Association between high fear-avoidance beliefs about physical activity and chronic disabling low back pain in nurses in Japan

Kinesiophobia among health professionals' interventions: a scoping review

Health professionals are regularly confronted with patients suffering from a fear of movement-related pain (unknown as kinesiophobia). The fear-avoidance attitudes and beliefs of healthcare professionals are likely to play a key role in their patients' therapeutic approach. However, kinesiophobia among health professionals is a relatively young topic. This scoping review aims to explore and catalogue the extent of scientific research that identifies the causes and consequences of kinesiophobia among health professionals while they perform their interventions. The review was based on the Joanna Briggs Institute manual and the PRISMA method for a scoping review. The research was conducted in May 2024 using CINHAL, Medline and Sportdiscus databases with the search terms "fear-avoidance", "kinesiophobia", "pain-related" and "physical therapist". Out of 2,162 potential studies, thirteen articles were included. No study directly mentioned kinesiophobia among health professionals, but it was studied through fear-avoidance beliefs. Two-thirds of the articles indicate that professionals with fear-avoidance beliefs tend to refer their patients to other specialists less frequently and limit their patients' activity, despite treatment guidelines. Most of the studies found were physiotherapists' interventions for chronic back pain patients. The current review emphasizes the need for additional studies involving more healthcare professionals and diverse health conditions.

Work-Related Fear-Avoidance Beliefs and Risk of Low-Back Pain: Prospective Cohort Study Among Healthcare Workers

PURPOSE

Low-back pain (LBP) is a prevalent condition among healthcare workers, negatively affecting well-being and work ability. Research has identified fear-avoidance beliefs, i.e., the belief that physical activities worsen or prolong pain, as a key psychological factor in LBP. Given the physical demands of healthcare work, understanding the link between fear-avoidance and LBP is crucial for effective prevention and management strategies. This study investigated the prospective association between fear-avoidance beliefs and risk of increased LBP intensity and duration in hospital workers.

METHODS

Fear-avoidance beliefs and LBP were assessed in 1933 healthcare workers from 389 departments at 19 hospitals at baseline and 1-year follow-up. Associations between baseline work-related fear-avoidance beliefs (FABW) and LBP intensity and duration at follow-up were analyzed using cumulative logistic regression, adjusting for various factors including age, sex, baseline LBP, education, seniority, patient transfers, psychosocial work environment, and lifestyle.

RESULTS

Moderate and high FABW was associated with higher odds of increased pain intensity (OR: 1.37 [95% CI 1.09-1.73] and 1.85 [95% CI 1.18-2.88], respectively) and prolonged pain duration (OR: 1.37 [95% CI 1.05-1.78] and 2.27 [95% CI 1.50-3.44], respectively). A sensitivity analysis including only female nurses showed similar results, with the high FABW group having significantly higher odds of increased pain intensity (OR 2.95, 95% CI 1.84-4.72) and duration (OR 2.64, 95% CI 1.55-4.49).

CONCLUSIONS

Fear-avoidance beliefs increase the risk of LBP intensity and duration among healthcare workers, emphasizing the need for interventions dealing with psychological aspects of LBP.

Global prevalence of overweight and obesity among healthcare workers: a systematic review

OBJECTIVE

This systematic review aims to determine the global pooled prevalence of overweight and obesity among health care workers in the 6 World Health Organization (WHO) regions.

INTRODUCTION

The escalating prevalence of overweight and obesity among health care workers significantly affects both individual health and the quality of health care services. Understanding this global prevalence is crucial to be able to implement informed interventions, policies, and for the overall optimization of health care delivery.

INCLUSION CRITERIA

Systematic reviews with prevalence data for overweight and obesity among health care workers in both private and public health care facilities will be considered for inclusion. Transparent documentation of anthropometric measurements and adherence to established overweight and obesity criteria by the WHO, Asia Pacific standards, or Asian criteria are required to be eligible for inclusion. The review will focus on observational study designs, including cross-sectional, survey, case-control, and cohort studies.

METHODS

MEDLINE (PubMed), Scopus, and Web of Science will be searched for records with predefined keywords, including MeSH terms. Records found through hand-searching and reference lists will be added. Two researchers will independently screen studies, resolving any discrepancies with a third researcher. Standardized critical appraisal and data extraction forms will be used. If suitable, pooled prevalence for overweight and obesity based on the 6 WHO regions will be calculated using the DerSimonian-Laird random-effects model. Statistical analysis will be performed and publication bias will be assessed through funnel plot analysis and Egger's test.

