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The Prevalence of Burnout and Its Associations with Psychosocial Work Environment among Kaunas Region (Lithuania) Hospitals' Physicians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103739. [PMID: 32466238 PMCID: PMC7277716 DOI: 10.3390/ijerph17103739] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/17/2020] [Accepted: 05/22/2020] [Indexed: 01/02/2023]
Abstract
The primary prevention of occupational burnout should be considered as a public health priority worldwide. The aim of this study was to evaluate the prevalence of burnout and its associations with the work environment among hospital physicians in the Kaunas region, Lithuania. The cross-sectional study was carried out in 2018. The Job Content Questionnaire (JCQ) and the Copenhagen Burnout Inventory (CBI) were administered to examine occupational stress and personal, work-related, and client-related burnout among 647 physicians. Logistic regression analysis was applied to determine the association between dependent variable burnout and psychosocial environment among physicians, adjusting for potential confounders of age and gender. The prevalence rate of client-related, work-related, and personal burnout was 35.1%, 46.7%, and 44.8%, respectively. High job control, lack of supervisor, coworker support, job demands, and job insecurity were significantly associated with all three sub-dimensions of burnout. High job demands increased the probability of all three burnout dimensions, high job control reduced the probability of work-related, and client-related burnout and high job insecurity increased the probability of client-related burnout. The confirmed associations suggest that optimization of job demands and job control and the improvement of job security would be effective preventive measures in reducing occupational burnout among physicians.
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Rolander B, Lindmark U, Johnston V, Wagman P, Wåhlin C. Organizational types in relation to exposure at work and sickness - a repeated cross-sectional study within public dentistry. Acta Odontol Scand 2020; 78:132-140. [PMID: 31519122 DOI: 10.1080/00016357.2019.1659411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Organizations and state agencies that provide dental care continuously face various and novel demands related to the need for dental care. However, rearrangements of work tasks by reducing the number of tasks performed by dental personnel might make the work more monotonous, repetitive, and static within an organization. The aim of this study is to compare how two dental work organizations, with different staffing and clinic size, are perceived by dental personnel focusing on physical and psychosocial conditions, leadership, work ability and presenteeism in 2012 and 2014.Material and Methods: This repeated cross-sectional study included personnel from the Public Dental Service in Sweden. There were 282 dentists, dental hygienists, and dental nurses who answered a questionnaire 2012 and 299 in 2014.Results and conclusion: In 2012, nine per cent of medium clinics reported poor leadership compared with 27% in 2014. For large clinics, 17% perceived poor leadership in 2012 compared with 31% in 2014. A higher proportion of the employees reported presenteeism due to high physical load (43%) and high psychosocial load (21%) in 2014 compared with 31% and 13% in 2012. These results indicate the need for work place interventions promoting health among dental employees.
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Affiliation(s)
- B. Rolander
- Futurum, Academy for Health and Care, Jönköping County Council, Jönköping, Sweden
- Department of Behavioral Science and Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - U. Lindmark
- Centre for Oral Health, Department of Natural Sciences and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - V. Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - P. Wagman
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - C. Wåhlin
- Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine Center, Linköping University, Linköping, Sweden
- Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
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Sasaki N, Imamura K, Thuy TTT, Watanabe K, Huong NT, Kuribayashi K, Sakuraya A, Thu BM, Quynh NT, Kien NT, Nga NT, Giang NTH, Tien TQ, Minas H, Zhang M, Tsutsumi A, Kawakami N. Validation of the Job Content Questionnaire among hospital nurses in Vietnam. J Occup Health 2019; 62:e12086. [PMID: 31541525 PMCID: PMC6970404 DOI: 10.1002/1348-9585.12086] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 06/24/2019] [Accepted: 08/28/2019] [Indexed: 12/25/2022] Open
Abstract
Objectives The aim of this study was to examine the reliability and validity of the Job Content Questionnaire (JCQ) in Vietnamese among hospital nursing staff. Methods The 22‐items version of the JCQ was used. This includes four scales: (a) psychological demands (5 items); (b) job control (9 items); (c) supervisor support (4 items); and (d) coworker support (4 items). All 1258 nurses in a general hospital in Vietnam, excluding 11 who were due to retire, were invited to complete the cross‐sectional survey. The internal consistency reliability was estimated using Cronbach's α. Construct validity was examined using exploratory factor analysis (EFA). Convergent validity was evaluated by calculating correlations between the JCQ scores and DASS 21 and overtime work. Results In total, 949 (75%) of the 1258 eligible nurses completed the survey. Cronbach's α values demonstrated acceptable internal consistency in two scales (supervisor support α = .87; coworker support α = .86), while Cronbach's α was below the acceptable threshold of 0.70 for job control (α = .45) and job demand (α = .50). EFA assuming a four‐factor structure showed a factor structure that was almost identical to the original JCQ, with two items loading on other scales. The subscales of depression, anxiety, and stress response of DASS 21 and the subscales of JCQ were significantly correlated, as expected. Conclusion The results suggest that the JCQ in Vietnamese can be used with some reliability and validity for examining psychosocial work environment among nurses. Further studies should be done to confirm and expand our findings in a variety of occupational groups and in other Asian low‐ and middle‐income countries.
