Integrating ‘psychosocial’ factors into a theoretical model for work-related musculoskeletal disorders

Work-related back pain among diagnostic radiographers in Ghana: A qualitative study

INTRODUCTION

Work-related back pain has a major impact on diagnostic radiographers' clinical task performance in terms of sickness absenteeism, disability and loss of productivity due to presenteeism. However, there is limited information about the burden of work-related back pain among diagnostic radiographers in Ghana. The aim was to explore diagnostic radiographers' experiences of work-related back pain in Ghana.

METHODS

An exploratory-descriptive qualitative study using semi-structured telephone interviews was conducted. Purposive and snowball sampling techniques were used to recruit participants. The interviews were facilitated by an interview guide. Thematic network approach was used to analyse the data.

RESULTS

Eighteen participants, with 14 males and 4 females were interviewed. The mean age of the participants was 31.7 ± 7.3 years. Three themes were developed: increasing burden of work-related back pain; making sense of the multifaceted risk factors for work-related back pain; and preventing work-related back pain. Low back pain was the most common, followed by neck pain with thoracic pain as the least common reported work-related back pain by participants. Identified risk factors included: physical factors; environmental ergonomic factors; and psychosocial factors. Prevention strategies identified were categorised into: health and safety training; creating lifting team; leadership support from diagnostic imaging managers; participatory ergonomics; workforce planning and scheduling; mindfulness exercises; and physical rehabilitation.

CONCLUSION

Assessing the level of ergonomic risks is critical to identifying, analysing and controlling workplace risk factors that can lead to work-related back pain among diagnostic radiographers. Future research is recommended to design and evaluate a multicomponent ergonomic intervention for the prevention of work-related back pain among diagnostic radiographers to enable them deliver care safely and healthily.

IMPLICATIONS FOR PRACTICE

Understanding diagnostic radiographers experiences of work-related back pain can help develop effective strategies to reduce the growing burden of pain back.

Job satisfaction and job security as moderators in the relationships among job demands, musculoskeletal symptoms, and work performance

PURPOSE

This study examined whether job satisfaction and job security moderate the path from physical demands and job strain to impaired work performance via musculoskeletal symptoms in the upper extremities (MSUE). Moderation effects on five paths were examined: (1) from job strain to MSUE; (2) from job strain to work performance; (3) from physical demands to MSUE; (4) from physical demands to work performance; (5) from MSUE to work performance.

METHODS

This was a cross-sectional study of 669 full-time workers from 9 manufacturing and 3 healthcare facilities. Data were collected via health interviews, on-site physical exposure assessments, and computation of the Strain Index by ergonomists, and self-administered questionnaires on psychosocial factors. Structural equation modeling and zero-inflated negative binomial regression analysis were performed to examine the moderation effect on each path.

RESULTS

Job satisfaction moderated the relationship between MSUE and impaired work performance (B = - 0.09, 95% CI: - 0.15, - 0.04) and job security moderated the relationship between physical demands and MSUE (B = - 0.64, 95% CI: - 1.17, - 0.11). Interaction between job satisfaction and MSUE was significant on both the occurrence (OR: 0.92, 95% CI: 0.87, 0.97) and the degrees of impaired work performance (mean ratio: 0.99, 95% CI: 0.97, 0.99), while the interaction between job security and physical demands was significant only on the degrees of MSUE (mean ratio: 0.94, 95% CI: 0.89, 0.99).

CONCLUSION

Job satisfaction and job security can, respectively, mitigate the adverse impacts of working with MSUE and physical demands on work performance. Workplace interventions to improve workers' job satisfaction and job security can contribute to their musculoskeletal health and work performance.

Feedback for the prevention and rehabilitation of work-related musculoskeletal disorders: A systematic review

BACKGROUND

Work-related musculoskeletal disorders (WRMSDs) remain a challenge despite research aimed at improving their prevention and treatment. Extrinsic feedback has been suggested for the prevention and rehabilitation of WRMSDs to improve sensorimotor control, and ultimately to reduce pain and disability. However, there are few systematic reviews on the effectiveness of extrinsic feedback for WRMSDs.

OBJECTIVE

To perform a systematic review investigating the effect of extrinsic feedback for the prevention and rehabilitation of WRMSDs.

