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

More Than Just a Pain in the Back: Pain Among American Nurses and Its Relationship to Modifiable Work Factors and Work Performance

Nursing is a profession with high rates of workplace injuries, hazards, and turnover. Improving the health and safety of nurses at work is vital to retain and grow the workforce to meet future demands. The purpose of this study was to describe the breadth of pain among American nurses and explore the relationships between this pain and modifiable work factors and perceived work performance. We used a cross-sectional descriptive design of 2312 nurses from across the United States. Nurses completed a survey containing questions about demographics, the presence of pain in the past week, the number of pain sites, pain locations, severity, and the impact on work performance. The median number of pain locations reported was 2, back pain was the most reported pain site, and average pain severity ranged from 4 to 5. Significant modifiable work factors associated with pain were average patient load and shift length. Many participants indicated that their pain impacted work performance, while a smaller proportion acknowledged that their pain impacted patient care. Pain among nurses spans multiple locations, is moderately severe, and impacts work performance. Addressing related modifiable work factors may decrease pain and the impact on the health, safety, and work performance of the nursing workforce.

Physical Inactivity Increases Impairment of Daily Activities Due to Pain in Workers: An Ordinal Regression Logistic and Correspondence Analysis

Background: The evidence for the health benefits of physical activity is growing; however, the prevalence of unhealthy lifestyles continues to contribute to the increase in chronic non-communicable diseases. We know that occupational-time physical activity does not provide the same benefits as leisure-time physical activity, which has been shown to reduce mortality and pain. We also know that multiple factors influence pain; however, there are no studies that specifically analyze the impact of type of working time and occupational-time physical activity on the impairment of daily activities due to pain. We aimed to study the influence of both personal and occupational factors on the impairment of daily activities due to pain, assessing whether leisure-time physical activity acts as a protective factor. Methods: A cross-sectional, population-based design was used based on the 2017 National Health Survey in Spain (ENSE). Sociodemographic, leisure-time physical activity, and work-related variables were collected. The outcome variable was the impairment of daily activities due to pain. Ordinal logistic regression was applied, and the analysis was complemented with simple correspondence analysis. Results: A total of 1,441 workers between 18 and 65 years of age were studied. Significant differences were found between sexes for all variables except age and leisure-time physical activity. Logistic regression revealed significant associations between sex, primary and secondary education levels, no leisure-time physical activity, and overweight with impairment of daily activities due to pain. Simple correspondence analysis showed that the categories doing leisure-time physical activity several times a week as well as several times a month are closer to the categories of little or no pain. Conclusion: Female gender, low educational level, overweight, and lack of leisure-time physical activity were associated with increases in impairment of daily activities due to pain. Occupational-time physical activity and work shift were not related to impairment of daily activities due to pain. Implications for Occupational Health Practice: Occupational Health Nursing interventions through education and counseling on the importance of leisure-time physical activity promotion programs potentially can reduce the impairment of daily activities due to pain in working populations.

A comparison of work characteristics and health status between Korean and US hospital nurses

AIM

A rigorous examination of the occupational features across cultures helps draw policy recommendations for nurses' quality care practices and good health. This study aimed to explore the differences in work characteristics and health status between Korean and US hospital nurses.

DESIGN

For this comparative secondary data analysis study, we constructed a dataset with 304 pairs of nurses from Korea and the United States, matched by age and gender.

METHODS

We used the data from the 2020 Korean Hospital Nurses Health Behaviors and Health Status study, collected from May to July 2020, and the Nurse Worklife and Wellness Study (NWWS), conducted between November 2020 and February 2021.

RESULTS

Compared to nurses in the United States, Korean nurses rated their job-related conditions much lower, had lower intentions to stay in their current workplace and were less satisfied with their jobs. Korean nurses reported that organizational support and employee health resources were less prevalent and their levels of healthy behaviour practice and health status were lower than their US counterparts. Nurses in Korea require better practice environments and employee health support. Adequate workload and staffing levels are needed to improve job conditions for Korean nurses. Organizational support and employee health resources should always be accessible at nurses' workplaces.

Circadian Rhythms Characteristics of Nurses Providing Direct Patient Care: An Observational Study

Background

In today's modern world, longer working hours, shift work, and working at night have become major causes of the disruption of our natural circadian rhythms. This study aimed to investigate the effects of the type of shift work (rotating vs. fixed day), duty period (on-duty vs. off-duty), and working period within each shift (nighttime vs. daytime) on the circadian rhythm characteristics of nurses who provide direct patient care.

Methods

This cross-sectional study used a purposive sampling method. Cosinor analysis was applied to analyze the actigraphy data of nurses providing direct patient care for seven consecutive days. The linear mixed effects model was then used to determine any variances between shift type, duty period, and working period within each shift for the nurses.

Results

The mesor value did not differ according to nurses' shift type, duty period, and working period within each shift. The amplitude was statistically higher in on-duty nurses and in daytime working hours. The acrophase was significantly delayed in nighttime working hours. As well as nurses in rotating shift had experience.

Conclusion

Our findings revealed that the peak activity of nurses occurs significantly later at night while working and nurses working during nighttime hours may have a weaker or less distinct circadian rhythm. Thus, this study suggests that limits be placed on the number of rotating nighttime shifts for nurses.

