Objective: To investigate the prevalence of work-related musculoskeletal disorders(WMSDs) among intensive care unit (ICU) nurses, assess its relationship with ergonomic load and overall exposure levels. Methods: A total of 272 ICU nurses from two tertiary hospitals in a city were selected as the research subjects using convenient sampling method. The Chinese Musculoskeletal Disorder Questionnaire was used to investigate the prevalence of WMSDs among the ICU nurses. The Quick Exposure Check (QEC) was used to assess the ergonomic load on the back, shoulder/arm, hand/wrist, and neck during different clinical nursing operations. Results: The annual prevalence of WMSDs was 75.7% among ICU nurses. The annual prevalence of WMSDs in different body parts, from high to low, was as follows： lower back, neck, shoulder/arm, back, knee, hip/leg, hand/wrist, ankle/foot, and elbow (54.8% vs 43.4% vs 40.8% vs 36.0% vs 21.3% vs 19.9% vs 18.8% vs 18.4% vs 8.1%, P<0.01). ICU nurses had the highest QEC scores on the back (dynamic), shoulder/arm, hand/wrist, and neck with assisting patient turning (all P<0.05) among the six clinical nursing items. During the operation of patient turning, patient lifting, patient bathing, and bed sheet changing for bedridden patients, the back (dynamic) and shoulder/arm were at a high load level, while the hand/wrist and neck were at a mild load level. When nurses were providing tracheostomy care and oral care for intubated patients, their back (static), shoulder/arm, hand/wrist, and neck were at a mild load level. The overall exposure rate for assisting patient turning, patient lifting, oral care for intubated patients, bed sheet changing for bedridden patients, patient bathing, and tracheostomy care were 77.8%, 66.5%, 63.6%, 60.2%, 58.5%, and 57.4%, respectively. The risk for assisting patient turning was classified as level four, while the risk for other clinical nursing items was level three. Conclusion: The prevalence of WMSDs in ICU nurses is high. Both ergonomic load level and total exposure rate of back, shoulder/arm, hand/wrist and neck were high during clinical nursing operations.

Objective:To explore the impact of Cox interaction model of client health behavior (IMCHB) on stress response and rehabilitation outcome in patients undergoing coronary artery bypass graft, and to provide reference for caregivers to reduce stress response in such patients and improve rehabilitation outcomes.Methods:This was a quasi-experimental study, and 62 surgical patients undergoing coronary artery bypass graft in the cardiac surgery department of the First Affiliated Hospital of Xinjiang Medical University were selected from January to June 2023.Among them, 31 patients admitted from January to March 2023 were in the control group, and routine nursing measures were taken; 31 patients admitted from April to June 2023 were in the intervention group with IMCHB nursing based on this routine nursing. The anxiety, depression, quality of life, hemodynamic indicators, postoperative activity time, evacuation time, pericardial/mediastinal drainage time, ICU stay length and total hospitalization length between the two groups were compared.Results:There were 31 cases were admitted in each group. There were 28 males and 3 females,aged (57.42 ± 7.38) years old in the control group. There were 27 males and 4 females, aged (56.29 ± 7.29) years old in the intervention group. After intervention, the total score of anxiety and depression and SF-36 in the intervention group were respectively (16.87 ± 4.83) points and (78.32 ± 13.41) points, and the control group were (20.81 ± 6.35) points and (69.97 ± 11.37) points, respectively, and the differences between the two groups were statistically significant ( t=2.75, -2.65, both P<0.05). Immediately after completion of cardiopulmonary bypass (T3), the mean arterial pressure in the intervention group was (85.55 ± 8.46) mmHg (1 mmHg=0.133 kPa), higher than (74.33 ± 17.40) mmHg in the control group, heart rate was (77.72 ± 10.97) times/min, lower than (88.35 ± 15.96) times/min in the control group. At the beginning of cardiopulmonary bypass (T2), and when leaving the operation room (T4), the heart rate of patients in the intervention group was (69.50 ± 10.94), (81.11 ± 10.22) times/min, significantly lower than (77.98 ± 14.51), (90.47 ± 15.44) times/min in the control group, the differences were statistically significant ( t values were -3.23 to 3.06, all P<0.05). In the intervention group, first ambulation, exhaust, pericardial/mediastinal drain retention, ICU stay, total hospitalization were (7.48 ± 2.83), (3.06 ± 0.99), (6.52 ± 2.39), (5.35 ± 3.20), (28.90 ± 5.63) d, all were significantly lower than (12.81 ± 4.84),(4.55 ± 1.65), (8.87 ± 3.30), (12.74 ± 7.31), (35.94 ± 8.82) d in the control group with statistical differences ( t values were 3.21-5.29, all P<0.05). Conclusions:The application of Cox health behavior interaction mode can reduce the anxiety and depression in coronary artery bypass graft patients, improve the quality of life, reduce the stress response of patients, and improve the rehabilitation outcomes.