103325. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5518939","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":387952080,"identity":"5d9fe93a-5cad-4a62-a801-241b9dae4a62","order_by":0,"name":"Hailing Yang","email":"","orcid":"","institution":"Qilu Hospital of Shandong University","correspondingAuthor":false,"prefix":"","firstName":"Hailing","middleName":"","lastName":"Yang","suffix":""},{"id":387952081,"identity":"a54aa377-7841-4ef2-9d8f-a926676070d8","order_by":1,"name":"Yuepeng Cheng","email":"","orcid":"","institution":"Shandong University of Traditional Medcine","correspondingAuthor":false,"prefix":"","firstName":"Yuepeng","middleName":"","lastName":"Cheng","suffix":""},{"id":387952082,"identity":"aa565c8a-66cf-4f53-ae09-1a7b7e3b0e2d","order_by":2,"name":"Xu Zhang","email":"","orcid":"","institution":"Shandong University","correspondingAuthor":false,"prefix":"","firstName":"Xu","middleName":"","lastName":"Zhang","suffix":""},{"id":387952083,"identity":"751bd68c-2a03-4be5-aaa3-7b280977a310","order_by":3,"name":"Hui Lin","email":"","orcid":"","institution":"Qilu Hospital of Shandong University","correspondingAuthor":false,"prefix":"","firstName":"Hui","middleName":"","lastName":"Lin","suffix":""},{"id":387952084,"identity":"976af34a-efc9-46d5-80bb-3add90ac89dc","order_by":4,"name":"Pia Vanessa Basilio","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8ElEQVRIiWNgGAWjYBACAyA+8ABEMjMwPmBgkAOyEhgYGBsIaEmAaGEGUsbEaQGpAQE2CaK0mLMff3ggocAGyGB+VvGzzYCBnz3HgLlwB24tlj05BkCHpTFYNrOZ3ewFapHseWPAPPMMHocdyAH55TADEJnd4G37w2BwA2gLbxseLeefP4BqYf9W+Bdoiz1BLTcSDKBaeMyAKg0YDCQIaLGc8QbsFx7LZp5iaZlzBjwSZ54VHJ6JR4s5f/rjDx/+2MiZ8x/f+PFNmYEcf3vyxseFeLTAAI8BjAEiDhPWwACNUxhgJkrLKBgFo2AUjBQAAIcVTl+TZaEnAAAAAElFTkSuQmCC","orcid":"","institution":"Angeles University Foundation","correspondingAuthor":true,"prefix":"","firstName":"Pia","middleName":"Vanessa","lastName":"Basilio","suffix":""},{"id":387952085,"identity":"c16a8911-6f9d-481a-8d83-63c75afacb6b","order_by":5,"name":"Mylene S.Calibjo","email":"","orcid":"","institution":"Angeles University Foundation","correspondingAuthor":false,"prefix":"","firstName":"Mylene","middleName":"","lastName":"S.Calibjo","suffix":""},{"id":387952086,"identity":"80c456ed-c43e-437c-b650-10ff0ce58e2a","order_by":6,"name":"Aixia Ma","email":"","orcid":"","institution":"Qilu Hospital of Shandong University","correspondingAuthor":false,"prefix":"","firstName":"Aixia","middleName":"","lastName":"Ma","suffix":""}],"badges":[],"createdAt":"2024-11-25 09:38:36","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5518939/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5518939/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":71004821,"identity":"ce50f08f-5a62-44ec-a24a-4900455082c8","added_by":"auto","created_at":"2024-12-10 06:10:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":899537,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5518939/v1/3b8a0a3c-8296-42c1-aef4-1f015a6a74b8.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Cognitive on Prevention of Work-Related Musculoskeletal Disorders among Nurses in Shandong Province of China: A cross- sectional study","fulltext":[{"header":"1. INTRODUCTION","content":"\u003cp\u003eThe increasing awareness of professional self-protection has led to a greater focus on work-related illnesses among practitioners and managers (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). WMSDs typically contribute to a significant portion of occupational morbidity (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Nurses are more often to report to be vulnerable to sustaining occupational health including WMSDs during the shift (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Because WMSDs are among the major work-related illnesses that threaten the occupational health of nurses; impair not only the health of nurses but also their capacity to work, their quality of life, and, eventually, their work efficiency, further potentially hurting patient care and safety(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Nurses are a significant part of health, and the nurse team is an important force on the health front, thus, more attention should be given to this topic by managers and nurses (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA meta-analysis of 42 articles with a total sample size of 36,934 nurses revealed that nurses' overall understanding of WMSD knowledge and protective practices was not promising internationally(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).Chinese nurses lack knowledge and behaviors related to WMSDS protection and have a high demand for knowledge and skills related to WMSDS protection but lack systematic training, which further increases the risk among nurses(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) .\u003c/p\u003e \u003cp\u003eIn summary, this study will assess the factors and work-related outcomes of having WMSDs among nurses and evaluate their knowledge, attitudes, and practices toward self-protection behaviors toward WMSDs. The impact of the study will increase awareness not only of hospital administration but also of public health.\u003c/p\u003e"},{"header":"2. STUDY OBJECTIVES","content":" \u003cp\u003e2.1 To describe the study participants' characteristics as follows: a) demographic profile, b) work-related characteristics, c) lifestyle-related characteristics.\u003c/p\u003e\u003cp\u003e2.2 Identifying the area/s of discomfort about WMSD profiles of the study participants.\u003c/p\u003e \u003cp\u003e2.3 Determining nurses' knowledge, attitudes, and practices regarding self-protecting behaviors toward WMSD prevention.\u003c/p\u003e"},{"header":"3. METHODS","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Study Design and Study Locale\u003c/h2\u003e \u003cp\u003eA cross-sectional research design was selected.\u003c/p\u003e \u003cp\u003eThe convenience sampling method was used to recruit eligible participants from tertiary and secondary hospitals in Shandong Province, and the nursing staff of the hospital were contacted to solicit their consent and cooperation to confirm the feasibility of this study. An online questionnaire is generated online which is then pushed to the nurses through WeChat, they can fill in the questionnaire online by phone.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Study participants\u003c/h2\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e3.2.1. Sample size\u003c/h2\u003e \u003cp\u003eAccording to the requirement of sample size for multivariate factor analysis, the sample size should be 5\u0026ndash;10 times the study variable (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). This study included demographic information, the WMSD discomfort form, questionnaires on knowledge, attitudes, and practices related to self-protection behavior toward WMSDs, lifestyle-related characteristics, health education service profiles; etc. and a total of 46 variables. A sample size of 575 was ultimately determined by taking 10 study variables and a 20% invalid questionnaire rate into consideration. A total of 697 valid questionnaires were collected in this study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e3.2.2. Inclusion and exclusion criteria\u003c/h2\u003e \u003cp\u003eThe eligible study participants were selected on the basis of the inclusion and exclusion criteria. Those who quit, became pregnant, or could not participate for other reasons were excluded.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eThe inclusion criteria were as follows\u003c/strong\u003e \u003cp\u003enurse practitioners who obtained the nurse's license issued by the Ministry of Health, worked for 1 year or more, worked in clinical nursing wards in selected hospitals of Shandong Province, and volunteered to participate in this study.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eThe exclusion criteria\u003c/b\u003e were as follows: nurses with musculoskeletal disorders caused by nonoccupational factors such as spinal diseases, gynecological diseases, or tumors; patients with a history of joint musculoskeletal injuries; nurses on leave; and trained nurses from other hospitals via self-reports.