METHODS

Five databases (CINAHL, Embase, Ergonomics Abstract, PsycInfo, PubMed) were searched. Studies of various designs assessing the effects of extrinsic feedback during work tasks on three outcomes (function, symptoms, sensorimotor control) in the context of prevention and rehabilitation of WRMSDs were included.

RESULTS

Forty-nine studies were included, for a total sample of 3387 participants (including 925 injured) who performed work-related tasks in the workplace (27 studies) or in controlled environments (22 studies). The use of extrinsic feedback was shown to be effective in controlled environments for short-term prevention of functional limitations and sensorimotor alterations (very limited to moderate evidence) and for improving, in injured participants, function, symptoms and sensorimotor control (moderate evidence). In the workplace, it was shown to be effective for short-term prevention of functional limitations (limited evidence). There was conflicting evidence regarding its effect for WRMSD rehabilitation in the workplace.

CONCLUSION

Extrinsic feedback is an interesting complementary tool for the prevention and rehabilitation of WRMSDs in controlled environments. More evidence is needed regarding its effect for the prevention and rehabilitation of WRMSDs in the workplace.

Evaluation of an Ecological Model for Work-Related Musculoskeletal Disorders

Work-related musculoskeletal disorder is a major occupational health problem worldwide. The ecological model by Sauter and Swanson proposes a way in which psychosocial factors can influence musculoskeletal disorders. Employing Chinn and Kramer's framework, we evaluated the ecological model and found it had a specific scope for the working populations and clear concepts. This model also demonstrated high clarity, consistency, generalizability, and accessibility aligning with a nursing metaparadigm. Empirical evidence supports the applicability of the ecological model in nursing research and practices, but more research is needed for nursing-specific application.

The problem with "ergonomics injuries": What can ergonomists do?

Effects of psychosocial hazards on risk of musculoskeletal disorders (MSDs) are often very substantial, but workplace risk management practices focus largely on biomechanical hazards, as do the risk assessment methods used by ergonomists. Translation of research evidence into more effective workplace practices demands a more holistic risk management framework that encompasses both types of hazard. In this context, we evaluate the validity of different MSD risk assessment methods for different purposes, focusing particularly on requirements for routine workplace risk management. These include choice of fit-for-purpose assessment methods, prioritisation of hazards that are most affecting risk, and control actions as high as possible in the risk control hierarchy. Ergonomists could facilitate more effective workplace risk management by promoting: awareness of the need for change; improvements to guidance from OHS regulators; research on MSD-related workplace management issues; and professional development programs on this topic for ergonomists and other OHS practitioners.

Stress Detection from Surface Electromyography using Convolutional Neural Networks

The study of stress and its implications has been the focus of interest in various fields of science. Many automated/semi-automated stress detection systems based on physiological markers have been gaining enormous popularity and importance in recent years. Such non-voluntary physiological features exhibit unique characteristics in terms of reliability, accuracy. Combined with machine learning techniques, they offer a great field of study of stress identification and modelling. In this study, we explore the use of Convolutional Neural Networks (CNN) for stress detection through surface electromyography signals (sEMG) of the trapezius muscle. One of the main advantages of this model is the use of the sEMG signal without computed features, contrary to classical machine learning algorithms. The proposed model achieved good results, with 73% f1-score for a multi-class classification and 82% in a bi-class classification.

Injury by design: A thematic networks and system dynamics analysis of work-related musculoskeletal disorders in tram drivers

Tram driving is a safety critical task where work-related musculoskeletal disorders (WRMSDs) and injuries are associated with interacting occupational design factors over time. These interactions then carry implications for workforce retention, public safety, workplace relations and supports. To better understand such interactions, this study used thematic networks and system dynamics (causal loop diagrams) analysis with the aim to unearth a global theme underscoring occurrence of WRMSDs, and describe the factors influencing the system dynamics of WRMSD occurrence in tram drivers. Building on earlier work focused on occupational participation, secondary analysis of driver interviews (n = 13) and driving observations (n = 11) produced thematic network and causal loop models of risk factors that highlighted an Injury by Design problem structure as a global theme. Research targeting organisational culture, human factors, and design standards is needed to minimise WRMSDs risk in tram drivers.

