Investigating association between job stress dimensions and prevalence of low back pain among hospital nurses

Perceived stress and lower back pain amongst nurses during the SARS-CoV-2, across hospitals in Durban, South Africa

BACKGROUND

 The coronavirus disease 2019 (COVID-19) pandemic strained the healthcare sector and workers. Nurses experienced stress and burnout because of strain in resources, limited staff and exposure risk. Resultant lower back pain was prevalent. Nurses were poorly equipped to manage these conditions physically and psychologically.

OBJECTIVES

 The study aims to investigate lower back pain and stress levels during COVID-19. It also aims to provide data describing any association between both.

METHOD

 Pain and stress were determined using questionnaires. Quantitative, descriptive design and convenient sampling were used. The Chi-square goodness-of-fit-test tests significant Back Pain Functional Scale (BPFS) responses (12 daily activities lower back pain) and determines the relationship between pain and stress before and during COVID-19 related to the current time. Chi-square test of independence is used on cross-tabulations to determine the relationship between stress and lower back pain. Fisher's exact test was used for conditions not met. The Binomial test was used for the significance check of yes/no response to medication use. A questionnaire was provided on exercise levels and provision by workplace.

RESULTS

 Higher pain and stress were noted during versus prior to COVID-19. Back Pain Functional Scale showed no difficulty performing the majority of activities. A small percentage used medication, showing no significant change. Majority did not perform exercise for reducing lower back pain prior to or during COVID-19. Exercise intervention was not provided by workplaces for the majority, during or prior to COVID-19.

CONCLUSION

 Lower back pain and perceived stress levels increased during the COVID-19 pandemic. Provision of lower back pain education and exercise intervention in preventing and managing lower back pain in hospital nurses was needed. This study adds to the stress and lower back pain knowledge base in South Africa.Contribution: The findings assist in understanding the effects of Covid-19 on stress and lower back pain in nurses, linkage of the two, and possible interventions to reduce these effects using knowledge enhancement and prescribed exercise interventions.

Frequency, severity, and associated risk factors of low back pain among nurses working in public tertiary care hospitals of Rawalpindi. A cross-sectional study

BackgroundNurses face a greater risk of developing low back pain because of the physically demanding nature of their work and excessive workloads. In developing countries such as Pakistan, the lack of modern mechanical assistive devices for patient handling further increases this risk, as nurses often rely on manual methods for assisting and repositioning patients.ObjectivesTo determine the frequency of LBP among nurses working in tertiary care hospitals in Rawalpindi, the associated risk factors that lead to the prevalence of LBP, should be explored, and the intensity of LBP should be quantified via a visual analog scale (VAS) of pain intensity.MethodsThis quantitative descriptive cross-sectional study was conducted in Rawalpindi's three main tertiary care hospitals. Data were collected via a non-probability purposive sampling technique. A validated modified Nordic questionnaire was used to assess low back pain (LBP) frequency, whereas the Visual analog scale was used to quantify pain intensity. Statistical analysis was performed via SPSS version 23.ResultsAmong a sample of 300 female nurses, 60% were married, 74.3% had a normal BMI, and 79% reported no history of accidents. The 12-month prevalence of low back pain (LBP) was 72%, with 54.3% experiencing activity limitations due to LBP. Moderate pain was reported by 37.3% of the participants. Advanced age, workload, and job experience were identified as significant risk factors for LBP.ConclusionThis study confirms the high prevalence of low back pain (LBP) among nurses in Pakistan, which aligns with previous research. Key risk factors include older age, excessive workload, occupational stress, and over 15 years of job experience.

Job stress and chronic low back pain: incidence, number of episodes, and severity in a 4-year follow-up of the ELSA-Brasil Musculoskeletal cohort

ABSTRACT

We investigated the association between job stress, as assessed by the effort-reward imbalance model, and the incidence of chronic low back pain (CLBP) over a 4-year period. A total of 1733 participants from the ELSA-Brasil Musculoskeletal cohort, who were free from LBP at baseline (2012-2014), were included. Episodes of LBP in the past 30 days, intensity, and the presence of disability were investigated in annual telephone follow-ups (2015-2018). Chronic LBP was defined as episodes of LBP lasting >3 months with at least moderate intensity. We analyzed the incidence of at least one episode of CLBP (yes/no), the number of CLBP episodes (0, 1, ≥2), and CLBP severity/disability (absent, nondisabling, severe/disabling). The association between these outcomes and tertiles of the effort-to-reward ratio, as well as each dimension of the effort-reward imbalance model, was investigated using multinomial logistic and Poisson regression models adjusting for sociodemographic and occupational variables. The cumulative incidence of CLBP over 4 years was 24.8%. High effort-reward imbalance increased the chances of experiencing multiple CLBP episodes and severe/disabling CLBP by 67% (95% confidence interval [CI]: 1.12-2.47) and 70% (95% CI: 1.14-2.53), respectively. High overcommitment increased the incidence of CLBP by 23% (95% CI: 1.01-1.50) and the chances of multiple CLBP episodes and severe/disabling CLBP by 67% (95% CI: 1.11-2.50) and 57% (95% CI: 1.05-2.34), respectively. These results indicate that exposure to job stress is associated with a higher incidence, a greater number of episodes, and increased severity of CLBP over a 4-year period. If this association is causal, measures aimed at reducing exposure to job stress are likely to alleviate the burden of CLBP.