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Research instruments\u003c/h2\u003e \u003cp\u003eIn this study, the questionnaires, including demographic information, the WMSD discomfort form, a questionnaire on knowledge, attitudes, and practices for self-protection behavior toward WMSDs. The online questionnaire was generated through the website (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003ca href=\"http://www.wenjuanxing.com\" target=\"_blank\"\u003ewww.wenjuanxing.com\u003c/a\u003e\u003c/span\u003e\u003cspan address=\"http://www.wenjuanxing.com\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e) and was pushed to the nurses online so that the nurses could answer via a smartphone. This form is convenient, and is popular, widely used before. Nurses were able to self-manage by completing and submitting online questionnaires during the survey, and researchers could receive feedback in real time.\u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e3.3.1 Demographic Questionnaire\u003c/h2\u003e \u003cp\u003eA self-administered questionnaire consisting of 45 items on socio-demographic characteristics, self-reported medical conditions, work-related characteristics, lifestyle-related characteristics, and health education service profiles was administered. Data such as sex, age, highest education level, locality, marital status, height, weight, number of children, personal monthly income, family monthly income, etc.\u003c/p\u003e \u003cp\u003eWork-related information (including title, years of nursing, department, weekly working hours, shifts, daily work steps, and perceived work stress), and physiological and psychological characteristics, including working time/shifts and exercise time per week. Organizational environment characteristics, such as working environment, temperature, humidity, working table and chair height, ward bed height, artificial mechanical auxiliary equipment configuration, pressure, etc.,, were collected as demographic variables.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003e3.3.2 WMSD discomfort form\u003c/h2\u003e \u003cp\u003eThe questionnaire used was prepared by Yan Ping, a scholar from Xinjiang (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e), to measure the area of discomfort and work-related outcomes due to WMSDs. With the consent of the original authors of the questionnaire, Yang Lei et al. consulted the Nordic Musculoskeletal Disorders Questionnaire (NMQ) (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). This paper combines the Dutch Musculoskeletal Questionnaire (DMQ) and takes into account the actual situation in China and the experiences of previous investigations and studies. The overall Cronbach's α coefficient was 0.81. The Cronbach's α coefficients of each dimension ranged from 0.52\u0026ndash;0.92. The questionnaire has high structural validity, discriminative validity, and prediction validity(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) and has high retest reliability in a nurse group study, which is suitable for the nurse population (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). The participants were evaluated for pain or discomfort in 9 parts of the neck, shoulder, back, waist, elbow, wrist, hip/hip, knee, and ankle/foot by self-reports at three points since starting work, in the past year, and in the past week via self-reports. The questionnaire provides a schematic diagram of human body parts to clarify the range of the above 9 parts and to facilitate the choice of respondents.\u003c/p\u003e \u003cp\u003eThe scoring guidelines include the following(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e):\u003c/p\u003e \u003cp\u003ePrevious WMSD prevalence\u0026thinsp;=\u0026thinsp;Number of people with WMSDs in any part of the body since work/number of respondents (%). \"Since working\" refers to the period from the time of participation in nursing work to the time of participation in this survey.\u003c/p\u003e \u003cp\u003eWMSD Weekly prevalence\u0026thinsp;=\u0026thinsp;Number of people with WMSDs in any part of the body/number of responders in the last week (%). \"Within the last week\" refers to a period of seven days calculated from the time of the survey.\u003c/p\u003e \u003cp\u003eAnnual prevalence of WMSDs in the neck, shoulder, back, waist, elbow, wrist, hip/hip, knee, and ankle/foot\u0026thinsp;=\u0026thinsp;Number of patients with WMSDs in the neck, shoulder, back, waist, elbow, wrist, hip/hip, knee, and ankle/foot/number of respondents (%).\u003c/p\u003e \u003cp\u003eBody part WMSD prevalence\u0026thinsp;=\u0026thinsp;Number of patients with n sites/number of respondents (%)\u003c/p\u003e \u003cp\u003eNursing absence rate due to WMSDs\u0026thinsp;=\u0026thinsp;Number of absences due to WMSDs of any body part/number of responders (%)\u003c/p\u003e \u003cp\u003eIn addition, the questionnaire surveyed whether they had taken time off work due to pain and/or discomfort in any of the above areas since they started working, in the past year and in the past week.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e3.3.3 Questionnaire on Knowledge, Attitudes, and Practices for Self-Protecting Behavior toward WMSDs\u003c/h2\u003e \u003cp\u003eA tool developed by Chinese researcher (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) was adopted in this study to measure knowledge, attitudes, and practices related to self-protecting behavior and organizational support toward WMSDs. The questionnaire consists of 45 items with 4 dimensions: protection-related knowledge with 13 items, protection attitudes with 8 items, protection practices with 14 items, and organizational support with 10 items, which were previously used at the Hospital of Xinjiang Medical University. The reliability of the questionnaire's broken half ranged from 0.751\u0026ndash;0.975, its Cronbach's α ranged from 0.833\u0026ndash;0.977, and its retest reliability ranged from 0.725\u0026ndash;0.954. The content validity indices of knowledge, attitudes, behavior, and organizational support linked to protection were 0.940, 0.963, 0.919, and 0.852, respectively. Through exploratory factor analysis, eight common variables were identified, with a cumulative contribution rate of 73.715%. The questionnaire satisfies psychometric standards in terms of validity and reliability, making it a useful instrument for assessing nurses' WMSD status.\u003c/p\u003e \u003cp\u003eThe scoring method of the questionnaire: The questionnaire consists of 4 parts. All the items are scored via the Likert 5-level scoring method, and each dimension of the questionnaire is scored. The questionnaire on knowledge related to the protection of WMSDs of nurses includes 13 items and adopts a 5-part Likert scale, with 1 point for \"do not know\", 2 points for \"understand\", 3 points for \"general\", 4 points for \"familiar\" and 5 points for \"master\". The highest score is 65, whereas the lowest score is 13. The higher the score is, the better the knowledge of WMSD protection. The questionnaire on the protective attitudes toward occupational musculoskeletal diseases of nursing staff includes 8 items: a 5-part Likert scale, \"strongly disagree\", \"disagree\", \"general\", \"agree\", \"strongly agree\", and \"strongly agree\". The highest score is 40, the lowest score is 8, and the higher the score is, the more positive the attitude of the nursing staff toward the protection of WMSDs. The questionnaire on the prevention practices of WMSDs, which includes 14 items, uses a 5-part Likert scale: \"never\" is 1 point, \"occasionally\" is 2 points, \"general\" is 3 points, \"often\" is 4 points, and \"always\" is 5 points. The highest score is 70, while the lowest score is 14. The higher the score is, the more the nurse focuses on taking the right actions to protect WMSDs(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe organizational support questionnaire for WMSDs in nurses includes 10 items answered with \"yes\" or \"no.\" These items are used to determine organizational support status. One multiple-choice question was added to the scale to understand the sources of knowledge related to WMSDs among nurses. This item is not included in the scale rating.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Research procedure\u003c/h2\u003e \u003cp\u003eOnline questionnaires were selected to carry out the survey for free through the online collection system by researchers, and information was hidden and protected and sent to the research participants through WeChat. The questionnaires used included demographic questionnaires, discomfort questionnaires, questionnaires on knowledge, attitudes, and practices for protection, etc.