Association between psychosocial factors and musculoskeletal symptoms among Iranian nurses

Department of Occupational Medicine, Tehran University of Medical Sciences, Iran.
American Journal of Industrial Medicine (Impact Factor: 1.59). 10/2010; 53(10):1032-9. DOI: 10.1002/ajim.20869
Source: PubMed

ABSTRACT While psychosocial factors have been associated with musculoskeletal symptoms among nurses in some countries, previous studies of Iranian nurses show little association using a demand and control questionnaire. The aim of this study is to assess and evaluate the prevalence of musculoskeletal symptoms and to assess their relationships with psychosocial factors among nurses in Iran.
In a cross-sectional study, 347 hospital nurses completed a self-reported questionnaire containing the Standardized Nordic questionnaire for musculoskeletal symptoms and the General Nordic questionnaire for Psychological and Social factors at work (QPS Nordic 34+ Questionnaire).
Prevalence of low back pain, knee pain, shoulder pain, and neck pain were 73.2%, 68.7%, 48.6%, and 46.3%, respectively. Middle and high stress groups had higher crude and adjusted odds than the low stress group for all body sites. The association for neck, wrist/hand, and upper back and ankle/foot reports (adjusted odds ratio for high stress ranging from 2.4 to 3.0) were statistically significant.
We observed a high prevalence of self-reported musculoskeletal symptoms at a number of body sites, which were associated with psychosocial factors and specifically stress as defined by the QPS Nordic 34+ Questionnaire.

