Foot and Ankle Disorders: the Overlooked Challenge for Nurses
By Rafael Bernardes
Nurses, among other healthcare professionals, walk an average of 3.7 miles per shift in the hospital and stand in static positions for many hours. Therefore, there has been a rise in musculoskeletal disorders, particularly in the foot and ankle region. These disorders contribute to an increase in work-related dissatisfaction and absenteeism, thus leading to long-term shortages in the nursing workforce.
Better understanding of the main characteristics of foot and ankle disorders is crucial for the development of new interventions and to help expand our knowledge of the phenomena.
To this end, previous studies have focused on lower back, neck, and shoulder disorders, with notably low attention given to the foot and ankle region. Our recently published review has demonstrated that disorders in this region, which exhibit a range of signs and symptoms from pain to structural deformities like changes in foot arch, are highly prevalent among nurses. The three main findings of this study are:
A list and characterization of the most frequent disorders found in the literature: calluses, corns, hyperhidrosis, fungal infections, contact dermatitis, onychomycosis, ingrown toenail, verrucae, warts, foot/ankle strain and sprain, pain (metatarsalgia, generalized forefoot pain), numbness, burning feet, cold feet, bunions (hallux valgus, bone spurs), hammer toes, low foot arch, high foot arch, and flat feet.
The reported prevalence of the aforementioned disorders. Three studies found that they were the most prevalent musculoskeletal disorders among nurses.
The reported walking and standing hours lack consensus across studies due to contextual, personal, and occupational factors.
Specific gender-related differences, where female nurses are the most affected.
Collectively or individually, all the disorders listed above have specific manifestations, which can be prevented or treated through a personalized monitoring of one’s health, and lifestyle, but also through adequate occupational health policies. For example, footwear can be an important risk factor if inadequate, or a great protective external factor if correctly adjusted. Other implications for occupational health nursing practice are the need to increase awareness among healthcare professionals and administrators, empower nurses to apply better foot and ankle self-care interventions, and the development of specific guidelines and recommendations for the prevention, diagnosis, and treatment of foot and ankle disorders.
Article Details
Foot and Ankle Disorders in Nurses Exposed to Prolonged Standing Environments: A Scoping Review
Rafael A. Bernardes, Sílvia Caldeira, Pedro Parreira, Liliana B. Sousa, João Apóstolo, Inês F. Almeida, Paulo Santos-Costa, Minna Stolt, and Arménio Guardado Cruz
First published online January 13, 2023
DOI: 10.1177/21650799221137646
Workplace Health & Safety
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