Links between nurses’ organisational work environment and upper limb musculoskeletal symptoms: Independently of effort–reward imbalance! The ORSOSA study

Abstract

The role of psychosocial factors in the development of upper limb musculoskeletal disorders has now been clearly demonstrated. However, only a few studies have analysed the association between the organisational work environment and musculoskeletal disorders in health care workers. The main goal of this study was to test the hypothesis that some specific organisational constraints may be related to upper limb musculoskeletal symptoms experienced by registered nurses, independently of the effort/reward imbalance model and major confounding factors. In 2006, 2194 female registered nurses in 7 French teaching hospitals, recruited from the baseline screening of an epidemiological cohort study (the ORSOSA study), responded to valid self-report questionnaires (ERI [effort-reward imbalance], Nordic-style questionnaire). The organisational work environment was assessed by the self-rated Nursing Work Index-Extended Organisation scale. Multilevel models were used for analyses. We found that 2 organisational health care constraints: low level of shared values about work between members in the unit and lack of support from the administration were significantly associated with upper limb symptoms, independently of ERI perceptions. This study identified and quantified specific health care organisational factors that have an impact on nurses' upper limb symptoms, sometimes independently of ERI perception. A prospective study is needed to clarify the causal role of psychosocial and organisational work factors in upper limb injury in nurses. Organisational approaches may be more effective in improving health at work and may also have a longer-lasting impact than individual approaches.

Musculoskeletal pain and effort-reward imbalance- a systematic review

“…Five studies examined populations in care facilities [21,23,25,26,39] and four studies researched the association between ERI and musculoskeletal pain in employees of passenger transport companies [27-29,36], although the study by Dragano et al [28] was a reanalysis of Joksimovic et al [27]. This study was still included because – unlike the paper by Joksimovic et al – it considered chronification of musculoskeletal pain.…”

“…In addition to the psychosocial factors ascertained using the ERI model, ten studies [25-27,30-33,36,37,39] analysed other psychosocial factors. These were based on the demand-control model [10], the Copenhagen Psychosocial Questionnaire (COPSOQ) [41] and the Nursing Work Index – Extended Organisation Questionnaire (NWI-EO Questionnaire) [42].…”

The association between rotating shift work and increased occupational stress in nurses

“…For example, Sakata et al 3) reported that 12.2 and 44.4% of medical resi- dents in Japan experienced effort/reward imbalance and overcommitment, whereas Conway et al 8) reported that 16.1 and 26.3% of health-care workers in Italy experienced effort/reward imbalance and overcommitment. A survey of a group of nurses in the ORSOSA study in France identified effort/reward imbalance in 10.7% of the nurses and overcommitment in 40.8% of the nurses 19) . Comparisons of the results of the current study with earlier studies of other occupations in Taiwan show effort/reward ratios of 0.74 (0.22) and 0.97 (0.34) in litigious lawyers and healthy engineers, respectively 2,20) .…”

Role of the work-unit environment in the development of new shoulder pain among hospital workers: a longitudinal analysis

“…Among healthcare workers, few studies looked at the association between MSD and the organizational characteristics of the work environment, mainly focusing on shiftwork (7,11). More recently, studies have addressed the effect of the perception of healthcare workers of the work-unitlevel psychosocial and organizational environment on the occurrence of MSD (12,13), including MSD of the neck and shoulders (14). However, these studies were crosssectional and no conclusion could be drawn concerning causal relationships.…”