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已发表论文
结构化微休息干预措施对手术室护士肌肉骨骼健康、心理福祉和患者安全的长期影响：一项多中心纵向队列研究
Authors Gao W , Fan G, Liu D, Fan G
Received 1 July 2025
Accepted for publication 26 September 2025
Published 11 October 2025 Volume 2025:17 Pages 527—548
DOI https://doi.org/10.2147/JHL.S550777
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Russell Taichman
Wenhui Gao,1 Guangmei Fan,1 Dandan Liu,2 Guangrui Fan3
1Department of Anesthesiology, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, People’s Republic of China; 2Department of Media and Communication Studies, Faculty of Arts and Social Sciences, Universiti Malaya, Kuala Lumpur, Malaysia; 3School of Computer Science and Technology, Taiyuan University of Science and Technology, Taiyuan, Shanxi, People’s Republic of China
Correspondence: Guangmei Fan, School of Computer Science and Technology, Taiyuan University of Science and Technology, 66 Waliu Road, Taiyuan, Shanxi, People’s Republic of China, Email fgr@tyust.edu.cn
Background: Operating room (OR) nurses frequently experience work-related musculoskeletal disorders (MSDs) and psychological strain due to prolonged static postures, repetitive movements, and high-stress conditions. While short-term benefits of microbreak interventions have been demonstrated, evidence on their long-term effectiveness and impact on patient safety remains limited. This study aimed to evaluate the sustained effects of structured microbreaks on MSD outcomes, psychological wellbeing, and patient safety, and to explore organizational factors influencing intervention adherence.
Methods: A nonrandomized, controlled, multicenter mixed methods study, six-month follow up (N = 178 analyzed) was conducted in five hospitals in Shanxi Province, China. Ninety-one OR nurses received a structured microbreak intervention (2– 3-minute breaks every 30 minutes during procedures > 60 minutes, including ergonomic exercises and mindfulness practices), while 87 served as controls (analyzed cohorts after attrition). Quantitative data (Nordic Musculoskeletal Questionnaire, Perceived Stress Scale, Maslach Burnout Inventory, patient safety metrics) were collected at baseline and six months. Qualitative data were gathered through semi-structured focus groups and interviews with intervention participants.
Results: Compared to controls, intervention nurses experienced significantly greater reductions in MSD prevalence (− 20.9 vs − 5.7 percentage points, p < 0.01) and pain intensity (p < 0.001), alongside marked improvements in perceived stress (− 4.4 vs − 0.6 points, p < 0.001) and burnout dimensions (emotional exhaustion: − 6.3 vs − 0.8 points, p < 0.001). Improvements in patient safety metrics were also observed, with larger reductions in medication errors (− 7.4% vs − 2.5%) and surgical site infections (− 5.2% vs − 1.6%), and increased patient satisfaction scores (+1.5 vs +0.5 points, p < 0.01). Qualitative findings highlighted leadership engagement, clear protocols, and cultural integration as key facilitators, while emergency cases and staff shortages posed barriers. Adaptive strategies, such as flexible scheduling, supported sustained implementation.
Conclusion: Structured microbreaks yielded sustained improvements in MSD outcomes, psychological wellbeing, and patient safety, with organizational support and adaptability proving crucial for long-term success. Integrating microbreaks into routine OR workflows may enhance nurse health, reduce errors, and improve patient care quality, offering a strategic, resource-feasible intervention for high-stress healthcare settings. Findings support embedding microbreaks into standard operating procedures and orientation, using leadership role modeling, brief “buddy” coverage, and lightweight prompts to optimize fidelity at scale.
Keywords: microbreaks, musculoskeletal disorders, occupational health, operating room nurses, patient safety, mixed-methods
1Department of Anesthesiology, Shanxi Provincial People’s Hospital, Taiyuan, Shanxi, People’s Republic of China; 2Department of Media and Communication Studies, Faculty of Arts and Social Sciences, Universiti Malaya, Kuala Lumpur, Malaysia; 3School of Computer Science and Technology, Taiyuan University of Science and Technology, Taiyuan, Shanxi, People’s Republic of China
Correspondence: Guangmei Fan, School of Computer Science and Technology, Taiyuan University of Science and Technology, 66 Waliu Road, Taiyuan, Shanxi, People’s Republic of China, Email fgr@tyust.edu.cn
Background: Operating room (OR) nurses frequently experience work-related musculoskeletal disorders (MSDs) and psychological strain due to prolonged static postures, repetitive movements, and high-stress conditions. While short-term benefits of microbreak interventions have been demonstrated, evidence on their long-term effectiveness and impact on patient safety remains limited. This study aimed to evaluate the sustained effects of structured microbreaks on MSD outcomes, psychological wellbeing, and patient safety, and to explore organizational factors influencing intervention adherence.
Methods: A nonrandomized, controlled, multicenter mixed methods study, six-month follow up (N = 178 analyzed) was conducted in five hospitals in Shanxi Province, China. Ninety-one OR nurses received a structured microbreak intervention (2– 3-minute breaks every 30 minutes during procedures > 60 minutes, including ergonomic exercises and mindfulness practices), while 87 served as controls (analyzed cohorts after attrition). Quantitative data (Nordic Musculoskeletal Questionnaire, Perceived Stress Scale, Maslach Burnout Inventory, patient safety metrics) were collected at baseline and six months. Qualitative data were gathered through semi-structured focus groups and interviews with intervention participants.
Results: Compared to controls, intervention nurses experienced significantly greater reductions in MSD prevalence (− 20.9 vs − 5.7 percentage points, p < 0.01) and pain intensity (p < 0.001), alongside marked improvements in perceived stress (− 4.4 vs − 0.6 points, p < 0.001) and burnout dimensions (emotional exhaustion: − 6.3 vs − 0.8 points, p < 0.001). Improvements in patient safety metrics were also observed, with larger reductions in medication errors (− 7.4% vs − 2.5%) and surgical site infections (− 5.2% vs − 1.6%), and increased patient satisfaction scores (+1.5 vs +0.5 points, p < 0.01). Qualitative findings highlighted leadership engagement, clear protocols, and cultural integration as key facilitators, while emergency cases and staff shortages posed barriers. Adaptive strategies, such as flexible scheduling, supported sustained implementation.
Conclusion: Structured microbreaks yielded sustained improvements in MSD outcomes, psychological wellbeing, and patient safety, with organizational support and adaptability proving crucial for long-term success. Integrating microbreaks into routine OR workflows may enhance nurse health, reduce errors, and improve patient care quality, offering a strategic, resource-feasible intervention for high-stress healthcare settings. Findings support embedding microbreaks into standard operating procedures and orientation, using leadership role modeling, brief “buddy” coverage, and lightweight prompts to optimize fidelity at scale.
Keywords: microbreaks, musculoskeletal disorders, occupational health, operating room nurses, patient safety, mixed-methods