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Affiliation(s)
- Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tran T T Thuy
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nguyen T Huong
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam
| | - Kazuto Kuribayashi
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Asuka Sakuraya
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Bui M Thu
- Nursing Office, Bach Mai Hospital, Hanoi, Vietnam
| | - Nguyen T Quynh
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen T Kien
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen T Nga
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Truong Q Tien
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam
| | - Harry Minas
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Melvyn Zhang
- Family Medicine & Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Nanyang, Singapore
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Udom C, Kanlayanaphotporn R, Janwantanakul P. Predictors for Nonspecific Low Back Pain in Rubber Farmers: A 1-Year Prospective Cohort Study. Asia Pac J Public Health 2018; 31:7-17. [PMID: 30486658 DOI: 10.1177/1010539518811159] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
High prevalence of low back pain (LBP) has been reported among farmers. A number of contributing factors have been associated with LBP. However, predictors for LBP in this population are unknown. This longitudinally designed study aimed to identify the predictors of LBP in a sample of rubber farmers whose work involves heavy manual labor. Three hundred and twenty-seven rubber farmers, aged 18 to 70 years who reported no LBP in the previous year, were face-to-face interviewed and examined physically. The incidence of LBP was assessed monthly. The 12-month incidence of LBP in the cohort was 35%. Having a history of LBP (hazard ratio = 1.55, 95% confidence interval = 1.05-2.30) and an active job (hazard ratio = 1.98, 95% confidence interval = 1.16-3.40) were the predictors for the new onset of LBP in this sample. These 2 factors could therefore potentially be targeted to prevent or reduce the incidence of LBP in rubber farmers.
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Psychosocial Work Factors and Musculoskeletal Pain: A Cross-Sectional Study among Swedish Flight Baggage Handlers. BIOMED RESEARCH INTERNATIONAL 2015; 2015:798042. [PMID: 26558282 PMCID: PMC4628997 DOI: 10.1155/2015/798042] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 04/15/2015] [Accepted: 04/27/2015] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Flight baggage handlers sort and load luggage to airplanes. This study aimed at investigating associations between psychosocial exposures and low back and shoulder musculoskeletal disorders (MSDs) among Swedish flight baggage handlers. METHODS A questionnaire addressing MSDs (Standardized Nordic Questionnaire) and psychosocial factors (Copenhagen Psychosocial Questionnaire, COPSOQ) was answered by 525 baggage handlers in six Swedish airports. RESULTS Low back (LBP) and shoulder pain (SP) were reported by 70% and 60%, respectively. Pain was reported to interfere with work (PIW) by 30% (low back) and 18% (shoulders), and intense pain (PINT) occurred in 34% and 28% of the population. Quality of leadership was the most dissatisfying psychosocial factor, while the most positive was social community at work. Low ratings in the combined domain Work organization and job content were significantly associated with PIW in both low back and shoulders (Adjusted Hazard Ratios 3.65 (95% CI 1.67-7.99) and 2.68 (1.09-6.61)) while lower ratings in the domain Interpersonal relations and leadership were associated with PIW LBP (HR 2.18 (1.06-4.49)) and PINT LBP and SP (HRs 1.95 (1.05-3.65) and 2.11 (1.08-4.12)). CONCLUSION Severity of pain among flight baggage handlers was associated with psychosocial factors at work, suggesting that they may be a relevant target for intervention in this occupation.
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Singh S, Chokhandre P. Assessing the impact of waste picking on musculoskeletal disorders among waste pickers in Mumbai, India: a cross-sectional study. BMJ Open 2015; 5:e008474. [PMID: 26408284 PMCID: PMC4593149 DOI: 10.1136/bmjopen-2015-008474] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To assess the prevalence of musculoskeletal disorders (MSDs) as well as the impact of the occupation of waste picking on complaints of MSDs among waste pickers. The study attempts to understand the risk factors for MSDs in various areas of the body. DESIGN A cross-sectional household survey was conducted using a case-control design. The survey instrument for measuring musculoskeletal symptoms was adopted from a standardised Nordic questionnaire. The impact of the occupation of waste picking on MSDs was analysed using the propensity score matching (PSM) method. PARTICIPANTS The study population consisted of waste pickers (n=200) who had been working for at least a year and a control group (n=213) selected from among or living close to the same communities. RESULTS The 12-month prevalence of MSDs was higher among waste pickers (79%) compared to controls (55%) particularly in the lower back (54-36%), knee (48-35%), upper back (40-21%) and shoulder (32-12%). Similar patterns were observed in the 12-month prevalence of MSDs which prevented normal activity inside and outside the home, particularly for the lower back (36-21%), shoulder (21-7%) and upper back (25-12%) for waste pickers and controls. Analysis of the impact of waste picking on complaints of MSDs suggests that the occupation of waste picking raises the risk of MSDs particularly in the shoulder, lower and upper back. Older age and longer duration of work are significant risk factors for MSDs. CONCLUSIONS The findings suggest a relatively higher prevalence of MSDs among waste pickers, particularly in the lower and upper back and shoulder, compared to controls. Preventive measures and treatment to minimise the burden of MSDs among waste pickers are strongly recommended.