\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e \u003ch2\u003e3.4.3 Quality control of the intervention implementation process\u003c/h2\u003e \u003cp\u003eGood communication and assistance should be ensured before implementation should be organized(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Nurses were contacted to elaborate on the purpose of the study, the requirements for completing the questionnaire, and their cooperation, and they were invited to complete the questionnaire online and submit it after completion. In this process, the researchers monitored the completion of the questionnaire in a timely manner, contacted the head nurse in time, and communicated on relevant precautions(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). The respondents were encouraged to fill out the questionnaire carefully, truthfully, and completely.\u003c/p\u003e \u003cp\u003eIn the collation, export, and analysis stage of the data collection, a two-person system was adopted for verification. First, the collected questionnaires were cleaned, and those with less than 80% of the questionnaire content and those with large and consistent answers to the questionnaire were excluded. The valid questionnaires are numbered uniformly.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"4. STATISTICAL ANALYSIS OF DATA","content":"\u003cp\u003eData analysis involved both descriptive and inferential statistics.\u003c/p\u003e \u003cp\u003eDescriptive statistics include frequency, mean, value, median, mode, range, quartile, standard deviation, etc. Furthermore, inferential statistical tests include the chi-square test and t test for the assessment of relationships between demographic variables; the ANOVA and ANCOVA tests; and logistic regression to compare and identify relationships between the research variables. \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"5. RESULTS and DISCUSSION","content":"\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e5.1 General information about the participants\u003c/h2\u003e \u003cp\u003eThere were 697 nurses from 53 different specialty departments, 53 hospitals, and 11 cities, with an average age of 34.61\u0026thinsp;\u0026plusmn;\u0026thinsp;7.694 years from 19\u0026ndash;59 years. The average length of nursing was 12.55\u0026thinsp;\u0026plusmn;\u0026thinsp;8.471 years, ranging from 1\u0026ndash;42 years. The BMI ranged from 11.53 kg/m\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;~\u0026thinsp;32.39 kg/m\u003csup\u003e2\u003c/sup\u003e, with an average of 22.45\u0026thinsp;\u0026plusmn;\u0026thinsp;3.33 kg/m\u003csup\u003e2\u003c/sup\u003e; there were 653 females (93.7%) and 44 males (6.3%). The working environment temperature and humidity accounted for 91.4% and 91.8%, respectively. There were 86 college level (12.4%), 596 bachelor\u0026rsquo;s level (85.5%), and 15 master\u0026rsquo;s level (2.2%). Among the ways of commuting, 38% were by car, 50.1% by motorcycle or electric car, 3.6% by bicycle, 6.7% by bus and 21.1% by foot. A total of 98% of the nurses did not smoke. The working hours ranged from 40\u0026ndash;120 hours per week, with an average of 46.36\u0026thinsp;\u0026plusmn;\u0026thinsp;12.11 hours.\u003c/p\u003e\u003cp\u003eTable 1 \u0026nbsp;General information about the participants (\u003cem\u003eN\u003c/em\u003e=697)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"605\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003eMinimum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003eMaximum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003eStandard\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eStandard Deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e34.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e7.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eHeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e163.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e5.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eWeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e85.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e59.974\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e9.36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eBMI (kg/m2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e11.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e32.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e22.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e3.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eWork years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e12.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e8.471\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eMonthly income(RMB)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e2000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e120000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e6296.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e5117.199\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eMonthly household income(RMB)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e2000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e300000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e15477.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e23463.307\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eWorking hours per week(h)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e140.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e46.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e12.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eScreen exposure time min per week\u003c/p\u003e\n \u003cp\u003e(min)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e24000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e1204.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e2002.49\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eExercise time min per week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e2100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e81.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e191.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eCommuting time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e15.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e9.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eHow many breaks can you take during your work shift?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 26.6116%;\"\u003e\n \u003cp\u003eHow many breaks do you have per shift (min)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.0496%;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e2880\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 16.3636%;\"\u003e\n \u003cp\u003e55.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.6116%;\"\u003e\n \u003cp\u003e149.84\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\u003c/br\u003e\u003cp\u003eIn terms of protective equipment for nurses, 94.5% indicated that there were nurse shoes, 13.5% indicated that there were protective objects (such as waist support, wrist guards, etc.), 19.1% indicated that there was patient mobility AIDS (such as turning AIDS), and 20.9% indicated that there was ergonomic equipment (such as ergonomic chairs and ergonomic keyboard/mouse).\u003c/p\u003e \u003cp\u003eIn the past 6 months, patients have engaged mainly in shift work; direct nursing patients (day) account for 52.2%, and direct nursing patients (night) account for 16.4%. In the past 6 months, they have received relevant treatments such as acupuncture, massage, cupping, moxibustion, hot compress, drug treatment and surgical treatment, accounting for 10.6%, 32.4%, 12.5%, 16.9%, 32.9% and 2.3%, respectively. Only 12.2% of nurses were absent from work due to illness or accidents within six months.\u003c/p\u003e \u003cp\u003eIn terms of the understanding of occupation-related skeletal and muscular diseases among the nursing staff, 31.3% said that they did not know WMSDs, and 5.6% and 4.0% were familiar with WMSDSs.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eWork-related information and hospital occupational protection training information within 6 months (\u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;697)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eIn the past 6 months, I have been mainly engaged in shift work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 Direct patient care (day)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e364\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 Direct patient Care (night)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 Drug Class\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 General duty/watch\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 Others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eRelated treatment in the last 6 months\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAcupuncture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e623\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e89.