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    ABSTRACT: This study examined the relationships between psychosocial work factors and risk of WRMSDs among public hospital nurses in the Klang Valley, Malaysia. We conducted a cross-sectional study among 660 public hospital nurses. A self-administered questionnaire was used to collect data on the occurrence of WRMSDs according to body regions, socio-demographic profiles, occupational information and psychosocial risk factors. 468 questionnaires were returned (response rate of 71%), and 376 questionnaires qualified for subsequent analysis. Univariate analyses were applied to test for mean and categorical differences across the WRMSDs; multiple logistic regression was applied to predict WRMSDs based on the Job Strain Model's psychosocial risk factors. Over two thirds of the sample of nurses experienced discomfort or pain in at least one site of the musculoskeletal system within the last year. The neck was the most prevalent site (48.94%), followed by the feet (47.20%), the upper back (40.69%) and the lower back (35.28%). More than 50% of the nurses complained of having discomfort in region one (neck, shoulders and upperback) and region four (hips, knees, ankles, and feet). The results also revealed that psychological job demands, job strain and iso-strain ratio demonstrated statistically significant mean differences (p < 0.05) between nurses with and without WRMSDs. According to univariate logistic regression, all psychosocial risk factors illustrated significant association with the occurrence of WRMSDs in various regions of the body (OR: 1.52-2.14). Multiple logistic regression showed all psychosocial risk factors were significantly associated with WRMSDs across body regions (OR: 1.03-1.19) except for region 1 (neck, shoulders and upper back) and region 4 (hips, knees, ankles, and feet). All demographic variables except for years of employment were statistically and significantly associated with WRMSDs (p < 0.05). The findings indicated the high prevalence of WRMSDs in many body regions, and the risks of developing WRMSDs according to the various body regions were associated with important psychosocial risk factors based on the job strain model. These findings have implications for the management of WRMSDs among public hospital nurses in the Klang Valley, Malaysia.
    01/2014; 26(23):1-9. DOI:10.1186/s40557-014-0023-2
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    ABSTRACT: Background: Prevalence of low back pain (LBP) and neck pain (NP) in workers, especially in nurses is high, but their knowledge of ergonomics is not enough. Objectives: The aim of this study was to evaluate the impact of ergonomic training on low back pain and neck pain, posture, and function in female hospital personnel of Najaf-Abad, Iran. Patients and Methods: In this queasy experimental study, 47 female staffs with LBP or NP were selected through a simple consecutive sampling method. The subjects completed a questionnaire on LBP and NP and were evaluated for posture, back tests, and cost of related treatments. Afterward, they participated in an ergonomic training program, including face to face and group education sessions on ergonomic risk factors for LBP and NP, in the work place. After six months of follow up, all the tests and data collection were repeated and data was analyzed using paired t-test and regression analysis. Results: Prevalence of LBP and NP were 87% and 45.7%, respectively. Repetitive motions were the most frequent cause of pain (67%). Pain intensity, posture, risk of musculoskeletal disorders, weight, waist circumference, sick leaves, and the costs of treatments reduced significantly after intervention (P < 0.05). Conclusions: With regards to the influence of ergonomic training on improving LBP and NP and decreasing the treatment costs, this intervention beside others can be useful for controlling musculoskeletal disorders in hospital personnel. Low back pain (LBP) and neck pain (NP) are of the most prevalent musculoskeletal disorders due to technological improvement and sedentary life style in developed and developing countries, in a way that 60-80% of people have experienced LBP at least once in their lives (1). Although LBP is often self-improving, half of the affected subjects have history of prolong or repetitive LBP (2). This group of patients is accounted for 80% of LBP-related cost (3). In Iran, the prevalence of LBP in general population, employees , students and pregnant women is different from 14.4% to 84.1% (4). Studies have shown that the prevalence of LBP and NP is high among hospital nurses; thus, they are considerable subjects for investigation (5, 6). Mohse-ni et al. reported the prevalence of LBP and NP among nurses of north of Iran to be more than 50% (7). Mehrdad and his colleagues indicated that the prevalence of LBP and NP was 73.2% and 48.6%, respectively (8). The most important reasons reported for vertebral spine and joints disorders included: awkward position of the joints during resting or working, lack of awareness about physical health during daily activities such as working for a long time uninterruptedly or wrong habits and awkward postures , muscle imbalance, neglecting treatment of such disorders, and poor condition of work environment such as inappropriate instruments (9). Several studies have shown the related risk factors for LBP and NP; but, there is controversy on relation of posture with LBP and NP (10, 11), since most of the studies have been performed among industrial populations or specific health personnel, in addition to poor methodologies due to assessments by questionnaires. Musculoskeletal disorders (MSDs), especially LBP, result in high prevalence of drug consump-tions, work absenteeism, disability, and psychosocial problems (12-20). Physical factors such as heavy lifting, repetitive tasks and staying in a static position for a long time, as well as psychological factors like high level of stress, depression, self-satisfaction and social support are important in job-related MSD (21). The high prevalence of MSD imposes direct and indirect cost for both patients and the society (22, 23). Recognition of the related risk factors and planning for their prevention and reduction are necessary. Previous studies have shown that the cost of LBP and NP was about 761 million dollars; however, the cost of leaves of health personnel was nine times more than the direct cost of MSD treatment (24). In our society, more studies are needed on effectiveness of these strate
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    ABSTRACT: Low back pain (LBP) is a common medical problem among nurses. A better understanding of nurses' experiences about LBP may help to develop preventative approaches. The study aimed to explore risk perceptions of nonspecific LBP among nurses in Bandar Abbas City, southern Iran. This qualitative study conducted as directed content analysis in 2013. Private semi-structured interviews were conducted with a convenience sample of 30 nurses with minimum of 1-year working experience in hospital. The interview questions were based on perceived severity and vulnerability structures of Protection Motivation Theory. All interviews were transcribed and analyzed using thematic analysis. Perceived Severity had the following sub-themes: developing disorders in one's own life and profession, psychical and mental consequences, conflicts and problems in family life, and financial problems. Two sub-themes (problems and limitations in hospital's working system, nature of nursing profession) were identified in relation to perceived vulnerability. Nurses reflected their concerns about the impact of LBP on their job security and their considerations about how their back pain might be interpreted by their employers and co-workers. Importance of transparent medical diagnostic procedure and clinical evidence to justify degree of LBP and its burden on the nurses' performance was also addressed.


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Jul 11, 2014