Influencia de la promoción de la salud y medidas preventivas en el trabajo sobre la capacidad laboral en el sector sanitario: una revisión sistemática
DOI:
https://doi.org/10.4321/s0465-546x2025000200005Palabras clave:
promoción de la salud, medidas preventivas, capacidad de trabajo, trabajadores sanitarios, revisión sistemáticaResumen
Introducción: Los profesionales sanitarios cuidan la salud de las personas. Para mantener su capacidad de trabajo necesitan tener buena salud, entornos de trabajo seguros y un equilibrio entre sus recursos personales y las demandas físicas y mentales. El objetivo de la revisión fue conocer más sobre los efectos de la promoción de la salud y las medidas preventivas en el trabajo sobre la capacidad laboral de estos trabajadores.
Método: Se buscaron estudios observacionales y experimentales publicados desde 2014 hasta 2024 en PubMed, Scopus, Web of Science, Cochrane Library y Google Scholar, para identificar, en trabajadores del ámbito sanitario, intervenciones de promoción de la salud o prevención realizadas en el lugar de trabajo. La medida de resultado fue el índice de capacidad para el trabajo. Dos revisores seleccionaron los estudios y analizaron su calidad y fiabilidad tras una lectura crítica. Además, evaluaron el riesgo de sesgo y la calidad de la evidencia.
Resultados: Se seleccionaron 19 estudios (10 ensayos aleatorizados, 6 cuasiexperimentales y 3 observacionales), de calidad media-baja y riesgo de sesgo incierto-alto. Se observó una mejora significativa en la capacidad de trabajo en 12 estudios (63 %), que analizaban programas de entrenamiento físico, dotación de recursos frente a las exigencias mentales, asesoramiento en hábitos saludables y mejoras ergonómicas. La calidad de la evidencia fue moderada.
Discusión: Estas intervenciones pueden mejorar la capacidad laboral del personal sanitario. Se requieren estudios de mayor calidad y seguimientos más largos. Los hallazgos pueden ayudar a profesionales de salud ocupacional y gestores sanitarios en la decisión de implementar programas efectivos de promoción de la salud y prevención para los empleados.
Descargas
Citas
World Health Organization. Occupational health [Internet]. Geneva: WHO; 2024 [cited 2024 Nov 10]. Available from: https://www.who.int/health-topics/occupational-health
European Network for Workplace Health Promotion (ENWHP) [Internet]. Perugia: ENWHP; 2024 [cited 2024 Nov 10]. Available from: https://www.enwhp.org/
Burton J. WHO healthy workplace framework and model: background and supporting literature and practices [Internet]. Ginebra: World Health Organization; 2010 [cited 2024 Nov 10]. Available from: https://iris.who.int/handle/10665/44466
Tuomi K, Eskelinen L, Toikkanen J, Jarvinen E, Ilmarinen J, Klockars M. Work load and individual factors affecting work ability among aging municipal employees. Scand J Work Environ Health. 1991;17 Suppl 1:128-34.
Tuomi K, Ilmarinen J, Martikainen R, Aalto L, Klockars M. Aging, work, life-style and work ability among Finnish municipal workers in 1981-1992. Scand J Work Environ Health. 1997;23 Suppl 1:58-65.
Ilmarinen J. The Work Ability Index (WAI). Occup Med (Lond). 2007 Mar 1;57(2):160. DOI: 10.1093/occmed/kqm008
Gould R, Ilmarinen J, Järvisalo J, Koskinen S, editors. Dimensions of work ability: results of the Health 2000 Survey. Helsinki: Finnish Centre for Pensions; 2008. 185 p.