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Affiliation(s)
- Shrikant Singh
- Department of Mathematical Demography, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Praveen Chokhandre
- International Institute for Population Sciences, Mumbai, Maharashtra, India
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Coluci MZO, Alexandre NMC. Psychometric properties evaluation of a new ergonomics-related job factors questionnaire developed for nursing workers. APPLIED ERGONOMICS 2014; 45:1588-1596. [PMID: 24931478 DOI: 10.1016/j.apergo.2014.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 05/20/2014] [Accepted: 05/21/2014] [Indexed: 06/03/2023]
Abstract
The objectives of this study were to develop a questionnaire that evaluates the perception of nursing workers to job factors that may contribute to musculoskeletal symptoms, and to evaluate its psychometric properties. Internationally recommended methodology was followed: construction of domains, items and the instrument as a whole, content validity, and pre-test. Psychometric properties were evaluated among 370 nursing workers. Construct validity was analyzed by the factorial analysis, known-groups technique, and convergent validity. Reliability was assessed through internal consistency and stability. Results indicated satisfactory fit indices during confirmatory factor analysis, significant difference (p < 0.01) between the responses of nursing and office workers, and moderate correlations between the new questionnaire and Numeric Pain Scale, SF-36 and WRFQ. Cronbach's alpha was close to 0.90 and ICC values ranged from 0.64 to 0.76. Therefore, results indicated that the new questionnaire had good psychometric properties for use in studies involving nursing workers.
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Thompson JM, Pranger T, Sweet J, VanTil L, McColl MA, Besemann M, Shubaly C, Pedlar D. Disability correlates in Canadian Armed Forces Regular Force Veterans. Disabil Rehabil 2014; 37:884-91. [PMID: 25203768 DOI: 10.3109/09638288.2014.947441] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study was undertaken to inform disability mitigation for military veterans by identifying personal, environmental, and health factors associated with activity limitations. METHOD A sample of 3154 Canadian Armed Forces Regular Force Veterans who were released during 1998-2007 participated in the 2010 Survey on Transition to Civilian Life. Associations between personal and environmental factors, health conditions and activity limitations were explored using ordinal logistic regression. RESULTS The prevalence of activity reduction in life domains was higher than the Canadian general population (49% versus 21%), as was needing assistance with at least one activity of daily living (17% versus 5%). Prior to adjusting for health conditions, disability odds were elevated for increased age, females, non-degree post-secondary graduation, low income, junior non-commissioned members, deployment, low social support, low mastery, high life stress, and weak sense of community belonging. Reduced odds were found for private/recruit ranks. Disability odds were highest for chronic pain (10.9), any mental health condition (2.7), and musculoskeletal conditions (2.6), and there was a synergistic additive effect of physical and mental health co-occurrence. CONCLUSIONS Disability, measured as activity limitation, was associated with a range of personal and environmental factors and health conditions, indicating multifactorial and multidisciplinary approaches to disability mitigation.
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Affiliation(s)
- James M Thompson
- Veterans Affairs Canada , Charlottetown, Prince Edward Island , Canada
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Abstracts. Am J Health Promot 2014. [DOI: 10.4278/0890-1171-28.4.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kim IH, Muntaner C, Vahid Shahidi F, Vives A, Vanroelen C, Benach J. Welfare states, flexible employment, and health: A critical review. Health Policy 2012; 104:99-127. [PMID: 22137444 DOI: 10.1016/j.healthpol.2011.11.002] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 10/24/2011] [Accepted: 11/05/2011] [Indexed: 10/14/2022]
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Jablonska B, Soares JJF, Sundin O. Pain among women: Associations with socio-economic and work conditions. Eur J Pain 2012; 10:435-47. [PMID: 16054408 DOI: 10.1016/j.ejpain.2005.06.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2005] [Revised: 06/07/2005] [Accepted: 06/13/2005] [Indexed: 10/25/2022]
Abstract
We examined pain prevalence (general/body sites) and its characteristics/consequences among a randomised sample of women from the general population between 18 and 64 years (n=3,616). We also scrutinised associations between pain and various factors (e.g. socio-economic) by means of multivariate logistic/linear regression analyses. The women completed a questionnaire assessing various areas (e.g. pain). The design was cross-sectional and data were collected during 8 consecutive weeks. Sixty-three per cent of women reported pain during the last 3 months, of which 65% during more than 3 months. The multivariate analyses revealed associations between various socio-economic factors (e.g. financial strain) and pain in general/all studied body sites. In addition, psychosocial work conditions (i.e. work strain and social support) were significantly related to pain. Moreover, the multivariate analyses conducted among women with pain indicated relationships between socio-economic/psychosocial work conditions, and pain characteristics (e.g. intensity) and consequences (i.e. disability). A large number of women from the general population suffer from pain, in particularly prolonged pain. Women in a deprived socio-economic situation not only run a higher pain risk, but also experience their pain as more severe/disabling than their more privileged counterparts. Improvements of, for example, the socio-economic status among women living in deprived social and material circumstances, along with improved working environment may be crucial to reduce women's pain problems.
