https://doi.org/10.15218/ejnm.2024.14 Erbil j. nurs. midwifery, Vol. 7, No. (2), Nov 2024 Original Article Nurses’ Knowledge and Practice of Body Mechanic Techniques at Emergency Teaching Hospitals in Erbil City/Kurdistan region – Iraq ABSTRACT Background and Objectives: Body mechanics is a term that indicates a coordinated effort between the neurological and musculoskeletal systems to maintain balance, posture, and body alignment in daily activities, which is essential for efficient bodily functioning. The study aimed to assess nurses’ knowledge and practice regarding mechanical body movement at emergency hospitals in Erbil City. Methods: The study was carried out at the West, East Emergencies and Emergency Man- agement Center (EMC) in Erbil City -Kurdistan Region, Iraq. A non-probability convenient sample of 300 nurses at all emergencies in Erbil city was selected. A special questionnaire was prepared by an extensive literature review and opinion experts. The questionnaires consist of two parts, the nurses’ knowledge questionnaire, which consists of 25 items, and the observation checklist to evaluate practice, which consists of 35 items. The reliability of the questionnaire was determined the performance of the pilot study. Data analysis was performed by using SPSS "vesion26" (Frequency, Percentage, and Chi-square test). Results: The highest percentage of overall knowledge scores was poor (71.7%) and the highest percentage of overall practice scores were fair, (86%). The result showed signifi- cant associations and high significant associations between gender, level of education (Diploma in nursing), and knowledge. Also, the result showed a very high significant asso- ciation between extra jobs and practice. Conclusions: The study concluded that the total means score of knowledge was better than practice about body mechanics techniques. Those results revealed nurses' need for an education program to improve their knowledge and practice. Keywords: Knowledge; Practice; Body Mechanics; Nurses. Kameran Wzw Rasool; Department of Nursing, College of Nursing, Duhok University, Kurdistan Region, Duhok, Iraq. (Correspondence: kameranw.rasool@gmail.com) Ronak Nematalah Hussain; Department of Nursing, College of Nursing, Hawler Medical University, Kurdistan Region, Erbil, Iraq. 148 Received: 18/10/2022 Accepted: 01/07/2023 Published: 30/11/2024 Copyright ©2024The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. mailto:kameranw.rasool@gmail.com mailto:kameranw.rasool@gmail.com?subject=kameranw.rasool@gmail.com mailto:jawdat.baker@hmu.edu.krd?subject=jawdat.baker@hmu.edu.krd%20%20%20 https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.14 Erbil j. nurs. midwifery, Vol. 7, No. (2), Nov 2024 Original Article Body mechanics is a word that describes how to use the body in daily life, it includes the ways to maintain the body when sitting, standing, bending, and lifting heavy objects. By using body mechanics, the body protects from musculoskeletal injuries like low back pain; in contrast, un execution body mechanics principle the body at risk of injuries. [1]Nurses are more prone to work-related physical injuries which result in symptoms like back pain and other MSPs (musculoskeletal problems). Therefore, nursing officers required to incorporate knowledge and skills into the practice of body mechanics. Many nursing activities require muscle exertion to reduce the risk of musculoskeletal injury to the nursing officers while transferring patients; the nursing officers must know about the prop- er body mechanics [2]. The use of good body mechanics can lessen the chance of musculoskeletal system injury while simul- taneously facilitating body movement, al- lowing for physical mobility without caus- ing muscular strain or excessive use of muscle energy [3] Poor body mechanics are often the cause of back problems. When we do not move correctly and safe- ly, the spine is subjected