Healthcare workforce satisfaction and perceptions pertaining to application of ergonomics in primary health care settings in Qatar

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Evidence suggests that there are serious health risks such as work-related musculoskeletal diseases, mental health diseases and lower job satisfaction levels among healthcare workforce who are exposed to work environments which are structured without proper consideration and application of ergonomic principles. The study aims to investigate the perceptions of a diverse healthcare workforce pertaining to their work environment to highlight the existing practices and application of ergonomics principles in a highly demanding and extensive primary care setting in the state of Qatar. Methods The study utilized validated online questionnaire (with structured and open-ended questions section) which was distributed through official emails to the healthcare workforce registered in primary healthcare corporation which is comprised of 31 primary health care centers distributed across the country. The domains and items in the survey encompassed general principles of ergonomics within healthcare settings, overall satisfaction levels, wellbeing and perceptions pertaining to the work environment. Quantitative data was analyzed in Microsoft Excel as frequency, distribution, and multiple regression models. Significance level: α = 0.05 (95% confidence). Responses to the open-ended section were analyzed by framework thematic analysis. This approach encompassed interpreting, exploring, and reporting patterns and clusters of meaning within the given data. Results Half of the healthcare workforce (50%) that participated in the online survey documented that they were either satisfied or very satisfied with their work-life balance. Feeling supported by colleagues and supervisors in terms of mental and emotional well-being at work significantly reduced the risk of reporting a work-related discomfort by half (adjusted OR = 0.54) after adjusting for the remaining explanatory variables as reported by the multiple regression model. The themes that emerged from qualitative analysis included desirable workspace, long working hours, increasing awareness relating to ergonomics principles at workplace and factors associated with staff satisfaction. Conclusions The findings of the study further substantiate the existing evidence base in this area of research and suggest devising innovative strategies and interventions to ensure that ergonomic principles within specific healthcare systems are updated, regularly monitored and effectively implemented to safeguard the health and overall wellbeing of healthcare workforce. Ergonomics Healthcare workforce Primary care Figures Figure 1 Introduction Ergonomics is a well-documented concept which relates to the processes involved in designing and arranging workplaces, products, and systems to ensure the overall wellbeing of the workforce[ 1 ]. The concept is mostly applied and practiced considering its fundamental principle which is to ‘fit the job to the person’[ 2 ]. Globally, the healthcare workforce operates in diverse healthcare settings, putting in strenuous efforts in management of patients and carrying out administrative duties. They often risk their own wellbeing by working in environments which are often not best suited for them[ 3 – 7 ]. Evidence suggests that health care professionals across the globe are more prone to work related musculoskeletal disorders (WMSDs)[ 7 – 10 ]. The first line health workforce such as physicians and surgeons are more susceptible to WMSDs followed by nurses and allied healthcare professionals such as physiotherapists[ 5 ]. A recent systematic review[ 7 ] investigating the prevalence of body area WMSDs among healthcare professionals documented that neck, lower back, shoulder, and wrists/hands were the region’s most prone to disease. Moreover, the study reported that surgeons and dentists had the highest prevalence of MSDs in lower back, shoulder, and upper extremity. The risk factors associated with these MSDs were maintenance and repetition of awkward postures. [ 7 ] Hence, it is important to ensure that the workforce involved in delivering, managing and accessing healthcare services are provided with optimal working conditions which are best suited for them. Evidence suggests that applying such ergonomic measures not only contribute towards the general wellbeing of the healthcare workforce but can also increase their efficiency which leads to improved patient care and the overall quality of the health services provided within a healthcare system[ 7 , 11 ]. Various studies have been conducted internationally to signify the importance of building consistent real work descriptions (within the broader domains of ergonomics) within healthcare particularly primary care settings[ 12 – 14 ]. The published literature emphasizes the need to improve work situations which would lead to increased efficiency and quality of services both from a healthcare professional and patient’s perspective[ 12 , 13 , 15 , 16 ]. Moreover, studies have also been conducted in the eastern Mediterranean region within primary health care settings highlighting the occupational health challenges, the need to further develop such health services and associated health risks such as musculoskeletal disorders.[ 17 – 19 ] The various domains mentioned in recent literature that need to be considered while investigating ergonomics and its application within healthcare settings mainly include duration of working hours in context to postures (musculoskeletal) while performing tasks, lighting conditions, noise levels, overall ventilation mechanisms within workplace, overall satisfaction levels with assigned tasks and factors associated with work related stress and overall psychological wellbeing of the health workforce. [ 7 , 12 , 13 , 15 , 16 , 20 ] The state of Qatar has invested substantially in its healthcare system. The primary care is provided by well-structured and organized body, the Primary Health Care Cooperation (PHCC) which is independent government institute running 31 different primary health care centers in the country[ 21 , 22 ]. There are a wide range of health professionals (doctors, nurses, allied healthcare professionals etc.) working within PHCC who have the responsibility of delivering highest levels of health services which are efficient, timely and patient centered[ 21 , 22 ]. The study aimed to investigate the perceptions of diverse healthcare workforce (HCW) pertaining to their work environment to highlight the existing practices & their general wellbeing within the context pertaining to application of ergonomics in health care settings. The key objectives of the study included identification of any existing gaps, challenges and HCWs satisfaction in a highly demanding and state of the art primary care settings. Methods Study settings: ‘Qatar, a peninsular Arab country (with having world’s third-largest natural gas and oil reserves) has recently emerged as a leading primary healthcare provider country that aims to provide comprehensive primary care with due consideration of the fundamental principles outlined within the concept by the World Health Organization. This was mainly achieved by the development of a universal publicly funded primary healthcare service delivered by the PHCC. PHCC is one of the main and most significant primary care providers in the country publicly with 32 health centers. Importantly all the primary health centers are accredited by Accreditation Canada International and distributed across three geographical regions.’[ 23 ] Study design, sampling, and study participants The study utilized cross sectional study design in which an online questionnaire was distributed through official email to PHCC staff utilizing Microsoft Forms. Healthcare workforce with registered and active official email accounts who are working in PHCC (including doctors, nurses, pharmacists, non-clinical staff, administrative etc.) were invited to participate in the online survey from 10 December 2023 to 21 December 2023. The participants were recruited by purposive convenience sampling. The healthcare staff received a reminder one week after the first invitation to participate in the online survey (which was sent to their official email address). Study tool The online questionnaire comprised of various components which mainly included structured questions with an open-ended question in the end. The domains and items in the survey encompassed general principles of ergonomics within healthcare settings, overall satisfaction levels, wellbeing and perceptions pertaining to the work environment. These mainly included working hours, postures (musculoskeletal) while performing tasks, lighting conditions, noise levels, overall ventilation mechanisms within workplace, overall satisfaction levels with assigned tasks and factors associated with work related stress and overall psychological wellbeing of the health workforce. The main domains and items included in the questionnaire are derived from previous published studies [ 11 – 13 , 15 , 16 , 20 ]. Moreover, the questionnaire was pilot tested among the staff of clinical research department for clarity and feasibility of the content (items and domains included in the study tool). Data analysis The quantitative data was analyzed in Microsoft Excel. Descriptive variables were presented as frequency and percentage. A multiple logistic regression was applied to assess the net contribution of a set of explanatory/predictor variables towards predicting the risk of experiencing any discomfort / health issues related to work environment. The responses to the open ended question were analysed using framework thematic analysis.[ 24 ] This approach encompasses ‘interpreting, exploring, and reporting patterns and clusters of meaning within the given data’[ 25 ] and was facilitated by reading and re-reading the text of responses to open ended question for a full familiarisation. This was followed by application of open codes to 50 responses of different participants to identify emerging themes of relevance by two authors (MS & ST)[ 26 ]. This was followed by agreement by the researchers (MS & ST) on a set of codes which could be used with the rest of the responses. During this stage categories were constructed and defined by grouping of codes. This led to the development of a working coding framework which was utilized with the rest of the data and amended as necessary. Ethical considerations The study was approved by the primary health care corporation institutional review board (Reference BUHOOTH-D-23-00077). The responses from the staff members were kept anonymous to maintain confidentiality of the healthcare staff. Only Variables such as gender, designation and years of service were mentioned in the demographic details of the participants. Patient and Public Involvement There was no Patient and Public Involvement while formulating the study tools and designing the research methodology. Results i) Demographic details of the participants The online questionnaire was distributed (sent to their official work email address) among 800 HCW of Primary Health Care Corporation and 507 responded with a response rate of 63%. In the study a significant percentage (65%, n=329) of participants were females (table 1). 