The purpose of this study was to identify factors that promote or inhibit the introduction and utilization of no-lifting care in social welfare facilities in Japan. No-lifting care prevents back pain among caregivers by avoiding manual lifting of patients.

Back pain among caregivers is a growing issue in Japan and other countries, often caused by manual lifting. While other countries recommend using equipment that eliminates manual lifting to prevent back pain, in Japan, the Ministry of Health, Labor, and Welfare also endorses no-lifting care. However, nationwide adoption of no-lifting care is limited, and even where implemented, it is often underutilized. A lack of caregiver knowledge is a noted barrier to no-lifting care adoption in social welfare facilities, but the factors that either promote or hinder no-lifting care use are not sufficiently understood. To address this, we conducted semi-structured interviews with caregivers leading no-lifting care efforts (no-lifting care instructional staff) in facilities that have adopted no-lifting care. Through qualitative analysis, we identified the factors that facilitate and inhibit the introduction and utilization of no-lifting care.

The results show that the initial inhibiting factor was the resistance from caregivers who opposed changes in their work methods, while the facilitating factor was the involvement of rehabilitation specialists. During utilization, the facilitating factor was the acquisition of experience using the welfare equipment. In contrast, the inhibiting factor was the lack of opportunities for no-lifting care guidance committee members to gain sufficient knowledge and skills in physical function assessments. Furthermore, it became clear that the no-lifting care instructional staff are structured in a way that puts them in a position where they are forced to assume the leadership role of to the rest of the staff.

Future research should explore broader facility types and include diverse caregiver perspectives to further validate these findings.