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMassage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e226\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e471\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCupping glass\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e610\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMoxibustion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e579\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e83.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eApply hot compress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e446\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDrug therapy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e468\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSurgical treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e681\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e97.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAbsence from work in the last 6 months due to illness or accident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e612\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eUnderstanding of occupationally related skeletal and muscular diseases in nursing staff\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever heard of\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKnow a little\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e412\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore familiar with\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKnow well\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDoes the hospital carry out relevant WMSDs occupational protection training?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e454\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAre you willing to participate in WMSDs occupational protection training organized by the hospital?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e632\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eInterested training content\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1WSMDs Definition, symptoms, hazards\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 How can caregivers prevent WMSDs? How to configure and use WMSDs-related protective equipment and objects?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e309\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3. Application of artificial mechanics in clinical nursing work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4. What should caregivers pay attention to if they suffer from WMSDs?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5. Others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eA total of 65.1% said that their work units had not carried out occupational protection training for work-related skeletal and muscular diseases, and 90.7% said that they were willing to participate in such training.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e5.2 Analysis of influencing factors for the participants\u003c/h2\u003e \u003cp\u003eAmong nurses, the prevalence rate in women was higher than that in men (96.02% vs 20.45%). The prevalence rate in nurses aged\u0026thinsp;\u0026ge;\u0026thinsp;41 years and those with 16\u0026ndash;20 years of working experience was the highest (98.01%, 98.90%), the prevalence rate in married nurses was 95.85%, and the prevalence in nurses with a BMI\u0026thinsp;\u0026ge;\u0026thinsp;32.0 kg/m\u003csup\u003e2\u003c/sup\u003e (obesity) was the highest (100%). \u003cb\u003eP\u003c/b\u003e\u0026thinsp;\u003cb\u003e\u0026lt;\u0026thinsp;0.05.\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe results of single factor analysis revealed that WMSDs were correlated with nurses' gender, age, years of work, marital status, educational background, BMI, working hours, knowledge related to protection, behaviors related to protection, feeling tired, work tasks, being equipped with protective equipment (shoes, waist guards, wrist guards, etc.), hot packs, absence due to illness, etc. Whether the unit carries out occupational protection training for work-related skeletal and muscular diseases, smoking, job changes, bending and turning when lifting weights at work, leaning forward of the neck and holding it for a long time at work, standing for a long time at work, and using force of the upper limbs or hands at work was not related to the number of children, personal monthly income, family monthly income, department, screen exposure time, weekly exercise time, work commuting time, number of work breaks, work breaks, main work shift, disease awareness, work environment satisfaction, work transportation, or willingness to participate in training.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e5.3 The presence of WMSDs and work-related outcomes of discomfort\u003c/h2\u003e \u003cp\u003eThe nurses experienced pain or discomfort in any of the following body parts since you started working. The prevalence of lower back pain was the highest, at 92.3%.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevious WMSD prevalence(since started working)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParts\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRatio%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCL95%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeck\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e86.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[84.0-89.1]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShoulders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[80.9\u0026ndash;86.4]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUpper Back\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e80.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[77.8\u0026ndash;83.7]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElbows\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[48.7\u0026ndash;56.1]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower Back\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e92.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[90.3\u0026ndash;94.2]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWrists/Hands\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[64.8\u0026ndash;71.8]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHips/Thighs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e62.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[58.7\u0026ndash;65.9]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnees\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e66.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[62.5\u0026ndash;69.5]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnkles/Feet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e60.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[56.9\u0026ndash;64.2]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe nurses experienced pain or discomfort in any of the following areas of their bodies in the past year:\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevalence of WMSDs in the past year\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParts\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRatio%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCL95%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeck\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e[80.6\u0026ndash;86.1]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShoulders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e[78.4\u0026ndash;84.2]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUpper Back\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e76.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e[73.2\u0026ndash;79.5]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElbows\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e[45.3\u0026ndash;52.8]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower Back\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e90.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e[87.7\u0026ndash;92.2]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWrists/Hands\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e62.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e[58.8\u0026ndash;66.0]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHips/Thighs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e[55.2\u0026ndash;62.5]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnees\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e63.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e[60.1\u0026ndash;67.3]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnkles/Feet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e55.