The predicting factors of chronic pain among nursing students: a national study in Iran

BACKGROUND

Nursing students are faced with a variety of challenges that demand effective cognitive and emotional resources. The physical and psychological well-being of the students plays a key part in the public health of the community. Despite the special lifestyle of nursing students, few studies have addressed chronic pain in this population. Accordingly, the present study aims to identify the predictors of chronic pain among nursing students.

METHODS

This cross-sectional study was conducted on 1,719 nursing students aged 18-42 years, between February and November 2019. Sampling was carried out in several stages. Data were collected using seven instruments, namely a demographics survey, the characteristics of chronic pain form, Spielberger State-Trait Anxiety Inventory (STAI), the Patient Health Questionnaire-9 (PHQ-9), the Bar-on Emotional Quotient Inventory, Academic Satisfaction Scale, and Procidano and Heller Social Support Scale. Descriptive statistics, multinomial logistic regression, and regression models were used to describe the characteristics of the pain and its predictive factors.

RESULTS

The average age of the participants was 22.4 ± 2.96 years. The results of univariate analysis showed that gender (P = 0.506), mother's education (P = 0.056, P = 0.278, P = 0.278), father's education (P = 0.817, P = 0.597, P = 0.41), place of residence (P = 0.215), depression (P = 0.501), grade point average (P = 0.488), academic satisfaction (P = 0.183) and chronic pain weren't significantly correlated with chronic pain in nursing students. The results of the multiple logistic regression models showed that chronic pain was positively correlated with age, social support, state anxiety, and trait anxiety (OR = 1.07, 95% CI: 1.02-1.12; OR = 0.95, 95% CI: 0.93-0.97; OR = 1.03, 95% CI: 1.02-1.05; and OR = 1.97, 95% CI: 0.95-1.99; respectively).

CONCLUSION

The prevalence of chronic pain was relatively high in these students. In addition, age, social support, and anxiety could be important factors in the development or persistence of chronic pain in nursing students. The results also provided basic and essential information about the contributing factors in this area. However, consideration of factors such as referral for treatment, home medications for pain relief, and outcomes of chronic pain are suggested in future longitudinal studies.

Acute Musculoskeletal Complaints Vary According to the Perceived Stress Among Hungarian Professional Dancers

Introduction: Studies showed that professional dance is often associated with a high degree of acute musculoskeletal injuries. These injuries' etiology predominantly describes their biomechanical or other extrinsic factors, but there is a limited number of scientific reports dealing with the perceived stress or mental health status concerning the physical complaints especially, among Hungarian professional dancers. Materials and Methods: In this study, we used validated questionnaires (RESTQ, SEFIP, Mental Health Test) filled out by Hungarian professional female dancers (N = 168) via an online platform anonymously and analyzed statistically. Results: Our findings showed a significantly positive relationship between musculoskeletal complaints and perceived stress, an elevated level of general stress, and a higher level of resilience in this population compared to the general population. Conclusion: Dancers demonstrate a heightened perception of stress; however, they exhibit elevated scores on resilience assessments, indicative of heightened functionality in their daily lives. Stress, per se, may not be directly regarded as a causative factor for acute musculoskeletal conditions, but it could potentially influence the severity of pain sensations and subjective pain levels in the context of existing injuries. Additional investigations are warranted to elucidate the precise mechanisms by which stress exacerbates the pain experience among dancers.

Assessment of Load Manual Lifting among Shelf-Stoking Workers in Chain Stores: A Cross-Sectional Study

In Iranian stores, shelf workers, in addition to shelf-stocking, perform diverse tasks, such as working as a cashier, cleaning, barcode reading, labeling goods, and entering the price with the portable data terminal (PDT). Therefore, this study aimed to investigate the prevalence of work-related musculoskeletal symptoms (WMSs) and assess load manual lifting among shelf-stoking workers. This cross-sectional study was conducted among 101 shelf-stoking workers (60 males and 41 females) in chain stores at Shiraz city, Iran. The subjects were selected by cluster sampling from chain stores in Shiraz city, namely Refah, Canbo, Soroush, and Tirazis. Then, the required number of samples was selected and entered into the study from each cluster in proportion. The Persian version of the Nordic Musculoskeletal Questionnaire and the National Institute of Occupational Safety and Health-variable lifting index method were used to collect the required data. Data were analyzed by SPSS software version 22 using the Mann-Whitney U test, Spearman's correlation coefficient, and linear regression. Ankles/feet, lower back, and knees had the highest prevalence of WMSs among the participants. About 70.3% of workers had a VLI higher than 1. There was an association between gender and VLI. The VLI was higher in males than females. The study's findings revealed that the medians of the VLI were significantly different among participants with/without upper back symptoms during 12 months prior to the study and among participants with/without lower back symptoms during 7 days prior to the study. According to the linear regression analysis, gender and lower back symptoms during 7 days prior to the study remained in the model and were associated with the VLI. The findings revealed that the back region of the shelf-stoking workers is prone to work-related musculoskeletal disorders. In addition, based on the results, gender and lower back symptoms during the 7 days prior to the study were predicting variables for VLI. This study provides an overview of pain/discomfort and postural load in shelf-stoking workers. Since the principles of ergonomics for the placement and layout of shelves are the same in all stores, the findings of the present study can be used in other stores.