71% of the participants were between 30 to 49 years of age. Half of the PHCC staff (n=258) that participated in the survey were doctors followed by dentists, nurses and other allied healthcare professionals, researchers and administrative staff as depicted in table 1. Table 1 Demographic profile of HCWs Variables Number of participants (n) Percentage (%) Gender Male Female Total 178 329 507 35.1 64.9 100 Age groups <30 years of age 30-39 years of age 40-49 years of age 50 years of age and above total 17 239 172 79 507 3.4 47.1 33.9 15.6 100 Designation of participants (within PHCC) Doctor Dentist Nurse Physiotherapist Dietician Health educator Quality and accreditation officer Clinical researcher Clinical coding specialist Administrative staff Laboratory technologist Pharmacist Total 258 52 65 12 18 09 03 23 03 31 13 20 507 50.9 10.2 12.8 2.4 3.5 1.8 0.6 4.5 0.6 6.1 2.6 4 100 Years of employment within PHCC 6 months to 1 year Between 1 to 2 years Between 2 to 3 years Between 3 to 4 years Between 4 to 5 years More than 5 years Total 78 48 77 85 57 162 507 15.4 9.4 15.2 16.8 11.2 32 100 ii) Staff satisfaction and application of ergonomics within healthcare settings A significant percentage (71%, n=360) of the PHCC staff that participated in the survey reported that they had received adequate training pertaining to ergonomic practices within their respective work settings as shown in table 2. A significant percentage of participants responded positively to the application of ergonomic principles which included workstations designed to meet ergonomic standards, being supported by colleagues and line managers regarding mental health and emotional wellbeing and having good lighting conditions at workspace (table 2). However, 22% (n=109) of staff members reported that they were not provided with equipment to minimize physical strain while performing tasks. Half of the staff (50%, n=254) documented that they were either satisfied or very satisfied with the work-life balance at PHCC as depicted in table 2. Table 2 Staff satisfaction and responses relating to practical application of ergonomics in primary healthcare settings. Frequency of items indicating staff satisfaction and application of ergonomic principles in work environment (N=507) N % Received training/guidance on proper ergonomic practices at PHCC 360 71.0 Aids/equipment provided to minimize physical strain in performing tasks 109 21.5 Having an adjustable chair and monitor stand that allows maintaining a comfortable eye level and posture while working at a computer 380 75.0 Feeling supported by colleagues and supervisors in terms of mental and emotional well-being at work 382 75.3 Satisfied or very satisfied with workstation setup and the arrangement of equipment for work related activities 317 62.5 Often or very often taking short breaks (2-5 minutes) to stretch or change sitting posture during your work hours 156 30.8 Satisfied or very satisfied with your work-life balance at PHCC 254 50.1 Good or excellent lighting conditions in the workspace 401 79.1 Satisfied or very satisfied with your overall well-being while working at PHCC 313 62 iii) Multiple logistic regression model to assess the risk of experiencing any discomfort or health issues related to work environment. To assess the net contribution of a set of explanatory/predictor variables towards predicting the risk of experiencing any discomfort / health issues related to work environment a multiple logistic regression model was used (table 3). The model was statistically significant with an overall predictive accuracy of 71.3%. Gender, availability of aids/equipment to minimize physical strain in performing tasks, feeling supported by colleagues and supervisors in terms of mental and emotional well-being at work, and being satisfied/very satisfied with your work-life balance at PHCC were the important and statistically significant predictors for work related discomfort (table 3). Being a male significantly reduced the risk of declaring a work-related discomfort by half (adjusted OR=0.56) compared to females after adjusting for the possible confounding effect of all the remaining explanatory variables included in the model (table 3). The availability of aids/equipment to minimize physical strain in performing tasks significantly decreased the risk of documenting work related health issues by 2.18 times after adjusting for other confounders. Feeling supported by colleagues and supervisors in terms of mental and emotional well-being at work significantly reduced the risk of reporting a work-related discomfort by half (adjusted OR=0.54) after adjusting for the remaining explanatory variables included in the model (table 3). In addition, being satisfied/very satisfied with your work-life balance at PHCC significantly reduced the risk of declaring a work-related discomfort by more than a half (adjusted OR=0.43) after adjusting for the remaining explanatory variables as shown in table 3. Table 3: Findings of the multiple logistic regression model Variables Adjusted OR 95% confidence interval OR P Male gender compared to female 0.56 (0.35 to 0.88) 0.012 Received training/guidance on proper ergonomic practices at PHCC 0.81 (0.49 to 1.34) 0.42[NS] Availability of aids/equipment provided to minimize physical strain in performing tasks 2.18 (1.28 to 3.73) 0.004 Having an adjustable chair and monitor stand that allows maintaining a comfortable eye level and posture while working at a computer 0.62 (0.36 to 1.05) 0.08[NS] Feeling supported by colleagues and supervisors in terms of mental and emotional well-being at work 0.54 (0.29 to 0.98) 0.043 Age group (Years) 0.5[NS] Being 30-39 years old compared to <30 years 2.13 (0.65 to 7) 0.22[NS] Being 40-49 years old compared to <30 years 2.41 (0.7 to 8.27) 0.16[NS] Being 50+ years old compared to <30 years 2.76 (0.73 to 10.46) 0.13[NS] Hours per day spent on average using a computer or other digital devices for work-related tasks 0.33[NS] Second (Average) tercile (6.1 - 7.0) compared to First (lowest) tercile (<= 6.0) 1.32 (0.82 to 2.13) 0.25[NS] Being Third (highest) tercile (7.1+) compared to First (lowest) tercile (<= 6.0) 0.88 (0.47 to 1.64) 0.69[NS] Satisfied/very satisfied with workstation setup and the arrangement of equipment for work related activities 0.64 (0.38 to 1.07) 0.09[NS] Often/very often performing physically demanding tasks as part of daily job 1.41 (0.9 to 2.19) 0.13[NS] Often/very often taking short breaks (2-5 minutes) to stretch or change sitting posture during your work hours 0.68 (0.43 to 1.09) 0.11[NS] Satisfied/very satisfied with your work-life balance at PHCC 0.43 (0.25 to 0.74) 0.002 '*' Moderate/high level of stress in the work environment 1.60 (0.92 to 2.78) 0.09[NS] Good/excellent lighting conditions in the workspace 0.67 (0.37 to 1.24) 0.21[NS] Very loud/too loud noise levels in the workspace 0.56 (0.26 to 1.2) 0.13[NS] Satisfied/very satisfied with your overall well-being while working at PHCC 0.75 (0.42 to 1.34) 0.33[NS] Constant 4.18 0.05[NS] Overall predictive accuracy = 71.3% P (Model) <0.001 iv) Qualitative feedback of primary healthcare staff pertaining to the work environment, satisfaction levels, wellbeing, and awareness about ergonomics Four important themes emerged from qualitative analysis of the responses given to the open-ended question in the survey pertaining to the overall satisfaction, work environment and awareness about the significance of application of ergonomics in healthcare settings. These include 1) desirable workspace, 2) long working hours, 3) increasing awareness relating to ergonomics principles at the workplace and 4) factors associated with staff satisfaction (table 4). 1) Desirable workspace The staff expressed their desire to be equipped with chairs that were ergonomically designed to support their spine and help maintain posture to prevent musculoskeletal disease (MSD) cases as documented in table 4. Participants emphasized the significance of having adequate room space which influenced their satisfaction with the work environment and overall wellbeing. For instance, a doctor commented: ‘Rooms for consultation should be fixed, every time room is changed (depending on Availability of the room) causes discomfort. in some room one can’t adjust the chair, examination couch etc. according to the need’. Moreover, the staff suggested that computer screens should be covered with protective screens to prevent eye strain and there should be thermostats within individual rooms to adjust temperature as the unregulated air conditioning made the work environment uncomfortable to work in. 2. Long working hours The HCWs emphasized that working continuously for long hours was a risk factor for physical strain and could negatively impact on the mental health of the staff. A nurse working in a primary health center narrated: ‘With overwhelming workloads and long shifts takes a toll on my mental health. There is no balance. I struggle to maintain work life balance.’ Suggestions were given to facilitate and relieve the staff during long shifts, particularly night duties (table 4). A pharmacist suggested: ‘It really drains me when I have night shifts due to long hours standing. I think there should be short breaks and rest areas provided in between night shifts.’ 3. Increasing awareness relating to ergonomics principles at the workplace There were various suggestions given by the HCWs regarding increasing awareness of ergonomics principles at workplace which included training of new staff recruited by PHCC regarding understanding the basic principles of ergonomics and its association with their general wellbeing, ongoing health education campaigns, regular scheduled visits and screening. These measures were reported to ensure the principles of ergonomics are applied and the required standards are implemented to ensure the overall well-being of the health care professionals working in PHCC (table 4). 4. Factors associated with staff satisfaction Lower satisfaction levels were reported by staff who had continuous evening shifts and regular outdoor visits (table 4). Similarly, a doctor who was working late evening shifts narrated: ‘I feel that there can be reduced satisfaction among PHCC staff mainly because of the late evenings shifts issue. It is extremely exhausting to work late hours.’ The HCWs recommended different suggestions to increase satisfaction levels which mainly included encouraging short breaks during continuous work, having a relaxing space (lounge) and creating a friendly workplace by encouraging a multicultural environment. For example, a clinical researcher emphasized: ‘Something that can create a health work environment leading to satisfaction with job I would say is that we need to look into establishing multicultural environment which will also ultimately help individual and team to have success stories in PHCC.’ Table 4 Findings of thematic analysis Theme Sub-themes Quotes Desirable workspace Preference for chairs ‘Choose a chair that supports your spine’. ‘Chairs arm support are not adjustable which interferes with the desk so as per height is incompatible.’ ‘Adjustable chair can minimize the back pain and good posture especially in triage’. ‘Kindly provide good chair for nurses. Some desktop tables are too high, and chair cannot adjust to that much height’. ‘Replace the leather covered chair with cushion seated chairs, provide an orientation class to customer service call center agents regarding the rules and regulations of transfer protocols in health centers.’ Room space ‘Overall, I feel the clinic rooms are small with less moving space around, feels congested.’ not having a window in the room, feels claustrophobic at times.’ ‘Rooms for consultation should be fixed, every time room is changed (depending on Availability of the room) causes discomfort. in some room one can’t adjust the chair, examination couch etc. according to the need’. ‘Our clinics have no windows we feel suffocated’. ‘The sitting area for staff should be carefully adjusted with working stations providing adequate space to move about with good lighting and ventilation.’ ‘I would recommend placing standalone workstations to balance the work in sitting and standing position’. ‘Poor crowd control and logistical management and constant opening and banging of doors causes regular headaches.’ ‘Poor crowd control and logistical management and constant opening and banging of doors causes regular headaches.’ Computer screens ‘Please add a screen cover to reduce the harmful rays emanating from the screen towards the eyes.’ ‘It is important that we are encouraged to move about and take breaks while working long hours on computers. I don’t see this happening in my office and colleagues sit too long staring at their computers.’ Temperature control ‘The very difficult control air condition most time so cold or make it off so hot why no control key in every room like any central cooling.’ ‘I struggle in summers as it gets too cold at times with central air conditioning, there should be thermostat within individual rooms, it will really be helpful.’ ‘There should be more natural light and the temperature of the air conditioning should be made normal and not freezing.’ Long working hours Mental health issues ‘With overwhelming workloads and long shifts takes a toll on my mental health. There is no balance. I struggle to maintain work life balance.’ ‘Working continuously for hours can without rest can seriously affect mental health of staff and policies should be revised considering the maximum a staff can work in one go.’ Proposed mitigation strategies ‘The night shifts can be difficult, if we can have a resting bed for the night shifts that would be lovely.’ ‘It really drains me when I have night shifts due to long hours standing. I think there should be short breaks and rest areas provided in between night shifts.’ ‘We should be given dedicated break for lunch or dinner as shifts are long.’ ‘I hope there will be an official stated break time that is sufficient for the employee to pray and have a breakfast.’ ‘I think it will be beneficial if we are given reminders about stretching and relaxing our muscles during long shifts.’ Increasing awareness relating to ergonomics principals at workplace Training new staff ‘I would strongly recommend that the ergonomics department should play a role in screening the newly joined staff to provide the necessary support needed if he or she has a pre-employment condition that needs ergonomics related support, like back problems etc. Every new staff should receive training and how to approach the ergometric department when they need them.’ Ongoing training of existing staff ‘It would be great if we have ergonomics session/ training at least monthly or quarterly. This will help the staff be aware about the importance of ergonomics and how to avoid MSDs. Also health education campaigns relating to this topic should also be conducted regularly.’ Regular visits and screening ‘Regular and scheduled occupational Health and safety briefing should be done for all staffs yearly. We need to find any high-risk staffs related to back or neck pain and give support by change in workplace arrangements.’ Factors associated with staff satisfaction Late hour shifts ‘I feel that there can be reduced satisfaction among PHCC staff mainly because of late evening and night shifts. It can be exhausting to work late hours.’ Recreational areas within workspace ‘We need break time during the working hours. Facilities like relaxing lounge and a common cafeteria can lead to overall job satisfaction among the staff.’ Significance of multicultural environment ‘Something that can create a health work environment leading to satisfaction with job I would say is that we need to look into establishing multicultural environment which will also ultimately help individual and team to have success stories in PHCC.’ Outdoor shifts ‘When we have an outdoor shift, which I know is only limited to home care team, it is stressful and more challenging due to travelling and making home visits. In the summers its always exhausting due to humidity and heat. Discussion Main findings of the study The main findings of the study highlight that a significant percentage of the PHCC staff reported that they were satisfied and received adequate training pertaining to the application of ergonomic principles within their respective work environments. However, the unmet need to provide supportive equipment while performing long duration tasks which strained the susceptible regions of the body (back, neck, shoulders, and hands/wrists) was emphasized as a concern by HCWs who participated in the survey. The multiple logistic regression model reported that the availability of aid or equipment to minimize physical strain in performing tasks significantly decreased the risk of documenting work related health issues by two times. The model also inferred that the feeling of being supported by colleagues regarding mental and emotional wellbeing at work significantly reduced risk of reporting work related discomfort. The qualitative analysis of the open-ended component of the survey highlighted themes which outlined attributes of desirable workspace from HCW’s factors affecting their satisfaction levels and suggestions to increase awareness pertaining to application of ergonomics principles within primary health care settings. The triangulation of the main findings of the study infers a triad relationship with HCWs satisfaction levels, application of ergonomic principles within primary health care settings and their general wellbeing as depicted in Fig. 1 . The satisfaction levels of the HCWs are closely associated with practical implementation of the fundamental principles of ergonomics within the primary healthcare settings as reported in the study which have a direct influence on the overall wellbeing of the staff. This relationship is substantiated with existing evidence which suggests designing the workspace within healthcare settings to optimize the efficiency of healthcare workforce with due consideration to the overall wellbeing and mitigating any ergonomically related health risks.[ 27 , 28 ] Comparison of the findings with existing evidence One of the main concerns that was highlighted by the healthcare workforce was the unmet need to provide the necessary equipment and facilities to support physical strain during long working hours shifts which involved maintenance and repetition of awkward movements. This finding is supported by a recent systematic review[ 7 ] pertaining to the prevalence of work related MSDs which highlighted that the main risk factors associated with these MSDs were maintenance and repetition of awkward postures. Moreover, studies[ 29 – 31 ] also report increased incidence of musculoskeletal diseases among healthcare staff who work for long hours without adequate ergonomic support in the workplace. Therefore, it is important to acknowledge the importance of supportive equipment and its accessibility to the healthcare workforce who are prone to injury and at risk of developing MSDs. Furthermore, it would be beneficial to evaluate such ergonomic tools and ensure the work environment is suited to reducing the exposure to MSDs. This exercise can also take into account the specificities of each profession in context to the associated risks.[ 32 ] The HCWs also associated the impact of working continuously for long hours without short breaks with lower job satisfaction and emphasized its negative impact on mental health and their overall wellbeing. Similarly, a study[ 33 ] utilizing data from a 18 year longitudinal study of working time, health and occupational turnover documented that healthcare professionals who had long working hours suffered from higher basal mass indexes, had higher levels of mental stress and were more likely to leave their occupation. Among the statistically significant findings of the multiple logistic regression model reported that male HCWs were less likely to declare work related discomfort. Literature suggests that the male HCWs are at a higher risk of developing MSDs[ 29 , 34 ]. The lack of reporting and raising their concerns pertaining to work related discomfort can be associated with gender stereotypes within healthcare which have been recognized in recent times [ 35 – 37 ]. This can put them at greater risk of developing WMSDs due to low reporting, feeling unsupported and less compliance to preventive strategies. The study substantiated the significance of ongoing support mechanisms (from colleagues and supervisors) to address work related stress which was associated with increased satisfaction levels and overall mental health and wellbeing of healthcare staff. The participants also suggested devising further strategies and interventions to further strengthen these support mechanisms. Evidence[ 10 , 32 , 38 – 41 ] suggests that devising innovative interventions and practicing ongoing mental health and wellbeing programs within healthcare settings creates a conducive work environment, increases efficiency and satisfaction with designated job roles and overall wellbeing of staff.[ 32 ] Limitations of the study The main limitation of the study is that the online survey mainly included structured questions and more in-depth information that could be retrieved by conducting qualitative interviews among the healthcare staff. However, the questionnaire included an open-ended section which provided an opportunity for participants to provide detailed feedback. This section was answered in detail by most of the participants which provided rich qualitative data which was analyzed by framework thematic analysis. Moreover, the survey was completed by 507 staff members from diverse backgrounds and job roles, which substantiates the generalizability of the findings of the study. Furthermore, if only a qualitative approach was adopted to address the study question the epistemological view of the main interviewer might have influenced the responses from participants. [ 42 ] Conclusions The study further substantiates the existing evidence in this area of research and emphasizes the need to devise innovative strategies and interventions to ensure that ergonomic principles within healthcare are updated in context to the specific healthcare systems, regularly monitored and effectively implemented to safeguard the overall health and wellbeing of healthcare workforce. Devising innovative interventions in context to ergonomic principles by including the necessary equipment to prevent MSDs among healthcare workforce and practicing ongoing mental health and wellbeing programs within healthcare settings can create a conducive work environment, increase overall efficiency, and job satisfaction. Declarations Ethics approval and consent to participate: Ethical approval was received by Primary Health Care Corporation Institutional Review Board and the consent to participate was included in the beginning section of the online survey. Consent for publication: NOT APPLICABLE Funding: The publication fees (APC) were covered by Primary Healthcare Corporation Author Contribution 1. Dr Muslim Abbas Syed (Contributions: Conception of idea, drafting of protocol, literature review, data analysis and interpretation, drafting of manuscript)2. Dr Ahmed Sameer Alnuaimi (Contributions: data analysis and interpretation, drafting of manuscript, review of manuscript)3. Dr Mohamed Ahmed Syed (Contributions: Conception of idea, literature review, data analysis and interpretation, drafting of manuscript, review of manuscript)4. Dr. Shajitha Thekke Veettil (Contributions: Co-drafting of protocol, data collection, review of manuscript)5. Dr. Hafiz Ahmed Mohamed (Contributions: Literature review, data analysis and interpretation, review of manuscript)6. Dr. Abduljaleel Abdullatif Zainel (Conception of idea, literature review, data analysis and interpretation, co-drafting of manuscript) Acknowledgement Primary Health Care Corporation covered the publication fees (APC) for this study. Data Availability The datasets used and/or analyzed during this study are available from the corresponding author on reasonable request. References Salvendy, G., Handbook of human factors and ergonomics . 2012: John Wiley & Sons. Wilson, J.R., Fundamentals of ergonomics in theory and practice . Applied ergonomics, 2000. 31(6): p. 557–567. Galinsky, T., T. Waters, and B. Malit, Overexertion injuries in home health care workers and the need for ergonomics . Home health care services quarterly, 2001. 20(3): p. 57–73. Hedge, A., T. James, and S. Pavlovic-Veselinovic, Ergonomics concerns and the impact of healthcare information technology . International Journal of Industrial Ergonomics, 2011. 41(4): p. 345–351. 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Abed Al Jawad, An Investigation of the Knowledge, Attitudes, and Practices of Physicians Regarding Child Oral Health at Primary Health Centers in Qatar: A Cross-Sectional Study . European journal of dentistry, 2022. 17(01): p. 107–114. Al Kuwari, M.G., et al., The impact of COVID-19 on primary health care services in Qatar: 2 years of response and coping 2020–2021 . Journal of Family Medicine and Primary Care, 2022. 