to abnormal stresses that over time can lead to degen- eration of spinal structures like discs and joints, injury, and unnecessary wear and tear. That is why it is important to learn the principles of proper body mechanics [4].There are several practical reasons to use proper body mechanics when perform- ing physical tasks. Not only to reduce the risk of injury but also to use the correct techniques can keep from becoming overly fatigued when doing physical labor. Em- ploying the appropriate body mechanics requires less energy to complete a task, makes it easier to lift or move a large or heavy object, and puts less strain on the back, legs, and arms [5]. The study design was carried out in the (West Emergency Hospital, East, Emergency Hospital and EMC-emergency management center) emergency hospitals in Erbil City. The administration departments of emergency hospitals were provided with all necessary information to obtain on nurses during data collected from December 26th, 2021, to March 26th, 2022. Samples of the study were non– probability purposive samples of 300 nurses who were worked in emergency hospitals that mentioned above. Data was collected through self-structure tools based on an extensive review of literature which includes nurses’ sociodemographic data, and medical data of nurses’ knowledge and practices; by using an observation checklist for it. According to practice scores, nurses were always practicing took two, sometimes practice took one, and never practice took zero. Statistical analysis was done by using SPSS 26, using frequency, percentage, and chi- square, with P-value =<0.05 considered statistically significant. Table1 shows the Sociodemographic characteristics of emergency nurses. The result revealed that 74.7% nurses were 40 years or less and 56.7% of them were males. The majority of them 77% have diplomas in nursing. Whereas the highest percentage, 84% of them had less than fifteen years of experience, and about 47% of the nurses were from the West Emergency Hospital. 71% of nurses did not participate in body mechanics movement training sessions. And also 46.7 % of nurses had not done any extra jobs after hospital work. 80.7% of emergency nurses worked from four to six days per week. 149 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. INTRODUCTION METHODS RESULT https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.14 Erbil j. nurs. midwifery, Vol. 7, No. (2), Nov 2024 Original Article only 28.3% of them had good knowledge about body mechanics The figure1 illustrates that 71.7 % of emer- gency nurses had poor knowledge, while . 150 Copyright ©2024The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 1 : Sociodemographic Characteristics of Nurses Emergency Sociodemographic characteristics of emergency nurses F. (%) Age group ( years) 26-30 12 (4) 31-35 110 (36.7) 36-40 102 (34) 41-45 48 (16) 46-50 13 (4.3) > 50 15 (5) Gender of nurse Male 170 (56.7) Female 130 (43.3) Level of education Secondary nursing school 30 (10) Technical Diploma in nursing 231 (77) B.Sc. in Nursing 39 (13) Years of experience 1-5 15 (5) 6-10 90 (30) 11-15 147 (49) 16-20 35 (11.7) 21-25 11 (3.7) >25 2 (0.6) Setting of nurses East emergency 93 (31) West emergency 141 (47) Emergency management center 66 (22) Participation in body mechanic training Session Yes 87 (29) No 213 (71) Secondary or extra job Nothing 140 (46.7) Private hospital 39 (13) Self-clinic 41 (13.7) Pharmacy 23 (7.7) Others 57 ( 19) Working days per week in Hospitals 1-3 58 (19.3) 4-6 242 (80.7) Figure 1 Nurses’ level Knowledge regarding Body Mechanic https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.14 Erbil j. nurs. midwifery, Vol. 7, No. (2), Nov 2024 Original Article Figure2 depicts the distribution frequency of nurses according to the practice of body mechanics , the highest percentage Regarding nurses’ knowledge, Table 2 shows that the mean score is 15.113 for nurses' knowledge out of a total of 25 questions with a standard Of emergency nurses, 86% had fair prac- tice and 14% of emergency nurses had poor practices of body mechanics. deviation of 2.427. While the average prac- tice score across all 70 scores was 27.7700, with a standard deviation of 5.685. 