REVIEW REGISTRATION

PROSPERO CRD42023452330.

Effectiveness of exercise programs to reduce low back pain among nurses and nursing assistants: A systematic review and meta-analysis

INTRODUCTION

Nurses have a high prevalence of low back pain due to ergonomic hazards in healthcare workplaces. While exercise programs have been suggested as an intervention strategy, the effectiveness of low back pain programs has been inconsistent in the research literature. The purpose of study is to determine the effect of exercise programs to reduce low back pain among nursing staff.

METHODS

A systematic review and meta-analysis was conducted with five databases and systematically searched. Following the PRISMA guidelines, included studies evaluated low back pain relief among nurses or nursing assistants and described the exercise program. Two reviewers independently appraised, extracted, and synthesized all available studies. The study protocol was registered in PROSPERO (CRD42022359511).

RESULTS

A total of 296 articles with 1,355 nursing staff from nine countries were obtained. Nine randomized controlled trials with a moderate to low risk of bias quality were included. Exercise programs had a small but significant effect on low back pain of nursing staff (SMD = -0.48; 95% CI = -0.76 to -0.19; p = 0.03, I2 = 62%, p = 0.001). A subgroup analysis of nurses and nursing assistants showed moderate and small effects, respectively (I2 = 0% p < 0.0001, SMD -0.73 CI 95% [-0.97 to -0.48], p = 0.76, and I2 = 0% p = 0.002, SMD -0.23 CI 95% [-0.38 to -0.08], p < 0.88). Exercise for back and trunk exhibited a moderate effect on low back pain (SMD -0.56 CI 95% [-0.86 to -0.25], p = 0.01, I2 = 66%, p < 0.0004). A subgroup analysis comparing age, under 40 years old revealed a moderate effect size (SMD = -0.59; 95% CI = -0.83to -0.35; p = 0.06; I2 = 64%, p < 0.0001).

CONCLUSIONS

Exercise programs are an effective treatment to reduce low back pain in nurses and nursing assistants, especially among younger staff.

PRACTICAL APPLICATION

Back and trunk exercise programs should be recommended for nursing staff with low back pain.

Association between multisite musculoskeletal pain and disability trajectories among community-dwelling older adults

BACKGROUND

Pain is linked to disability, but how multisite musculoskeletal pain leads to disability over time is not well elaborated.

OBJECTIVE

To examine the associations of multisite musculoskeletal pain with disability among a nationally representative cohort.

DESIGN

We used data from the National Health and Aging Trends Study (NHATS) 2015-22. Disability was assessed by basic activities of daily living (ADL) and instrumental activities of daily living (IADL).

PARTICIPANTS

A total of 5557 individuals with multisite musculoskeletal pain dwelling in the community were included in this study.

METHODS

Group-based trajectory models were applied to identify distinct profiles of disability in ADL and IADL. Design-based logistic regressions were used to examine associations among multisite musculoskeletal pain, disability, and dual trajectory group memberships, adjusted for sociodemographic, health status, behavioral, and mental characteristics.

RESULTS

Persons who experienced multisite musculoskeletal pain were at higher risk of disability in ADL and IADL. We identified five heterogeneous disability trajectories and named them based on baseline levels and rates of increase over time. Approximately, 52.42% of older adults with multisite musculoskeletal pain were in trajectories with ADL and IADL declines, and 33.60% experienced a rapid decline. Multisite musculoskeletal pain was associated with elevated relative risk for the adverse disability trajectories, which generally increases with multisite musculoskeletal pain frequency and number of sites.

CONCLUSIONS

Persons with multisite musculoskeletal pain had a higher risk of disability. It is essential to adopt effective pain management strategies to maintain the independent living ability of older adults and to realize active aging.

Enhancing feedback by health coaching: the effectiveness of mixed methods approach to long-term physical activity changes in nurses. An intervention study

BACKGROUND

Although knowledge of the barriers and motivators to physical activity participation among nurses is increasing, the factors influencing motivation methods' effectiveness are not completely defined. This study aimed to identify the methods that support increasing the level of daily physical activity and the factors that influence the effectiveness of motivation methods among nurses.

METHODS

This study was based on an intervention study protocol. All registered nurses in clinical settings were invited to participate in the study. The study involved 71 professionally active nurses. A self-reported questionnaire was used to collect sociodemographic and employment data. The level of physical activity was assessed using the International Physical Activity Questionnaire, and the daily number of steps was assessed using a pedometer. Body composition was measured using a bioimpedance method, and the 5-year risk of cardiovascular events was assessed using the Harvard Score. The intervention included self-monitoring daily steps using a pedometer and completing a diary daily for one month. Additionally, a few-minute speech was sent to each participant via email on the intervention's 7th, 14th, and 21st days.