Prediction of work productivity outcomes by identifying critical risk factors among garment industry workers

Work productivity is one of the most important economic measures in the manufacturing industry. However, the physical, psychosocial and individual risk factors of an industrial work environment affect workers' physical or mental health, resulting in work productivity loss, absenteeism and presenteeism. Therefore, this study aims to identify the most critical risk factors and develop statistical models for predicting work productivity loss, absenteeism and presenteeism of garment industry workers. A sample of 224 sewing machine operators was taken for data collection through observation and self-reported studies. The results indicated that the average work productivity loss, absenteeism and presenteeism was 38.21, 2.35 and 37.23%, respectively. Finally, the statistical models of work productivity loss, absenteeism and presenteeism was developed using multiple linear regression with precision of 69.9, 53.7 and 84.0%, respectively. Hence, this study will help garment industries to improve their work productivity by taking initiatives based on the developed models.

A systematic overview on the risk effects of psychosocial work characteristics on musculoskeletal disorders, absenteeism, and workplace accidents

The present article provides a systematic overview on the relationship between psychosocial work characteristics and musculoskeletal disorders, absenteeism, and workplace accidents. The study identified and reviewed the findings of 24 systematic reviews or meta-analysis and 6 longitudinal studies. Publications were systematically searched in several databases from 1966 to January 2021. To summarize the level of evidence, a best evidence synthesis was performed, and the quality of included studies was rated. High job demands, high job strain, high effort/reward-imbalance and low social support showed a strong evidence to increase the risk for musculoskeletal disorders. In addition to job demands and job strain, low perceived fairness proved to be a risk factor of absenteeism with strong evidence. Due to the small number of studies, no reliable evidence assessment for workplace accidents was possible. The summarized findings can improve risk assessment methods, by providing a systematic estimation of the potential risk severity of psychosocial work characteristics and assist practitioners in further developing the psychosocial risk assessment.

Interaction between occupational physical burdens and low job control on musculoskeletal pain: Analysis of the 5th Korean Working Environment Survey

OBJECTIVE

This study aimed to investigate the interactive impacts between occupational physical burdens and psychological job demand or control on musculoskeletal pain (MSP) using nationally representative data for Korean workers.

METHODS

Using 5th Korean Working Conditions Survey (KWCS), we explored the interaction between occupational physical burdens and levels of psychological job demand or control on risk of MSP in 49 572 eligible participants. For quantitative evaluation of the interaction, relative excess risk due to interaction (RERI) was calculated.

RESULTS

In a group with low job control and at least one occupational physical burden, odds ratio (OR) for neck and upper extremity pain was 2.44 (95% CI, 2.24-2.66) compared with a group with high job control and no physical burden (a reference group: lowest risk), which was the highest value among the four groups, and the RERI was 0.35 (95% CI, 0.19-0.51). Similarly, OR for lower extremity pain was 2.15 (95% CI, 1.95-2.37) and RERI was 0.26 (95% CI, 0.07-0.45). However, the RERI was not significant in the case of psychological job demand.

CONCLUSION

This study revealed significant interactions between occupational physical burdens and low job control on MSP.

Distress and worry as mediators in the relationship between psychosocial risks and upper body musculoskeletal complaints in highly automated manufacturing

As a result of changes in manufacturing including an upward trend in automation and the advent of the fourth industrial revolution, the requirement for supervisory monitoring and consequently, cognitive demand has increased in automated manufacturing. The incidence of musculoskeletal disorders has also increased in the manufacturing sector. A model was developed based on survey data to test if distress and worry mediate the relationship between psychosocial factors (job control, cognitive demand, social isolation and skill discretion), stress states and symptoms of upper body musculoskeletal disorders in highly automated manufacturing companies (n = 235). These constructs facilitated the development of a statistically significant model (RMSEA 0.057, TLI 0.924, CFI 0.935). Cognitive demand was shown to be related to higher distress in employees, and distress to a higher incidence of self-reported shoulder and lower back symptoms. The mediation model incorporating stress states (distress, worry) as mediators is a novel approach in linking psychosocial risks to musculoskeletal disorders. Practitioners' Summary With little requirement for physical work in many modern automated manufacturing workplaces, there is often minimal management focus on Work-Related Musculoskeletal Disorders (WRMSDs) as important occupational health problems. Our model provides evidence that psychosocial factors are important risk factors in symptoms of WRMSD and should be managed.

Psychosocial work factors and low back pain in taxi drivers

INTRODUCTION

Taxi drivers are at high risk for low back pain (LBP).