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e[51.5\u0026ndash;58.9]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe nurses experienced pain or discomfort in any of the following areas of their bodies in the past week (weekly prevalence):\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eWeekly prevalence of WMSDs\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParts\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRatio%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCL95%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeck\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e73.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[70.0-76.6]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShoulders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[66.6\u0026ndash;73.4]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUpper Back\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e64.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[61.0-68.1]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElbows\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[34.4\u0026ndash;41.6]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower Back\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[76.2\u0026ndash;82.2]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWrists/Hands\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[48.2\u0026ndash;55.7]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHips/Thighs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[45.1\u0026ndash;52.5]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnees\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[48.1\u0026ndash;55.5]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnkles/Feet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e[41.3\u0026ndash;48.8]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn this study, the prevalence of WMSDs among nurses at three time points was 94.98% (past prevalence: 662/697), 93.11% (past year prevalence: 649/697) and 87.37% (weekly prevalence: 609/697). The results were higher than those of Xinjiang scholars (81.15%, 76.94%, 23.19%).\u003c/p\u003e \u003cp\u003eAmong the 9 body parts of the nursing staff, the top 5 WMSD prevalence were lower back, neck, shoulder, upper back and wrist, which were similar to the results of Xinjiang scholars. Among the patients, 2.87% had one body part involved, 3.30% had two body parts involved, and 88.81% had three or more body parts involved, among which the percentage of patients with three or more body parts was greater than that reported by Xinjiang scholars (71.96%).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e5.4 Nurses' knowledge, attitudes, and practices regarding self-protecting behaviors toward WMSD prevention\u003c/h2\u003e \u003cp\u003eThe survey results revealed that the WMSD protection-related knowledge score of the nursing staff was 47.29\u0026thinsp;\u0026plusmn;\u0026thinsp;12.51 points, and the average score of each item was above 3.55 points. The highest score for \"correct posture for turning a bedridden patient\" was 4.16\u0026thinsp;\u0026plusmn;\u0026thinsp;1.092, the lowest score was 3.55\u0026thinsp;\u0026plusmn;\u0026thinsp;1.293 for \"Training methods for health care and protection of limbs and joints\" and 3.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.86 for \"Learning human mechanics knowledge is very important for nursing work\".\u003c/p\u003e \u003cp\u003eThe score of protective attitudes was 36.67\u0026thinsp;\u0026plusmn;\u0026thinsp;5.36 points, the average score of each item was above 4.55 points, and the score of protective behavior was 56.44\u0026thinsp;\u0026plusmn;\u0026thinsp;11.97 points, which was higher than the research results of Xinjiang scholars; that is, the total score of protective knowledge of Xinjiang nursing staff was 36.35\u0026thinsp;\u0026plusmn;\u0026thinsp;12.88 points, and the average score of each item was below 3.0 points. The total score of the protective attitudes of the nursing staff was 31.04\u0026thinsp;\u0026plusmn;\u0026thinsp;6.44, and the total score of the protective behavior of the nursing staff was 41.26\u0026thinsp;\u0026plusmn;\u0026thinsp;4.83.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eScores of WMSD protection-related knowledge, attitudes and practices among nurses (x\u0026thinsp;\u0026plusmn;\u0026thinsp;s)(N\u0026thinsp;=\u0026thinsp;697)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItem\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ex\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003es\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK1. Correct posture during intravenous infusion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.211\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK2. Proper posture for intramuscular injections\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.176\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK3. Correct posture for bedridden patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.113\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK4. Correct posture for turning a bedridden patient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.092\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK5. Correct posture for lifting the patient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.092\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK6. Change the correct position of the drainage device\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.118\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK7. Correct posture when working in a seated position\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.098\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK8. Proper posture when working standing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.085\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK9. Method of expanding the support surface during operation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.195\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK10. Method of lowering center of gravity during operation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.185\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK11. Health care and protective training methods of lumbar and back muscles\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.281\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK12. Training methods for health care and protection of the neck\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.268\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eK13. Training methods for health care and protection of limbs and joints\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.293\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA1. Learning human mechanics is very important for nursing work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.717\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA2. The correct posture of human mechanics in nursing operations should be actively learned\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.705\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA3. Knowledge of human mechanics should be applied in nursing operations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.709\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA4. You should do exercises to exercise the muscles in the corresponding parts\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.716\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA5. Weight should be assessed before handling patients or heavy objects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.688\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA6. Help should be sought when carrying heavy patients or objects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.673\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA7. The hospital environment should be improved to reduce the incidence of occupational musculoskeletal disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.685\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA8. Departments should actively allocate labor-saving workers for nurses according to specialty characteristics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.689\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP1. Lunge of both legs and knee flexion for bedridden patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.082\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP2. Assess the patient's weight before