الفهرس 
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Abstract
Low back pain is a major medical, social, and economic problem in both developed and developing countries, due to its impact on ADL, sickness absence and work disability.
Nursing profession is one of the most frequently affected professions with LBP worldwide. It leads to a significant negative physical, psychosocial, social impact on individual’s QOL. The etiology of LBP among nurses is usually multifactorial, because the job demands in nursing tasks is a mixture of physically such as manual handling of patients and mentally demanding tasks such as dealing with crises.
Low back pain has a negative impact on a nurses’ QOL, contributing to anxiety and socially avoidant behavior. It has been observed that, individuals suffering from LBP might develop major disruptions in their physical, social, and mental well-being, which could affect their occupations. Physical impact includes the loss of physical function and deteriorate general health. Social impact includes decrease participation in social activities. While psychosocial impacts are manifested through insomnia, anxiety, and depression.
Therefore, the focus of LBP management is to reduce pain, associated functional limitations and restrictions on workplace activities as well as ADL, and in turn improve QOL.
The aim of the study
Consequently, the present study aimed to assess QOL of nurses suffering from LBP.
The study was conducted at all surgical and Medical units of the Main University Hospital. The hospital contains six surgical units namely (Cardiopulmonary, Colorectal and Gastroenterology, Oncology, Vascular, Urology, and Neurosurgery units) and contain six medical units, i.e. (Cardiopulmonary, Gerontology, Hepatobiliary, Endocrine, Rheumatoid, and Renal units). Each unit divided into eight rooms and each room contains approximately from 3 to 8 patients. Total beds number in all surgical units are 350 beds, average 58 bed /unit. Total bed number in medical units is 300 beds, average 50 beds /unit. Each nurse was responsible for caring almost four room, where the nurse to patients was 1:26 patients.
A convenience sample of (100) nurses who were working in the above-mentioned setting at the time of the study and were involved in direct patient care and were meeting the following criteria: Age (21< 60) years old, suffer from LBP & under its medical treatment, Free from any other chronic disease and willing to participate in the study.
One tool was adapted by the researcher to collect the necessary data in order to fulfill the objectives of the study. It was entitled as:
Quality of Life Assessment Structured Interview Schedule. It was adapted from Wisconsin Quality of Life Client Questionnaire (2000) (89) and the Oswestry Low Back Pain Disability Questionnaire (2000), (169) was translated into Arabic and it comprised of two parts:
Part I: Nurses’ quality of life related to back pain: It is used to collect data about the main four health domains, including physical, psychological, social and environmental health domains. Part II: Satisfaction level of nurses with low back pain, it assesses nurses’ satisfaction level, as it comprised (9) items namely: support from family, friends, ability to support others, health care services and the cost of the treatment, personal safety, the income, working and sexual relation.
Additionally, Socio-demographic and Clinical data sheet was attached to the adapted tool:
a) Socio-demographic data, it aimed to collect the nurses‘ personal data such as: age, sex, residence, marital status, department, educational level, number of hours standing during work, numbers of working hours per week, home responsibilities, and monthly income.
b) Clinical data: It was utilized to obtain information about nurses‘ present medical condition as: onset of symptoms, pain characteristic, pain associated manifestation such as; limping, limitation of movement, pharmacological treatment, non-pharmacological treatment, duration of treatment, follow up, any health teaching the nurse receive in order to reduce back pain and pain assessment data, including; site, quality, duration, precipitating factors, aggravating factors and pain intensity which was assessed using; the Visual Analogue Scale (VAS).
The adapted tool was revised by five members of the Faculty of Nursing - Alexandria University in the field of Medical-Surgical Nursing, to test its content validity, correction and clarifying of the items was done. A pilot study was conducted with 10 nurses out of the sample before the actual study to test the clarity and applicability of the tool; necessary modification was done.
Data collection: Nurses were interviewed individually using the translated tool. This interview took approximately 30-45 minutes for each nurse to complete the questionnaire, at the previously mentioned study setting during morning shifts. The data were collected over period of three months and 25 days; starting at 5th of March and ending at the 30th June 2017.
The main results of the present study were as following:
- Age of studied nurses ranged from 21 to less than 60 years with a mean age of 34.04 ± 8.01years, where more than one third of the studied nurses, their age group between 21-30 years old. 61% married subjects. Their educational level varies between Diploma, Bachelor and Doctorate degree representing (37%, 62%, and 1%), respectively. More than two third of them were from Urban areas and more than half of them their monthly income was not enough.
- The number of working hours per week were more than 48 hours per week, nearly three quarters (73%) of the nurses, were standing 3 – 6 hours per shift.
- Low back pain complaint for more than three years was reported by nearly half of the studied nurses (44%). Rest and weight reduction were the most reported non-pharmacological measures to manage LBP by 47.0% and 5.0% of the subjects respectively. On the other hand, analgesic and anti-inflammatory drugs were reported to be the most common pharmacological treatments used by 94.0% and 46% of the nurses.
- More than three quarters of the nurses had no previous hospitalization with LBP. The vast majority (98.0%) of them didn’t comply with the regular specialist follow up visit, since economic problems were the most common reason for noncompliance with this regular follow up among more than half of studied nurses (55.0%).
- According to the present complaints of LBP, the results show that; the highest percentage represented by the studied nurses (82%, 87%, 43%, 61%, 56%, and 86%) respectively, were reported that; their LBP was moderate, intermittent pain, radiated mainly to the left side, described it as heaviness sensation, increased by prolonged sitting or standing, decreased by analgesic and associated with decreased movement.
- More than two third of the studied subjects (67%) were represented on fair quality of life (33 – 66.7%) with a mean percent score and standard deviation of 52.24 ± 15.05 and moderate satisfaction level with a mean percent score and standard deviation of 46.39±14.11. Good quality of life (>66.67%) and high satisfaction level were represented only by 17.0% and 11.0% of the studied subjects, respectively.
- There were statistically significant differences were found between the nurses‘ QoL mean percent score and sociodemographic data and for those whose age ranged between 21 < 30 years old, those who are married, nurses whose monthly income isn’t enough, nurses working more than 48 hours per week and nurses who had assistance in their home responsibilities.
- Statistically significant differences were found between the nurses‘ QoL mean percent score and their clinical characteristic related to the onset and severity of LBP, duration of treatment and previous hospitalization; for the favor of those nurses who had pain onset less than one year, who received treatment for less than one year, had no and mild pain and those who have not been hospitalized before. Statistically significant relation was found between studied nurses QoL and severity of pain for those who had moderate pain; as P <0.001
- Statistically significant negative correlation was declared between the nurses‘ QoL health domains (physical, psychological, social, and environmental domains) mean percent score & satisfaction level as well as severity of LBP; where P <0.001.
The main recommendations of the present study are:
1. A comprehensive policy guideline that addresses the management of LBP amongst staff must be placed and made available to all nursing staff.
2. A comprehensive preventative and rehabilitative LBP program are recommended.
3. Developing manual and standards specific to LBP prevention and treatment in Arabic is highly required.
4. An orientation program for newly nurses and in-service training program for experienced nurses about LBP prevention should be developed.
5. Study the effect of back program educational sessions on prevention of LBP and associated health related QoL.
6. Identify barriers hindering healthcare providers’ application of safety measures that prevent incidence of LBP is highly recommended.
7. Finally, replication of study on larger samples is very important.