RESULTS

The analysis revealed a higher value of physical activity recorded in the follow-up compared to the initial and final measurement in the Recreation domain [Met] (p < 0.001) and a higher value of daily steps in the follow-up compared to the final measurement (p = 0.005). Participants with a higher Harvard Score were more likely to increase their daily number of steps (OR = 6.025; 95% CI = 1.70-21.41), and nurses working in hospital wards were less likely to do so (OR = 0.002; 95% CI = 0.00-0.41).

CONCLUSIONS

Recommendations for physical activity in the nursing population should focus on increasing leisure time physical activity and regular risk assessment of cardiovascular events. A mixed methods approach, such as feedback enhanced by health coaching, effectively achieves long-term physical activity changes in nurses.

Efficacy of an Omaha system-based remote ergonomic intervention program on self-reported work-related musculoskeletal disorders (WMSDs) - A randomized controlled study

Purpose

Heavy biomechanical loadings at workplaces may lead to high risks of work-related musculoskeletal disorders. This study aimed to explore the efficacy of an Omaha System-based remote ergonomic intervention program on self-reported work-related musculoskeletal disorders among frontline nurses.

Materials and methods

From July to October 2020, 94 nurses with self-reported pain in one of the three body parts, i.e., neck, shoulder, and low back, were selected and were randomly divided into two groups. The intervention group received a newly developed remote program, where the control group received general information and guidance on health and life. Program outcome was evaluated by a quick exposure check approach.

Results

After 6 weeks, the intervention group exhibited significantly less stress in the low back, neck, and shoulder/forearms, compared to the control group (p < 0.05). In addition, the occurrence of awkward postures, such as extreme trunk flexion or twisting, was also significantly reduced (p < 0.05).

Conclusions

The newly developed Omaha System-based remote intervention program may be a valid alternative to traditional programs for frontline nurses during the COVID-19 pandemic, reducing biomechanical loadings and awkward postures during daily nursing operations.

Fear-Avoidance Beliefs Associated with Non-Specific Chronic Low Back Pain in College Athletes

Purpose

This study aimed to determine the psychosocial factors associated with non-specific chronic low back pain (NS-CLBP) among college athletes.

Material and Methods

A cross-sectional study was performed at one university. A non-anonymous, self-administered online questionnaire was collected from each athlete. Participants with a history of orthopaedic spine disease or surgery were excluded. Online responses from 368 college athletes belonging to 18 clubs were collected, among which 263 were included in the analysis. In the 263 responses, 41 individuals were identified as having NS-CLBP. Multivariate logistic regression analyses were performed to determine factors associated with presence of NS-CLBP. Independent variables included the Fear-Avoidance Beliefs Questionnaire physical activity subscale (FABQ-PA) score, Tampa Scale for Kinesiophobia-11 (TSK-11) score, Roland-Morris Disability Questionnaire (RDQ) score, and body mass index (BMI). Additionally, the Mann-Whitney U-test was utilized to compare FABQ-PA, TSK-11, RDQ scores, and BMI between the NS-CLBP and non-NS-CLBP groups.

Results

The FABQ-PA (odd ratio = 1.096, P = 0.003) was significantly associated with NS-CLBP. No significant association was observed between NS-CLBP and TSK-11 (P = 0.776), RDQ (P = 0.074), and BMI (P = 0.296). The scores for FABQ-PA, TSK-11, RDQ, and BMI in the group with NS-CLBP were found to be significantly higher compared to the group without NS-CLBP (P < 0.001, P = 0.034, P < 0.001, and P = 0.022, respectively).

Conclusion

The present study revealed a significant relationship between higher FABQ-PA scores and NS-CLBP among college athletes. Conversely, TSK-11 and BMI values showed no significant association with NS-CLBP presence. The findings suggest that addressing fear-avoidance beliefs may be crucial in managing NS-CLBP among college athletes.