11(12): p. 7743. Syed, M.A., S. Razaq, and A.S. Alnuaimi, Epidemiological Investigation of Disease Patterns, Accessibility, and Patient Characteristics Following the Introduction of Dermatology Specialty Clinics Within Primary Care Settings in Qatar . Cureus, 2024. 16(11): p. e72964. Holloway, I., Qualitative research in health care . 2005: McGraw-Hill Education (UK). Seale, C., et al., Qualitative research practice . 2004: Sage. Gale, N.K., et al., Using the framework method for the analysis of qualitative data in multi-disciplinary health research . BMC medical research methodology, 2013. 13(1): p. 1–8. Adiga, U., Enhancing occupational health and ergonomics for optimal workplace well-being: a review . International Journal of Chemical and Biochemical Sciences, 2023. 24(4): p. 157–164. Hedge, A., Ergonomic workplace design for health, wellness, and productivity . 2016: CRC Press. Yasobant, S. and P. Rajkumar, Work-related musculoskeletal disorders among health care professionals: A cross-sectional assessment of risk factors in a tertiary hospital, India . Indian journal of occupational and environmental medicine, 2014. 18(2): p. 75. Yizengaw, M.A., et al., Prevalence and factors associated with work-related musculoskeletal disorder among health care providers working in the operation room . Annals of Medicine and Surgery, 2021. 72: p. 102989. Das, S.K., V.S. Patyal, and S. Ambekar, Modeling of risk factors leading to workrelated musculoskeletal disorders in medical practitioners . Safety Science, 2024. 172: p. 106427. Abdul Halim, N.S.S., Z. Mohd Ripin, and M.I.Z. Ridzwan, Efficacy of Interventions in Reducing the Risks of Work-Related Musculoskeletal Disorders Among Healthcare Workers: A Systematic Review and Meta-Analysis . Workplace health & safety, 2023. 71(12): p. 557–576. Kramer, A. and J. Son, Who cares about the health of health care professionals? An 18-year longitudinal study of working time, health, and occupational turnover . Ilr Review, 2016. 69(4): p. 939–960. Shankar, C. and R. Venkatesan, Work-related musculoskeletal disorders among male health-care professionals in a private health care organization, India: Prevalence and associated risk factors . Indian Journal of Physical Therapy and Research, 2021. 3(1): p. 3–7. Finnegan, M.W., Male nurses' experience of gender stereotyping over the past five decades: A narrative approach . 2019, Molloy College. Martínez-Morato, S., et al., Emotion management and stereotypes about emotions among male nurses: a qualitative study . BMC nursing, 2021. 20(1): p. 114. Habib, R.R., et al., Sex and gender in research on healthcare workers in conflict settings: a scoping review . International journal of environmental research and public health, 2020. 17(12): p. 4331. Myrick, K. and P. Del Vecchio, Peer support services in the behavioral healthcare workforce: State of the field . Psychiatric rehabilitation journal, 2016. 39(3): p. 197. Kinnafick, F.E., A. Papathomas, and D. Regoczi, Promoting exercise behaviour in a secure mental health setting: Healthcare assistant perspectives . International journal of mental health nursing, 2018. 27(6): p. 1776–1783. Johnson, J., et al., Mental healthcare staff well-being and burnout: A narrative review of trends, causes, implications, and recommendations for future interventions . International journal of mental health nursing, 2018. 27(1): p. 20–32. Panagioti, M., et al., Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis . JAMA internal medicine, 2017. 177(2): p. 195–205. Braun, V. and V. Clarke, Successful qualitative research: A practical guide for beginners . 2013: sage. 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-6721426","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":475742904,"identity":"edad2df5-81b6-4f7d-8374-5231873f9cb3","order_by":0,"name":"Muslim Abbas Syed","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0ElEQVRIiWNgGAWjYNACNhsGA1K1pJGu5TAJWnRnpD+T+FB2Ps+c/fADxi8Vhxn4jh/Ar8XsRo6Z5Ixzt4ste9IMmGXOHGaQPJNAUAubNG/b7cQNN3gYmCXbgJ46QFBL+jPpv23nkLScf0BIS4KZNGPbAbAWxo9twNC+QciWM2+MLXvOJRcbnEkzOMxwxoZH8gYhW46nP7zxo8wuz+D44YcPf1RIyPGdJ2ALELBIAAmwssM8DAw8DAcI6mBg/gDTwvgDRBKhZRSMglEwCkYWAACBRkjTWO/iqgAAAABJRU5ErkJggg==","orcid":"","institution":"Primary Health Care Corporation","correspondingAuthor":true,"prefix":"","firstName":"Muslim","middleName":"Abbas","lastName":"Syed","suffix":""},{"id":475742905,"identity":"2b38c80b-f7ed-483f-8c8d-ec8525683c40","order_by":1,"name":"Ahmed Sameer Alnuaimi","email":"","orcid":"","institution":"Primary Health Care Corporation","correspondingAuthor":false,"prefix":"","firstName":"Ahmed","middleName":"Sameer","lastName":"Alnuaimi","suffix":""},{"id":475742906,"identity":"6e268a03-663d-4942-8776-7916d6535802","order_by":2,"name":"Mohamed Ahmed Syed","email":"","orcid":"","institution":"Primary Health Care Corporation","correspondingAuthor":false,"prefix":"","firstName":"Mohamed","middleName":"Ahmed","lastName":"Syed","suffix":""},{"id":475742907,"identity":"0cccb1ad-e076-4c3a-9dbe-be9337f31a13","order_by":3,"name":"Shajitha Thekke Veettil","email":"","orcid":"","institution":"Primary Health Care Corporation","correspondingAuthor":false,"prefix":"","firstName":"Shajitha","middleName":"Thekke","lastName":"Veettil","suffix":""},{"id":475742908,"identity":"59e58433-4f80-4c39-ae8c-31314a0eab73","order_by":4,"name":"Ahmed Mohamed","email":"","orcid":"","institution":"Primary Health Care Corporation","correspondingAuthor":false,"prefix":"","firstName":"Ahmed","middleName":"","lastName":"Mohamed","suffix":""},{"id":475742909,"identity":"92375d0d-69dd-4364-8991-131ed6da6b90","order_by":5,"name":"Abduljaleel Abdullatif Zainel","email":"","orcid":"","institution":"Primary Health Care Corporation","correspondingAuthor":false,"prefix":"","firstName":"Abduljaleel","middleName":"Abdullatif","lastName":"Zainel","suffix":""}],"badges":[],"createdAt":"2025-05-22 05:38:31","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6721426/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6721426/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85735314,"identity":"55176159-fde8-4023-8b0d-87406ce4ffce","added_by":"auto","created_at":"2025-07-01 07:57:56","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":178182,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThe triad relationship of HCWs satisfaction, general wellbeing and application of ergonomics principles in primary care settings\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6721426/v1/62df605b8b48da376722694d.jpeg"},{"id":91619469,"identity":"6c31f0c7-cbfc-4138-89c4-81bc3a11cf8d","added_by":"auto","created_at":"2025-09-18 11:09:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1976561,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6721426/v1/c15cf512-d343-4544-9e3c-9f8f6a274f08.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Healthcare workforce satisfaction and perceptions pertaining to application of ergonomics in primary health care settings in Qatar","fulltext":[{"header":"Introduction","content":"\u003cp\u003eErgonomics is a well-documented concept which relates to the processes involved in designing and arranging workplaces, products, and systems to ensure the overall wellbeing of the workforce[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The concept is mostly applied and practiced considering its fundamental principle which is to \u0026lsquo;fit the job to the person\u0026rsquo;[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Globally, the healthcare workforce operates in diverse healthcare settings, putting in strenuous efforts in management of patients and carrying out administrative duties. They often risk their own wellbeing by working in environments which are often not best suited for them[\u003cspan additionalcitationids=\"CR4 CR5 CR6\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Evidence suggests that health care professionals across the globe are more prone to work related musculoskeletal disorders (WMSDs)[\u003cspan additionalcitationids=\"CR8 CR9\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The first line health workforce such as physicians and surgeons are more susceptible to WMSDs followed by nurses and allied healthcare professionals such as physiotherapists[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. A recent systematic review[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] investigating the prevalence of body area WMSDs among healthcare professionals documented that neck, lower back, shoulder, and wrists/hands were the region\u0026rsquo;s most prone to disease. Moreover, the study reported that surgeons and dentists had the highest prevalence of MSDs in lower back, shoulder, and upper extremity. The risk factors associated with these MSDs were maintenance and repetition of awkward postures. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eHence, it is important to ensure that the workforce involved in delivering, managing and accessing healthcare services are provided with optimal working conditions which are best suited for them. Evidence suggests that applying such ergonomic measures not only contribute towards the general wellbeing of the healthcare workforce but can also increase their efficiency which leads to improved patient care and the overall quality of the health services provided within a healthcare system[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Various studies have been conducted internationally to signify the importance of building consistent real work descriptions (within the broader domains of ergonomics) within healthcare particularly primary care settings[\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The published literature emphasizes the need to improve work situations which would lead to increased efficiency and quality of services both from a healthcare professional and patient\u0026rsquo;s perspective[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Moreover, studies have also been conducted in the eastern Mediterranean region within primary health care settings highlighting the occupational health challenges, the need to further develop such health services and associated health risks such as musculoskeletal disorders.[\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThe various domains mentioned in recent literature that need to be considered while investigating ergonomics and its application within healthcare settings mainly include duration of working hours in context to postures (musculoskeletal) while performing tasks, lighting conditions, noise levels, overall ventilation mechanisms within workplace, overall satisfaction levels with assigned tasks and factors associated with work related stress and overall psychological wellbeing of the health workforce. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThe state of Qatar has invested substantially in its healthcare system. The primary care is provided by well-structured and organized body, the Primary Health Care Cooperation (PHCC) which is independent government institute running 31 different primary health care centers in the country[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. There are a wide range of health professionals (doctors, nurses, allied healthcare professionals etc.) working within PHCC who have the responsibility of delivering highest levels of health services which are efficient, timely and patient centered[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The study aimed to investigate the perceptions of diverse healthcare workforce (HCW) pertaining to their work environment to highlight the existing practices \u0026amp; their general wellbeing within the context pertaining to application of ergonomics in health care settings. The key objectives of the study included identification of any existing gaps, challenges and HCWs satisfaction in a highly demanding and state of the art primary care settings.