網球按摩減緩護理人員肌肉骨骼不適及增強自我效能成效探討

Tennis Ball Massage Therapy in Clinical Nurses: Effect on Relieving Musculoskeletal Disorders and Enhancing Self-Efficacy

10.6224/JN.202304_70(2).06

洪月美(Yuen-Mei HUNG)；陳淑雯(Shu-Wen CHEN)

肌肉骨骼不適 ； 網球按摩 ； 觸痛點 ； 自我效能 ； musculoskeletal disorders ； tennis ball massage ； trigger point ； self-efficacy

護理雜誌

70卷2期（2023 / 04 / 01）

34 - 44

繁體中文;英文

背景：肌肉骨骼不適是常見職業病，護理人員盛行率為65.1%－87.3%，以頸、肩及下背部為多數。目的：探討網球按摩緩解肌肉疼痛及提升緩解疼痛自我效能之成效。方法：本研究為類實驗、單組前後測設計，先普查216位地區教學醫院護理人員，普查出身體至少有一處疼痛者後，依單位屬性採系統性隨機抽樣，抽出36位護理人員，接受四週「打擊疼痛」介入方案，以「疼痛視覺量表」及「緩解疼痛自我效能量表」為評估工具，進行前測及3次後測評量，以單因子及二因子重複測量變異數分析、符號等級檢定及相依樣本中位數差異測試，檢測介入前後成效。結果：肌肉疼痛以肩部最多（94.4%），其次頸部（88.9%）、上背部（55.6%）；頸肩背疼痛部位與四次測量時間具交互作用（F = 2.69, p = .020），事後比較，測量時間以第三次後測疼痛改善最佳，其次為第二次；前測與第三次後測疼痛改善均達顯著差異（t = 6.39, 8.68, 6.96, p < .001）。疼痛緩解自我效能方案於介入前後具顯著差異（F = 53.49, p < .001），事後比較，第三次後測提升最高，前測最低；前測與四週方案結束後測（t = -10.25, p < .001）達顯著差異。結論／實務應用：經由本研究顯示，網球按摩確實能改善護理人員頸肩背疼痛及提升緩解疼痛自我效能，網球按摩具方便取用、無時間空間限制、無需假手他人的特點，運用於忙碌的護理工作中，可減輕肌肉疼痛的困擾，提升活動舒適感及工作效率，使肌肉疼痛不再是影響工作的絆腳石。

Background: Musculoskeletal disorders are a common occupational disease. The prevalence of musculoskeletal disorders among nurses is estimated at 65.1%-87.3%, with neck, shoulders, and lower back being most affected. Purpose: To explore the effectiveness of tennis ball massage therapy in alleviating muscle soreness and improving pain relief self-efficacy. Methods: In this quasi-experimental, single-group, pre- and post-test study, 216 nurses in regional teaching hospitals were screened for neck, shoulder, and back pain. Based on the unit attributes, systematic random sampling was employed to recruit 36 nurses to participate in a four-week "fighting pain" intervention program. The "Pain Visual Scale" and "Pain Relief Self-efficacy Scale" were used as the assessment tools. One-way and two-way repeated measure analysis of variance, a signed ranks test, and the Friedman test were used to assess longitudinal change in the data. Results: Shoulders were the most reported site of muscle pain (94.4%), followed by the neck (88.9%) and the upper back (55.6%). The locations of neck, shoulder, and back pain were interacted differently with the four measurement times (F = 2.69, p = .020). In the post hoc comparison, pain relief effectiveness was most significant in the third posttest, followed by the second. The pain relief was significantly different between the pre-test and the third post-test (t = 6.39, 8.68, 6.96, p < .001). There was a significant difference before and after the intervention of the pain relief self-efficacy (F = 53.49, p < .001). The post hoc comparison results revealed that self-efficacy was lowest at pretest and highest at the third posttest. Significant differences were observed between the pre-test and third post-test at the end of the intervention (t = -10.25, p < .001). Conclusions/ Implications for Practice: This study shows that tennis ball massage can improve neck, shoulder, and back pain in nurses and improve pain relief self-efficacy. Tennis ball massage is easy to implement, has no time and space restrictions, and requires no assistance to operate. This equipment can be used to effectively reduce muscle pain, improve the comfort of performing regular activities, and raise work efficiency, reducing the negative impact of muscle pain on work.