151 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Figure 2 Nurses practice Body Mechanic The total mean of nurses’ knowledge and their practices Overall Knowledge Overall Practice Mean 15.1133 27.7700 Std. Deviation 2.42765 5.68549 Minimum 9 14 Maximum 22 48 Table 2 :the overall mean of nurses’ knowledge and their practice https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.14 Erbil j. nurs. midwifery, Vol. 7, No. (2), Nov 2024 Original Article 152 level of schooling, while there was a non- significant association between nurses’ knowledge with other characteristics such as age, job, experience, and working days per week, at p-value (0.35, 0.54, 0.39, 0.92, 0.36, 0.64 respectively). Table 3 revealed a significant association between emergency nurses' knowledge and their gender (p-value of 0.022), and a highly significant p-value of 0.008 associa- tion between emergency nurses' knowledge of body mechanics and their Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table3: association between overall nurses’ knowledge and their sociodemographic characteristics Socio-demographic characteristics Overall Knowledge poor Good P- Value F (%) F (%) Age group (years) 26-30 9 (75) 3 (25) 0.358 31-35 77 (70) 33 (30) 36-40 74 (72.5) 28 (27.5) 41-45 35 (72.9) 13 (27.1) 46-50 12 (92.3) 1 (7.7) > 50 8 (53.3) 7 (46.7) Gender of nurse Male 113 (66.5) 57 (33.5) 0.022 Female 102 (78.5) 28 (21.50 Level of education Secondary nursing school 24 (80) 6 (20) 0.008 Diploma in nursing 171 (74) 60 (26) B.Sc. in nursing 20 (51.3) 19 (48.7) Experience in job 1-5 8 (53.3) 7 (46.7) 0.541 6-10 64 (71.1) 26 (28.90) 11-15 108 (73.5) 39 (26.5) 16-20 27 (77.1) 8 (22.9) 21-25 8 (63.6) 5 (36.4) Setting of nurse East emergency 71 (76.3) 22 (23.7) 0.396 West emergency 100 (70.9) 41 29.1 Emergency management center 44 (66.7) 22 33.3 Participation in body me- chanic training Session Yes 62 (71.3) 25 (28.7) 0.921 No 153 (71.8) 60 (28.2) Secondary or extra job Nothing 105 (75) 35 (25) 0.366 Private hospital 24 (61.5) 15 (38.5) Self-clinic 32 (78) 9 (22) Pharmacy 16 (69.6) 7 (30.4) Others 38 (66.7) 19 (33.30 Working days per week in Hospital 1-3 days 43 (74.1) 15 (25.9) 0.642 4-6 days 172 (71.1) 70 (28.9) https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.14 Erbil j. nurs. midwifery, Vol. 7, No. (2), Nov 2024 Original Article practice (p-value > 0.05), except for the variable extra job, which was significantly associated with practice (p-value 0.001). 153 Table 4 showed that none of the socio- demographic characteristics of nurses were significantly associated with their Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 4: association between overall nurses’ practices and their sociodemographic char- acteristics. Socio-demographic characteristics Overall Practice P-Value Poor Fair F % F (%) Age group ( years) 26-30 3 (25) 9 (75) 0.769 31-35 14 (12.7) 96 (87.3) 36-40 12 (11.8) 90 (88.3) 41-45 8 (16.7) 40 (83.3) 46-50 4 (30.8) 9 (69.2) > 50 1 (6.7) 14 (93.3) Gender of nurse Male 25 (14.7) 145 (85.3) 0.420 Female 17 (13.1) 113 (86.9) Level of education Secondary nursing school 4 (13.3) 26 (86.7) 0.878 Diploma in nursing 34 (14.7) 197 (85.3) B.Sc. in nursing 4 (10.3) 35 (89.7) Experience in job 1-5 3 (20) 12 (80) 0.603 6-10 13 (14.4) 77 (85.6) 11-15 16 (10.9) 131 (89.2) 16-20 8 (22.9) 27 (77.1) 21-25 2 (9.1) 11 (90.9) Setting of nurses East emergency 10 (10.8) 83 (89.3) 0.238 West emergency 22 (15.6) 119 (84.4) Emergency management center 10 (15.2) 56 (84.8) Participation in body mechanic training Session Yes 10 (11.5) 77 (88.5) 0.596 No 32 (15) 181 (85) Secondary or extra job Nothing 22 (15.7) 118 (84.3) 