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Affiliation(s)
- Beata Jablonska
- Unit of Mental Health, Stockholm Centre of Public Health, Department of Public Health Sciences, Karolinska Institute, P.O. Box 17533, SE-11891 Stockholm, Sweden
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Vanroelen C, Louckx F, Moors G, Levecque K. The clustering of health-related occupational stressors among contemporary wage-earners. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2010. [DOI: 10.1080/13594320903043393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Back Injury Trajectories in Heavy Industries: Defining Outcomes for Epidemiological Research. J Occup Environ Med 2010; 52:908-12. [PMID: 20798645 DOI: 10.1097/jom.0b013e3181f02806] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Silva VRLD, Menezes AMB, Noal RB. Sintomas articulares crônicos em adultos de Pelotas, Rio Grande do Sul, Brasil: prevalência e determinantes. CAD SAUDE PUBLICA 2009; 25:2571-81. [DOI: 10.1590/s0102-311x2009001200005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Accepted: 09/08/2009] [Indexed: 11/21/2022] Open
Abstract
Com o objetivo de estimar a prevalência de sintomas articulares crônicos e seus determinantes, foi realizado um estudo transversal, com 2.953 adultos com 20 anos ou mais, residentes em Pelotas, Rio Grande do Sul, Brasil. Foram investigadas a presença de dor, edema ou rigidez articular, além de informações demográficas, sócio-econômicas e sobre problemas de saúde. A análise multivariável foi realizada pela regressão de Poisson. A prevalência geral de sintomas articulares crônicos foi de 36,5% (42,4% nas mulheres e 28,7% nos homens). A presença da tríade - dor, edema e rigidez articulares - foi de 14,1% e 5,5% nas mulheres e homens, respectivamente. Sintomas articulares crônicos se mostraram linearmente associados ao aumento da idade (RP: 2,9; IC95%: 2,4-3,5), do índice de massa corporal (RP: 1,6; IC95%: 1,3-2,0) e à menor escolaridade (RP: 1,5; IC95%: 1,3-1,8). Somente 6% dos homens e 18% das mulheres relataram diagnóstico médico de artrite. As prevalências gerais de limitações para atividades de vida diária e para atividades laborais, secundárias a sintomas articulares crônicos, foi de 15% e 21%, respectivamente. Os jovens e homens representam a maioria dos indivíduos com sintomas articulares crônicos subdiagnosticados.
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Souville M, Cabut S, Viau A, Iarmarcovai G, Arnaud S, Verger P. General practitioners and patients with psychological stress at work. JOURNAL OF OCCUPATIONAL REHABILITATION 2009; 19:256-263. [PMID: 19462158 DOI: 10.1007/s10926-009-9182-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 04/29/2009] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Identifying patients with psychological stress at work (PSW) and managing them are complex tasks. We studied the frequency of PSW as perceived by general practitioners (GPs), their practices in such situations, and the factors associated with these perceptions and practices, especially drug prescription. METHODS Cross-sectional telephone study of GPs in southeastern France with a questionnaire about knowledge, attitudes, behavior, and practices in occupational health. We explored the management of PSW with a case-vignette of a 45-year-old supermarket cashier consulting for psychological stress that he or she attributes to the job. RESULTS In all, 391 GPs participated; 87.2% reported that they encountered PSW often in their practice. GPs reported that they would treat the case-vignette patient by prescribing anxiolytics (66.5%) or sick leaves (65.7%) or referral to an occupational physician (80.3%) or a mental health specialist (44.8%). A multiple logistic regression showed that GPs reported prescribing an anxiolytic most frequently for the vignette-patient when they saw a high number of patients daily, asked patients about working conditions, suggested a sick leave or a referral to a specialist to the case-vignette patient and perceived more obstacles to reporting an occupational disease. CONCLUSION Our study suggests that PSW is perceived by GPs as one of the principal work-related health problems and that in such situations, most GPs say they would prescribe drugs and sick leave and refer the patient to an occupational physician. Initial and continuing education programs and good practice guidelines would be useful to help them deal with these problems.
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Affiliation(s)
- M Souville
- Research Unit UMR 912 (SE4S), INSERM-IRD, Marseille, France
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Psychometric properties of the Thai version of the 22-item and 45-item Karasek job content questionnaire. Int J Occup Med Environ Health 2009; 21:331-44. [PMID: 19228579 DOI: 10.2478/v10001-008-0036-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To evaluate the validity and reliability of the Thai version of the job content questionnaire (TJCQ) both 22-item and 45-item versions. MATERIALS AND METHODS The study encompassed 10,450 employees in Songkhla province, Thailand. A 45-item job content questionnaire (JCQ) was translated and back translated complying with the JCQ usage policy. TJCQ covers seven scales as follows: psychological demand, decision latitude, supervisor support, coworker support, physical demand, job security and hazard at work. Internal consistency was examined using Cronbach's alpha coefficient. Factor validation was tested using both exploratory and confirmatory factor analysis. RESULTS Both 22-item and 45-item versions of TJCQ demonstrated acceptable internal consistency in nearly all scales except for psychological demand. The exploratory and confirmatory factor analysis result gave support to 5-factor model in 22-item version and 8-factor model in 45-item version of TJCQ. The psychological demand scale tended to split into two subscales. Other scales were consistent with the expected dimensions though some items extracted differently along the theoretical dimensions. CONCLUSIONS Our study provided evidence for the reliability and validity of the TJCQ among Thai employees and supported the ongoing debate on multifaceted psychological demand and its complexity, making it feasible to extend the TJCQ beyond its original structure.
