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Appl Nurs Res. 2017 Feb;33:72-77. doi: 10.1016/j.apnr.2016.09.003. Epub 2016 Sep 14.

Work related musculoskeletal disorders in primary health care nurses.

Author information

Community Nurse Specialist, Unidade de Cuidados de Saúde Primários - Penha de França, 1170-201 Lisbon, Portugal. Electronic address:
Ergonomist, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa; CISP, Avenida Padre Cruz, 1600-560 Lisbon, Portugal.
Professor, Escola Superior de Saúde, Universidade de Aveiro, 3810-193 Aveiro, Portugal.



Work related musculoskeletal disorders (WRMSDs) constitute a serious occupational health problem among registered nurses (RN) all around the world. Its prevalence is mainly associated with nurses' high physical demands that still remain poorly studied in primary health care (PHC).


To describe nurses' self-reported symptoms of WRMSDs (mainly discomfort and pain) in PHC, featuring the main work tasks that may have risk factors for its development.


A cross-sectional study was developed to identify self-reported WRMSD symptoms by nurses that worked on PHC in Portugal. Nurses answered an online Portuguese version of the Nordic Musculoskeletal Questionnaire (NMQ) (surveymonkey platform). Data was analyzed using the Statistical Package for the Social Science (SPSS17) program. Statistical analysis was based on descriptive statistics and associations with the χ2 test, Cramér's V, Mann-Whitney and Kruskal-Wallis test, with a significance level of 5%.


A sample (n=409), mostly female (84.0%), showed a high prevalence of WRMSDs symptoms in the last 12months (89.0%). The lower back was the most affected body region (63.1%), followed by cervical, dorsal, shoulders and the wrist/hand. In the same period, absenteeism related to these complaints was high (51.4%) and strongly connected with standing work (48.8%), bending the trunk (42.3%), rotating the trunk (40.6%), applying force with hands or fingers (37.3%), sitting work (36.6%) and repetitive arm movement (34.3%). This study showed associations between the prevalence of WRMSDs symptoms in different body regions and some individual characteristics such as: gender, age, BMI, presence of other pathologies and regular physical exercise.


This study indicates that, as in other areas of nursing practice, in PHC nurses are also exposed to risk factors that are linked with a high prevalence of WRMSDs symptoms. "Inadequate" and extreme postures sustained for prolonged periods and their repetitiveness will contribute to this occurrence. This shows the need to develop occupational prevention programs to curb this occupational health issue among PHC nurses.


Epidemiology; Nursing; Occupational health; Primary health care; Work related musculoskeletal disorders symptoms

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