Aims: To identify the work factors that predict intense low back pain (LBP) and LBP related sick leaves in nurses' aides. Methods: The sample comprised 4266 randomly selected Norwegian nurses' aides, not bothered or only a little bothered by LBP during the previous three months, and not on sick leave when completing a mailed questionnaire in 1999. Of these, 3808 (89.3%) completed a second questionnaire 3 months later and 3651 (85.6%) completed a third questionnaire 15 months later. Intensity of low back symptoms and certified sick leaves attributed to LBP during the observation period were assessed by self reports at the follow ups. Results: After adjustments for LBP during the three months prior to baseline, baseline health complaints, demographic and familial factors, and a series of physical, psychological, and social work factors, logistic regression analyses revealed the following associations: intense low back symptoms were predicted by frequent positioning of patients in bed, perceived lack of support from immediate superior, and perceived lack of pleasant and relaxing culture in the work unit. LBP related sick leaves were predicted by frequent handling of heavy objects, medium level of work demands, perceived lack of supportive and encouraging culture in the work unit, working night shifts, and working in a nursing home. Long term LBP related sick leaves were associated with changes of work or work tasks during the observation period that resulted in a perceived reduction of support and encouragement at work. Conclusions: Not only frequent mechanical exposures, but also organisational, psychological, and social work factors, such as night shift work, perceived lack of support from superior, and perceived lack of a pleasant and relaxing or supporting and encouraging culture in the work unit, are associated with an increased risk of intense low back symptoms and LBP related sick leaves in nurses' aides. S tudies from around the world have documented the enormous burden of low back pain (LBP) to individuals and society.1 Nurses' aides, doing both emotional and heavy physical work, and being exposed to a combination of mechanical and psychosocial stress at work, are one of the occupational groups that are most frequently affected by LBP. 2-4A large number of studies have explored the relation between work factors and LBP, in both nursing personnel and other occupational groups.5-8 Heavy lifting, frequent twisting and bending, whole body vibration, low social support at work, and low job satisfaction have been consistently associated with the risk of LBP. In most studies, however, the intensity and the functional consequences of the pain were not reported. Hence, it may be difficult to tell whether the identified predictors are predictors of ''humdrum nuisance'' or severe disease.The relation between mechanical exposures at work and the occurrence of LBP related sickness absence was reported in several studies, with a majority of positive associations. The relation of social and psychological work factors to ...
BackgroundPrevious studies indicate that psychological, social, and organizational factors at work contribute to health, motivation, absence from work, and functional ability.The objective of the study was to assess the current state of knowledge of the contribution of psychological, social, and organizational factors to disability retirement by a systematic review and meta-analyses.Methods Data sources: A systematic literature search for studies of retirement due to disability in Medline, Embase, and PsychINFO was performed. Reference lists of relevant articles were hand-searched for additional studies. Data extraction: Internal validity was assessed independently by two referees with a detailed checklist for sources of bias. Conclusions were drawn based on studies with acceptable quality. Data synthesis: We calculated combined effect estimates by means of averaged associations (Risk ratios) across samples, weighting observed associations by the study’s sample size. Thirty-nine studies of accepted quality were found, 37 of which from the Nordic countries.ResultsThere was moderate evidence for the role of low control (supported by weighted average RR = 1.40; 95% CI = 1.21-1.61) and moderate evidence for the combination of high demands and low control (although weighted average was RR = 1.45; 95% CI = 0.96-2.19) as predictors of disability retirement. There were no major systematic differences in findings between the highest rated and the lowest rated studies that passed the criterion for adequate quality. There was limited evidence for downsizing, organizational change, lack of employee development and supplementary training, repetitive work tasks, effort-reward imbalance to increase risk of disability pension. Very limited evidence was found for job demands, evening or night work, and low social support from ones superior.ConclusionsPsychological and organizational factors at work contribute to disability retirement with the most robust evidence for the role of work control. We recommend the measurement of specific exposure factors in future studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4059-4) contains supplementary material, which is available to authorized users.
Background: Nurses' aides (assistant nurses), the main providers of practical patient care in many countries, are doing both emotional and heavy physical work, and are exposed to frequent social encounters in their job. There is scarce knowledge, though, of how working conditions are related to psychological distress in this occupational group. The aim of this study was to identify work factors that predict the level of psychological distress in nurses' aides.
The aims of this article are: (1) to explore patterns (clusters) of coping strategies; (2) to examine the stability of individual coping strategies and patterns of coping over time; and (3) to establish long term associations between coping and psychological distress. Coping strategies were assessed with the Brief Cope questionnaire, whereas psychological distress was measured with the ten-item version of the Hopkins Symptom Checklist, in a two-year prospective sample comprising 3,738 employees. Based on TwoStep cluster analysis of the Brief Cope, three different coping patterns were identified: low coping, engagement coping, and disengagement coping. Analyses of long-term stability indicated malleable properties for the individual coping strategies as well as the three clusters. Disengagement coping strategies in the form of self-blame and self-distraction were most strongly associated with distress at follow-up, whereas baseline distress was related to increased use of these strategies two years later. Coping patterns at baseline had no main effects on later levels of distress, but levels of distress at baseline predicted subsequent use of engagement and disengagement coping patterns. The finding that specific coping strategies are malleable suggests that it is possible to modify and develop dysfunctional strategies. The associations between disengagement coping strategies and distress indicate that this kind of coping is especially problematic with regard to mental health problems. A main contribution of this study is that it establishes cluster analytic techniques as beneficial in the assessment of coping.
Data from a community-based 4-year prospective study were used to investigate job characteristics as predictors of neck pain. Of 1791 working responders who completed a questionnaire in 1990, 1429 (79.8%) returned a second questionnaire 4 years later (1994). In responders without neck pain during the previous 12 months in 1990, the "little influence on own work situation" factor predicted neck pain during the previous 12 months (odds ratio = 2.21; 95% confidence interval, 1.18 to 4.14) and previous 7 days in 1994 (OR = 2.85; 95% confidence interval, 1.21 to 6.73) after adjustment for a series of potential confounders. In responders with neck pain in 1990, the little influence on own work situation factor was associated with persistent neck pain 4 years later. The study indicates that having little influence on one's own work situation is a predictor of neck pain.
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