Thomas Bucher’s research while affiliated with ZHAW Zurich University of Applied Sciences and other places

Aim To compare student nurses' expectations and newly qualified nurses' experiences regarding clinical practice in Switzerland 1 year after graduation. Design A secondary explorative analysis of a cross‐sectional survey. Methods The data were sourced from the Swiss National Graduate Survey of Health Professionals covering six universities of applied sciences between 2016 and 2019, with information on three cohorts of bachelor student nurses, with a 1‐year follow‐up between each year. The participants were 533 bachelor‐prepared nursing graduates. Results The student nurses' overall expectations included the following top two prioritized aspects: ‘contributing to something important’ and ‘adequate time to spend with patients’. Newly graduated nurses' clinical practice experiences demonstrated that not all expectations were met 1 year after graduation. The largest gaps were found in ‘adequate time to spend with patients’, ‘work–life balance’ and experiencing ‘good management’. Conclusion The most crucial expectation gaps are related to having sufficient time to spend with patients and a good work–life balance. The most important result is whether there is a shortage of places for nurses to work rather than the oft‐cited shortage of nurses. Implications for the Profession and/or Patient Care The expectations of Swiss newly qualified nurses can be better met by an assessment in the first year about which individual perceptions of workplace characteristics cause them to make choices to change something about their work, affect their job satisfaction or influence their intention to stay. Impact Few of the student nurses' expectations were met 1 year after graduation, therefore Swiss healthcare institutions should improve needs assessments to strengthen the nurse workforce starting early in employment. The results underscore the importance of a constructive management culture, such as that in magnet hospitals in the United States which underpins the philosophy of changing in nursing. The results can be used internationally as a benchmark and as a basis for introducing potential interventions for nurse retention. Reporting Method This study was reported following the Standardized Reporting of Secondary Data Analyses Checklist. Patient or Public Contribution There were no patient or public contributions. Trial and Protocol Registration This study has not been registered.

Background Musculoskeletal pain, especially back pain, is common among health care professionals (HP). For prevention purposes, it is important to know whether HP develop their symptoms before or after entering the health care workforce. Cross-sectional studies among HP cannot answer this question. This follow-up study measures the prevalence and individual course of musculoskeletal pain among full-time HP students at the end of their studies and one year after entering the health care workforce. Method Self-reported one-year prevalence for low back pain, neck/shoulder pain, pain in arms/hands, and pain in legs/feet was collected at two timepoints from 1046 participating HP using an online questionnaire. Participants were asked whether their musculoskeletal pain was related to study or work conditions. Generalized estimating equation (GEE) models of the binomial family with log link were used to estimate adjusted prevalence and corresponding normal based 95% confidence intervals were derived using the bootstrap method with 1000 replications. Results The prevalence of low back pain as well as neck and shoulder pain was very high at baseline and follow-up in all full-time students and later HP. Prevalence for pain in arms/hands, legs/feet was low and there were significant differences between the professions. HP clearly associated their low back pain and neck/shoulder pain with study and work conditions; HP strongly associated pain in arms/hands, legs/feet only with work conditions. Conclusion Many HP suffer from back/neck/shoulder pain already as students before starting their professional career. The prevention of back/neck/shoulder pain must be part of the education of all health professions at universities. As an example of best practice, universities should incorporate ergonomic measures and exercises into the daily routine of training health professionals. The effects of physically demanding professional tasks on the upper and lower extremities need to be investigated in further studies to take preventive measures.

Background: Musculoskeletal pain, especially back pain, is common among health professionals (HPs). They reduce work productivity and cause high costs. This follow up study investigates the prevalence and individual course of Musculoskeletal pain among HP students at the end of their studies and one year after entering the health care workforce. Participants were asked whether their Musculoskeletal pain was related to study or work conditions. Method: Self reported one year prevalence for lower back pain, neck and shoulder pain, pain in arms or hands, and pain in legs or feet was collected by an online questionnaire at two timepoints from 1046 participating HPs. Generalized estimating equation (GEE) models of the binomial family with log link were employed to estimate adjusted prevalence and corresponding normal based 95% confidence intervals were derived using the bootstrap method with 1,000 replications. Results: Prevalence of lower back pain as well as neck and shoulder pain was very high at baseline and follow up in all students and later HPs. Prevalence for pain in arms or hands, legs or feet was lower and there were significant differences between the professions. HP associated their lower back pain and neck and shoulder pain clearly with study and work conditions; HPs linked pain in arms or hands, legs or feet strongly with work conditions only. Conclusion: The prevention of lower back pain and neck and shoulder pain must be included in the curricula of all health professions at universities. As best practice example, they should incorporate ergonomic measures and exercises as a daily routine of the formation of health professionals. The impact of physically demanding professional tasks on upper and lower extremities needs to be investigated in further studies in order to take preventive measures.

Background: Low back pain (LBP) and neck pain (NP) are of considerable socioeconomic burden. Considering the escalating demand on health services that LBP and NP have globally, they represent an arguably unsustainable drain on resources with the projected increased demand secondary to an ageing population. Identifying populations at risk for LBP and NP may inform public health prevention strategies. Health professions’ (HP) students may be more susceptible due to their demograp hic factors and potentially risky postural demands of their education and formative clinical practice. The aim of our study was to compare self-reported LBP and NP of HP students with the general and stratified Swiss population to identify their prevalence. In addition, we compared theprevalence of LBP and NP in students studying different professions in order to identify whether susceptibilities exist. Methods: In this cross-sectional study, self-reported LBP and NP reported by final-year HP students (n=1848) were compared with the Swiss national population aged ≥ 15 years living in private households (n=21,597). Binary regression models estimated crude prevalence and prevalence adjusted for age, gender, and education. Design-based F-Tests assessed differences between students and the Swiss population. Results: Crude, overall four-week (4w) prevalence (mean (95% CIs)) for LBP was 61.0% (58.4–63.5) in all HP students versus 40.0% (39.2–40.9) in the Swiss population. Female HP students aged 21–30 years (63.3% (60.5–66.1)) reported higher LBP than the same-aged Swiss female population with secondary (43.7% (39.5–47.9)) or tertiary (36.6% (30.8–42.9)) education. Crude, overall 4w prevalence for NP was 59.8% (57.2–62.3) in all HP students versus 36.4% (35.6–37.3) in the Swiss population. Female health professions’ students aged 21–30 years reported higher NP (63.2% (60.4–66.0)) than the same-aged Swiss female population with secondary (36.6% (32.7–40.8)) or tertiary (35.4% (29.6–41.8)) education. The inter-rofessional differences shown indicate midwifery to be most susceptible to reporting both conditions. Conclusions: Considerably higher LBP and NP were reported by final year HP students when compared with the general and stratified Swiss population. Worrying inter-professional susceptibilities were shown and reveal the need for further explanatory studies. Measures to reduce complex health problems like LBP and NP should be introduced into curricula in order to optimize the longevity of clinical careers and to protect the future HP workforce.