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy settings:\u003c/h2\u003e \u003cp\u003e\u0026lsquo;Qatar, a peninsular Arab country (with having world\u0026rsquo;s third-largest natural gas and oil reserves) has recently emerged as a leading primary healthcare provider country that aims to provide comprehensive primary care with due consideration of the fundamental principles outlined within the concept by the World Health Organization. This was mainly achieved by the development of a universal publicly funded primary healthcare service delivered by the PHCC. PHCC is one of the main and most significant primary care providers in the country publicly with 32 health centers. Importantly all the primary health centers are accredited by Accreditation Canada International and distributed across three geographical regions.\u0026rsquo;[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy design, sampling, and study participants\u003c/h3\u003e\n\u003cp\u003eThe study utilized cross sectional study design in which an online questionnaire was distributed through official email to PHCC staff utilizing Microsoft Forms. Healthcare workforce with registered and active official email accounts who are working in PHCC (including doctors, nurses, pharmacists, non-clinical staff, administrative etc.) were invited to participate in the online survey from 10 December 2023 to 21 December 2023. The participants were recruited by purposive convenience sampling. The healthcare staff received a reminder one week after the first invitation to participate in the online survey (which was sent to their official email address).\u003c/p\u003e\n\u003ch3\u003eStudy tool\u003c/h3\u003e\n\u003cp\u003eThe online questionnaire comprised of various components which mainly included structured questions with an open-ended question in the end. The domains and items in the survey encompassed general principles of ergonomics within healthcare settings, overall satisfaction levels, wellbeing and perceptions pertaining to the work environment. These mainly included working hours, postures (musculoskeletal) while performing tasks, lighting conditions, noise levels, overall ventilation mechanisms within workplace, overall satisfaction levels with assigned tasks and factors associated with work related stress and overall psychological wellbeing of the health workforce. The main domains and items included in the questionnaire are derived from previous published studies [\u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Moreover, the questionnaire was pilot tested among the staff of clinical research department for clarity and feasibility of the content (items and domains included in the study tool).\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eThe quantitative data was analyzed in Microsoft Excel. Descriptive variables were presented as frequency and percentage. A multiple logistic regression was applied to assess the net contribution of a set of explanatory/predictor variables towards predicting the risk of experiencing any discomfort / health issues related to work environment. The responses to the open ended question were analysed using framework thematic analysis.[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] This approach encompasses \u0026lsquo;interpreting, exploring, and reporting patterns and clusters of meaning within the given data\u0026rsquo;[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] and was facilitated by reading and re-reading the text of responses to open ended question for a full familiarisation. This was followed by application of open codes to 50 responses of different participants to identify emerging themes of relevance by two authors (MS \u0026amp; ST)[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. This was followed by agreement by the researchers (MS \u0026amp; ST) on a set of codes which could be used with the rest of the responses. During this stage categories were constructed and defined by grouping of codes. This led to the development of a working coding framework which was utilized with the rest of the data and amended as necessary.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical considerations\u003c/h3\u003e\n\u003cp\u003eThe study was approved by the primary health care corporation institutional review board (Reference BUHOOTH-D-23-00077). The responses from the staff members were kept anonymous to maintain confidentiality of the healthcare staff. Only Variables such as gender, designation and years of service were mentioned in the demographic details of the participants.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003ePatient and Public Involvement\u003c/h2\u003e \u003cp\u003eThere was no Patient and Public Involvement while formulating the study tools and designing the research methodology.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003ei) \u003cu\u003eDemographic details of the participants\u0026nbsp;\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe online questionnaire was distributed (sent to their official work email address) among 800 HCW of Primary Health Care Corporation and 507 responded with a response rate of 63%. In the study a significant percentage (65%, n=329) of participants were females (table 1). 71% of the participants were between 30 to 49 years of age. Half of the PHCC staff (n=258) that participated in the survey were doctors followed by dentists, nurses and other allied healthcare professionals, researchers and administrative staff as depicted in table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eTable 1 Demographic profile of HCWs\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51.6854%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.7079%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of participants (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6067%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51.6854%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.7079%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003cp\u003e329\u003c/p\u003e\n \u003cp\u003e507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6067%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e35.1\u003c/p\u003e\n \u003cp\u003e64.9\u003c/p\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51.6854%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge groups\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026lt;30 years of age\u003c/p\u003e\n \u003cp\u003e30-39 years of age\u003c/p\u003e\n \u003cp\u003e40-49 years of age\u003c/p\u003e\n \u003cp\u003e50 years of age and above\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003etotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.7079%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e239\u003c/p\u003e\n \u003cp\u003e172\u003c/p\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003cp\u003e507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6067%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003cp\u003e47.1\u003c/p\u003e\n \u003cp\u003e33.9\u003c/p\u003e\n \u003cp\u003e15.6\u003c/p\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51.6854%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDesignation of participants (within PHCC)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eDoctor\u003c/p\u003e\n \u003cp\u003eDentist\u003c/p\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003cp\u003ePhysiotherapist\u003c/p\u003e\n \u003cp\u003eDietician\u003c/p\u003e\n \u003cp\u003eHealth educator\u003c/p\u003e\n \u003cp\u003eQuality and accreditation officer\u003c/p\u003e\n \u003cp\u003eClinical researcher\u003c/p\u003e\n \u003cp\u003eClinical coding specialist\u003c/p\u003e\n \u003cp\u003eAdministrative staff\u003c/p\u003e\n \u003cp\u003eLaboratory technologist\u003c/p\u003e\n \u003cp\u003ePharmacist\u003c/p\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.7079%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e258\u003c/p\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003cp\u003e09\u003c/p\u003e\n \u003cp\u003e03\u003c/p\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003cp\u003e03\u003c/p\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6067%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e50.9\u003c/p\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003cp\u003e12.8\u003c/p\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003cp\u003e3.5\u003c/p\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003cp\u003e4.5\u003c/p\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003cp\u003e6.1\u003c/p\u003e\n \u003cp\u003e2.6\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 51.6854%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYears of employment within PHCC\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e6 months to 1 year\u003c/p\u003e\n \u003cp\u003eBetween 1 to 2 years\u003c/p\u003e\n \u003cp\u003eBetween 2 to 3 years\u003c/p\u003e\n \u003cp\u003eBetween 3 to 4 years\u003c/p\u003e\n \u003cp\u003eBetween 4 to 5 years\u003c/p\u003e\n \u003cp\u003eMore than 5 years\u003c/p\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33.7079%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003cp\u003e162\u003c/p\u003e\n \u003cp\u003e507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.6067%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e15.4\u003c/p\u003e\n \u003cp\u003e9.4\u003c/p\u003e\n \u003cp\u003e15.2\u003c/p\u003e\n \u003cp\u003e16.8\u003c/p\u003e\n \u003cp\u003e11.2\u003c/p\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cu\u003e\u0026nbsp;\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eii) \u003cu\u003eStaff satisfaction and application of ergonomics within healthcare settings\u0026nbsp;\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA significant percentage (71%, n=360) of the PHCC staff that participated in the survey reported that they had received adequate training pertaining to ergonomic practices within their respective work settings as shown in table 2. A significant percentage of participants responded positively to the application of ergonomic principles which included workstations designed to meet ergonomic standards, being supported by colleagues and line managers regarding mental health and emotional wellbeing and having good lighting conditions at workspace (table 2). However, 22% (n=109) of staff members reported that they were not provided with equipment to minimize physical strain while performing tasks. Half of the staff (50%, n=254) documented that they were either satisfied or very satisfied with the work-life balance at PHCC as depicted in table 2.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 Staff satisfaction and responses relating to practical application of ergonomics in primary healthcare settings.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"609\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 448px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency of items indicating staff satisfaction and application of ergonomic principles in work environment (N=507)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 448px;\"\u003e\n \u003cp\u003eReceived training/guidance on proper ergonomic practices at PHCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e360\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e71.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 448px;\"\u003e\n \u003cp\u003eAids/equipment provided to minimize physical strain in performing tasks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e21.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 448px;\"\u003e\n \u003cp\u003eHaving an adjustable chair and monitor stand that allows maintaining a comfortable eye level and posture while working at a computer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e380\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e75.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 448px;\"\u003e\n \u003cp\u003eFeeling supported by colleagues and supervisors in terms of mental and emotional well-being at work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e382\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e75.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 448px;\"\u003e\n \u003cp\u003eSatisfied or very satisfied with workstation setup and the arrangement of equipment for work related activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e62.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 448px;\"\u003e\n \u003cp\u003eOften or very often taking short breaks (2-5 minutes) to stretch or change sitting posture during your work hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e30.