1. 黃奕翔, Y.-H.,王鶴森, H.-S.(2020)。運動誘發延遲性肌肉痠痛後使用間歇充氣加壓按摩對痠痛指數及下肢肌力表現之效益。運動表現期刊，7(2)，59-72。
   連結：
2. 溫明堂, M.-T.,賴世烱, S.-J.(2016)。彼拉提斯運動者之自我效能與身體覺察。運動與健康研究，5(1)，1-25。
   連結：
3. Bandura, A.(1977).Self-efficacy: Toward a unifying theory of behavioral change.Psychological Review,84(2),191-215.
4. Chamorro-Koc, M.,Peake, J.,Meek, A.,Manimont, G.(2021).Self-efficacy and trust in consumers’ use of health-technologies devices for sports.Heliyon,7(8),e07794.
5. Guimberteau、 J.-C.,Armstrong, C.,徐其昭（譯）, C.-C.(Trans.)(2019).人體筋膜結構：內視鏡下的細胞＆細胞外基質.楓書坊=Maple House.
6. Haleema, B.,Riaz, H.(2021).Effects of thoracic spine manipulation on pressure pain sensitivity of rhomboid muscle active trigger points: A randomized control trial.Journal of the Pakistan Medical Association,71(7),1720-1724.
7. Hämmig, O.(2020).Work- and stress-related musculoskeletal and sleep disorders among health professionals: A cross-sectional study in a hospital setting in Switzerland.BMC Musculoskeletal Disorders,21(1),319.
8. Hughes, G. A.,Ramer, L. M.(2019).Duration of myofascial rolling for optimal recovery, range of motion, and performance: A systematic review of the literature.International Journal of Sports Physical Therapy,14(6),845-859.
9. Juchli, L.(2021).Effectiveness of massage including proximal trigger point release for plantar fasciitis: A case report.International Journal of Therapeutic Massage & Bodywork,14(2),22-29.
10. Kalkim, A.,Midilli, T. S.,Dogru, S.(2019).Musculoskeletal disorder symptoms in nurses and etiological factors: A cross-sectional research.Annals of Medical Research,26(3),374-381.
11. Kim, M.,Lee, M.,Kim, Y.,Oh, S.,Lee, D.,Yoon, B.(2016).Myofascial pain syndrome in the elderly and self-exercise: A single-blind, randomized, controlled trial.The Journal of Alternative and Complementary Medicine,22(3),244-251.
12. Krishnan, K. S.,Raju, G.,Shawkataly, O.(2021).Prevalence of work-related musculoskeletal disorders: Psychological and physical risk factors.International Journal of Environmental Research and Public Health,18(17),9361.
13. Kuorinka, I.,Jonsson, B.,Kilbom, A.,Vinterberg, H.,Biering-Sørensen, F.,Andersson, G.,Jørgensen, K.(1987).Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms.Applied Ergonomics,18(3),233-237.
14. Li, S.-Y.(2021).The relationships among self-efficacy, social support, and self-care behavior in the elderly patients with chronic pain (a STROBE-compliant article).Medicine,100(9),e24554.
15. Lin, S. C.,Lin, L. L.,Liu, C. J.,Fang, C. K.,Lin, M. H.(2020).Exploring the factors affecting musculoskeletal disorders risk among hospital nurses.PLOS ONE,15(4),e0231319.
16. Luan, H. D.,Hai, N. T.,Xanh, P. T.,Giang, H. T.,Van Thuc, P.,Hong, N. M.,Khue, P. M.(2018).Musculoskeletal disorders: Prevalence and associated factors among district hospital nurses in Haiphong, Vietnam.BioMed Research International
