Work–family conflict and neck and back pain in surgical nurses

How is social support defined, categorized and measured in studies of work-related musculoskeletal disorders among hospital nurses: A scoping review

AIM

To summarize current literature on the definition, categorization and measurement of social support in studies of work-related musculoskeletal disorders among hospital nurses.

DESIGN

A scoping review.

DATA SOURCES

A literature search of four databases (CINAHL, Medline, Embase and Web of Science) was employed to map the evidence between January 2012 and April 2023 on the definition, categorization and measurement of social support in studies of work-related musculoskeletal disorders among nurses in hospital settings.

REVIEW METHODS

This review adopted Arksey and O'Malley's framework for conducting scoping reviews. Data extraction was reported using PRISMA Scoping Review guidelines and articles synthesized using a descriptive approach.

RESULTS

Fifteen studies met the criteria for inclusion in the review. Social support was distinctly defined in only two studies. Four main categories of social support identified were Co-worker, Supervisor, Family and Overall support. Eight tools were found to measure social support, and the most used tool was the Job Content Questionnaire.

CONCLUSIONS

The review identified that social support is often not explicitly defined. Furthermore, social support can be categorized and measured in different ways, using diverse tools. This variation may affect the understanding of social support and the approaches in measuring and providing social support in the workplace.

IMPACT

Studies should clearly define the social support category evaluated, to facilitate comparisons between studies of nurses with work-related musculoskeletal disorders. Healthcare managers should obtain feedback from nurses to ensure that the category of social support provided matches that which the nurse requires to ensure it helps the nurse from an organizational perspective. Healthy social relationships should be encouraged among nurses to promote nurses' well-being and by extension patient care.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public involvement.

The impact of work-family conflict on occupational fatigue among endoscopy nurses in China: a moderated mediation model

Background

Endoscopy nurses in China face significant work-family conflicts, where the clash between high work demands and family responsibilities markedly increases the risk of occupational fatigue. This not only affects the nurses' physical and mental health and overall well-being, but also poses a threat to the quality of care and patient safety. This study, grounded in the Conservation of Resources theory, constructs a moderated mediation model to examine the mediating role of positive coping style in the relationship between work-family conflict and occupational fatigue among endoscopy nurses in China, as well as the moderating effect of perceived social support.

Methods

A convenience sampling method was employed to select 315 endoscopy nurses from 25 tertiary hospitals across 14 provinces in China. A questionnaire survey was conducted using the Fatigue Assessment Instrument, the Work-Family Conflict Scale, the Simplified Coping Style Questionnaire, and the Perceived Social Support Scale. The moderated mediation model was validated using Stata16.0.

Results

Our findings reveal that work-family conflict is a significant predictor of occupational fatigue, with a negative impact on positive coping style. Positive coping style, in turn, is negatively associated with occupational fatigue. Furthermore, positive coping style partially mediates the relationship between work-family conflict and occupational fatigue, accounting for 35.52% of the total effect. Additionally, perceived social support mitigates the negative effects of work-family conflict on positive coping style and occupational fatigue.

Conclusion

There exists a moderated mediation effect between work-family conflict and occupational fatigue among endoscopy nurses in China, wherein positive coping style serve as a mediating variable. Perceived social support mitigates the negative impact of work-family conflict on positive coping style, while enhancing the alleviating effect of positive coping style on occupational fatigue. Therefore, improving endoscopy nurses' levels of perceived social support and coping strategies may help to prevent and alleviate the occurrence of occupational fatigue.

Social determinants and work-related musculoskeletal disorders in Brazil

This study aimed to analyze the prevalence of work-related musculoskeletal disorders (WMSD) and their association with individual and contextual factors in the Brazilian population. This quantitative cross-sectional study used secondary data from the Brazilian National Health Survey from August 2013 to February 2014. The dependent variable included WMSD, and independent variables were analyzed as individual and contextual factors. WMSD was mostly prevalent in females, individuals aged 43 to 59 years, with chronic physical or mental disorders, reporting frequent sleep disorders, and performing integrative and complementary health practices, physical exercise or sports, and heavy physical activity or housework. Regarding contextual factors, high social classes and proportion of individuals with formal work were associated with a high prevalence of WMSD, whereas a high Gini index was associated with a low prevalence. Thus, a high prevalence of WMSD in the Brazilian population was associated with individual and contextual factors, which should be the target of health professionals for actions of promotion, prevention, and intervention at individual or collective care levels.