Longer working hours and musculoskeletal pain: a meta-analysis

Objectives. Musculoskeletal pain is the most common health problem in the workplace, and one of the most important risk factors for this pain is longer working hours. This study aimed to investigate the association between long working hours and musculoskeletal pain. Methods. Based on the keywords, two scientific sources - PubMed and Embase - were reviewed. The time limit search included articles that were published until May 2020 and only studies published in English were eligible. The results of the studies were combined based on random effects and pooled odds ratio (OR) reported. The degree of heterogeneity in all analyses was investigated and reported based on χ² and I² tests. Publishing bias was also measured using statistical tests. Results. Longer working hours are associated with increased musculoskeletal pain with OR = 1.11 and 95% confidence interval (CI) [1.08, 1.14]. The result was OR = 1.52 and 95% CI [1.14, 2.03] in men and OR = 1.11 and 95% CI [1.00, 1.24] in women. Conclusion. Long working hours are an important and threatening factor for musculoskeletal health. Therefore, this issue should be considered in health policy as well as treatment and prevention.

Fear-Avoidance Beliefs for Physical Activity Among Chronic Low Back Pain: A Multicenter Cross-Sectional Study

Background

Among different psychological predictors of outcome in low back pain (LBP) adults, the negative influence of fear-avoidance beliefs in physical activity is an area of research attention. However, there is a lack of evidence on the burden of fear avoidance about physical activity among chronic LBP adults in Ethiopia.

Objective

To describe fear-avoidance beliefs about physical activity and explore its association with socio-demographic and clinical factors among low back pain patients attending physiotherapy treatment in 3 Amhara regional comprehensive hospitals.

Methods

A multi-center cross-sectional study was conducted and adults with chronic LBP (n = 263) participated. Data were collected by face-to-face interview using the modified Fear-Avoidance Belief Questionnaire about Physical Activity (mFABQ-PA) tool. Multivariable logistic regression at a p-value <0.05 significance level was used to identify predictors of fear-avoidance beliefs about physical activity.

Results

Among the 263 participants, 113 subjects (43%, 95% CI (36.9-49.0)) reported a higher cut-off (>15) mFABQ-PA. The logistic regression model demonstrated that LBP adults with a higher mFABQ-PA score were more likely to be urban residents (AOR 2.75, 95% CI (1.32, 5.88)), and ADL-related LBP (AOR 1.97 95% CI (1.18, 3.29)). The clinical-specific factor indicative of a higher cut-off score of mFABQ-PA was using analgesic medications (AOR 2.00, 95% CI (1.19, 3.37)). The model fit was 0.21 and 0.11 (R² = Nagelkerke's, Cox & snell respectively).

Conclusion

High fear avoidance beliefs about physical activity in adults with low back pain were found and associated with residence, work, and medication intake. These findings might urge the researchers to explore further associations and assist clinicians in choosing subgroups to use behavioral therapy and graded exposure to physical activity.

Association of Low Back Pain with Shift Work: A Meta-Analysis

Shift work (SW) is the main working schedule worldwide, and it may cause sleep disorders, breast cancer, and cardiovascular disease. Low back pain (LBP) is a common problem in the workplace; however, the association between LBP and SW remains unclear. Therefore, we conducted a meta-analysis to determine the association between SW and LBP. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, and Web of Science databases using a set of associated keywords were queried. The inclusion criteria were as follows: (1) adult employees hired by a company or organization; (2) SW exposure; and (3) the outcome of LBP according to examination or assessment. A total of 40 studies were included that met the inclusion criteria for the meta-analysis. SW was significantly associated with LBP (odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.18−1.47, p < 0.00001). Furthermore, it was observed that LBP was significantly associated with night shift (NS) (OR: 1.49, 95% CI: 1.24−1.82, p < 0.0001) but not with rotating shift (RS) (OR: 0.96, 95% CI: 0.76−1.22, p = 0.49). Moreover, LBP was significantly associated with SW in health care workers (HCWs) (OR: 1.40, 95% CI: 1.20−1.63, p < 0.0001) but not in non-HCWs (OR: 1.19, 95% CI: 0.94−1.50, p = 0.14). SW was significantly associated with LBP. Furthermore, the subgroup analysis showed that NS, but not RS, was associated with LBP. Compared with SW in non-HCWs, SW in HCWs was significantly associated with LBP.

Association Between Low Back Pain, Workaholism, and Work Engagement in Japanese Hospital Workers: A Quantitative Cross-sectional Study

OBJECTIVE

This study aimed to examine the association between two types of heavy work investment, workaholism and work engagement, and low back pain prevalence.

METHODS

We conducted a paper-based survey of Japanese hospital workers. The Dutch Workaholism Scale (DUWAS) and the Utrecht Work Engagement Scale (UWES) were used to classify the participants into four groups and perform multiple logistic regression analyses.

