Ergonomic Risks and Cultural Context of Embroidery among Older Iu-Mien Women: A Mixed-Methods Study to Synthesize Culturally Appropriate Health Promotion Approaches

Abstract

This study aimed to assess ergonomic risks, explore cultural contexts, beliefs, health perceptions, and adaptation patterns, and synthesize health promotion approaches among older lu-mien, an ethnic minority group, women engaged in embroidery. A sequential explanatory mixed-methods design was employed. Quantitative data were collected from 23 older Lu-Mien women using the Rapid Upper Limb Assessment (RULA) tool, while qualitative data were obtained through in-depth interviews with 12 key informants. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using thematic content analysis.

The findings revealed that participants had a mean ergonomic risk score of 4.48 (S.D. = 1.04). Of the participants, 60.87% were classified as requiring ergonomic intervention, whereas 39.13% required further investigation and monitoring. Most participants reported neck, back, and shoulder pain associated with prolonged forward-bending postures and repetitive work activities. Despite the identified ergonomic risks, many older women perceived such discomfort as a normal consequence of aging and daily work, leading to limited attention to ergonomic prevention practices. Embroidery was found to hold significant cultural, psychological, and social value, serving as a life skill, a marker of cultural identity, and a means of fostering social relationships within the community. Health management practices were largely based on trial-and-error adaptations and reliance on traditional local wisdom, such as Gua Sha or Scraping Therapy, a traditional Chinese medicine treatment. The findings led to the synthesis of culturally appropriate health promotion approaches that integrate ergonomic principles with cultural contexts by using embroidery as a foundation for health promotion, while encouraging movement during work and improving work environments in ways that are compatible with older adults’ lifestyles.