Ilmarinen J. Work ability - a comprehensive concept for occupational health research and prevention. Scand J Work Environ Health. 2009 Jan;35(1):1-5. DOI: 10.5271/sjweh.1304
Ilmarinen J. From work ability research to implementation. Int J Environ Res Public Health. 2019 Aug 12;16(16):2882. DOI: 10.3390/ijerph16162882
Van Den Berg TIJ, Elders LAM, De Zwart BCH, Burdorf A. The effects of work-related and individual factors on the Work Ability Index: a systematic review. Occup Environ Med. 2009 Apr;66(4):211-20. DOI: 10.1136/oem.2008.039883
Oakman J, Neupane S, Proper KI, Kinsman N, Nygård CH. Workplace interventions to improve work ability: A systematic review and meta-analysis of their effectiveness. Scand J Work Environ Health. 2018 Mar 1;44(2):134-146. DOI: 10.5271/sjweh.3685
Shiri R, Nikunlaakso R, Laitinen J. Effectiveness of workplace interventions to improve health and well-being of health and social service workers: a narrative review of randomised controlled trials. Healthcare. 2023 Jun 17;11(12):1792. DOI: 10.3390/healthcare11121792
Cuidar a los que cuidan: guía para la elaboración y ejecución de programas de salud y seguridad en el trabajo para los trabajadores de la salud [Internet]. Ginebra: Organización Mundial de la Salud y Organización Internacional del Trabajo; 2024 [citado 2024 Nov 10]. Disponible en: https://www.who.int/es/publications/i/item/9789240040779
Orden SCO/1526/2005, de 5 de mayo, por la que se aprueba y publica el programa formativo de la especialidad de Medicina del Trabajo. Boletín Oficial del Estado; 2005.
Orden SAS/1348/2009, de 6 de mayo, por la que se aprueba y publica el programa formativo de la especialidad de Enfermería del Trabajo. Boletín Oficial del Estado; 2009.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;372:n71. DOI: 10.1136/bmj.n71
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan - a web and mobile app for systematic reviews. Syst Rev. 2016 Dec 5;5:210. DOI: 10.1186/s13643-016-0384-4
Rayyan - Intelligent Systematic Review [Internet]. 2021 [cited 2024 Nov 24]. Available from: https://www.rayyan.ai/
López de Argumedo M, Reviriego E, Gutiérrez A, Bayón JC. Actualización del Sistema de Trabajo Compartido para Revisiones Sistemáticas de la Evidencia Científica y Lectura Crítica (Plataforma FLC 3.0). Ministerio de Sanidad, Servicios Sociales e Igualdad. Servicio de Evaluación de Tecnologías Sanitarias del País Vasco; 2017. Informes de Evaluación de Tecnologías Sanitarias: OSTEBA. Disponible en: http://www.lecturacritica.com/es/acerca.php
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editors. Cochrane handbook for systematic reviews of interventions. Versión 6.5 (updated August 2024). Cochrane; 2024. Available from: https://training.cochrane.org/handbook
McGuinness, LA, Higgins, JPT. Risk-of-bias VISualization (robvis): An R package and Shiny web app for visualizing risk-of-bias assessments. Res Synth Methods. 2021 Jan;12(1):55-61. DOI: 10.1002/jrsm.1411
Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008 Apr 26;336(7650):924-6. DOI: 10.1136/bmj.39489.470347.AD
GRADEpro GDT: GRADEpro Guideline Development Tool [software]. McMaster University and Evidence Prime; 2024. Available from: https://www.gradepro.org
Barene S, Krustrup P, Holtermann A. Effects of the workplace health promotion activities soccer and zumba on muscle pain, work ability and perceived physical exertion among female hospital employees. PLoS One. 2014 Dec 10;9(12):e115059. DOI: 10.1371/journal.pone.0115059
Jakobsen MD, Sundstrup E, Brandt M, Jay K, Aagaard P, Andersen LL. Physical exercise at the workplace prevents deterioration of work ability among healthcare workers: cluster randomized controlled trial. BMC Public Health. 2015 Nov 25;15:1174. DOI: 10.1186/s12889-015-2448-0
Heinrich C. Interdisciplinary work place health promotion in health care. Arbeitsmedizin Sozialmedizin Umweltmedizin [Internet]. 2016 [cited 2024 Oct 25];51(8):587-92. Available from: https://www.asu-arbeitsmedizin.com/originalia/berufsgruppenuebergreifende-betriebliche-gesundheitsfoerderung-bgf-im-gesundheitswesen