AIM

Identify the association between psychosocial-work factors (Job strain, Iso-strain, effort-reward imbalance [ERI], unfairness, and mental exertion) and LBP in taxi drivers.

METHODS

A cross-sectional study was done with 129 taxi drivers.

RESULTS

Approximately 63% reported LBP in the prior 12 months. Chi square or t-test analyses identified the associations between demographic, work, health, and psychosocial work factors, and self-report of LBP in the prior 12 months. Depression, perceived physical exertion, dispatcher and manager support, unfair treatment at work, and unfair treatment due to nationality were significantly associated with LBP in bivariate analyses. Multivariate logistic regression was done to identify the predictors of LBP. High dispatcher support remained the sole significant predictor for lower prevalence of LBP (OR = 0.66, P = 0.017).

CONCLUSION

Greater understanding of psychosocial work factors may aid in developing interventions to prevent LBP in taxi drivers.

Researching Complex and Multi-Level Workplace Factors Affecting Disability and Prolonged Sickness Absence

Purpose There is growing research evidence that workplace factors influence disability outcomes, but these variables reflect a variety of stakeholder perspectives, measurement tools, and methodologies. The goal of this article is to summarize existing research of workplace factors in relation to disability, compare this with employer discourse in the grey literature, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability, held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience. Results Predominant factors in the scientific literature were categorized as physical or psychosocial job demands, work organization and support, and workplace beliefs and attitudes. Employees experiencing musculoskeletal disorders in large organizations were the most frequently studied population. Research varied with respect to the basic unit of assessment (e.g., worker, supervisor, policy level) and whether assessments should be based on worker perceptions, written policies, or observable practices. The grey literature suggested that employers focus primarily on defining roles and responsibilities, standardizing management tools and procedures, being prompt and proactive, and attending to the individualized needs of workers. Industry publications reflected a high reliance of employers on a strict biomedical model in contrast to the more psychosocial framework that appears to guide research designs. Conclusion Assessing workplace factors at multiple levels, within small and medium-sized organizations, and at a more granular level may help to clarify generalizable concepts of organizational support that can be translated to specific employer strategies involving personnel, tools, and practices.

Intervention development to reduce musculoskeletal disorders: Is the process on target?

Work related musculoskeletal disorders remain an intractable OHS problem. In 2002, Haslam proposed applying the stage of change model to target ergonomics interventions and other health and safety prevention activities. The stage of change model proposes that taking into account an individual's readiness for change in developing intervention strategies is likely to improve uptake and success. This paper revisits Haslam's proposal in the context of interventions to reduce musculoskeletal disorders. Effective MSD interventions require a systematic approach and need to take into account a combination of measures. Research evidence suggests that in practice, those charged with the management of MSDs are not consistently adopting such an approach. Consequently, intervention development may not represent contemporary best practice. We propose a potential method of addressing this gap is the stage of change model, and use a case study to illustrate this argument in tailoring intervention development for managing MSDs.

An implementation evaluation of a qualitative culture assessment tool

Safety culture has been identified as a critical element of healthy and safe workplaces and as such warrants the attention of ergonomists involved in occupational health and safety (OHS). This study sought to evaluate a tool for assessing organisational safety culture as it impacts a common OHS problem: musculoskeletal disorders (MSD). The level of advancement across nine cultural aspects was assessed in two implementation site organisations. These organisations, in residential healthcare and timber processing, enabled evaluation of the tool in contrasting settings, with reported MSD rates also high in both sectors. Interviews were conducted with 39 managers and workers across the two organisations. Interview responses and company documentation were compared by two researchers to the descriptor items for each MSD culture aspect. An assignment of the level of advancement, using a five stage framework, was made for each aspect. The tool was readily adapted to each implementation site context and provided sufficient evidence to assess their levels of advancement. Assessments for most MSD culture aspects were in the mid to upper levels of advancement, although the levels differed within each organisation, indicating that different aspects of MSD culture, as with safety culture, develop at a different pace within organisations. Areas for MSD culture improvement were identified for each organisation. Reflections are made on the use and merits of the tool by ergonomists for addressing MSD risk.