lifting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.989\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP3. Knee flexion while lifting patient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.059\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP4. Keep your arms close to your sides when lifting the patient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.040\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP5. The handling of overweight patients will take a collaborative approach\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.839\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP6. Squat while observing drainage fluid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.954\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP7. When bending over to pick up items, place your feet front and back apart, and then squat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.094\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP8. Use ladders, footstools, and other items when taking high objects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.951\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP9. When rotating the body, the whole body is rotated instead of the trunk rotation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.064\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP10. Stand, walk, squat, and stand with at least one foot between them\u003c/p\u003e \u003cp\u003eA distance of 15 cm\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.059\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP11. Feel comfortable at work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.093\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP12. Can maintain an optimistic and positive mental state\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.901\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP13. Focus on physical exercise\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.198\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP14. When turning over a patient who is awake or allowed to cooperate, ask the patient to exert force\u003c/p\u003e \u003cp\u003eCoordinate turning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.893\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"6. CONCLUSION AND RECOMMENDATIONS","content":"\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e6.1 Conclusion\u003c/h2\u003e \u003cdiv id=\"Sec22\" class=\"Section3\"\u003e \u003ch2\u003e6.1.1 Knowledge, attitudes and behavior related to WMSDs protection among nursing staff WMSDs is not optimal\u003c/h2\u003e \u003cp\u003eThis study investigated the knowledge, attitudes and behavior of nurses with respect to WMSDs protection to provide a basis for further changes in their behavior. According to the study, the scores of WMSDs protection-related knowledge, protective attitudes and protective behavior were 47.29\u0026thinsp;\u0026plusmn;\u0026thinsp;12.51, 36.67\u0026thinsp;\u0026plusmn;\u0026thinsp;5.36 and 56.44\u0026thinsp;\u0026plusmn;\u0026thinsp;11.97, respectively, all of which were higher than the results of similar studies by Xinjiang scholars (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). A total of 31.3% said that they did not know about WMSDs, 65.1% said that their hospitals had not carried out relevant occupational protection training for work-related skeletal and muscular diseases, and 90.7% said that they were willing to participate in relevant occupational protection training. This finding is consistent with the research results of the other Chinese researchers (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan additionalcitationids=\"CR18 CR19\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e); however, 31.3% of the nursing staff had never been exposed to WMSDs knowledge, and 90.7% were willing to participate in the training organized by the hospital, which showed that the government, the relevant hospital departments and the nursing staff themselves had not paid enough attention to WMSDs(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). It is suggested that starting with school training, WMSDs-related courses should be added, occupational protection content should be increased, and nurses' awareness and ability to protect WMSDs should be fully improved (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study revealed that nursing staff have a good protective attitude toward WMSDs, which is related to the high prevalence rate of WMSDs among nursing staff, which not only affects their normal physiological function but also reduces their normal working ability and their own quality of life(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). A survey revealed that many professionals lacked awareness of WMSDs protection, believed that WMSDs caused by work were inevitable, and did not believe that changing the nature of work could prevent the occurrence of pain(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) .\u003c/p\u003e \u003cp\u003eTherefore, there is an urgent need to carry out WMSDs-related training and improve awareness of WMSDs protection among nurses.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec23\" class=\"Section2\"\u003e \u003ch2\u003e6.2 Recommendations\u003c/h2\u003e \u003cp\u003eWMSD prevention is a long-term process. The occurrence of WMSDs is related to many factors(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Many preemptive measures have been used to reduce its occurrence and development, but the lack of administrative intervention has not been effective(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Improving the nurse practice environment requires strong support from the management department(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). For example, the state should provide policy support, including monitoring quality evaluation indicators, improving public awareness, updating nurse regulations for nurse legislation, and incorporating the professional protection of nurses into legal content(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHospital managers do not pay enough attention, and support measures need to be further strengthened. A small nurse‒patient ratio in a hospital means that the workload of nurses will increase significantly, and the nurse‒patient ratio is closely related to the decisions of management decision-making departments(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). More organizational support, such as improving the bed-to-nurse ratio, carrying out more forms of mixed training, carrying out more health science popularization and evaluation, incorporating WMSDSs into the nursing quality evaluation duty system for regular evaluation, and distributing professional protective gear, protective shoes, insoles, belts, etc., in key departments to provide humanistic care to nurses, should be provided(\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Preventive sports playgrounds, facilities, training courses, positive nurses who meet the correction to massage Chinese medicine, acupuncture and other health care treatment should be provided(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). In terms of the working environment, the logistics support of the ward environment and the office equipment and facilities should take into account the principles of economy and ergonomics(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). It is recommended to set up a work break room and work break time every day.