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Matos MG, Hennington EA, Hoefel AL, Dias-da-Costa JS. [Lower back pain in health insurance policyholders: prevalence and associated factors]. CAD SAUDE PUBLICA 2009; 24:2115-22. [PMID: 18813687 DOI: 10.1590/s0102-311x2008000900017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2007] [Accepted: 02/15/2008] [Indexed: 11/22/2022] Open
Abstract
A cross-sectional study was conducted with individuals of both sexes (20-59 years of age), all covered by the COOPERSINOS Health Care Plan of Vale do Rio dos Sinos University. The study aimed to determine the prevalence of lower back pain and associated factors in the previous three months. A self-applied questionnaire included socioeconomic, demographic, occupational, and lifestyle questions. Prevalence of lower back pain among the 775 individuals was 52.8% in the previous year (95%CI: 49.3-56.3) and 46% in the previous three months (95%CI: 42.5-49.5). Poisson regression for lower back pain in the previous 90 days showed an association with: (1) age 40-49 years; (2) self-reported strenuous or difficult work; and (3) smoking. Despite the high prevalence of lower back pain and difficulty in performing work activities, the pain was not disabling. Although 29.9% of workers reported some difficulty in performing their daily or work-related activities due to lower back pain, absenteeism was quite low.
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Affiliation(s)
- Mauro Gomes Matos
- Programa de Pós-graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brasil
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Vanroelen C, Levecque K, Moors G, Gadeyne S, Louckx F. The structuring of occupational stressors in a Post-Fordist work environment. Moving beyond traditional accounts of demand, control and support. Soc Sci Med 2009; 68:1082-90. [DOI: 10.1016/j.socscimed.2009.01.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Indexed: 10/21/2022]
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Psychosocial working conditions and self-reported health in a representative sample of wage-earners: a test of the different hypotheses of the Demand-Control-Support-Model. Int Arch Occup Environ Health 2008; 82:329-42. [PMID: 18607618 DOI: 10.1007/s00420-008-0340-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Accepted: 06/06/2008] [Indexed: 10/21/2022]
Abstract
PURPOSE This paper presents an in-depth examination of the demand-control-support-model (DCS-model). Each hypothesis of the DCS-model is tested: the main effects of job demands, job autonomy, task variation and social support; the additive effects of job strain, active learning and iso-strain; and the interactive buffer-effects of job autonomy, task variation and support on job demands. METHODS Data from a representative cross-sectional sample of 11,099 male and female wage-earners are investigated using log linear methods. The outcome measures are self-reported persistent fatigue, musculoskeletal complaints and emotional well-being. RESULTS There is some support for each of the hypotheses. Quantitative job demands and superior support have the strongest effects. The job autonomy and buffer hypotheses are only partially supported. CONCLUSIONS The strong effects of job demands, support, job strain and active learning are suggesting that a policy aimed at improving psychosocial working conditions should focus on a bearable level of job demands and the quality of social relationships at work.
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Karmakar SD, Breslin FC. The role of educational level and job characteristics on the health of young adults. Soc Sci Med 2008; 66:2011-22. [DOI: 10.1016/j.socscimed.2008.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2006] [Indexed: 10/22/2022]
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Lee H, Wilbur J, Kim MJ, Miller AM. Psychosocial risk factors for work-related musculoskeletal disorders of the lower-back among long-haul international female flight attendants. J Adv Nurs 2008; 61:492-502. [PMID: 18261058 DOI: 10.1111/j.1365-2648.2007.04511.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM This paper is a report of a study to examine the relationships between work-related psychosocial factors and lower-back work-related musculoskeletal disorders among long-haul international female flight attendants. BACKGROUND Recent attention has focused on the influence of work-related psychosocial factors on work-related musculoskeletal disorders. To date, however, little is known about the influence of psychosocial factors at work on lower back work-related musculoskeletal disorders in female flight attendants. METHOD A cross-sectional, mailed survey was conducted in 2004 with flight attendants in one major airline who were randomly selected from a union membership list. The work-related psychosocial factors included psychological job demand, decision latitude, social support, job insecurity, and external environmental concerns. Physical load was defined by overall strenuousness across 41 job tasks and measured by a 4-point scale of strenuousness. Lower-back work-related musculoskeletal disorders were defined as lower-back symptoms that occurred at least once a month or lasted at least 1 week in the past year and caused at least moderate pain. FINDINGS The flight attendants with lower back work-related musculoskeletal disorders, compared with those without lower-back work-related musculoskeletal disorders, had higher perceived psychological job demands, job insecurity, and physical load. After controlling for physical load and personal factors, high job insecurity significantly increased the risk for lower-back work-related musculoskeletal disorders. CONCLUSION Occupational health nurses in the airline industry should be cognizant of the importance of assessing the influence of both job tasks and work-related psychosocial factors on lower-back work-related musculoskeletal disorders.
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Affiliation(s)
- Hyeonkyeong Lee
- Nursing Policy Research Institute, Yonsei University College of Nursing, Seoul, Korea.