0.001 Private hospital 3 (7.7) 36 (92.3) Self-clinic 4 (9.8) 37 (90.2) Pharmacy 4 (17.4) 19 (82.6) Others 9 (15.8) 48 (84.2) Working days per week in Hospitals 1-3 7 (12.1) 51 (87.9) 0.695 https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.14 Erbil j. nurs. midwifery, Vol. 7, No. (2), Nov 2024 Original Article Body mechanics is an important practice that should be practiced in simple or com- plex treatment procedures. to avoid mus- culoskeletal disorders such as back pain. In conclusion, this study tried to determine the extent of knowledge and practice of body mechanics among nurses, which re- vealed that their knowledge and practice were not good; therefore, nurses need ed- ucation and training programs to improve their knowledge and practice. The authors report no financial assistance or conflicts of interest. [1] Akhtar A, Afzal M, Kousar R, Waqas A, Gilani SA. Assess knowledge and practices of body mechanic technique among nurses at Punjab Institute of Cardiology Lahore. Saudi Journal of Medical and Pharmaceutical Sciences. 2017;3:545-55. [2] SAINI SK, Pandey V, Kumar A, Elhence A. Musculoskeletal problems and expressed practices of body mechanics among nursing officers at All India Institute of Medical Sci- ences Jodhpur, Rajasthan, India. Journal of Integrative Nursing. 2021 Sep 29;3(3):128- 34. [3] Rawat A, Negi A, Rana M, Gusain M, Negi N, Tomar N, et al., Knowledge assessment on use of Body mechanics and Safety measures among ward attendants in selected hospital of Dehradun, Uttarakhand. Age (in years). 2017 Dec 6;21(30):31-40. [4] Jayakrishnan K. Knowledge and practice among staff nurses regarding body mechan- ics. International Journal of Advances in Nursing Management. 2016 Sep 28;4(3):259 -63. [5] Howyida S, Heba A, Abeer Y. Impact of Appli- cation of Body Mechanic Principles on Im- proving Low Back Pain among Female Work- ers at Benha University. Journal of American Science. 2011;7(11):457-67. The present study revealed that the ma- jority of nurses had fair knowledge and 28.3% of nurses had good knowledge about body mechanics techniques. This result is supported by studies conducted by [1], in Saudi Arabia., [7, 9, 10,] in India, [11] in Malaysia. And also, this result is not congruent with studies done by [4, 12, 13, 14], in India, who revealed that most nurs- es had good knowledge. The result of this study shows that the majority of nurses had fair practice and the lowest percent- age of emergency nurses had poor practic- es of body mechanics. A similar result was found in a study done by [6] in India. This found that 60% of nurses had average practice and 40% of them had poor prac- tice regarding body mechanics. There was a significant association and a high signifi- cant association between nurses’ knowledge and their select sociodemo- graphic variables like gender and level of education (p-value 0.022, 0.008 respec- tively). There was no significant associa- tion between variables like age, experi- ence in the job, setting, training session, or extra job at the level of p>0.05. This was congruent with the results of the studies done by [4,6] in India and [8], in Egypt. There was no significant association be- tween nurses’ practice and variables of sociodemographic except for the variable extra job. The p-value was 0.001 an indica- tors of a very high significant association between extra jobs and nurses’ practice regarding body mechanics. it was support- ed by [6,9,16] in India. [15], in South Ko- rea. [ 8], in Egypt. 154 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. DISCUSSION CONCLUSION CONFLICT OF INTERES REFERENCES https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.14 Erbil j. nurs. midwifery, Vol. 7, No. (2), Nov 2024 Original Article [14] Dash K, Das M. 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It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. https://creativecommons.org/licenses/by-nc-sa/4.0/