\u003c/p\u003e \u003cp\u003eThe notice of the General Office of the National Health Commission on work related to May 12, 2024, Nurses' Day clearly requires hospitals at all levels to implement the relevant provisions of the \"Regulations on Nurses\" and protect the legitimate rights and interests of nurses in accordance with the law, such as salary, welfare benefits, social insurance, health protection, and safety practices(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThere are 31 nursing quality evaluation indicators in hospitals, among which 5 are structural indicators, which are related to nurse manpower allocation, and 18 are outcome indicators. Only the number of sharp instrument injuries of nurses is related to nursing occupational protection, and the remaining nurses have no WMSD evaluation or monitoring indicators(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNurses should continue to strengthen their disease understanding, build good health literacy in terms of knowledge, attitudes and practice, and prevent disease(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Improving working conditions is the most basic measure for preventing and controlling WMSDs. The reasonable organization and arrangement of work is an important means to prevent and control WMSDs. Health education and training are important measures for preventing and controlling WMSDs(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe prevalence rates of WMSDs at the three time points were 94.98% (historical prevalence: 662/697), 93.11% (past year prevalence: 649/697) and 87.37% (weekly prevalence: 609/697), which were higher than the results of relevant studies by Xinjiang scholars(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Among the 9 body parts of nurses, the top 5 WMSD prevalence rates were waist, neck, shoulder, back and wrist. Among the patients, 2.87% had 1 body part involved, 3.30% had 2 body parts involved, and 88.81% had 3 or more body parts involved. Among nurses, the prevalence rate in women was higher than that in men (96.02% vs 20.45%). The prevalence rate in nurses aged\u0026thinsp;\u0026ge;\u0026thinsp;41 years and those with 16\u0026ndash;20 years of working experience was the highest (98.01%, 98.90%), the prevalence rate in married nurses was 95.85%, and the prevalence rate in nurses with a BMI\u0026thinsp;\u0026ge;\u0026thinsp;32.0 kg/m\u003csup\u003e2\u003c/sup\u003e was the highest (100%). \u003cb\u003eP\u003c/b\u003e\u0026thinsp;\u003cb\u003e\u0026lt;\u0026thinsp;0.05.\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe results of single factor analysis revealed that WMSDs were correlated with nurses' gender, age, years of work, marital status, educational background, BMI, working hours, knowledge related to protection, behaviors related to protection, feeling tired, work tasks, being equipped with protective equipment (shoes, waist guards, wrist guards, etc.), hot packs, absence due to illness, etc. Whether the unit carries out occupational protection training for work-related skeletal and muscular diseases, smoking, job changes, bending and turning when lifting weights at work, leaning forward of the neck and holding it for a long time at work, standing for a long time at work, and using force of the upper limbs or hands at work was not related to the number of children, personal monthly income, family monthly income, department, screen exposure time, weekly exercise time, work commuting time, number of work breaks, work breaks, main work shift, disease awareness, work environment satisfaction, work transportation, or willingness to participate in training.\u003c/p\u003e \u003cp\u003eThe prevalence of WMSDs among nursing staff in Shandong Province was greater than that among those in Xinjiang(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e),China, and the prevalence of WMSDs in multiple parts of the body was greater(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e),especially in lower back. Binary logistic regression analysis revealed that female sex, standing for a long time and lifting weights with one hand were risk factors for WMSDs. Strong defense-related behavior is a protective factor for WMSDs. The scores of knowledge and behavior related to protection are low, and the attitude of protection is good, which deserves high attention from nursing managers at all levels and timely intervention measures(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eWMSDs, Work-related musculoskeletal disorders\u003c/p\u003e\n\u003cp\u003eNMQ, the standardized Nordic Questionnaire\u003c/p\u003e\n\u003cp\u003eBMI, Body Mass Index\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved from the Ethic Committee of the selected hospital (Ethic No. KYLL-2024001-004-1) and the University of Angeles University Foundation (ERC code: 2024-DPH-Student-040).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data used to support the findings of this study are available from the corresponding author upon request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflicts of interest to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no funding by others to declare.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u003c/strong\u003e\u003cstrong\u003e`s\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ec\u003c/strong\u003e\u003cstrong\u003eontributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYHL, CYP conceived and designed the study. YHL,ZX LX and CYP collected and analyzed the data. YHL, CYP wrote the paper. Mylene S.Calibjo did the review of \u0026nbsp;data analytics,MAX communicated with those nurses,YHL, Pia Vanessa Basilio reviewed and edited the manuscript. All authors read and approved the manuscript and agree to be accountable for all aspects of the research in ensuring that the accuracy or integrity of any part of the work are appropriately investigated and resolved.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe acknowledgement the participants in this study of the hospitals,also give thanks for the managers of those nursing department from Shandong Province for their support and assistance.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKhodayarimotlagh Z, Ahmadi F, Sadooghiasl A, Vaismoradi M. Professional protection as the strategy of nurse managers to deal with nursing negligence. Int Nurs Rev. 2022;69(4):442\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOccupational health. health workers [Internet]. [cited 2024 Nov 30]. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/news-room/fact-sheets/detail/occupational-health%2D%2Dhealth-workers\u003c/span\u003e\u003cspan address=\"https://www.who.int/news-room/fact-sheets/detail/occupational-health%2D%2Dhealth-workers\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLe TTT, Jalayondeja W, Mekhora K, Bhuuanantanondh P, Jalayondeja C. Prevalence and risk factors of work-related musculoskeletal disorders among physical therapists in Ho Chi Minh City, Vietnam. BMC Public Health. 2024;24(1):6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMailutha J. Prevalence of Musculoskeletal Disorders among Nurses in Kenya: Part 1, Anthropometric Data and MSDS. 2020;10:158\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBernal D, Campos-Serna J, Tobias A, Vargas-Prada S, Benavides FG, Serra C. Work-related psychosocial risk factors and musculoskeletal disorders in hospital nurses and nursing aides: a systematic review and meta-analysis. Int J Nurs Stud. 2015;52(2):635\u0026ndash;48.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNational Health Commission of China. Further promoting occupational health protection action to improve the level of occupational health literacy of workers [Internet]. 2024 [cited 2024 Feb 2]. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.nhc.gov.cn/zyjks/s7824k/202401/4637c5d73ff34a538f90d1b098a3a2ae.shtml\u003c/span\u003e\u003cspan address=\"http://www.nhc.gov.cn/zyjks/s7824k/202401/4637c5d73ff34a538f90d1b098a3a2ae.shtml\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang C, Yang Z, Zhang H. Psychometric Evaluation of the Chinese Version of Occupational LowBack Pain Prevention Behaviors Questionnaire Among Clinical Nurses: A Validation Study. Front Public Health. 2022;10:827604.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang T, Tian Y, Yin Y, Sun W, Tang L, Tang R, et al. Efficacy of an Omaha system-based remote ergonomic intervention program on self-reported work-related musculoskeletal disorders (WMSDs) - A randomized controlled study. Heliyon. 2024;10(2):e24514.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAthanasakis E. A meta-synthesis of how registered nurses make sense of their lived experiences of medication errors. J Clin Nurs. 2019;28(17\u0026ndash;18):3077\u0026ndash;95.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYan P. Research on prevalence status of work-related musculoskeletal disorders and intervention among nursing staff in Xinjiang [Thesis of Doctor Degree]. [xinjiang]: Xin Jiang Medical University; 2017.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHildebrandt VH, Bongers PM, van Dijk FJ, Kemper HC, Dul J. Dutch Musculoskeletal Questionnaire: description and basic qualities. Ergonomics. 2001;44(12):1038\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYan P, Li F, Zhang L, Yang Y, Huang A, Wang Y, et al. Prevalence of Work-Related Musculoskeletal Disorders in the Nurses Working in Hospitals of Xinjiang Uygur Autonomous Region. Pain Res Manag. 2017;2017:5757108.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee J. Understanding nurses\u0026rsquo; experiences with near-miss error reporting omissions in large hospitals. Nurs Open. 2021;8(5):2696\u0026ndash;704.