Abstract
1
Pensar Enfermagem / v.30 n.Sup / Jan-Dec 2026 / DOI: 10.71861/pensarenf.v30iSup.503 / e00503
Obstetric Nurses' Perception and Assessment of Work-Related
Musculoskeletal Disorder Risk: A Mixed-Methods Study
Armando Sousa1*, Cristina Lavaredas Baixinho2, Maria Helena Presado2, Maria Adriana Henriques2
1 Escola Superior de Enfermagem São José de Cluny, Funchal; Nursing Research Innovation and Development Centre of Lisbon (CIDNUR),
School of Nursing, Universidade de Lisboa. Lisbon. Portugal; https://orcid.org/0000-0002-6393-5896
2 Nursing Research Innovation and Development Centre of Lisbon (CIDNUR), School of Nursing, Universidade de Lisboa. Lisbon. Portugal;
https://orcid.org/0000-0001-7417-1732
3 Nursing Research Innovation and Development Centre of Lisbon (CIDNUR), School of Nursing, Universidade de Lisboa. Lisbon. Portugal;
https://orcid.org/0000-0002-6852-7875
4 Nursing Research Innovation and Development Centre of Lisbon (CIDNUR), School of Nursing, Universidade de Lisboa. Lisbon. Portugal;
https://orcid.org/0000-0003-0288-6653
* Corresponding author: adsousa@esesjcluny.pt
Abstract
Introduction
The occupational health literature documents a high prevalence of work-related musculoskeletal disorders
(WMSDs) among healthcare professionals, with nurses consistently identified as the occupational group at
greatest risk. The etiology is recognized as multifactorial, combining biomechanical demands (such as patient
handling and transfer maneuvers) and psychosocial factors (e.g., work pressure), often exacerbated by
organizational constraints including understaffing and inadequate material resources. This synergy of risk
factors constitutes a primary determinant of increased absenteeism, premature workforce attrition, and elevated
turnover rates. Consequently, systematic ergonomic risk assessment, coupled with critical analysis of high-
demand tasks, is imperative to inform evidence-based primary and secondary prevention strategies.
Objective
To analyze obstetric nurses' perceptions of WMSD risks and objectively assess the risk level of postures adopted
during clinical practice.
Methods
A convergent mixed-methods study was implemented, integrating Photovoice and ergonomic analysis.
Activities perceived as high-risk for WMSDs were photographically documented by obstetric nurses, followed
by narrative interviews to extract their risk perceptions. The same photographic corpus was then subjected to
objective ergonomic assessment using the REBA (Rapid Entire Body Assessment) tool to determine postural
risk levels.
Results
Twenty obstetric nurses participated (95.8% female; mean experience 24.55 years). REBA analysis revealed that
65.3% of postures (10.5% very high risk; 54.8% high risk) required immediate intervention, with no low-risk
postures identified. Confined spaces, inadequate equipment, work organization, and job demands were
identified as key risks, reflecting nurses' expressed concerns.
Conclusion
The convergence between subjective perception and objective assessment confirms the high-risk nature of
obstetric work. These findings underscore the urgent need for targeted ergonomic and organizational
interventions to mitigate WMSD risks and confirm obstetric nurses' risk awareness.
Keywords
Nurse Midwives; Perception; Occupational Health; Ergonomic; Occupational Injuries.
References
1. Luan HD, Hai NT, Xanh PT, Giang HT, Thuc PV, Hong NM, et al. Musculoskeletal disorders:
prevalence and associated factors among district hospital nurses in Haiphong, Vietnam. Biomed Res
Abstract
2
Pensar Enfermagem / v.30 n.Sup / Jan-Dec 2026 / DOI: 10.71861/pensarenf.v30iSup.503 / e00503
Int [Internet]. 2018 [cited 2025 Dec 7]; (1): 1-9. Available from:
https://onlinelibrary.wiley.com/doi/epdf/10.1155/2018/3162564
2. Creswell JW, Creswell JD. Research design: qualitative, quantitative, and mixed methods
approaches. 5th. Thousand Oaks: SAGE Publications; 2018.
3. Jarldorn M. Photovoice handbook for social workers: method, practicalities and possibilities for
social change. Cham: Palgrave Macmillan; 2019.