RESULTS

Among 699 participants, the group with low DUWAS and high UWES at 37.1% had the lowest low back pain prevalence. In order, the groups with low DUWAS and UWES were at 51.7%; those with high DUWAS and UWES, 58.5%; and those with high DUWAS and low UWES, 62.4%, with multivariate-adjusted odds ratios of 1.77, 2.01, and 2.33, respectively.

CONCLUSIONS

Low back pain prevalence among Japanese hospital workers was reduced by high levels of work engagement, even at high levels of workaholism.

Physical activity, fear avoidance beliefs and level of disability in a multi-ethnic female population with chronic low back pain in Suriname: A population-based study

BACKGROUND

Chronic low back pain (CLBP) is an important cause for reduced daily physical activity (PA) and loss of quality of life, especially in women. In Suriname, a middle-income country in South America, the relationship between PA and CLBP is still unknown.

AIMS

To assess the level of PA in women with CLBP of different ethnicity, and to identify whether fear avoidance beliefs (FAB), disability, co-occurring musculoskeletal pain sites and various sociodemographic and lifestyle factors were associated with self-reported PA.

METHODS

A cross-sectional community-based house-to-house survey was conducted between April 2016 and July 2017. The survey followed the Community Oriented Program for Control of Rheumatic Diseases methodology. Selection criteria were being female of Asian-Surinamese, African-Surinamese or of Mixed ethnicity and aged 18 or older, living in an urban area, and reporting CLBP. Data was collected on PA, FAB, disability, co-occurring musculoskeletal pain sites, CLBP intensity and sociodemographic and lifestyle factors.

RESULTS

Urban adult women with current CLBP (N = 210) were selected. Nearly 57% of the population met the WHO recommendation on PA, with work-related PA as the largest contributor to total self-reported PA. Most women showed low FAB scores (FABQ-Work ≤34 (96.2%) and FABQ-PA ≤14 (57.6%)) and low disability levels (Oswestry Disability Index ≤20 (62.4%)). An inverse association between total PA and FABQ-Work (OR = 0.132, CI: 0.023; 0.750) was found. In contrast, total PA had a significant, positive association with disability (OR = 2.154, CI: 1.044; 4.447) and workload (OR = 2.224, CI: 1.561; 3.167). All other variables showed no association with total PA.

CONCLUSION

This was the first study in Suriname reporting that 43.3% of urban adult women with CLBP were physically inactive. Total self-reported PA is influenced by FABQ-Work, average to heavy workload and moderate to severe disability. In this study, PA-Work was the major contributor to total PA. Therefore, future longitudinal studies should evaluate different types and aspects of PA in relation to CLBP management.

Patterns of Systemic Disease Diagnoses among Medical Professionals in Taiwan: Statistical Analysis and Data Mining

INTRODUCTION

Although high-risk work environments and heavy workload expose medical professionals to long-term risks of disease, no comprehensive analysis has been conducted on the corresponding risks of diseases to each type of medical professionals. This study pre-analyzed the risks of medical professionals in developing various systemic diseases in Taiwan to provide a comprehensive examination of the differences between each type of systemic disease.

METHODS

From the secondary databases of 2002-2013, 15,407 medical professionals were selected for analysis. A chi-squared test and logistic regression were performed to identify the relationship between types of medical professionals and systemic diseases. The life trajectories of diagnosis sequence of the medical professionals were illustrated accordingly.

RESULTS

The physicians were the most vulnerable to infectious, parasitic, and digestive diseases. This was possibly associated with their work characteristics and occupational risks.

CONCLUSION

According to the life trajectories, all types of the medical professionals exhibited a similar trend in the orders of risks to each type of systemic disease, which suggests that their work environment exposes them to real risks of health hazard.

Changes in task-specific fear of movement and impaired trunk motor control by pain neuroscience education and exercise: A preliminary single-case study of a worker with low back pain