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 448px;\"\u003e\n \u003cp\u003eSatisfied or very satisfied with your work-life balance at PHCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e50.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 448px;\"\u003e\n \u003cp\u003eGood or excellent lighting conditions in the workspace\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e401\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e79.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 448px;\"\u003e\n \u003cp\u003eSatisfied or very satisfied with your overall well-being while working at PHCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e313\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 80px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eiii) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u003cu\u003eMultiple logistic regression model to assess the risk of experiencing any discomfort or health issues related to work environment.\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo assess the net contribution of a set of explanatory/predictor variables towards predicting the risk of experiencing any discomfort / health issues related to work environment a multiple logistic regression model was used (table 3). The model was statistically significant with an overall predictive accuracy of 71.3%. Gender, availability of aids/equipment to minimize physical strain in performing tasks, feeling supported by colleagues and supervisors in terms of mental and emotional well-being at work, and being satisfied/very satisfied with your work-life balance at PHCC were the important and statistically significant predictors for work related discomfort (table 3). Being a male significantly reduced the risk of declaring a work-related discomfort by half (adjusted OR=0.56) compared to females after adjusting for the possible confounding effect of all the remaining explanatory variables included in the model (table 3). The availability of aids/equipment to minimize physical strain in performing tasks significantly decreased the risk of documenting work related health issues by 2.18 times after adjusting for other confounders. Feeling supported by colleagues and supervisors in terms of mental and emotional well-being at work significantly reduced the risk of reporting a work-related discomfort by half (adjusted OR=0.54) after adjusting for the remaining explanatory variables included in the model (table 3). In addition, being satisfied/very satisfied with your work-life balance at PHCC significantly reduced the risk of declaring a work-related discomfort by more than a half (adjusted OR=0.43) after adjusting for the remaining explanatory variables as shown in table 3.\u003c/p\u003e\n\u003cp\u003eTable 3: Findings of the multiple logistic regression model\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"616\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted OR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% confidence interval OR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eMale gender compared to female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.35 to 0.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eReceived training/guidance on proper ergonomic practices at PHCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.49 to 1.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.42[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eAvailability of aids/equipment provided to minimize physical strain in performing tasks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(1.28 to 3.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eHaving an adjustable chair and monitor stand that allows maintaining a comfortable eye level and posture while working at a computer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.36 to 1.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.08[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eFeeling supported by colleagues and supervisors in terms of mental and emotional well-being at work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.29 to 0.98)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.043\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u003cu\u003eAge group (Years)\u003c/u\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.5[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eBeing 30-39 years old compared to \u0026lt;30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.65 to 7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.22[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eBeing 40-49 years old compared to \u0026lt;30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.7 to 8.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.16[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eBeing 50+ years old compared to \u0026lt;30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.73 to 10.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.13[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u003cu\u003eHours per day spent on average using a computer or other digital devices for work-related tasks\u003c/u\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.33[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eSecond (Average) tercile (6.1 - 7.0) compared to First (lowest) tercile (\u0026lt;= 6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.82 to 2.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.25[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eBeing Third (highest) tercile (7.1+) compared to First (lowest) tercile (\u0026lt;= 6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.47 to 1.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.69[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eSatisfied/very satisfied with workstation setup and the arrangement of equipment for work related activities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.38 to 1.07)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.09[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eOften/very often performing physically demanding tasks as part of daily job\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.9 to 2.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.13[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eOften/very often taking short breaks (2-5 minutes) to stretch or change sitting posture during your work hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.43 to 1.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.11[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eSatisfied/very satisfied with your work-life balance at PHCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.25 to 0.74)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.002\u003cem\u003e\u0026apos;*\u0026apos;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eModerate/high level of stress in the work environment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.92 to 2.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.09[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eGood/excellent lighting conditions in the workspace\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.37 to 1.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.21[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eVery loud/too loud noise levels in the workspace\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.26 to 1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.13[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eSatisfied/very satisfied with your overall well-being while working at PHCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\n \u003cp\u003e(0.42 to 1.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.33[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 346px;\"\u003e\n \u003cp\u003eConstant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e4.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 118px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.05[NS]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eOverall predictive accuracy = 71.3%\u003c/p\u003e\n\u003cp\u003eP (Model) \u0026lt;0.001\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eiv) \u003cu\u003eQualitative feedback of primary healthcare staff pertaining to the work environment, satisfaction levels, wellbeing, and awareness about ergonomics\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFour important themes emerged from qualitative analysis of the responses given to the open-ended question in the survey pertaining to the overall satisfaction, work environment and awareness about the significance of application of ergonomics in healthcare settings. These include 1) desirable workspace, 2) long working hours, 3) increasing awareness relating to ergonomics principles at the workplace and 4) factors associated with staff satisfaction (table 4).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1) \u0026nbsp; Desirable workspace\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe staff expressed their desire to be equipped with chairs that were ergonomically designed to support their spine and help maintain posture to prevent musculoskeletal disease (MSD) cases as documented in table 4. Participants emphasized the significance of having adequate room space which influenced their satisfaction with the work environment and overall wellbeing. For instance, a doctor commented:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026lsquo;Rooms for consultation should be fixed, every time room is changed (depending on Availability of the room) causes discomfort. in some room one can\u0026rsquo;t adjust the chair, examination couch etc. according to the need\u0026rsquo;.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMoreover, the staff suggested that computer screens should be covered with protective screens to prevent eye strain and there should be thermostats within individual rooms to adjust temperature as the unregulated air conditioning made the work environment uncomfortable to work in.\u003c/p\u003e\n\u003cp\u003e2. \u0026nbsp; Long working hours\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe HCWs emphasized that working continuously for long hours was a risk factor for physical strain and could negatively impact on the mental health of the staff. A nurse working in a primary health center narrated:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026lsquo;With overwhelming workloads and long shifts takes a toll on my mental health. There is no balance. I struggle to maintain work life balance.\u0026rsquo;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSuggestions were given to facilitate and relieve the staff during long shifts, particularly night duties (table 4). A pharmacist suggested:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026lsquo;It really drains me when I have night shifts due to long hours standing. I think there should be short breaks and rest areas provided in between night shifts.\u0026rsquo;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e3. \u0026nbsp; Increasing awareness relating to ergonomics principles at the workplace\u003c/p\u003e\n\u003cp\u003eThere were various suggestions given by the HCWs regarding increasing awareness of ergonomics principles at workplace which included training of new staff recruited by PHCC regarding understanding the basic principles of ergonomics and its association with their general wellbeing, ongoing health education campaigns, regular scheduled visits and screening. These measures were reported to ensure the principles of ergonomics are applied and the required standards are implemented to ensure the overall well-being of the health care professionals working in PHCC (table 4).\u003c/p\u003e\n\u003cp\u003e4. \u0026nbsp; Factors associated with staff satisfaction\u003c/p\u003e\n\u003cp\u003eLower satisfaction levels were reported by staff who had continuous evening shifts and regular outdoor visits (table 4). Similarly, a doctor who was working late evening shifts narrated:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026lsquo;I feel that there can be reduced satisfaction among PHCC staff mainly because of the late evenings shifts issue. It is extremely exhausting to work late hours.