Early career demanding psychosocial work environment and severe back pain and neck/shoulder pain in experienced nurses: A cohort study

AIMS

Back pain and neck/shoulder pain are common among nurses. The aim of this study was to investigate the association between nurses' exposure to a demanding psychosocial work environment during the first three years after graduation and the occurrence of severe back pain and neck/shoulder pain in the longer term, 11-15 years later.

METHODS

The Longitudinal Analysis of Nursing Education (LANE) study (nursing graduates from 26 Swedish universities in the years 2002, 2004 and 2006) was used to create two risk cohorts of nurses not reporting severe back pain (n=1764) or neck/shoulder pain (n=1707). Nurses exposed to a demanding psychosocial work environment for one, two or three of the first three years in their career were compared to nurses not having a demanding psychosocial work environment for any of these three years regarding the incidence of severe back pain or neck/shoulder pain at follow-up, 11-15 years later. Relative risks (RR) with 95% confidence intervals (CI) were calculated using binomial regression.

RESULTS

The RR (95% CI) of having severe back pain for nurses who had a demanding psychosocial work environment for one of the three years was 1.36 (0.82-2.28) and 2.08 (1.21-3.57) for two of the three years and 2.82 (1.43-5.55) for all three years. Corresponding RRs (95% CIs) for severe neck/shoulder pain were 1.35 (0.87-2.10), 1.49 (0.88-2.51) and 1.41 (0.62-3.20), respectively.

CONCLUSIONS

Nurses who were repeatedly exposed to a demanding psychosocial work environment early in their career reported severe back pain to a higher extent in the longer term.

Differential Relationships Between Work-Life Interface Constructs and Intention to Stay in or Leave the Profession: Evidence From Midwives in Canada

This paper investigates how positive and negative work-personal life interface constructs are differentially associated with intentions to stay in or leave the profession. The findings help map work-personal life interface constructs on the typology of determinants of intention to stay and intention to leave (disengagers, retainers, criticals, and neutrals). The ordered logistic regression (ologit) modelling of cross-sectional data from a representative sample (n = 601) of midwives in Canada shows that work interference with personal life is a disengager, which has a stronger association with intention to leave than with intention to stay in the profession. Among the work-personal life interface constructs, work enhancement of personal life seems to be the most critical determinant, showing the most substantive association with both intention to stay and intention to leave. This finding suggests that interventions to increase midwives' intention to stay and decrease their intention to leave should focus on amplifying the enhancing effects of working on midwives' personal lives. Interventions that aim to reduce work interference with personal life might be more effective in decreasing intention to leave the profession than increasing intention to stay.

Influence of job demands on implicit absenteeism in Chinese nurses: mediating effects of work-family conflict and job embeddedness

Purpose

It has been widely noted that implicit absenteeism is common among nurses, with job demand influencing it. Theoretically, work-family conflict and job embeddedness may help link job demands to implicit absenteeism. However, the mediating effects of the two on the association between job demands and implicit absenteeism remain unclear. Thus, this study aims to explore the association between nurses' job demands and implicit absenteeism, and the chain mediating effect of work-family conflict and job embeddedness in this relationship.

Patients and methods

Data were collected from 1,420 nurses from five tertiary public hospitals in China. They were asked to respond to a questionnaire asking about job demands, implicit absenteeism, work-family conflict, and job embeddedness. The data were coded and analyzed using IBM SPSS version 21.0. Descriptive analysis, t-test, one-way ANOVA, hierarchical multiple regression analysis, and bootstrapping were used to analyze the extracted data.

Results

The mean score for implicit absenteeism was 17.75 ± 5.60. There was a significant correlation (p < 0.05) between nurses' job demands, work-family conflict, job embeddedness, and implicit absenteeism. Nurses' job demands directly influenced implicit absenteeism and indirectly influenced implicit absenteeism through the mediating effects of work-family conflict and job embeddedness. Furthermore, work-family conflict and job embeddedness have a chain effect on the association between job demands and implicit absenteeism.

Conclusion

The study found that nurses' job demands directly and positively influence implicit absenteeism, and indirectly influence implicit absenteeism through single and chain mediating effects of work-family conflict and job embeddedness.