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Fréquence des lombalgies dans la population française de 30 à 64 ans. Résultats issus de deux enquêtes nationales. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/j.annrmp.2007.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Gourmelen J, Chastang JF, Ozguler A, Lanoë JL, Ravaud JF, Leclerc A. Frequency of low back pain among men and women aged 30 to 64 years in France. Results of two national surveys. ACTA ACUST UNITED AC 2007; 50:640-4, 633-9. [PMID: 17631977 DOI: 10.1016/j.annrmp.2007.05.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2007] [Accepted: 05/29/2007] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In France, most studies of low back pain (LBP) have been carried out among workers or patients. Until very recently, the frequency of LBP in the general population was not known, because National Health Surveys did not include questions on LBP. OBJECTIVE To estimate the prevalence of LBP in the French population aged 30 to 64 years. MATERIALS AND METHODS The main data were from the National Health Survey 2002-2003 (n=14,248). LBP was assessed by an accompanying self-administered questionnaire asking details about duration of LBP in the previous 12 months. Weights were used to estimate the prevalence of LBP in the French population, with two definitions of LBP. Additional results dealing with chronic LBP, from another national survey (Handicap, Disability and Dependence), are also briefly presented. RESULTS More than half of the French population in this age group experienced LBP at least one day in the previous 12 months (LBP1), with 17% experiencing LBP for more than 30 days in the previous 12 months (LBP30); prevalence differed between men and women and that of LBP30 increased with age. DISCUSSION-CONCLUSION The prevalence of LBP as assessed by the National Health Survey is similar to that found in countries other than France. These estimates can be used as a reference for surveys in specific populations, provided that comparable methodologies are used.
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Affiliation(s)
- J Gourmelen
- Inserm, unité 687 IFR69, 14, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France
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Stansfeld S. Chronic pain, depressive disorder, and the role of work. J Psychosom Res 2006; 61:661-2. [PMID: 17084144 DOI: 10.1016/j.jpsychores.2006.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2006] [Revised: 06/05/2006] [Accepted: 06/27/2006] [Indexed: 10/24/2022]
Affiliation(s)
- Stephen Stansfeld
- Center for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and The London, Queen Mary's School of Medicine and Dentistry, London, UK.
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Dionne CE, Bourbonnais R, Frémont P, Rossignol M, Stock SR, Nouwen A, Larocque I, Demers E. Determinants of "return to work in good health" among workers with back pain who consult in primary care settings: a 2-year prospective study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2006; 16:641-55. [PMID: 16868783 PMCID: PMC2213556 DOI: 10.1007/s00586-006-0180-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2005] [Revised: 04/13/2006] [Accepted: 06/15/2006] [Indexed: 10/24/2022]
Abstract
Many factors have been linked to return to work after a back pain episode, but our understanding of this phenomenon is limited and cross-sectional dichotomous indices of return to work are not valid measures of this construct. To describe the course of "return to work in good health" (RWGH--a composite index of back pain outcome) among workers who consulted in primary care settings for back pain and identify its determinants, a 2-year prospective study was conducted. Subjects (n = 1,007, 68.4%) were workers who consulted in primary care settings of the Quebec City area for a nonspecific back pain. They completed five telephone interviews over 2 years (follow-up = 86%). Analyses linking baseline variables with 2-year outcome were conducted with polytomous logistic regression. The proportion of "success" in RWGH increased from 18% at 6 weeks to 57% at 2 years. In women, persistent pain, pain radiating to extremities, increasing job seniority, not having a unionized job, feeling that the physician did listen carefully and increasing fear-avoidance beliefs towards work and activity were determinants of "failure" in RWGH. In men, decreasing age, cigarette smoking, poor self-reported health status, pain in the thoracic area, previous back surgeries, a non-compensated injury, high pain levels, belief that job is below qualifications, likelihood of losing job, job status, satisfaction with health services and fear-avoidance beliefs towards work were all significant. RWGH among workers with back pain receives multiple influences, especially among men. In both genders, however, fear-avoidance beliefs about work are associated with failure and high self-efficacy is associated with success.
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Affiliation(s)
- Clermont E Dionne
- Unité de recherche en santé des populations, Centre de recherche du CHA de Québec, Hôpital du Saint-Sacrement, 1050, chemin Ste-Foy, Quebec City, QC, Canada, G1S 4L8.
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Abstract
STUDY DESIGN A national population-based survey focusing on disability. OBJECTIVE To describe the frequency of chronic back conditions among those aged 30 to 64 years, the consequences on their daily lives, their employment status, and source of income. SUMMARY OF BACKGROUND DATA.: Descriptive data from community-based surveys are sparse. METHODS In the French Handicap, Disability and Dependence survey, 1,289 subjects with chronic back problems were compared with the general population. RESULTS The estimates for prevalence of chronic back problems were 7.9% for men (95% confidence interval, 7.2-8.5) and 7.5% for women (95% confidence interval, 7.0-8.1). Despite functional limitations, most people in France who had back problems were employed in a ordinary work: 71.5% among men (77.7% in the general population), 53.5% among women (60.2% in the general population). Among them, blue-collar workers were overrepresented. Of the subjects with back conditions, a very small proportion had a source of permanent income related to their health problems. CONCLUSIONS The results from this national population-based survey emphasize the weight of chronic back problems in the community, in a country where the legislation offers few alternatives to ordinary work for those who suffer from chronic limitations due to low back pain.