Rasmussen CDN, Holtermann A, Jørgensen MB, Ørberg A, Mortensen OS, Søgaard K. A multi-faceted workplace intervention targeting low back pain was effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence: Stepped wedge cluster randomised trial. Scand J Public Health. 2016 Aug; 44(6):560-70. DOI: 10.1177/1403494816653668
Abedian Z, Safaei M, Mazlum SR, Attarzadeh Hoseini SR. The effect of aerobic exercise training on work ability of midwives working in health care centers. Journal of Midwifery and Reproductive Health. 2017 Jan;5(1):828-33. DOI: 10.22038/jmrh.2016.7992
Stenner HT, Eigendorf J, Kerling A, Kueck M, Hanke AA, Boyen J, et al. Effects of six month personalized endurance training on work ability in middle-aged sedentary women: a secondary analysis of a randomized controlled trial. J Occup Med Toxicol. 2020 May 6;15:8. DOI: 10.1186/s12995-020-00261-4
Das Gecim GY, Esin MN. A self-management programme for work ability and quality of life in nurses aged 45 years and over: A randomized controlled trial. Int J Nurs Pract. 2021;27(6):e12963. DOI: 10.1111/ijn.12963
Lin S, Tsai CC, Liu X, Wu Z, Zeng X. Effectiveness of participatory ergonomic interventions on musculoskeletal disorders and work ability among young dental professionals: A cluster-randomized controlled trail. J Occup Health. 2022 Jan;64(1):e12330. DOI: 10.1002/1348-9585.12330
Montano D, Kuchenbaur M, Peter R. Outcomes and process evaluation of a cluster-randomised participatory organisational intervention among German healthcare workers. BMC Health Serv Res. 2023 Mar 16;23(1):260. DOI: 10.1186/s12913-023-09240-x
Ketelaar SM, Nieuwenhuijsen K, Gärtner FR, Bolier L, Smeets O, Sluiter JK. Mental Vitality @ Work: The effectiveness of a mental module for workers’ health surveillance for nurses and allied health professionals, comparing two approaches in a cluster-randomised controlled trial. Int Arch Occup Environ Health. 2014 Jul;87(5):527-38. DOI: 10.1007/s00420-013-0893-6
Schwarze M, Egen C, Gutenbrunner C, Schriek S. Early workplace intervention to improve the work ability of employees with musculoskeletal disorders in a German university hospital - results of a pilot study. Healthcare (Basel). 2016 Sep 7;4(3):64. DOI: 10.3390/healthcare4030064
Rapisarda V, Cannizzaro E, Barchitta M, Vitale E, Cinà D, Minciullo F, et al. A combined multidisciplinary intervention for health promotion in the workplace: A pilot study. J Clin Med. 2021 Apr 5;10(7):1512. DOI: 10.3390/jcm10071512
Pleho D, Hadžiomerović AM, Pašalić A, Katana B, Jaganjac A. The effect of the ergonomic intervention program on work-related musculoskeletal disorders in healthcare professionals. J Health Sci. 2023;13(3 (Suplement 1)):223-7. DOI: 10.17532/jhs.2023.2624
Hasenoehrl T, Steiner M, Ebenberger F, Kull P, Sternik J, Reissig L, et al. “Back Health 24/7/365” - A novel, comprehensive “one size fits all” workplace health promotion intervention for occupational back health among hospital employees. Int J Environ Res Public Health. 2024 Jun 14;21(6):772. DOI: 10.3390/ijerph21060772
Axén I, Follin G. Medical yoga in the workplace setting−perceived stress and work ability−a feasibility study. Complement Ther Med. 2017;30:61-6. DOI: 10.1016/j.ctim.2016.12.001
Escriche-Escuder A, Calatayud J, Andersen LL, Ezzatvar Y, Aiguadé R, Casaña J. Effect of a brief progressive resistance training program in hospital porters on pain, work ability, and physical function. Musculoskelet Sci Pract. 2020 Aug;48:102162. DOI: 10.1016/j.msksp.2020.102162
Kusma B, Pietsch A, Riepenhof H, Haß S, Kuhn D, Fischer K, et al. The Back College for nurses - an evaluation of intermediate effects. J Occup Med Toxicol. 2019 Jun 20;14:19. DOI: 10.1186/s12995-019-0239-8