A Survey of Neck Pain among Dentists of the Lebanese Community

Results

The majority of participants were between the ages of 25 and 35, and the gender distribution of the demographic distribution was comparable. The prevalence of pain was 86.8% (97/342 dentists). NDI analysis showed that 65.7% had mild disability, 12.8% have a moderate disability, and 1% had severe disability. Bivariate analysis showed that pain was affected by age (p=0.013), orthodontist practices (p=0.031), regular exercise (p < 0.001), using vibrating instruments (p < 0.001), cervical flexion for better vision while working (p < 0.001), knowledge, and experience about ergonomic posture (p < 0.005). Multivariate analysis showed four predictors for pain: age (p=0.017), performing stretching exercises after finishing clinical practice (p=0.022), orthodontist specialty (p=0.029), and performing cervical flexion for better vision while working (p=0.004).

Conclusion

This study showed that through the application of some strategies such as stretching, exercising, and being careful in using vibrating instruments, the dentist may be able to relieve the pain.

Compassion satisfaction, compassion fatigue, burnout, working environments, and musculoskeletal disorders among nurses

PURPOSE

It was aimed to determine the perceptions of nurses' working environment and professional quality of life and to compare nurses with and without musculoskeletal discomfort.

DESIGN AND METHODS

It is a descriptive and comparative study. The data were collected from 333 nurses working at different units.

FINDINGS

Those, who did not have discomfort in their body parts, had a higher mean score in the Practice Environment Scale of the Nursing Work Index; whereas, those having discomfort in all parts of the body had a higher mean score in the Professional Quality of Life Scale (p < 0.05; p < 0.01; p < 0.001).

PRACTICE IMPLICATIONS

Attempts to reduce nurses' musculoskeletal discomfort can positively increase perceptions of the working environment and professional quality of life.

Effects of resilience, burnout, and work-related physical pain on work-life balance of registered nurses in South Korean nursing homes: A cross-sectional study

BACKGROUND

While nursing homes increase, the number of registered nurses (RNs) working there continues to decline. This study explored the effects of resilience, burnout, and work-related physical distress on the work-life balance of RNs to improve retention rates.

METHODS

This cross-sectional study involved 155 RNs working in 37 nursing homes, spread across 10 South Korean cities. Data were collected from May to July 2019 using self-report questionnaires, with items relating to general and work-related characteristics, work-life balance, resilience, and burnout. Multiple regression analysis was performed to identify factors affecting participants' work-life balance, including variables that showed significant results in univariate analysis. All analyses were performed using the PASW SPSS win 26.0 program.

RESULTS

Participants' average age was 48.48 years, and they had been working as RNs for 17.36 years on average. Work-related physical pain was reported by 70.3% of participants. Resilience had a positive correlation with work-life balance (r = 0.38; P < .001), whereas burnout had a negative correlation with work-life balance (r = -0.45; P < .001). Work-related physical pain (β = -0.27; 95% confidence interval [CI], -25.89 to -7.48), resilience (β = 0.20; 95% CI, 0.02-0.70), and burnout (β = -0.33; 95% CI, -0.9 to -0.24) affected participants' work-life balance.

CONCLUSION

Interventions to facilitate work-life balance among nursing home RNs must aim to increase resilience and reduce burnout and work-related physical pain. A healthy work-life balance should improve RN retention in nursing homes, boosting the safety and quality of life of residents in turn.

Neck pain: global epidemiology, trends and risk factors

BACKGROUND

Neck pain is one of the most common musculoskeletal disorders, having an age-standardised prevalence rate of 27.0 per 1000 population in 2019. This literature review describes the global epidemiology and trends associated with neck pain, before exploring the psychological and biological risk factors associated with the initiation and progression of neck pain.

METHODS

The PubMed database and Google Scholar search engine were searched up to May 21, 2021. Studies were included that used human subjects and evaluated the effects of biological or psychological factors on the occurrence or progression of neck pain, or reported its epidemiology.

RESULTS

Psychological risk factors, such as long-term stress, lack of social support, anxiety, and depression are important risk factors for neck pain. In terms of the biological risks, neck pain might occur as a consequence of certain diseases, such as neuromusculoskeletal disorders or autoimmune diseases. There is also evidence that demographic characteristics, such as age and sex, can influence the prevalence and development of neck pain, although further research is needed.

CONCLUSIONS

The findings of the present study provide a comprehensive and informative overview that should be useful for the prevention, diagnosis, and management of neck pain.