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Schneider S, Lipinski S, Schiltenwolf M. Occupations associated with a high risk of self-reported back pain: representative outcomes of a back pain prevalence study in the Federal Republic of Germany. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2006; 15:821-33. [PMID: 16432750 PMCID: PMC3489435 DOI: 10.1007/s00586-005-1015-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2005] [Revised: 07/01/2005] [Accepted: 07/31/2005] [Indexed: 01/29/2023]
Abstract
Given the increasing medical and economic implications of back pain, occupation-specific prevalence data may provide important pointers for preventive programmes targeted at promoting preventive behaviour and improving conditions. The National German Health Survey is the first study to provide the basis for a representative nationwide analysis of back pain prevalence by occupational category. The net sample comprises a total of 3,488 earners aged 18-69. One in three earners in the Federal Republic of Germany (34%) experienced back pain during the 7 days prior to being interviewed. The 1-year prevalence rate is 60%. Occupational categories associated with a lower-than-average back pain prevalence are highly qualified professionals, senior management, and production occupations associated with a comparatively low degree of manual labour. In contrast, an above-average prevalence was identified for occupations associated with physically strenuous work involving one-sided postures, moving, carrying and holding heavy weights, and work typically performed in poor conditions or bad weather. Our data demonstrates significant inter-occupational differences in terms of self-reported back pain. The results underline the importance of measures to promote preventive behaviour and improve the working conditions of those in low-skill manual labour occupations.
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Affiliation(s)
- Sven Schneider
- Section Neuroorthopaedics, Orthopädische Universitätsklinik Heidelberg, Heidelberg, Germany.
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Cole DC, Ibrahim S, Shannon HS. Predictors of work-related repetitive strain injuries in a population cohort. Am J Public Health 2005; 95:1233-7. [PMID: 15933237 PMCID: PMC1449345 DOI: 10.2105/ajph.2004.048777] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed predictors of work-related repetitive strain injuries using data from 4 waves of the Canadian National Population Health Survey. METHODS Participants were 2806 working adults who completed an abbreviated version of the Job Content Questionnaire in 1994-1995 and did not experience repetitive strain injuries prior to 2000-2001. Potential previous wave predictors of work-related repetitive strain injuries were modeled via multivariate logistic regression. RESULTS Female gender (odds ratio [OR] = 1.98; 95% confidence interval [CI]=1.24, 3.18), some college or university education (OR=1.98; 95% CI=1.06, 3.70), job insecurity (OR=1.76; 95% CI=1.07, 2.91), high physical exertion levels (OR = 2.00; 95% CI = 1.29, 3.12), and high levels of psychological demands (OR = 1.61; 95% CI = 1.02, 2.52) were all positively associated with work-related repetitive strain injuries, whereas working less than 30 hours per week exhibited a negative association with such injuries (OR=0.2; 95% CI=0.1, 0.7). CONCLUSIONS Modifiable job characteristics are important predictors of work-related repetitive strain injuries.
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Affiliation(s)
- Donald C Cole
- Institute for Work & Health, 481 University Ave, Suite 800, Toronto, Ontario M5G 2E9, Canada.
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Schneider S, Schmitt H, Zoller S, Schiltenwolf M. Workplace stress, lifestyle and social factors as correlates of back pain: a representative study of the German working population. Int Arch Occup Environ Health 2005; 78:253-69. [PMID: 15824916 DOI: 10.1007/s00420-004-0576-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2004] [Accepted: 09/09/2004] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the prevalence of back pain in the German working population and the relationship between back pain and workplace stresses, lifestyle and social factors. METHODS The first National Health Survey of the Federal Republic of Germany was carried out between October 1997 and March 1999. It comprised a representative epidemiological cross-sectional study of the working population, with a total sample of 3,488 persons between the ages of 18 and 69 years. The participants took part in a medical examination and answered a self-rating questionnaire. The relationship between subjective back pain and workplace stresses and social and lifestyle factors was investigated with bivariate tests and multiple logistical regression analyses. RESULTS The 7-day prevalence for back pain in the German working population was found to be 34%, and the 1-year prevalence was 60%. The odds ratios were significantly higher in women, persons of lower socioeconomic status, married and depressed persons and non-athletes. Carrying heavy loads or maintaining a single working posture were the most significant work-related correlates of back pain, for members of both the female and male working population, while environmental stress and psychological stress correlated significantly with back pain in men only. CONCLUSIONS This study reports the first representative epidemiological prevalence data for back pain, and its correlates and potential risk factors, for the German working population. To reduce the negative impact of back pain the most promising behavioural and conditional prevention measures in the workplace would be to reduce carrying stress and to vary working posture. In addition, a more active, athletic lifestyle, plus the avoidance of being overweight, should provide an additional protective or preventive effect.
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Affiliation(s)
- Sven Schneider
- Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstrasse 200, 69118 Heidelberg, Germany.
