Hand and wrist complaints in dialysis nurses in Germany: a survey of prevalence, severity, and occupational associations.

BACKGROUND AND OBJECTIVE: Occupations involving repetitive movements of the wrists, activities that require a lot of force, and hand-arm swinging are particularly likely to contribute to the development of hand and wrist complaints. The daily setup and dismantling of dialysis machines as part of the dialysis treatment process can strain the wrists and fingers of nurses. However, evidence regarding the relationship between the work activities of dialysis nurses and the incidence of hand and wrist complaints is limited. This study aimed to investigate the prevalence and severity of hand and wrist complaints among dialysis nurses in Germany and to relate these to their work activities. METHODS: An online survey was created and sent to 836 dialysis centres in Germany. The Nordic Musculoskeletal Questionnaire was used in an online survey to assess the prevalence of musculoskeletal complaints in the hands and wrists. The Boston Carpal Tunnel Questionnaire (BCTQ) was used to assess symptom severity. Dialysis nurses rated the effort required to set up dialysis machines using the BORG-CR10 scale. The analysis was descriptive. RESULTS: A total of 122 dialysis nurses (18 male, 104 female; mean age 45 ± 12 years) participated in the survey, and 59% of them reported developing hands or wrist complaints in the last 12 months. According to BCTQ, the average severity of these complaints is 2.0 ± 0.8 (N = 72). The severity of symptoms increased significantly with the number of setups performed by a dialysis nurse per day (rs = 0.35, P = 0.003, N = 72). The nurses rated the effort required to set up the dialysis machines as 2.8 ± 1.8 on the BORG-CR10 scale (N = 101). DISCUSSION: The results of the online survey showed that dialysis nurses were more likely than the general population to experience hand and wrist complaints. The repetitive activities of the hands and wrists while setting up a dialysis machine are thought to be the cause. CONCLUSIONS: Preventive measures are needed to reduce hand and wrist strain in dialysis nurses.

Effectiveness of personalized music systems to influence neuropsychiatric symptoms associated with dementia: A quasi-experimental study.

CONTEXT: Studies have shown that music can improve the neuropsychiatric symptoms in people with dementia. Personalized music has the greatest impact. However, people with dementia in residential care rarely listen to personalized music; in doing so, they themselves as well as their caregivers pass up the positive effects associated with it. As a result, customizable music systems have been developed that allow people with dementia to listen to their favorite music. AIM: To determine the effectiveness of personalized music systems on the neuropsychiatric symptoms of people with dementia in residential care and the perceived distress of caregivers. METHOD: 14 residents heard personalized music during personal care for eight weeks. Outcomes were derived from pre-post-follow up assessments of residents' neuropsychiatric symptoms and caregivers' distress using the Neuropsychiatric Inventory Questionnaire (NPI-Q). The frequency of the music systems' usage was recorded in log files. A control group of 14 residents received standard care. RESULTS: Caregivers used the music systems among the residents with varying frequency. During the intervention, an increasing trend of the severity value of apathy was observed, while the severity values of delusions and nighttime disturbances tended to decrease. However, the trends did not reach statistical significance. Caregivers' perceived distress was not affected. CONCLUSION: A practicable solution for providing personalized music to people with dementia in residential care was tested. Possible positive effects were observed for delusions and nighttime disturbances in people with dementia, but a larger study will be required to verify these observations.

Feasibility of a Music System Intervention to Affect Mental Stress and Strain of Employees in Inpatient Dementia Care.

OBJECTIVES: If family caregivers participate with people with dementia in group music therapies, their mental stress can be reduced. The interventions investigated this context are often limited to active music therapies in groups, which do not consider the inclusion of formal caregivers. In the presented study, a music system was implemented in the routine nursing care of a dementia residential community. Aiming to investigate the use and the effects of the music system on employees' mental stress and strain, hypotheses were derived, which, for the first time, qualitatively describe this connection. METHODS: A controlled feasibility study with pretests and posttests was conducted. Two residential areas of an inpatient care facility for people with dementia participated as an intervention and control groups-these included 28 residents and 18 employees. In the intervention phase, the employees of the intervention group used the music systems during nursing activities and the operations were saved in log files. Mental stress and strain were recorded six times using the BGWmiab questionnaire. In the questionnaire part on mental stress, typical stress factors were assessed, while the part on mental strain records the extent of seven typical symptoms of overstrain. RESULTS: The music systems were used 1.6 (±1.3) times per day and per resident, dependent on the residents (P < 0.05, n = 13). Changes in total mental stress and strain scores could not be determined. Regarding the strain symptoms, scores of work motivation, fatigue, and aversions decreased. Seventy-one percent of the employees stated an improved daily work routine. The strain changes in employees of the intervention group correlated significantly with their work experience (r = 0.73, P = 0.04, n = 8). CONCLUSIONS: Eight hypotheses on the usage and effect of music systems were generated. These did not represent an additional stress factor and affected single strain symptoms. In addition, the study highlighted a positive impact that the music systems had on the employees' perception of stress. This is the first time that the positive effects of receptive music interventions on mental stress and strain of formal caregivers are described. Further investigations with an increased frequency of use of the music systems should validate and specify the findings and hypotheses.