A structural equation model of the relationship among occupational stress, coping styles, and mental health of pediatric nurses in China: a cross-sectional study

BACKGROUND

Pediatric nurses experience a wide rang of stressful events at work every day, which can trigger a lot of emotional responses. The objectives of this study were mainly to explore the potential interrelationships of occupational stress, coping styles and mental health among pediatric nurse.

METHODS

A total of 381 pediatric nurses from Chongqing, China were recruited in this cross-sectional study. We performed this study based on a questionnaire survey that contained the Chinese Perceived Stress Scale (CPSS), Simplified Coping Style Questionnaire and Symptom-Checklist 90(SCL-90).

RESULTS

The pediatric nurses reported having health risk stress(HRS) was 54.3%, and nurses with different medical professional titles, style of coping and profiles of mental health had significantly different occupational stress levels (P < 0.01). And with the application of the Spearman correlation analysis and Structural Equation Modelling were revealed a significant relationship among occupational stress, coping style and mental health. The positive coping style had a negative direct predictive effect on occupational stress (β = -0.499, P < 0.01) and mental health symptoms (β = -0.115, P < 0.01), negative coping styles had positive predictive effect on occupational stress (β = 0.185, P < 0.01) and mental health symptoms (β = 0.205, P < 0.01). Occupational stress had significant impact on mental health symptoms (β = 0.416, P < 0.01), and it was played a part of mediating effect between coping style and mental health.

CONCLUSION

These findings demonstrated significant associations between occupational stress, coping style and mental health in pediatric nurses, and this SEM model highlighted that the potential prediction effects of occupational stress and coping styles for mental health and the mediated effect of occupational stress between coping style and mental health, which we believe facilitates the understanding of these associations. This model should be useful in the formulation of strategies to improve mental health level for this population.

Further psychometric evaluation of the Structured Multidisciplinary Work Evaluation Tool (SMET) questionnaire: Practical implications in healthcare settings

BACKGROUND

Scientific research has identified a lack of psychometrically well-tested methods for evaluation of the work environment in healthcare settings. The Structured Multidisciplinary Work Evaluation Tool (SMET) questionnaire has been evaluated and has shown good content validity, as well as intra-rater and test-retest reliability. There are, however, still unknowns regarding the psychometric properties. If the SMET questionnaire is to be used in practical occupational health service (OHS) work and scientific research in healthcare settings, further psychometric evaluation is needed.

OBJECTIVE

The aim of this study was to gain further understanding of the psychometric properties of the SMET questionnaire when used in research and clinical OHS practice in healthcare settings.

METHODS

The psychometric evaluation was conducted using classical test theory (Cronbach's alpha, explorative factor analysis) and Rasch analysis (measurement targeting, category threshold order, person separation index) on data previously collected in development projects within the healthcare sector.

RESULTS

The results support the use of the SMET questionnaire as a psychometrically well-tested method for evaluation of the work environment in healthcare settings. They support the use of the initial 1-10 scale since all 10 steps are used. The results also support the trichotomization procedure since the trichotomized scale captures the construct of the work environment with good measurement targeting and good category threshold order.

CONCLUSION

The results of this study support the use of the SMET questionnaire as a psychometrically well-tested method for a broad multifactorial evaluation of the work environment in healthcare settings.

Work-related musculoskeletal symptoms among Iranian nurses and their relationship with fatigue: a cross-sectional study

Background

The present study aimed to determine the prevalence of work-related musculoskeletal symptoms (WMSs), identify potential factors associated with WMSs, and determine the association between WMSs and fatigue among nurses.

Methods

This cross-sectional study was carried out among 500 Iranian nurses. Data was gathered by the 1) Persian version of the Nordic musculoskeletal questionnaire (P-NMQ) to examine WMSs, and 2) Persian version of the Multidimensional Assessment of Fatigue (P-MAF) Scale to evaluate fatigue among the study population. Then, data was analyzed by SPSS version 21 using the χ2 test, multiple logistic regression for detection of potential factors associated with WMSs, and multiple linear regression for detection of potential factors associated with fatigue.

Results

Ankles/feet, lower back, knees, and shoulders had the highest prevalence of WMSs among nurses within the last 12 months prior to the study. Independent variables including age, job tenure, gender, smoking, shift work, and type of employment were significantly associated with WMSs in different body regions with odds ratios (ORs) ranging from 1.635–2.835. Moreover, WMSs in some body regions were associated with subscales of fatigue and total fatigue.

Conclusions

Ergonomic and organizational interventions for fitting the job to the nurses considering demographic/occupational characteristics are highly essential to improve musculoskeletal system health and relieve fatigue.