\u0026rsquo;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe HCWs recommended different suggestions to increase satisfaction levels which mainly included encouraging short breaks during continuous work, having a relaxing space (lounge) and creating a friendly workplace by encouraging a multicultural environment. For example, a clinical researcher emphasized:\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026lsquo;Something that can create a health work environment leading to satisfaction with job I would say is that we need to look into establishing multicultural environment which will also ultimately help individual and team to have success stories in PHCC.\u0026rsquo;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eTable 4 Findings of thematic analysis\u0026nbsp;\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"756\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTheme\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSub-themes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuotes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDesirable workspace\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreference for chairs\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;Choose a chair that supports your spine\u0026rsquo;.\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;Chairs arm support are not adjustable which interferes with the desk so as per height is incompatible.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;Adjustable chair can minimize the back pain and good posture especially in triage\u0026rsquo;.\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;Kindly provide good chair for nurses. Some desktop tables are too high, and chair cannot adjust to that much height\u0026rsquo;.\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;Replace the leather covered chair with cushion seated chairs, provide an orientation class to customer service call center agents regarding the rules and regulations of transfer protocols in health centers.\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRoom space\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;Overall, I feel the clinic rooms are small with less moving space around, feels congested.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003enot having a window in the room, feels claustrophobic at times.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;Rooms for consultation should be fixed, every time room is changed (depending on Availability of the room) causes discomfort. in some room one can\u0026rsquo;t adjust the chair, examination couch etc. according to the need\u0026rsquo;.\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;Our clinics have no windows we feel suffocated\u0026rsquo;.\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;The sitting area for staff should be carefully adjusted with working stations providing adequate space to move about with good lighting and ventilation.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;I would recommend placing standalone workstations to balance the work in sitting and standing position\u0026rsquo;.\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;Poor crowd control and logistical management and constant opening and banging of doors causes regular headaches.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;Poor crowd control and logistical management and constant opening and banging of doors causes regular headaches.\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eComputer screens\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;Please add a screen cover to reduce the harmful rays emanating from the screen towards the eyes.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;It is important that we are encouraged to move about and take breaks while working long hours on computers. I don\u0026rsquo;t see this happening in my office and colleagues sit too long staring at their computers.\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTemperature control\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;The very difficult control air condition\u0026nbsp;\u003c/p\u003e\n \u003cp\u003emost time so cold or make it off so hot why no control key in every room like any central cooling.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;I struggle in summers as it gets too cold at times with central air conditioning, there should be thermostat within individual rooms, it will really be helpful.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;There should be more natural light and the temperature of the air conditioning should be made normal and not freezing.\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLong working hours\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMental health issues\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;With overwhelming workloads and long shifts takes a toll on my mental health. There is no balance. I struggle to maintain work life balance.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;Working continuously for hours can without rest can seriously affect mental health of staff and policies should be revised considering the maximum a staff can work in one go.\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProposed mitigation strategies\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;The night shifts can be difficult, if we can have a resting bed for the night shifts that would be lovely.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;It really drains me when I have night shifts due to long hours standing. I think there should be short breaks and rest areas provided in between night shifts.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;We should be given dedicated break for lunch or dinner as shifts are long.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;I hope there will be an official stated break time that is sufficient for the employee to pray and have a breakfast.\u0026rsquo;\u003c/p\u003e\n \u003cp\u003e\u0026lsquo;I think it will be beneficial if we are given reminders about stretching and relaxing our muscles during long shifts.\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncreasing awareness relating to ergonomics principals at workplace\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTraining new staff\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;I would strongly recommend that the ergonomics department should play a role in screening the newly joined staff to provide the necessary support needed if he or she has a pre-employment condition that needs ergonomics related support, like back problems etc. Every new staff should receive training and how to approach the ergometric department when they need them.\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOngoing training of existing staff\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;It would be great if we have ergonomics session/ training at least monthly or quarterly. This will help the staff be aware about the importance of ergonomics and how to avoid MSDs. Also health education campaigns relating to this topic should also be conducted regularly.\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRegular visits and screening\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;Regular and scheduled occupational Health and safety briefing should be done for all staffs yearly. We need to find any high-risk staffs related to back or neck pain and give support by change in workplace arrangements.\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFactors associated with staff satisfaction\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLate hour shifts\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;I feel that there can be reduced satisfaction among PHCC staff mainly because of late evening and night shifts. It can be exhausting to work late hours.\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRecreational areas within workspace\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;We need break time during the working hours. Facilities like relaxing lounge and a common cafeteria can lead to overall job satisfaction among the staff.\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSignificance of multicultural environment\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;Something that can create a health work environment leading to satisfaction with job I would say is that we need to look into establishing multicultural environment which will also ultimately help individual and team to have success stories in PHCC.\u0026rsquo;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 161px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutdoor shifts\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 435px;\"\u003e\n \u003cp\u003e\u0026lsquo;When we have an outdoor shift, which I know is only limited to home care team, it is stressful and more challenging due to travelling and making home visits. In the summers its always exhausting due to humidity and heat.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eMain findings of the study\u003c/h2\u003e \u003cp\u003eThe main findings of the study highlight that a significant percentage of the PHCC staff reported that they were satisfied and received adequate training pertaining to the application of ergonomic principles within their respective work environments. However, the unmet need to provide supportive equipment while performing long duration tasks which strained the susceptible regions of the body (back, neck, shoulders, and hands/wrists) was emphasized as a concern by HCWs who participated in the survey. The multiple logistic regression model reported that the availability of aid or equipment to minimize physical strain in performing tasks significantly decreased the risk of documenting work related health issues by two times. The model also inferred that the feeling of being supported by colleagues regarding mental and emotional wellbeing at work significantly reduced risk of reporting work related discomfort. The qualitative analysis of the open-ended component of the survey highlighted themes which outlined attributes of desirable workspace from HCW\u0026rsquo;s factors affecting their satisfaction levels and suggestions to increase awareness pertaining to application of ergonomics principles within primary health care settings.\u003c/p\u003e \u003cp\u003eThe triangulation of the main findings of the study infers a triad relationship with HCWs satisfaction levels, application of ergonomic principles within primary health care settings and their general wellbeing as depicted in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The satisfaction levels of the HCWs are closely associated with practical implementation of the fundamental principles of ergonomics within the primary healthcare settings as reported in the study which have a direct influence on the overall wellbeing of the staff. This relationship is substantiated with existing evidence which suggests designing the workspace within healthcare settings to optimize the efficiency of healthcare workforce with due consideration to the overall wellbeing and mitigating any ergonomically related health risks.[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eComparison of the findings with existing evidence\u003c/h2\u003e \u003cp\u003eOne of the main concerns that was highlighted by the healthcare workforce was the unmet need to provide the necessary equipment and facilities to support physical strain during long working hours shifts which involved maintenance and repetition of awkward movements. This finding is supported by a recent systematic review[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] pertaining to the prevalence of work related MSDs which highlighted that the main risk factors associated with these MSDs were maintenance and repetition of awkward postures. Moreover, studies[\u003cspan additionalcitationids=\"CR30\" citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] also report increased incidence of musculoskeletal diseases among healthcare staff who work for long hours without adequate ergonomic support in the workplace. Therefore, it is important to acknowledge the importance of supportive equipment and its accessibility to the healthcare workforce who are prone to injury and at risk of developing MSDs. Furthermore, it would be beneficial to evaluate such ergonomic tools and ensure the work environment is suited to reducing the exposure to MSDs. This exercise can also take into account the specificities of each profession in context to the associated risks.