17. Marieb、 E. N.,Wilhelm, P. B.,Mallatt, J.,楊世忠（譯）, S.-C.(Trans.),馮琮涵（譯）, T.-H.(Trans.)(2017).人體解剖學.偉明=Wei Ming Book.
18. Mirmaroofi, N.,Ghahramanian, A.,Behshid, M.,Jabbarzadeh, F.,Onyeka, T. C.,Asghari-Jafarabadi, M.,Ganjpour-Sales, J.(2019).Relationship between self-efficacy and pain control in Iranian women with advanced knee osteoarthritis.Nigerian Journal of Clinical Practice,22(4),460-468.
19. Moodley, M.,Ismail, F.,Kriel, A.(2020).Work-related musculoskeletal disorders amongst undergraduate nursing students at the University of Johannesburg.Health SA Gesondheid,25,a1460.
20. Oh, S.,Kim, M.,Lee, M.,Kim, T.,Lee, D.,Yoon, B.(2018).Effect of myofascial trigger point therapy with an inflatable ball in elderlies with chronic non-specific low back pain.Journal of Back and Musculoskeletal Rehabilitation,31(1),119-126.
21. Ożóg, P.,Weber-Rajek, M.,Radzimińska, A.,Goch, A.(2021).Analysis of muscle activity following the application of myofascial release techniques for low-back pain-A randomized-controlled trial.Journal of Clinical Medicine,10(18),4039.
22. Ozsoy, G.,Ilcin, N.,Ozsoy, I.,Gurpinar, B.,Buyukturan, O.,Buyukturan, B.,Kararti, C.,Sas, S.(2019).The effects of myofascial release technique combined with core stabilization exercise in elderly with non-specific low back pain: A randomized controlled, single-blind study.Clinical Interventions in Aging,14,1729-1740.
23. Parvizy, S.,Tarvirdinasab, S.,Raznahan, R.,Aliakbari, M.(2020).The effect of pain management training in workshop on the knowledge, attitude and self-efficacy of pediatric nurses.Journal of Family Medicine and Primary Care,9(6),2880-2884.
24. Woodworth、 S.,謝靜玫（譯）, C.-M.(Trans.)(2019).滾筒運動圖解聖經.旗標=Flag.
25. Wu, Z.,Wang, Y.,Ye, X.,Chen, Z.,Zhou, R.,Ye, Z.,Huang, J.,Zhu, Y.,Chen, G.,Xu, X.(2021).Myofascial release for chronic low back pain: A systematic review and meta-analysis.Frontiers in Medicine,8,697986.
26. Zheng, X.,Yu, H.,Qiu, X.,Chair, S. Y.,Wong, E. M.-L.,Wang, Q.(2020).The effects of a nurse-led lifestyle intervention program on cardiovascular risk, self-efficacy and health promoting behaviours among patients with metabolic syndrome: Randomized controlled trial.International Journal of Nursing Studies,109,103638.
27. 李淑葒, S.-H.,林淑媛, S.-Y.(2012)。手術室女性護理人員肌肉骨骼不適嚴重度之風險因素。台灣醫學，16(5)，449-457。
28. 邱宜令, S.-H.,吳秋鳳, C.-F.,王梓柔, T.-J.,吳曼菱, M.-L.,黃鐙瑩, D.-Y.,丁雅葳, Y.-W.,翁稜雅, L.-Y.,蘇斌光, B.-G.(2018)。應用按摩舒緩待產婦的疼痛成效之研究。安泰醫護雜誌，24(1)，41-53。
29. 邱國聖, K.-S.,簡坤鐘, K.-Z.(2018)。按摩滾軸與自我肌筋膜放鬆健康效益。臺大體育，66，35-43。
30. 邱惠萍, H.-P.,蔡佩姍, P.-S.,馬先芝, H.-J.(2018)。某醫學中心肌肉骨骼不適員工介入方案之成效。醫療品質雜誌，12(2)，66-74。
31. 陳寬裕, K.-Y.,王正華, C.-H.(2020).論文統計分析實務：SPSS與AMOS的運用.五南=Wu-Nan.
32. 曾奕翔, I.-S.,林淑如, S.-J.,王顗婷, Y.-T.,賴育民, Y.-M.(2019)。某區域醫院員工之自覺疲勞與肌肉骨骼症狀問卷分析與其相關性研究。中華職業醫學雜誌，26(1)，47-54。
33. 蘇瑋筑, W.-C.(2020)。中山醫學大學=Chung Shan Medical University。
34. 龔威亦, W.-Y.(2019).網球鬆筋按摩手冊：肌肉透視圖解.蘋果屋=Apple House.

1. (2024)。醫院護理人員肌肉骨骼不適之相關因素探討。護理雜誌，71(1)，36-46。