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang L, Yan P, Dai YL, Li FY, Yang Y, HE. Construction of Questionnaire of Occupation Musculoskeletal Disorders on Protective Knowledge, Attitude, Behavior and Organizational Support in Nursing Staff and its reliability and validity. Chin J Mod Nurs. 2018;24(15):1806\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAltus I. Nurse Musculoskeletal Disorders (MSDs) Guide. [cited 2024 Jun 26]. Nurse Musculoskeletal Disorders (MSDs) Guide. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.altus-inc.com/insight/blog/nurse-musculoskeletal-disorders-msds-guide\u003c/span\u003e\u003cspan address=\"https://www.altus-inc.com/insight/blog/nurse-musculoskeletal-disorders-msds-guide\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKezhi DSHYJ, Zhou Yingfeng. Clinical practice guideline of Chinese nurses\u0026rsquo; occupational low back pain prevention and care - CNKI. J Nurses Train. 2021;13:1227\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDong H, Zhang Q, Liu G, Shao T, Xu Y. Prevalence and associated factors of musculoskeletal disorders among Chinese healthcare professionals working in tertiary hospitals: a cross-sectional study. BMC Musculoskelet Disord. 2019;20:175.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu Jingyun W, Aiping L. Meta-analysis of the prevalence rate of work-related musculoskeletal disorders in operation room nurses in China. Chin J Mod Nurs. 2018;24(33):4036\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHe X, Xiao B, Wu J, Chen C, Li W, Yan M. Prevalence of work-related musculoskeletal disorders among workers in the automobile manufacturing industry in China: a systematic review and meta-analysis. BMC Public Health. 2023;23(1):2042.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGan L, Li XE, Lu Q, Zhang LC. [The prevalence and influence factors of work-related musculoskeletal disorders of dental nurse]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi Zhonghua Laodong Weisheng Zhiyebing Zazhi Chin. J Ind Hyg Occup Dis. 2022;40(10):756\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInternational Labor Organization, World Health Organization. HealthWISE-Work Improvement in Health Services Trainers\u0026rsquo; Guide. Beijing: Science; 2015.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSun W, Yin L, Zhang T, Zhang H, Zhang R, Cai W. Prevalence of Work-Related Musculoskeletal Disorders among Nurses: A Meta-Analysis. Iran J Public Health. 2023;52(3):463\u0026ndash;75.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChina Health Supervision Association. Ergonomic principle for the prevention of work-related musculoskeletal disorders. 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlzghoul BI, Abdullah NAC. Pain Management Practices by Nurses: An Application of the Knowledge, Attitude and Practices (KAP) Model. Glob J Health Sci. 2015;8(6):154\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYu Z, Zhang J, Lu Y, Zhang N, Wei B, He R, et al. Musculoskeletal Disorder Burden and Its Attributable Risk Factors in China: Estimates and Predicts from 1990 to 2044. Int J Environ Res Public Health. 2023;20(1):840.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKazemi SS, Tavafian SS, Hiller CE, Hidarnia A, Montazeri A. Promoting behavior-related low back health in nurses by in-person and social media interventions in the workplace. BMC Nurs. 2022;21(1):271.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThe third Hospital of Peking University. A Guide for the Prevention of Work-related Musculoskeletal Disorders. 2023. A Guide for the Prevention of Work-related Musculoskeletal Disorders. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.puh3.net.cn/zybk/info/1008/3191.htm\u003c/span\u003e\u003cspan address=\"https://www.puh3.net.cn/zybk/info/1008/3191.htm\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNational Health Commission of China. Transcript of the press conference of the National Health Commission [Internet]. 2022 [cited 2023 Nov 7]. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.nhc.gov.cn/xcs/s3574/202205/521fc41948544e00a9ffe886eaac1496.shtml\u003c/span\u003e\u003cspan address=\"http://www.nhc.gov.cn/xcs/s3574/202205/521fc41948544e00a9ffe886eaac1496.shtml\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOffice of Healthy China Action Promotion Committee. Healthy China Action [Internet]. [cited 2023 Nov 7]. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.jkzgxd.cn/\u003c/span\u003e\u003cspan address=\"https://www.jkzgxd.cn/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoradi Z, Tavafian SS, Kazemi SS. Educational intervention program based on health belief model and neck pain prevention behaviors in school teachers in Tehran. BMC Public Health. 2022;22(1):1501.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYan P, Li F, Zhang L, Yang Y, Huang A, Wang Y, et al. Prevalence of Work-Related Musculoskeletal Disorders in the Nurses Working in Hospitals of Xinjiang Uygur Autonomous Region. Pain Res Manag. 2017;2017:5757108.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu Q, Liu X, Lin H, Sun Y, Geng L, Lyu Y, et al. Occupational low back pain prevention capacity of nurses in China: A multicenter cross-sectional study. Front Public Health. 2023;11:1103325.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Work-related musculoskeletal disorders (WMSDs), Chinese nurses, Cognitive self-protecting behaviors, Occupational health, Cross-sectional study","lastPublishedDoi":"10.21203/rs.3.rs-5518939/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5518939/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eWork-related musculoskeletal disorders (WMSDs) have become major occupational health problems worldwide. Last year, 91.2% of nurses reported experiencing WMSDs in at least one region of their body. However, this issue has not received adequate attention among nurses. This study aims to determine the frequency of WMSDs and assess nurses' knowledge, attitudes, and practices regarding self-protective behaviors.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional study was conducted in March 2024 among full-time registered nurses from various departments in hospitals across Shandong Province, China. Demographic data, the Nordic Standardized Musculoskeletal Questionnaire, and questionnaires on knowledge, attitudes, and behaviors related to protection were used.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 697 nurses participated, 93.7% of whom were female and 87.7% who held a bachelor's degree or higher. The prevalence rates of WMSDs were 94.98% (historical), 93.11% (annual), and 87.37% (weekly), which are higher than those reported in relevant studies from Xinjiang. The top five affected body parts were the waist, neck, shoulders, back, and wrist. The WMSD prevalence was higher in women (96.02%) than in men (20.45%) and was highest among nurses aged\u0026thinsp;\u0026ge;\u0026thinsp;41 years and those with 16\u0026ndash;20 years of experience (98.01% and 98.90%, respectively). Married nurses and those with a BMI\u0026thinsp;\u0026ge;\u0026thinsp;32.0 kg/m2 had prevalence rates of 95.85% and 100%, respectively. The factors significantly associated with WMSDs included sex, age, years of work, marital status, educational background, BMI, working hours, knowledge, and protective behaviors. The study revealed that 31.3% of nurses lacked knowledge about WMSDs, 65.1% reported no relevant training in their hospitals, and 90.7% were willing to participate in such training.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe prevalence of WMSDs among nurses in Shandong Province is high, with multiple body parts affected. Binary logistic regression analysis identified long periods of standing and lifting weights with one hand as risk factors. Strong protective behavioral abilities serve as a protective factor. This study highlights the need for increased attention and timely interventions from nursing managers.\u003c/p\u003e","manuscriptTitle":"Cognitive on Prevention of Work-Related Musculoskeletal Disorders among Nurses in Shandong Province of China: A cross- sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-10 06:02:37","doi":"10.21203/rs.3.rs-5518939/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"416a9fbc-e03b-4ed9-8ce1-b0dbbf9f3dee","owner":[],"postedDate":"December 10th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-12-10T06:02:37+00:00","versionOfRecord":[],"versionCreatedAt":"2024-12-10 06:02:37","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5518939","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5518939","identity":"rs-5518939","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}