Exploring the Social Contexts of Exoskeleton Design and Implementation in Long-Term Care: A Study of Nurses and Nurse Managers with Musculoskeletal Disorders

Nurses face significant physical demands during patient care, leading to high rates of musculoskeletal disorders (MSDs) among nurses in long-term care. Exoskeletons demonstrate promise in supporting nurses and nurse managers with MSDs; however, social contextual factors are crucial to their design and implementation. Through thematic analysis of 17 semi-structured interviews, this paper reveals social contextual factors important to exoskeleton use among nurses and nurse managers in long-term care. Participants expressed concerns about workplace discrimination, co-worker perceptions of their capabilities, and patient confidence. Our findings highlight the need for supportive organizational cultures and open communication channels. Recommendations include in-depth systems analysis to assess exoskeleton feasibility and efficacy, involving input from frontline nurses/managers, management, and patients. These findings can aid human factors and ergonomics (HF/E) experts in balancing social contextual factors and other work system elements to design work system contexts and exoskeletons that promote optimal outcomes in long-term care settings.