Hebrew adaptation and validation of a clinical-quantitative method of low back pain evaluation (the BADIX).

BACKGROUND: The BackAche Disability Index (BADIX) is a 2-section test: (a) the BackAche Index encompassing 5 active back movements, evaluated on a 4-point Likert-type rating scale; (b) the morning Back Stiffness Score, choosing the most fitting statement out of 6, upon awakening. OBJECTIVE: To perform a cross-cultural adaptation and evaluate the reliability and validity of the Hebrew version of BADIX. METHODS: Translation/retranslation of the English version of the BADIX was conducted, and the cross-cultural adaptation process performed. The Hebrew version BADIX was evaluated at two meetings, two weeks apart, in 51 female nurses (40 reported back pain and 11 reported no back problems). The Rolland Morris Disability Questionnaire (RMQ) and The Modified Oswestry Low Back Pain Disability Questionnaire (MODQ) were also evaluated. RESULTS: The mean age of the subjects was 45.34±11.11 years. Internal consistency calculated by the Cronbach's α coefficient was very high (α>0.9). A high degree of test-retest reliability was found, with an intraclass correlation coefficient (ICC) 95% CI) of 0.933 (0.839 - 0.973), and r=0.908. Concurrent validity of the BADIX domains with the RMQ and MODQ was found statistically significant and high (ρ=0.688, RMQ, and ρ=0.674, MODQ). CONCLUSIONS: The adapted and modified Hebrew version of the BADIX is reliable and measures the pain and mobility outcome of physical impairment and morning backache stiffness. It can be employed, in addition to self-reported outcome measures, by clinicians and researchers in quantitatively evaluating the clinical status and progression of patients with lower back pain in Hebrew-speaking populations.

Sliding Sheet Use in Nursing Practice: An Intervention Study.

Background: Previous studies have discovered that the utilization of sliding sheets in patient care is a valuable technique for repositioning bedridden patients compared with traditional cotton sheets or carriers. Our aim was to examine the effects of sliding sheet usage on work-related musculoskeletal disorders and disability, perceived workload, burnout, and job satisfaction, among nurses and nursing assistants. Method: This repeated measurement study included 41 female nurses and nursing assistants from three internal medicine departments who provided direct patient care. Participants completed an eight-part questionnaire (demographics, Neck Disability Index, Quick Disability of the Arms, Shoulder and Hand Questionnaire, Modified Oswestry Low Back Pain Disability Questionnaire, BackAche Disability Index workload, burnout, and job satisfaction) 4 times during the study period: 3 months prior to the intervention, on the first day of the intervention, and 3 and 6 months after commencement of the intervention. Findings: After 3 and 6 months of sliding sheet usage, pain and disability decreased in the neck (p < .001); arms, shoulders, hands (p = .041); and lower back (p < .001), with an increase in job satisfaction (p < .001). Discussion/Application to Practice: The findings of our study indicate a clear influence of reducing work-related musculoskeletal pain and disability while increasing job satisfaction when sliding sheets are introduced into nursing practice. Occupational health nurses in health care should consider this type of low-cost intervention as a method for reducing musculoskeletal injury among direct patient care providers.

Repositioning a passive patient in bed: Choosing an ergonomically advantageous assistive device.

Repositioning of passive patients in bed creates health risks to the nursing personnel. Therefore, appropriate assistive devices should be used. Our aim was to find the optimal assistive device for reducing musculoskeletal load while moving a passive patient in bed. Torso kinematic inputs evaluated by the Lumbar Motion Monitor (LMM) and perceived load (Borg scale) were measured in female nurses performing 27 patient transfers [represented by a mannequin weighing 55 (12 nurses), 65 (24 nurses) and 75 kg (12 nurses) in bed] using a regular sheet, a sliding sheet and a carrier. The lowest rates of perceived exertion were found when the sliding sheet and/or carrier were used, for all tasks (p ≤ 0.009). According to the predicted risk for Low Back Disorder (LBD) based on the LMM inputs, negligible differences between assistive devices were found. In a 75 kg mannequin, the participants were able to perform all tasks only by using a sliding sheet. Utilizing sliding sheets is an advantageous technique in comparison to traditional cotton sheets and even carriers.