Perceived privacy in home office and musculoskeletal complaints: a test of family–work conflict, work–family conflict, and relaxation as mediators

Many employees have had to telework all year during the COVID-19 pandemic. Even though working from home has many advantages, there are also some disadvantages worth to consider. Lack of privacy is a relevant factor when it comes to the development of severe musculoskelatal issues. This study investigated the link between perceived privacy in home office and musculoskeletal complaints (MSCs). Family–work conflict (FWC), work–family conflict (WFC), and relaxation were tested as potential mediators for the relationship between perceived privacy and MSCs. The present study’s questionnaire was filled out by 287 teleworking employees. Hypotheses were tested via multiple mediation analyses examining levels of perceived privacy in home office, and its relationship on MSCs. Furthermore, the underlying effect of FWC, WFC, and MSCs were tested with a structural equation model. As assumed, lack of privacy while working at home was linked to individuals more frequently experiencing MSCs. However, the structural equation model showed no significant mediation effect. Work design efforts must address privacy while employees perform telework at home to prevent MSCs.

Depression and work-family conflict mediating the effects of job stress on chronic pain: A structural equation modelling approach

PURPOSE

The majority of research studying the relationship between job stress and chronic pain has relied on physiological responses. This study aims to determine psycho-social mechanisms by which job stress can influence chronic pain in workers.

METHODS

This cross-sectional study was carried out among 793 workers in gas and oil platforms or petroleum refinery plants in southern Iran. Structural equation modelling was applied to evaluate the direct, indirect, and total effects of job stress on chronic pain in the presence of mediating variables (work-family conflict and depression).

RESULTS

According to the results, job stress (B=0.024, β=0.477), 95% CI [0.016, 0.032], work-family conflict (B=0.031, β=0.446), 95% CI [0.023, 0.038], depression (B=0.046, β=0.224), 95% CI [0.028, 0.064], and work experience (B=0.083, β=0.380), 95% CI [0.065, 0.101] had significant direct effects on chronic pain. The indirect paths from job stress to chronic pain via depression (B=0.002, β=0.042), 95%CI [0.001, 0.003] and work-family conflict (B=0.004, β=0.085), 95%CI [0.003, 0.006] were significant.

CONCLUSIONS

Given that depression and work-family conflict mediate the effects of job stress on pain, stress management programs for workers might include various strategies to reduce negative thoughts as well as cognitive biases and minimize role conflicts between work and private life.

Strain-based work-to-family conflict as a predictor of lumbar and cervical pain in Tunisian nursing staff

Objective. This study aimed to examine the association of the different dimensions and forms of work-family conflict with the occurrence of neck and lower back pain (LBP) in Tunisian nurses. Methods. We conducted a cross-sectional study on nurses assigned to a district hospital in Tunisia. The work-family interface was assessed with the work-family conflict scale of Carlson et al. Psychosocial and organizational constraints at work were assessed through the nursing work index - extended organization in its specific version designed for nurses. Assessment of neck and lumbar pain was carried out with the standardized Nordic musculoskeletal questionnaire. Results. Seventy-two nurses participated in the present study (participation rate = 100%) with a mean age of 42.38 ± 10.85 years. Binary logistic regression analyses retained strain-based work-to-family conflict as a significant determinant of both LBP (p < 10^-3; odds ratio [OR] = 5.07; 95% confidence interval [CI] [2.1, 11.7]) and neck pain (p = 0.001; OR = 6.8; 95% CI [2.13, 22]). Conclusions. Strain-based work-to-family conflict was found to predict lumbar and cervical pain more than the other types of conflict in nursing staff. Thus, reducing strain in health-care settings should be a central component of the preventive approach of musculoskeletal disorders in nursing staff.