[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThe HCWs also associated the impact of working continuously for long hours without short breaks with lower job satisfaction and emphasized its negative impact on mental health and their overall wellbeing. Similarly, a study[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] utilizing data from a 18 year longitudinal study of working time, health and occupational turnover documented that healthcare professionals who had long working hours suffered from higher basal mass indexes, had higher levels of mental stress and were more likely to leave their occupation.\u003c/p\u003e \u003cp\u003eAmong the statistically significant findings of the multiple logistic regression model reported that male HCWs were less likely to declare work related discomfort. Literature suggests that the male HCWs are at a higher risk of developing MSDs[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. The lack of reporting and raising their concerns pertaining to work related discomfort can be associated with gender stereotypes within healthcare which have been recognized in recent times [\u003cspan additionalcitationids=\"CR36\" citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. This can put them at greater risk of developing WMSDs due to low reporting, feeling unsupported and less compliance to preventive strategies.\u003c/p\u003e \u003cp\u003eThe study substantiated the significance of ongoing support mechanisms (from colleagues and supervisors) to address work related stress which was associated with increased satisfaction levels and overall mental health and wellbeing of healthcare staff. The participants also suggested devising further strategies and interventions to further strengthen these support mechanisms. Evidence[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan additionalcitationids=\"CR39 CR40\" citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e] suggests that devising innovative interventions and practicing ongoing mental health and wellbeing programs within healthcare settings creates a conducive work environment, increases efficiency and satisfaction with designated job roles and overall wellbeing of staff.[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eLimitations of the study\u003c/h2\u003e \u003cp\u003eThe main limitation of the study is that the online survey mainly included structured questions and more in-depth information that could be retrieved by conducting qualitative interviews among the healthcare staff. However, the questionnaire included an open-ended section which provided an opportunity for participants to provide detailed feedback. This section was answered in detail by most of the participants which provided rich qualitative data which was analyzed by framework thematic analysis. Moreover, the survey was completed by 507 staff members from diverse backgrounds and job roles, which substantiates the generalizability of the findings of the study. Furthermore, if only a qualitative approach was adopted to address the study question the epistemological view of the main interviewer might have influenced the responses from participants. [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe study further substantiates the existing evidence in this area of research and emphasizes the need to devise innovative strategies and interventions to ensure that ergonomic principles within healthcare are updated in context to the specific healthcare systems, regularly monitored and effectively implemented to safeguard the overall health and wellbeing of healthcare workforce. Devising innovative interventions in context to ergonomic principles by including the necessary equipment to prevent MSDs among healthcare workforce and practicing ongoing mental health and wellbeing programs within healthcare settings can create a conducive work environment, increase overall efficiency, and job satisfaction.\u003c/p\u003e "},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e \u003cp\u003eEthical approval was received by Primary Health Care Corporation Institutional Review Board and the consent to participate was included in the beginning section of the online survey.\u003c/p\u003e \u003ch2\u003eConsent for publication:\u003c/h2\u003e \u003cp\u003eNOT APPLICABLE\u003c/p\u003e \u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003eThe publication fees (APC) were covered by Primary Healthcare Corporation\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003e1. Dr Muslim Abbas Syed (Contributions: Conception of idea, drafting of protocol, literature review, data analysis and interpretation, drafting of manuscript)2. Dr Ahmed Sameer Alnuaimi (Contributions: data analysis and interpretation, drafting of manuscript, review of manuscript)3. Dr Mohamed Ahmed Syed (Contributions: Conception of idea, literature review, data analysis and interpretation, drafting of manuscript, review of manuscript)4. Dr. Shajitha Thekke Veettil (Contributions: Co-drafting of protocol, data collection, review of manuscript)5. Dr. Hafiz Ahmed Mohamed (Contributions: Literature review, data analysis and interpretation, review of manuscript)6. Dr. Abduljaleel Abdullatif Zainel (Conception of idea, literature review, data analysis and interpretation, co-drafting of manuscript)\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003ePrimary Health Care Corporation covered the publication fees (APC) for this study.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and/or analyzed during this study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSalvendy, G., \u003cem\u003eHandbook of human factors and ergonomics\u003c/em\u003e. 2012: John Wiley \u0026amp; Sons.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWilson, J.R., \u003cem\u003eFundamentals of ergonomics in theory and practice\u003c/em\u003e. Applied ergonomics, 2000. 31(6): p. 557\u0026ndash;567.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGalinsky, T., T. Waters, and B. 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Annals of Medicine and Surgery, 2021. 72: p. 102989.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDas, S.K., V.S. Patyal, and S. Ambekar, \u003cem\u003eModeling of risk factors leading to workrelated musculoskeletal disorders in medical practitioners\u003c/em\u003e. Safety Science, 2024. 172: p. 106427.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbdul Halim, N.S.S., Z. Mohd Ripin, and M.I.Z. Ridzwan, \u003cem\u003eEfficacy of Interventions in Reducing the Risks of Work-Related Musculoskeletal Disorders Among Healthcare Workers: A Systematic Review and Meta-Analysis\u003c/em\u003e. Workplace health \u0026amp; safety, 2023. 71(12): p. 557\u0026ndash;576.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKramer, A. and J. Son, \u003cem\u003eWho cares about the health of health care professionals? An 18-year longitudinal study of working time, health, and occupational turnover\u003c/em\u003e. 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International journal of mental health nursing, 2018. 27(6): p. 1776\u0026ndash;1783.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJohnson, J., et al., \u003cem\u003eMental healthcare staff well-being and burnout: A narrative review of trends, causes, implications, and recommendations for future interventions\u003c/em\u003e. International journal of mental health nursing, 2018. 27(1): p. 20\u0026ndash;32.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePanagioti, M., et al., \u003cem\u003eControlled interventions to reduce burnout in physicians: a systematic review and meta-analysis\u003c/em\u003e. JAMA internal medicine, 2017. 177(2): p. 195\u0026ndash;205.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraun, V. and V. Clarke, \u003cem\u003eSuccessful qualitative research: A practical guide for beginners\u003c/em\u003e. 2013: sage.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"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":"Ergonomics, Healthcare workforce, Primary care","lastPublishedDoi":"10.21203/rs.3.rs-6721426/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6721426/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eGlobally, the healthcare workforce operates in complex healthcare settings putting in strenuous efforts to provide the highest standards of care to patients. Evidence suggests that there are serious health risks such as work-related musculoskeletal diseases, mental health diseases and lower job satisfaction levels among healthcare workforce who are exposed to work environments which are structured without proper consideration and application of ergonomic principles. The study aims to investigate the perceptions of a diverse healthcare workforce pertaining to their work environment to highlight the existing practices and application of ergonomics principles in a highly demanding and extensive primary care setting in the state of Qatar.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe study utilized validated online questionnaire (with structured and open-ended questions section) which was distributed through official emails to the healthcare workforce registered in primary healthcare corporation which is comprised of 31 primary health care centers distributed across the country. The domains and items in the survey encompassed general principles of ergonomics within healthcare settings, overall satisfaction levels, wellbeing and perceptions pertaining to the work environment. Quantitative data was analyzed in Microsoft Excel as frequency, distribution, and multiple regression models. Significance level: α\u0026thinsp;=\u0026thinsp;0.05 (95% confidence). Responses to the open-ended section were analyzed by framework thematic analysis. This approach encompassed interpreting, exploring, and reporting patterns and clusters of meaning within the given data.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eHalf of the healthcare workforce (50%) that participated in the online survey documented that they were either satisfied or very satisfied with their work-life balance. Feeling supported by colleagues and supervisors in terms of mental and emotional well-being at work significantly reduced the risk of reporting a work-related discomfort by half (adjusted OR\u0026thinsp;=\u0026thinsp;0.54) after adjusting for the remaining explanatory variables as reported by the multiple regression model. The themes that emerged from qualitative analysis included desirable workspace, long working hours, increasing awareness relating to ergonomics principles at workplace and factors associated with staff satisfaction.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe findings of the study further substantiate the existing evidence base in this area of research and suggest devising innovative strategies and interventions to ensure that ergonomic principles within specific healthcare systems are updated, regularly monitored and effectively implemented to safeguard the health and overall wellbeing of healthcare workforce.\u003c/p\u003e","manuscriptTitle":"Healthcare workforce satisfaction and perceptions pertaining to application of ergonomics in primary health care settings in Qatar","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-01 07:57:51","doi":"10.21203/rs.3.rs-6721426/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":"c7c160d1-6fee-4ad0-864b-91a5e5a26acb","owner":[],"postedDate":"July 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-20T10:19:29+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-01 07:57:51","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6721426","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6721426","identity":"rs-6721426","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}