Gutenbrunner C, Briest J, Egen C, Sturm C, Schiller J, Kahl KG, Tegtbur U, Fuhr H, Korallus C. “Fit for work and life”: an innovative concept to improve health and work ability of employees, integrating prevention, therapy and rehabilitation. J Rehabil Med. 2021 May 31;53(5):jrm00199. DOI: 10.2340/16501977-2822
Lindegård A, Nordander C, Jacobsson H, Arvidsson I. Opting to wear prismatic spectacles was associated with reduced neck pain in dental personnel: a longitudinal cohort study. BMC Musculoskelet Disord. 2016 Aug 17;17:347. DOI: 10.1186/s12891-016-1145-1
Jakobsen MD, Sundstrup E, Brandt M, Kristensen AZ, Jay K, Stelter R, et al. Effect of workplace- versus home-based physical exercise on pain in healthcare workers: study protocol for a single blinded cluster randomized controlled trial. BMC Musculoskelet Disord. 2014 Apr 7;15:119. DOI: 10.1186/1471-2474-15-119
Jakobsen MD, Sundstrup E, Brandt M, Jay K, Aagaard P, Andersen LL. Effect of workplace- versus home-based physical exercise on musculoskeletal pain among healthcare workers: a cluster randomized controlled trial. Scand J Work Environ Health. 2015 Mar;41(2):153-63. DOI: 10.5271/sjweh.3479
Gärtner FR, Ketelaar SM, Smeets O, Bolier L, Fischer E, van Dijk FJ, et al. The Mental Vitality @ Work study: design of a randomized controlled trial on the effect of a workers’ health surveillance mental module for nurses and allied health professionals. BMC Public Health. 2011 May 10;11(1):290. DOI: 10.1186/1471-2458-11-290
Matera S, Filetti V, Rapisarda V, Ka K, Rapisarda L, Dounias G, et al. Workplace health promotion: results of a combined multidisciplinary intervention over a long period – preliminary results. Eur Rev Med Pharmacol Sci. 2023;27(19): 9346-9354. DOI: 10.26355/eurrev_202310_33962
Fairbank JCT, Davies JB, Couper J, O’Brien JP. The Oswestry Low Back Pain Disability Questionnaire. Physiotherapy. 1980;66(8):271-3.
Eigendorf J, Melk A, Haufe S, Boethig D, Berliner D, Kerling A, et al. Effects of personalized endurance training on cellular age and vascular function in middle-aged sedentary women. Eur J Prev Cardiolog. 2019 Nov;26(17):1903-1906. DOI: 10.1177/2047487319849505
Ware J, Kosinski M, Keller S. SF-12: how to score the SF-12 physical and mental health summary scales. 2nd ed. Boston (MA): The Health Institute, New England Medical Center; 1995.
Grimani A, Aboagye E, Kwak L. The effectiveness of workplace nutrition and physical activity interventions in improving productivity, work performance and workability: a systematic review. BMC Public Health. 2019 Dec 12;19(1):1676. DOI: 10.1186/s12889-019-8033-1
Mänttäri S, Oksa J, Lusa S, Korkiakangas E, Punakallio A, Oksanen T, et al. Interventions to promote work ability by increasing physical activity among workers with physically strenuous jobs: A scoping review. Scand J Public Health. 2021 Mar;49(2):206-218. DOI: 10.1177/1403494820917532
European Agency for Safety and Health at Work. Executive summary: current and emerging occupational safety and health (OSH) issues in the healthcare sector, including home and community care [Internet]. Bilbao: EU-OSHA; 2025 [cited 2025 Jan 10]. Available from: https://osha.europa.eu/es/publications/executive-summary-current-and-emerging-occupational-safety-and-health-osh-issues
Egan M, Bambra C, Petticrew M, Whitehead M. Reviewing evidence on complex social interventions: appraising implementation in systematic reviews of the health effects of organisational-level workplace interventions. J Epidemiol Community Health. 2009 Jan;63(1):4-11. DOI: 10.1136/jech.2007.071233
Rychetnik L, Frommer M, Hawe P, Shiell A. Criteria for evaluating evidence on public health interventions. J Epidemiol Community Health. 2002 Feb;56(2):119-27. DOI: 10.1136/jech.56.2.119
Center for Open Science. Open Science Framework (OSF) [Internet]. Charlottesville (VA): COS; 2025 [cited 2025 Jan 10]. Available from: https://osf.io/
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2025 Ángel Vega-Suárez, Álvaro Morán-Bayón, Rogelio González-Sarmiento, José Lorenzo Bravo-Grande
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