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Violante FS, Fiori M, Fiorentini C, Risi A, Garagnani G, Bonfiglioli R, Mattioli S. Associations of psychosocial and individual factors with three different categories of back disorder among nursing staff. J Occup Health 2004; 46:100-8. [PMID: 15090684 DOI: 10.1539/joh.46.100] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although back disorders are a major occupational problem for nursing staff, few studies distinguish different types. By means of a structured questionnaire, we performed a cross-sectional study on the prevalence of diagnosed lumbar disc hernia, chronic low-back pain (LBP) (at least 90 d in the preceding 12 months) and acute LBP (intense pain for at least 1 d) with respect to physical, individual and psychosocial factors among female nurses (n=587), nursing aides (n=228) and head-nurses (n=43) working in a university hospital (95% of the female workforce). Almost all respondents reported known high-risk occupational activities. Overall prevalence of reported back disorders was 44% (acute LBP 19%, chronic LBP 17%, lumbar hernia 8%). On multinomial logistic regression analysis, scoliosis and commonly stress-related psychosomatic symptoms were associated with all three types of back disorder; trauma/fractures of the spine, pelvis and/or legs and a global work-environment/job-satisfaction score with acute LBP; increasing age with lumbar disc hernia. While confirming the relevance of considering different definitions of back disorder, our data indicate items for investigation in cohort studies. These include: identification of specific risk factors for lumbar hernia; avoidance of possible work-environment risk factors such as hurried execution of different tasks at the same time; and influence on job suitability of underlying spinal pathologies such as scoliosis.
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Affiliation(s)
- Francesco S Violante
- Alma Mater Studiorum--University of Bologna, Occupational Medicine Unit, Sant'Orsola-Malpighi Hospital, Bologna, Italy.
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Cole DC, Rivilis I. Individual factors and musculoskeletal disorders: a framework for their consideration. J Electromyogr Kinesiol 2004; 14:121-7. [PMID: 14759757 DOI: 10.1016/j.jelekin.2003.09.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Individual factors have been variously defined as non-work, demographic, physiological or psychological factors. They may represent a variety of important constructs at different relevant levels that may not be initially evident in their measurement. These include: work-related factors e.g., job assignment, duration of exposure, work style, anthropometric mismatches, and differential responses to job demands; concomitant external or internal exposures e.g., sports, smoking, and endogenous hormones; and physical, psychological and social vulnerabilities e.g., prior injury, depression, socio-economic status. Such factors operate in different ways in the development, course and response to interventions of musculoskeletal disorders. Newer framings of their contribution to musculoskeletal disorders are providing new insights into the role of such factors as some among many which contribute to the burden of MSK disorders in working age populations. As researchers, practitioners and policy makers, we need to consider them in order to reduce burden, to protect the vulnerable and to match interventions to different groups of people most appropriately.
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Affiliation(s)
- Donald C Cole
- Department of Public Health Sciences, Institute for Work & Health, University of Toronto, 481 University Ave, Ste 800, Toronto, ON M5G 2E9, Canada.
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Cole DC, Manno M, Beaton D, Swift M. Transitions in self-reported musculoskeletal pain and interference with activities among newspaper workers. JOURNAL OF OCCUPATIONAL REHABILITATION 2002; 12:163-174. [PMID: 12228947 DOI: 10.1023/a:1016842611591] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Active surveillance of symptoms and disability due to musculoskeletal disorders (MSD) in working populations can map individual transitions in symptom intensity or disability level. Using repeat surveys, this study examined if aetiological risk factors for new symptoms or disability, measured by interference with activities, were similar to prognostic risk factors for subsequent outcomes of symptoms and disability. This paper reports on 379 Toronto newspaper workers who completed questionnaires in 1996 and 1997. Questions on pain/discomfort during the last year, episode frequency and duration formed the basis for constructing three mutually exclusive symptom levels: noncases (Level 1); mild cases (Level 2); and more severe or frequent pain cases (Level 3). A similar construction of overall interference levels was based on the frequency with which musculoskeletal pain/discomfort interfered with daily, recreational, social and family activities, or ability to do one's job during the previous 12 months. The last was also examined as work interference alone. Levels of symptoms were cross-tabulated by overall and work interference at the two time points and Markov models of transitions between states were formulated. Results indicate that period prevalence of symptoms and overall interference increased between phases, though only significantly for symptoms (Levels 2 and 3, 65.7-70.7%, p = 0.04), while work interference was unchanged (17.9-17.0%). Equivalent proportions of workers improved as worsened in symptoms (21.1 and 22.4%, respectively), overall interference (16.7 and 17.8%), and work interference (7.4 and 6.6%). The only significant predictor for those without work interference at time one was job tenure, which was protective against work interference (Odds Ratio (OR) 1.06, 95% Confidence Interval (CI) 1.01-1.12). Among those who had more severe/frequent symptoms at time one, lack of improvement over time was predicted by longer job tenure (OR = 0.92 per year, CI: 0.87-0.97), greater psychological demands of work (OR = 0.65 per point, CI: 0.51-0.84) and marginally by greater upper extremity disability score. At time one, women with work interference were more likely to have persistent interference at time two (OR = 7.22, CI: 1.57-33.20). Suggestive findings included opposite effects of social support at work: reduced risk of development of new symptoms but increased risk of persistence at the highest symptom level.
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Affiliation(s)
- Donald C Cole
- Institute for Work and Health, Department of Public Health Sciences, University of Toronto, Toronto, Canada.
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