We report a case (a worker with low back pain) who was provided patient education and therapeutic exercise, and we performed a detailed kinematic analysis of his work-related activity over time. The subjects were one 28-year-old male worker with low back pain. In addition, to clearly identify impaired trunk movement during work-related activity in the low back pain subject, 20 age-matched healthy males (control group) were also included as a comparison subject. He received pain neurophysiology education and exercise instruction. We analyzed the subject's trunk movement pattern during a lifting task examined by a three-dimensional-motion capture system. In addition, task-specific fear that occurred during the task was assessed by the numerical rating scale. The assessment was performed at the baseline phase (4 data points), the intervention phase (8 data points), and the follow-up phase (8 data points), and finally at 3 and 8 months after the follow-up phase. No intervention was performed in the control group; they underwent only one kinematic evaluation at baseline. As a result, compared to the control group, the low back pain subject had slower trunk movement velocity (peak trunk flexion velocity = 50.21 deg/s, extension velocity = -47.61 deg/s), and his upper-lower trunk segments indicated an in-phase motion pattern (mean absolute relative phase = 15.59 deg) at baseline. The interventions reduced his pain intensity, fear of movement, and low back pain-related disability; in addition, his trunk velocity was increased (peak trunk flexion velocity = 82.89 deg/s, extension velocity = -77.17 deg/s). However, the in-phase motion pattern of his trunk motor control remained unchanged (mean absolute relative phase = 16.00 deg). At 8 months after the end of the follow-up, the subject's in-phase motion pattern remained (mean absolute relative phase = 13.34 deg) and his pain intensity had increased. This report suggests that if impaired trunk motor control remains unchanged after intervention, as in the course of the low back pain subject, it may eventually be related to a recurrence of low back pain symptoms.

Fear-Avoidance Beliefs, Kinesiophobia, and Disability Risk Among Indians with Spine Pain

PURPOSE

To determine the burden of fear-avoidance beliefs (FAB), kinesiophobia, and risk of persistent disability among Indians with spine pain.

METHODS

Demographic and clinical data collected from 139 patients who attended a spine rehabilitation clinic for assessment and treatment of their spine pain were analyzed. Fear-avoidance beliefs, kinesiophobia, and risk of persistent disability were measured using the Fear-avoidance Beliefs Questionnaire (FABQ), Tampa Scale for Kinesiophobia (TSK), and the STarT Back Tool (SBT). A multivariate analysis was performed to determine the effect of pain, disability, age, gender, BMI, lifestyle, pain duration, and pain location on FAB, TSK, and SBT scores.

RESULTS

A majority of patients had medium to high-risk FAB-physical activities (FAB-P) (50.5%) and SBT (54%) scores. The percentage of patients with medium or high-risk FAB-P (p = 0.03), FAB-work (FAB-W) (p = 0.03), and SBT (p = 0.03) scores were significantly higher in patients with pain score > 7, and the percentage of patients with medium or high-risk with FAB-P (p < 0.0001), TSK (p = 0.0003), and SBT (p < 0.0001) scores were significantly higher in patients with severe, crippled or bed-ridden disability. Disability was the only significant predictor for FAB-W, FAB-P, and SBT scores.

CONCLUSION

The prevalence of fear-avoidance beliefs and risk of persistent disability was significant among Indians and should be taken into account while planning treatment for their spine pain.

Fear of Pain as a Predictor for Postoperative Pain Intensity among the Patients Undergoing Thoracoscopic Surgery

Background

Fear of pain (FOP) has been recognized as an influential moderator and determinant of the perception and disability of chronic pain. However, studies on FOP in postoperative acute pain are few and inconsistent.

Objective

To explore whether FOP is related to pain intensity after thoracic surgery and provide a reference for FOP study in postoperative pain.

Methods

From February to March 2022, 89 patients completed Chinese Version of Fear of Pain-9 Items (FOP-9), Chinese version of the Brief Pain Inventory (BPI, including least, worst, and average pain) and Simplified Chinese version of the Pain Catastrophizing Scale (PCS). Correlation analyses and mediation analyses were used for exploring the relationship between factors.

Results

Mediation analyses showed that the total effects of FOP-9 on BPI all were significant (least pain: effect = 0.085, p=0.013, 95% CI = 0.019∼0.151; worst pain: effect = 0.116, p=0.004, 95% CI = 0.037∼0.196; average pain: effect = 0.102, p=0.005, 95% CI = 0.031∼0.174) indicating that FOP-9 was a predictor to BPI. The 95% bias-corrected bootstrap confidence interval of estimate of indirect effect between FOP-9 and least pain/average pain through PCS was −0.036∼0.024 and −0.003∼0.069 (all contain zero), which indicated that PCS is not a mediator between FOP-9 and least pain/average pain. However, the estimate of indirect effect between FOP-9 and worst pain through PCS were 0.048 (95% CI = 0.095∼0.088), and direct effect was not statistically significant (95% CI = −0.017∼0.153), indicating that PCS acted as a complete intermediary between FOP-9 and worst pain. FOP-9 and PCS showed significant positive prediction effect on worst pain.

Conclusions

Both trait FOP and state FOP were associated with higher postoperative pain reports after thoracic surgery. Trait FOP influences postoperative pain through the mediating effect of state FOP.