Safety climate, hardiness, and musculoskeletal complaints: a mediated moderation model

This study explores the mechanisms linking the psychosocial characteristics of the workplace with employees' work-related musculoskeletal complaints. Poor safety climate perceptions represent a stressor that may elicit frustration, and subsequently, increase employees' reports of musculoskeletal discomforts. Results from an employee sample supported that when employees' perceived safety was considered a priority, they experienced less frustration and reported fewer work-related upper body musculoskeletal symptoms. Psychological hardiness, a personality trait that is indicative of individuals' resilience and success in managing stressful circumstances, moderated these relationships. Interestingly, employees with high hardiness were more affected by poor safety climate.

Risk factors and musculoskeletal disorders among women workers performing fish processing

BACKGROUND

The study examined the prevalence of musculoskeletal pain and discomfort (MSD) among workers engaged in fish processing activities and identified the occupational, environmental, and psychosocial factors contributing to the MSDs.

METHODS

An ergonomics checklist and questionnaire on general health and psycho-social issues were administered to women workers (N = 450). The relative risk for MSDs due to demographic factors, stress symptoms, and task variables were estimated.

RESULTS

Nearly 71% of the women (age 23.0 ± 6.4 years) reported MSDs, chiefly in upper back (54%), lower back (33%), knee (35%), and shoulders (27%). Workers engaged in mixed task (OR 13.8; CI 8.7-22.0), ring cutting (OR 18.3; CI 11.8-24.7), having job experience <3 years (OR1.9; CI1.3-2.9), being married (OR 1.5; CI 1.1-2.2), BMI18-25 (OR 1.7; CI 1.1-2.8) had increased risk of MSDs in the upper back. The severity of pain was high among the workers with elevated co-morbidity (pain in two or more regions). One third of the workers perceived the work environment to be cause of their MSDs. Multivariate analysis using binary logistic regression model indicated that highly specialized job (OR 13.0; CI 4.7-14.2), high physical activity (OR 11.7; CI 4.6-12.7), improperly designed tools (OR 8.1; CI 3.5-9.5), poor training (OR 7.0; CI 3.3-7.5), and poor job satisfaction (OR 1.5; CI 1.1-4.8) significantly increased the risk of MSDs. Almost all the psychosocial and work stress factors were associated with lower back MSD.

CONCLUSION

A cold and humid environment, awkward standing work posture for long hours, high physical activities, poor task clarity, and high mental overload are important risk factors for the development of MSDs.

Understanding the link between psychosocial work stressors and work-related musculoskeletal complaints

It is well established that psychosocial work stressors relate to employees' work-related musculoskeletal disorder (WRMSD) symptoms. Using a model investigating psychological strain as a mediator between work stressors and WRMSD complaints, this study demonstrated that high levels role conflict, low job control, and low safety-specific leadership are associated with increased employee strain. Strain, in turn, was related to higher levels of WRMSD symptoms of the wrist/hand, shoulders, and lower back. Partial mediation of some relationships was also found, suggesting that additional meditational mechanisms for the relationships between stressors and musculoskeletal symptoms are plausible. This work supports the notion that psychosocial stressors in the work environment have important links to employee health, especially WRMSDs.

Psychosocial precursors and physical consequences of workplace violence towards nurses: a longitudinal examination with naturally occurring groups in hospital settings

BACKGROUND

Workplace violence towards nurses is prevalent and consequential, contributing to nurses' reduced health and safety, worsened job attitudes, and compromised productivity.

OBJECTIVES

To examine if organizational violence prevention climate as perceived by nurses predicts nurses' physical violence exposure and if physical violence exposure predicts nurses' somatic symptoms and musculoskeletal disorder symptoms.

DESIGN

A two-wave longitudinal design with naturally occurring groups, with a 6-month interval.

METHODS

Analysis of covariance and logistic regression were applied to test the proposed hypotheses among 176 nurses from two hospitals in the U.S. who participated in both surveys required by this study. All nurses from the two hospitals were recruited to participate voluntarily. The response rate was 30% for the first survey and 36% for the follow-up survey. Among the subjects, only 8 were male. On average, the subjects were about 45 years old, had a job tenure of about 17 years, and worked approximately 37 h per week.

RESULTS

Violence prevention climate, specifically the dimension of perceived pressure against violence prevention, predicted nurses' chance of being exposed to physical violence over six months (odds ratio 1.69), with no evidence found that violence exposure affected change in climate reports. In addition, results supported that nurses' physical violence exposure had effects on somatic symptoms, and upper body, lower extremity, and low back pain over six months.

