Effectiveness of Participatory Ergonomic Interventions on Work-Related Musculoskeletal Disorders, Sick Absenteeism, and Work Performance Among Nurses: Systematic Review

Abstract

Background: Nurses face a higher risk of developing work-related musculoskeletal disorders (WMSDs) due to their primary roles in patient care. Participatory ergonomics (PE), an approach that integrates large-scale interventions performed at organizational and systems levels with small-scale interventions, is widely considered a promising approach to mitigate health problems at the workplace. However, its effectiveness in addressing WMSDs and secondary outcomes such as sickness absence and work performance among nurses is not fully understood.

Objective: This systematic review assessed the effectiveness of PE interventions in preventing WMSDs and mitigating two related outcomes, sickness absence and work performance, among nurses.

Methods: A literature search was performed in four electronic databases, PubMed, ScienceDirect, Scopus, and PsycNet, guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines to retrieve relevant papers published between 2017 and 2023. Papers fulfilling the eligibility criteria were analyzed and subjected to quality appraisal.

Results: Overall, 19 papers were included in the final analysis. Various categories of ergonomic interventions were identified, with the predominant being exercise and physical activities, health promotional activities and training, educational programs, and patient handling devices. Multicomponent interventions, especially those involving physical activities and exercise, demonstrated stronger effects in reducing the risk of WMSDs at 6 months (OR 1.64, 95% CI 1.12-4.54) and 12 months postintervention (OR 2.70, 95% CI 1.52-4.51) compared with single interventions. However, most ergonomic interventions had no statistically significant effect (P>.05) on sickness absence and work performance. More than half (n=13) of the studies demonstrated moderate to high risk of bias, reflecting the need for better quality interventions.

Conclusions: Multicomponent interventions, particularly those involving physical activities and exercise, are more effective in reducing the risk of WMSDs among nurses compared with individual interventions. However, their long-term effects in addressing WMSDs, sick absenteeism, and work performance are still unclear. These gaps could be addressed by integrating organizational factors and prevention policies into existing ergonomic interventions, thereby offering opportunities to improve psychological health, job satisfaction, and work dynamics.

Keywords: ergonomics; musculoskeletal disorders; nurses; sick absenteeism; work performance.

Figure 1.. Literature search process using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. WMSD: work-related musculoskeletal disorder.