Abstract:

Objective To investigate the status of knowledge, attitude, and practice (KAP) regarding occupational low back pain prevention among operating room nurses and analyze its influencing factors.

Methods The study was conducted during July 2021 to January 2024, according to a mixed-method research design. A convenience sampling method was used to survey operating room nurses at a certain hospital with a general information questionnaire and the Nurse Occupational Low Back Pain Prevention KAP Scale. Multiple linear regression analysis was performed to identify factors influencing KAP levels regarding occupational low back pain prevention. Furthermore, purposive sampling was adopted to recruit 16 operating room nurses with occupational low back pain for semi-structured in-depth interviews. The interview data were coded and thematically analyzed using Colaizzi’s seven-step phenomenological analysis method for qualitative analysis.

Results A total of 138 questionnaires were distributed, and all were valid (valid response rate of 100%). Among these nurses with low back pain, the scores for the prevention knowledge, attitude, practice dimensions and the total scale score were (20.35 ± 5.27), (15.54 ± 4.12), (25.52 ± 7.73), and (61.41 ± 10.57) points, all significantly lower than those in the non-low back pain group (all P < 0.001). Multiple linear regression analysis showed that those who received training on occupational low back pain prevention scored significantly higher on the knowledge dimension than those who did not (β = 1.346, P < 0.05). The nurses who received post-training follow-up assessments had significantly higher knowledge, attitude, and practice scores compared to those without such follow-up assessments (β = 0.987, 1.083, 2.811, all P < 0.05). Nurses with psychological fatigue and high work pressure had significantly lower attitude scores compared to those without psychological fatigue and with low work pressure, respectively (β = -2.567, -2.874, both P < 0.05). Nurses with junior college, bachelor’s degree, or postgraduate education, as well as those with ≥ 10 years of work experience, had significantly higher practice scores compared to those with technical secondary school education and < 1 year of work experience (β = 3.102 to 6.204, 2.101, all P < 0.05). The gap between knowledge training and practical application, the implementation of preventive behaviors restricted by high-intensity work, preventive attitudes weakened by psychological factors, and the lack of both institutional support and follow-up mechanisms were the affecting factors identified by the qualitative interviews in four themes.

Conclusions The presence of low back pain, high workload and mental fatigue, and the lack of post-training follow-up assessments and institutional support may be key factors influencing the KAP level regarding occupational low back pain prevention among operating room nurses. It is recommended to strengthen theoretical training and skill guidance in nursing practice, promptly attend to nurses’mental health, optimize nursing workflows, and establish systematic trainingassessment and support systems to comprehensively improve nurses’KAP levels in occupational low back pain prevention.