The association between proportion of night shifts and musculoskeletal pain and headaches in nurses: a cross-sectional study

BACKGROUND AND PURPOSE

Shift work is associated with musculoskeletal pain and headaches, but little is known about how the intensity of shift work exposure is related to musculoskeletal pain and headaches. This study aimed to investigate whether a higher proportion of night shifts is associated with a higher occurrence of musculoskeletal pain and headaches. Furthermore, to investigate whether sleep duration can mediate this potential association.

METHOD

The study included 684 nurses in rotating shift work who responded to a daily questionnaire about working hours, sleep, and pain for 28 consecutive days. The data were treated cross-sectionally.

RESULTS

A negative binomial regression analysis adjusted for age and BMI revealed that working a higher proportion of night shifts is not associated with a higher occurrence of musculoskeletal pain and headaches. On the contrary, those working ≥ 50% night shifts had a significantly lower occurrence of pain in the lower extremities than those who worked < 25% night shifts (IRR 0.69 95% CI 0.51, 0.94). There was no indication of a mediation effect with total sleep time (TST).

CONCLUSION

The results of this study indicate that working a higher proportion of night shifts is not associated with a higher occurrence of musculoskeletal pain and headaches.

The association between adverse ergonomic factors and work-related musculoskeletal symptoms among medical staff in China: a cross-sectional study

We investigated the prevalence of work-related musculoskeletal symptoms (WMSs) among medical staff and evaluated the associations of different levels of adverse ergonomic factors with WMSs. A total of 6099 Chinese medical staff were asked to complete a self-reported questionnaire to assess the prevalence and risk factors of WMSs from June 2018 to December 2020. A prevalence rate of 57.5% was observed for WMSs among overall medical staffs, which mainly affected the neck (41.7%) and shoulder (33.5%). 'Keeping sitting for long hours very frequently' (OR = 1.26, 95% CI: 1.04, 1.53) was positively associated with WMSs in doctors, while 'keeping sitting for long hours occasionally' (OR = 0.91, 95% CI: 0.85, 0.97) was identified as a protective factor of WMSs in nurses. The associations of adverse ergonomic factors, organisational factors, and environmental factors with WMSs were different among medical staff in different positions.Practitioner summary: We conducted a multi-city study concerning the risk factors of WMSs by carrying out a face-to-face one-to-multiple questionnaire survey among medical staff in China. As a risk factor of WMSs in medical staff, adverse ergonomic factors should be paid more attention by the standard setting department and policy makers.Abbreviations: WMSDs: work-related musculoskeletal disorders; WMSs: work-related musculoskeletal symptoms; MSDs: musculoskeletal disorders; NMQ: Nordic Musculoskeletal Questionnaires; DMQ: Dutch Musculoskeletal Questionnaires; NIOSH: National Institute for Occupational Safety and Health; ORs: odds ratios.

Designing shift work: Proposal for a participatory approach deployed in a hospital setting and focusing on actual work

Designing the working day is not just a matter of changing the shift system. It also requires reflection on the working conditions and a negotiation of solutions with the stakeholders concerned. This article seeks to show that a participatory approach, built using organisational simulation, provides a framework with which to understand the reality of each profession and co-construct suitable solutions. Our action-research took place in a hospital's pneumology ward. The methodology can be broken down into four phases: diagnosis, sharing of the diagnosis, organisational simulation (the focus of this article) and experimenting with solutions. The results show that the approach gave the stakeholders the opportunity to discover and discuss the rules and constraints of actual work, to compare their different views, and to develop a new and shared view of the work situation. The approach allowed them to co-construct relevant solutions and to appropriate the changes necessary for their success.

Short sleep and chronic neck and shoulder discomfort in nurses

OBJECTIVE

Short sleep duration is common among nurses. Sleep restriction has been associated with musculoskeletal discomfort. However, studies on the effect of short sleep duration on chronic neck and shoulder discomfort in nurses have been lacking. The aim of this study was to determine whether short sleep duration is related to chronic neck and shoulder discomfort.

METHODS

We conducted a cross-sectional survey of female nurses in secondary referral health centers in Taiwan. We applied stratified sampling based on region (north, central, south, and east) to select representative centers for this study. A self-administered structured questionnaire, including demographic data, the psychological working environment, and musculoskeletal symptoms, was administered to nurses. Multiple logistic regression and population attributable risk analyses were performed to assess the effect of average sleeping hours per working day on chronic neck and shoulder discomfort.

RESULTS

A total of 1602 (78.9%) questionnaires were eligible for final analysis. The prevalence rates of chronic neck and shoulder discomfort were 33.9% and 34.7%, respectively. Population attributable risk estimation revealed that a sleep duration of <7 hours per working day was the most crucial factor for chronic neck and shoulder discomfort in the nurses, accounting for 8.8% of chronic neck discomfort and 8.6% of chronic shoulder discomfort respectively.

CONCLUSION

Our study found that sleep duration on working days was associated with chronic neck and shoulder discomfort in female nurses. Further interventions are warranted for maintaining nurses' sleep hygiene.