CONCLUSIONS

Findings of this study suggest that reducing organizational pressure against violence prevention will help decrease the chance of nurses' physical violence exposure and benefit their health and safety.

Are there health effects of harassment in the workplace? A gender-sensitive study of the relationships between work and neck pain

The aim of this study was to identify workplace physical and psychosocial risk factors for neck pain among male and female workers and, in particular, to study the relationship between neck pain and intimidation and sexual harassment in the workplace in a representative sample of the Quebec working population. The study sample included 5405 men and 3987 women. In multiple logistic regression analyses, when taking into account individual and other workplace factors, neck pain was significantly associated with intimidation at work among both male (odds ratio (OR) 1.4 (1.01-1.8)) and female workers (OR 1.3 (1.01-1.8)). Among female workers, neck pain was alsosignificantly associated with unwanted sexual attention (OR 1.6 (1.1-2.4)). If confirmed in prospective studies, these results suggest that interventions to prevent harassment in the workplace may help reduce musculoskeletal disorders in the workplace and that workplace programmes to reduce harassment in the workplace should include prevention of sexual harassment.

PRACTITIONER SUMMARY

While taking into account relevant personal factors and previously identified workplace physical and psychosocial risk factors, this gender-based study identifies new work exposures associated with neck pain that have not previously been studied, including unwanted sexual attention, intimidation and difficult or tense situations with the public.

Psychosocial work factors and shoulder pain in hotel room cleaners

BACKGROUND

Hotel room cleaners have physically demanding jobs that place them at high risk for shoulder pain. Psychosocial work factors may also play a role in shoulder pain, but their independent role has not been studied in this group.

METHODS

Seventy-four percent (941 of 1,276) of hotel room cleaners from five Las Vegas hotels completed a 29-page survey assessing health status, working conditions, and psychosocial work factors. For this study, 493 of the 941 (52%) with complete data for 21 variables were included in multivariate logistic regression analyses.

RESULTS

Fifty-six percent reported shoulder pain in the prior four weeks. Room cleaners with effort-reward imbalance (ERI) were three times as likely to report shoulder pain (OR 2.99, 95% CI 1.95-4.59, P = 0.000) even after adjustment for physical workload and other factors. After adjustment for physical workload, job strain and iso-strain were not significantly associated with shoulder pain.

CONCLUSIONS

ERI is independently associated with shoulder pain in hotel room cleaners even after adjustment for physical workload and other risk factors.

Gender differences, work stressors and musculoskeletal disorders in weaving industries

A study was undertaken to identify the work stressors among male and female weavers (N=516) in powerloom and handloom and examine the association of work stressors with the prevalence of work related musculo-skeletal disorders (MSDs). Physical and psychosocial stresses of work, job diagnostics, hazards of workplace, working environment and MSDs prevalence were assessed. There is high prevalence of MSDs among weavers. Female weavers in powerloom and handloom were more prone to developing MSDs in upper back (OR 1.8; p<0.05 and OR 2.1; p<0.01) and lower back (OR 1.9; p<0.05 and OR 1.8; p<0.05). Male weavers were more prone to developing pain in the knee (OR 2.9; p<0.001), and hand (OR 2.2; p<0.05). Multivariate analysis indicated that job duration >10 yr (OR 3.7, p<0.05), manual material handling (OR 3, p<0.05), and poor machinery safety (OR 11, p<0.05), contributed to occurrence of MSDs amongst powerloom weavers. Among the handloom weavers, age >25 yr (OR 3.2, p<0.05), poor machinery design (OR 2.2, p<0.01), mental overload (OR 5.7, p<0.001), skill requirement to perform jobs (OR 20.7, p<0.05) had significant influence in the occurrence of pain. Gender differences exist in the prevalence of MSDs and the perception of work and psycho-social stresses among the weavers.