The Comorbidity of Musculoskeletal Disorders and Depression: Associations with Working Conditions Among Hospital Nurses

Background: Musculoskeletal disorders (MSDs) are the leading cause of pain and disability among nurses and are frequently accompanied by depression. However, the association between the comorbidity of MSDs and depression and working conditions has not been studied, which was the aim of this study. Methods: In 2015, all nurses (n = 1,102) employed at a community hospital in the Northeast United States were invited to participate in this cross-sectional study. A survey was distributed in which participants were asked to report on MSDs, depressive symptoms, as well as subjective working conditions assessed including physical demands, psychological demands, decision authority, social support, and work-family conflict. Findings: 397 nurses responded (36%), and the prevalence of the comorbidity of MSDs and depression was 14.5%. Poisson regression (PR) models suggested that work-family conflict was associated with increased risk of the comorbidity (PR = 2.18; 95% confidence interval [CI] = 1.33-3.58), as was 8-hour night shift (PR = 2.77; 95% CI = [1.22, 6.31]) or 12-hour day shift (PR = 2.20; 95% CI = [1.07, 4.50]). Other working conditions were not directly associated with the comorbidity. Conclusions/Application to Practice: The comorbidity of MSDs and depression is prevalent among hospital nurses, and work-family conflict and working night shift or longer shifts were significantly associated with this. Effective workplace programs are needed to address nurses' working conditions to reduce their work-family conflict, thereby improving their musculoskeletal and mental health.

Back pain occurrence and treatment-seeking behavior among nurses: the role of work-related emotional burden

PURPOSE

To assess the association of back pain and treatment-seeking behavior for such pain with work-related emotional burden (regret about care), regret coping strategies, and physical burden among newly practicing nurses.

METHODS

We used data from the Impact of Care-related Regret Upon Sleep (ICARUS) cohort collected between 05.2017 and 07.2018 using web-based surveys (weekly for measures of emotional burden, physical burden and coping strategies, and monthly for back pain and seeking care). We investigated immediate associations and temporal influences between burdens and back pain with linear mixed models and cross-lagged Bayesian models, respectively. Coefficients were standardized to allow comparison between burdens. Logistic regression was used to examine the association of burdens with seeking care.

RESULTS

Among 105 nurses with an average follow-up of 3 months, 80 reported at least one episode of back pain. Neither physical nor emotional burdens had an immediate association with back pain. However, number of days with back pain in a given month was associated with an increase in both burdens during the previous month, with similar degrees of association (emotional: b = 0.24, physical: b = 0.21). Decision to seek treatment was associated with an increase in back pain frequency (OR 1.12, p = 0.04) and intensity (OR 1.80, p = 0.002) and a decrease in emotional burden (OR 0.95, p = 0.03). Coping strategies were associated neither with the occurrence of back pain nor with care-seeking.

CONCLUSION

While both emotional and physical burdens were associated with increased frequency of back pain the following month, emotional burden additionally showed a negative association with the decision to seek care.

Lower back pain in nurses working in home care: linked to work-family conflict, emotional dissonance, and appreciation?

In industrial countries home care services for elderly people living in the community are growing rapidly. Home care nursing is intensive and the nurses often suffer from musculoskeletal pain. Time pressure and job control are job-related factors linked to the risk of experiencing lower back pain (LBP) and LBP-related work impairment. This survey investigated whether work-family conflict (WFC), emotional dissonance and being appreciated at work have incremental predictive value. Responses were obtained from 125 home care nurses (63% response rate). Multiple linear regression showed that emotional dissonance and being appreciated at work predicted LBP intensity and LBP-related disability independently of time pressure and job control. WFC was not a predictor of LBP-related disability in multiple regression analyses despite a zero-order correlation with it. Redesigning the working pattern of home care nurses to reduce the emotional demands and improve appreciation of their work might reduce the incidence of LBP in this group.

Work-Life Imbalance and Musculoskeletal Disorders among South Korean Workers

Employed workers often have family responsibilities such as childcare or homemaking. This dual burden may increase work-related health problems, particularly if there are conflicts between work and family responsibilities. This study assessed whether difficulty in work–life balance is associated with musculoskeletal disorders (MSD) among Korean employees. Data from the population-based Korean Working Conditions Survey of 2011, including 28,640 male and 21,392 female workers, were used. Men and women were analyzed separately to investigate gender differences. MSD were defined as pain in the back, neck, shoulder, or extremities during the past year. Self-assessed difficulty in work–life balance was defined as a work–life conflict (WLC). Adjustments for physical factors, as well as other occupational and socio-demographic variables, were made using multiple logistic regression analysis. Interaction terms including WLCs and key covariates were also incorporated. WLC was significantly associated with increased frequency of MSD in both men (OR: 1.49) and women (OR: 1.50). There were significant interaction effects between WLC and some key covariates (job stress for men and job stress, work hours, physical demand, and frequent overtime work for women). We suggest that having the flexibility to coordinate work and family life is important to prevent MSD among employees.