Prevention of Nurses' Work-Related Musculoskeletal Disorders Resulting From Repositioning Patients in Bed: Comprehensive Narrative Review.

Repositioning patients in bed to promote comfort and prevent impairments caused by continuously lying in a prone position is a task frequently performed by nurses and nursing assistants. Repositioning is a high-risk activity, frequently causing occupational injuries. These occupational injuries are attributed to excessive physical demands on nurses due to patients' weight and awkward nurse postures. During repositioning, risk of injury can be lowered by reducing friction between the patient and the bed. Hence, certain friction-reducing devices have been developed to reduce the manual force required to move patients. Nevertheless, further research is needed to evaluate the potential effectiveness of these devices. Therefore, the aim of this review was to present current research about the risk factors, prevention strategies, and assistive devices that could reduce work-related musculoskeletal disorders caused by repositioning patients in bed.

Use of restraints on dementia patients: an ethical dilemma of a nursing staff in Israel.

UNLABELLED: This quality improvement project investigates the ethical dilemmas faced by nursing staff (ie, registered nurses, practical nurses, and nurse aids) using restraints for dementia patients in "realistic" and "idealistic" situations. RATIONALE: There is a need to offer adequate care for a growing number of patients suffering from dementia and to ensure their safety. Restraints are a common practice for this purpose; however, they may inflict harm and contradict patient rights of freedom, autonomy, and respect. The issue becomes more complex in view of the multiple studies showing that the various justifications for using restraints are often based on caregiver interests and institutional considerations rather than on the patient's benefit. DESIGN: The project was conducted on a sample of 200 Israeli nursing staff members, half from internal medicine wards of 3 hospitals and the other half from 3 psychogeriatric nursing homes, all treating dementia patients. The project used a questionnaire composed of demographic data and an ethical preference questionnaire built on 18 situations concerning restraints. Situations were categorized into 3 purposes: (a) patient's benefit, (b) other patients' benefit, and (c) institutional benefit. These situations referred to realistic (ie, expressing views of daily practice) and idealistic (ie, expressing personal and professional beliefs and values) situations. RESULTS: The project exposes a discrepancy between the manner in which the nursing staff perceive use of restraints in an idealistic situation and in a realistic situation and the greater tendency to use restraints in the realistic situation than in the idealistic situation. The main contribution of the project is in revealing the conflict between the personal beliefs of the nursing staff and the nurses' perceptions of their institutional obligations. CONCLUSIONS: The project uncovered a discrepancy among the beliefs, the personal and professional values of the nursing staff, and their perception regarding the actual use of restraints in the daily work routine.

The use of physical restraints for patients suffering from dementia.

This study reviews the ethical dilemmas of nursing staff about using restraints on patients suffering from dementia in two types of health care settings in Israel: internal medicine wards of three general hospitals; and psychogeriatric wards of three nursing homes. The nurses' level of knowledge about the Patient's Rights Law, the Israeli Code of Ethics, and the guidelines on restraints was analysed. The purposes of restraints were defined as beneficial to: (1) the patient; (2) other patients; or (3) the institution. The concept was evaluated in a realistic situation (expressing views of daily practice) and in an idealistic situation (expressing personal and professional beliefs and values). It was shown that nurses in internal medicine wards of general hospitals agreed more with the use of restraints than those in psychogeriatric wards in nursing homes. Differences were more pronounced when restraints were beneficial to the institution. In addition, nurses working in psychogeriatric wards of nursing homes had more knowledge about the guidelines on restraints and were less inclined than their counterparts to agree with the use of restraints for the benefit of other patients or the institution.