A Holistic Evaluation of Risk Factors for Work-Related Musculoskeletal Distress Among Asymptomatic Sonographers Performing Neurosonology

A pilot study was conducted to gather holistic data points on female sonographers who executed neonatal neurosonography over four portable scanning sessions. The hypothesis was that specific risk factors contributed to work-related musculoskeletal distress in the hand and wrist as a result of neonatal neurosonography. A preexperimental pre-post research design was used to gather data on work demands, self-rated physical and mental health, posture/position during scanning, physiologic change, and pain scores. No statistically significant changes were detected between pre-post measures for work demands, physical and mental health, or pain scores as a result of portable scanning sessions. The physiologic changes, between scanning sessions, were recorded with the use of a hand-carried sonographic unit. Sonographic measures were less than the published criteria for carpal tunnel syndrome with a proximal cross-sectional area ≥10 mm 2 and an anterior bulge of the retinaculum of >4 mm. Sonography documented a statistically significant cross-sectional area change, within the median nerve, at the distal radius only after the first scanning session. Power and spectral Doppler was used to document perineural vascular flow within the median nerve, but it was not consistently obtained to allow for a rigorous comparison between pre- and postscanning sessions. This is the first pilot study to explore using a hand-carried sonographic unit to document change in the median nerve for an isolated sonographic examination. The results are only reflective of these particular participants, but much larger N and shorter scanning sessions are needed to confirm the hypothesis proposed.

The role of contextual factors for musculoskeletal disorders in the New Zealand meat processing industry

Musculoskeletal disorders (MSD) are the leading cause of occupational injury internationally. In New Zealand, the highest incidence of MSD is in meat processing, accounting for over half the injury compensation costs for the sector. MSD in meat processing have proven highly resistant to physical, micro-level interventions, suggesting a new approach is required. This paper reports on part of a 2-year study looking at MSD in the New Zealand meat processing industry. The qualitative study involved interviews with 237 workers, management, union and safety personnel in 28 processing sites. These data were summarised into a list of contextual factors, which, it is postulated, may create conditions under which greater exposure to physical and psychosocial factors can occur in meat processing. Some of the contextual factors are recognised as problematic by the industry, but have not previously been associated with MSD risk. The paper concludes by reflecting on conducting MSD research with a focus on contextual factors and how this may influence MSD prevention. The manuscript provides industry-based data on MSD risk and outlines the approach used in its collection. Identifying contextual factors and understanding their role in creating MSD risk may help improve the acceptance and effectiveness of MSD interventions in industry.

Measuring symptom occurrence and symptom distress: development of the symptom experience index

AIM

This paper is a report of a study to assess reliability and construct validity of revised and refined version of the Adapted Symptom Distress Scale: the Symptom Experience Index (SEI).

BACKGROUND

The development of the SEI, a 41-item Likert Scale assessing 20 symptoms, was based on self-regulation theory and an integrative conceptual analysis of symptom assessment and management. The model emphasizes the difference between the occurrence of a symptom (or multiple symptoms) and the distress (emotional) response to the occurrence of a symptom. It is the distress from symptom occurrence that promotes a person to take action and use known coping strategies to prevent the symptom occurrence or alleviate the distress from the symptom.

METHOD

A contrast-group and test-retest approach was used to assess construct validity and reliability with a convenience sample of 158 patients at United States of America in 2003-2004.

RESULTS

The SEI demonstrated reasonable internal consistency with a Cronbach's alpha of 0.91 for symptom experience, 0.85 for symptom occurrence and 0.84 for symptom distress. Test-retest reliability was supported by high intra-class correlation coefficients (symptom experience r = 0.93; symptom occurrence r = 0.94; symptom distress, r = 0.92). Construct validity was supported by statistically significant differences between patients and healthy adults.

CONCLUSION

The SEI can be used as a baseline and outcome measure to assess the impact of multiple symptoms on patients, and the effectiveness of interventions to manage these symptoms.

Counselor perceptions of organizational factors and innovations training experiences

Because work environment is central to understanding job performance, drug counselor perceptions of their programs and their skills were examined in relation to their attitudes about innovations training and its utilization. Latent profile analysis of measures on organizational climate and staff attributes for 1047 counselors from 345 programs defined three categories of counselors-labeled as isolated, integrated, and exceptional. All had generally positive views of their professional skills, although the isolated group scored lower on scales representing professional growth and influence on peers. They were less positive about the "climate" of programs in which they worked and were higher on stress. Program resources predicted the counselor groups, with the isolated having more limited resources. Counselor categorizations also differed in terms of workshop training experiences, with the isolated group of counselors reporting significantly less exposure, satisfaction, and program-wide use of workshop training.