The Relationship between Sociodemographic, Professional, and Incentive Factors and Self-Reported Level of Physical Activity in the Nurse Population: A Cross-Sectional Study

Research indicates that while nurses are aware of the benefits of physical activity (PA), their adherence to PA is low. The results of workplace interventions that increase PA are inconsistent. The study aim was identification the sociodemographic, professional, and incentive factors influencing nurses’ PA and investigation its relationship with the level of PA that they report. This study was based on observational cross-sectional research conducted among professionally active nurses working in a clinical setting (n = 350). The self-reported questionnaire was used to collect sociodemographic and employment data and motivators and barriers of participating in PA. The level of PA was assessed using International Physical Activity Questionnaire. The analysis revealed significant differences in the Total Physical Activity Score (TPAS) depending on the variables related to professional activity (working in a management position: p = 0.015; workplace: p = 0.01; shift type: p ≤ 0.002). Cluster analysis revealed that the most important statement in the group division about motivation was fear of the pain occurring after exercise. Nurses who were more motivated to be active showed a higher level of leisure-time PA than less motivated nurses. The recommendation of PA in the nursing population should be focused on increasing the leisure time PA, ensuring the appropriate time to recovery, and compliance with the principles of work ergonomics to prevent musculoskeletal disorders.

Occupational status and self-reported low back pain by gender: a nation-wide cross-sectional study among the general population in Japan

Background

We aimed to examine the cross-sectional association between occupational class and self-reported low back pain (LBP) in a representative sample of the Japanese general population.

Methods

We used anonymized data from a nationwide survey (31,443 men and 35,870 women aged ≥ 20). Occupational class variables included working status, occupation, employment status, and company size (number of employees). Covariates included age, socio-economic status, lifestyle, and comorbidities. Poisson regression models stratified by gender were used to estimate adjusted prevalence ratio (APR) and 95% confidence interval (CI) for self-reported LBP.

Results

The prevalence of self-reported LBP was 11.7% in men and 14.2% in women. After adjustment for covariates and mutual adjustment for all occupational class variables, among both genders, agricultural/forestry/fishery workers and non-workers had a significantly higher prevalence of self-reported LBP: APR (95% CI) of agricultural/forestry/fishery was 1.36 (1.08–1.70) in men and 1.59 (1.30–1.93) in women; that of non-workers was 1.42 (1.18–1.70) in men and 1.23 (1.08–1.40) in women. Among men, non-regular employees were more likely to have self-reported LBP than regular employees: APR (95% CI) was 1.25 (1.07–1.46) in part-timers and casual staff and 1.18 (1.03–1.35) in other types of non-regular employees. Moreover, compared to men working at companies with ≥ 100 employees, men working at companies with 30–99 employees had a significantly higher prevalence of self-reported LBP (APR 1.17; 95% CI, 1.03–1.34). Among women, professionals and technicians (1.26; 1.11–1.43) and sales workers (1.22; 1.04–1.43) had a significantly higher prevalence of self-reported LBP than clerks. Neither employment status nor company size was associated with self-reported LBP in women. After stratified analyses by age group, similar patterns were observed in participants aged 20–64, but not in those aged ≥ 65.

Conclusion

Our results suggest that self-reported LBP is highly prevalent among agricultural/forestry/fishery workers and the unemployed, regardless of gender, and that there are also gender differences in the association of occupational class factors with self-reported LBP. It is necessary, therefore, to take preventive measures against LBP based on gender and occupational class factors in Japan.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12199-021-01031-2.

The effectiveness of Chair Massage on Stress and Pain in Oncology

Background

There is a high prevalence of moderate-to-high levels of chronic stress among nurses, as well as an occurrence of musculoskeletal disorders.

Purpose

To evaluate the effectiveness of chair massage to reduce chronic stress and musculoskeletal pain in the Oncology Nursing team.

Setting

Two teaching cancer hospitals, one public and the other private, in São Paulo city, Brazil.

Participants

A total of 60 women from the Oncology Nursing team.

Research Design

A randomized controlled trial divided into two groups: chair massage and control without intervention.

Intervention

The massage group received two chair massage sessions lasting 15 minutes, twice a week, for three weeks.

Main Outcome Measure

Reduction of stress and pain measured by the List of Signs and Symptoms (LSS) and the Brief Pain Inventory (BPI), respectively.

Results

The average age was 32 (± 5.3) years. There was a reduction of stress measured by the LSS with a statistical difference in the group-time interaction (p < .001), with a Cohen’s d value of 1.21 between groups. The BPI analysis showed a statistically significant difference in the group-time interaction for general activity (p < .008), mood (p < .03), work (p < .000), and sleep (p = .03), with reduced pain interference in these components.

Conclusion

Chair massage reduced stress and pain interference in the team’s daily life activities, bringing a positive impact in the context of work stress and pain in Oncology nursing professionals.

Research Relating to Low Back Pain and Physical Activity Reported Over the Period of 2000-2020

BACKGROUND

Low back pain (LBP) is a highly prevalent musculoskeletal disorder that contributes to the greatest degree of disability worldwide. It has become a very serious public health problem that has attracted considerable research interest. The number of publications associated with LBP and physical activity (PA) is gradually increasing. Nevertheless, few studies have utilised visualisation in analysing the general aspects of this field. Therefore, we aimed to provide a systematic overview of global scientific research related to low back pain and physical activity from 2000 to 2020. It has significant benefits in terms of providing researchers with the status and trends of research on low back pain and physical activity.

METHODS

Publications on Science Citation Index-Expanded of Web of Science from 2000 to 2020 were searched, and publications relevant to LBP and PA were analysed using Citespace and SPSS. Analyses mainly included cooperation amongst authors, countries and institutions; co-occurrence analysis of keywords; and co-citation analysis of references, revealing productive researchers and contributing institutions tracking the status and trend of research fields.

RESULTS

Results of linear regression analysis showed that the number of publications on LBP and PA studies increased significantly (p<0.001). The subject categories predominantly focused on orthopaedics (2579, 26.54%), rehabilitation (2544, 26.18%) and sport sciences (2015, 25.44%). The United States had the highest number of published papers (2700, 27.789%) and citations (86, 958). In terms of the number of publications, amongst the top 20 journals, Spine contributed the most, whilst the British Journal of Sports Medicine had the highest impact factor (IF2019, 12.022). The University of Sydney had the highest number of publications (330 publications). Maher published the most papers (123 papers) and had the highest H-index (41). Several citation articles and keywords (such as aerobic, obesity and fear-avoidance beliefs) can be used to provide frontier clues for research on LBP and PA.

CONCLUSION

The results of our study may provide information, such as research trends and frontiers of research and collaborating partners, institutions and countries, on LBP and PA.

Differences between fixed day shift nurses and rotating and irregular shift nurses in work-related musculoskeletal disorders: A literature review and meta-analysis

OBJECTIVES

Work-related musculoskeletal disorders (WMSDs) are common occupational injuries for nurses. Furthermore, rotating and irregular shift work may exacerbate muscle tension and pain in nurses. The objective of this study was to examine the differences between fixed day shift (FDS) nurses and rotating and irregular shift (RS + IS) nurses in WMSDs using a systematic literature review and meta-analysis.

METHODS

Databases including PubMed, CINAHL, Cochrane Library, EBSCOhost, and Google Scholar were searched for relevant studies published between 2010 and 2020 using the target keywords.

RESULTS

This study obtained data on a total of 18 199 nurses, among which 12 786 comprised the RS + IS group and 5413 constituted the FDS group. The result of the heterogeneity test was Q = 79.27 (P < .001) and I squared = 57.11%, indicating that heterogeneity existed among the studies. Subgroup analyses were also conducted with four groups: neck pain (n = 1818), shoulder and upper limb pain (n = 2525), back pain (n = 11 962), and hip and lower limb pain (n = 1894). Significant differences were found between the RS + IS group and the FDS group with regard to back pain, with the forest plot presenting an odds ratio equaling 1.40 (95% CI: 1.19-1.64, P < .001).

CONCLUSIONS

This meta-analysis indicated that RS + IS nurses are more likely to experience back pain associated with WMSD than are FDS nurses. The results can serve as a reference to the clinical management for work improvement and thereby reduce or prevent the adverse effects of rotating and irregular shift work on back pain experienced by nurses.

Early differential diagnosis of ankylosing spondylitis among patients with low back pain in primary care

Diagnosing and treating low back pain (LBP) is a worldwide major primary care challenge in which a differential diagnosis between non-specific LBP and conditions with a known pathology is essential for choosing the optimal treatment strategy. The time required for the diagnosis of a condition such as ankylosing spondylitis (AS) was previously found too long. However, a recently published paper by Bashir et al. found that distinct episodes of axial pain separated by more than 6 months seem more predictive than currently applied characteristics in reaching an early diagnosis of AS.