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Villotti P, Kordsmeyer AC, Roy JS, Corbière M, Negrini A, Larivière C. Systematic review and tools appraisal of prognostic factors of return to work in workers on sick leave due to musculoskeletal and common mental disorders. PLoS One 2024; 19:e0307284. [PMID: 39018306 PMCID: PMC11253986 DOI: 10.1371/journal.pone.0307284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 07/03/2024] [Indexed: 07/19/2024] Open
Abstract
With the overall objective of providing implication for clinical and research practices regarding the identification and measurement of modifiable predicting factors for return to work (RTW) in people with musculoskeletal disorders (MSDs) and common mental disorders (CMDs), this study 1) systematically examined and synthetized the research evidence available in the literature on the topic, and 2) critically evaluated the tools used to measure each identified factor. A systematic search of prognostic studies was conducted, considering four groups of keywords: 1) population (i.e., MSDs or CMDs), 2) study design (prospective), 3) modifiable factors, 4) outcomes of interest (i.e., RTW). Studies showing high risk of bias were eliminated. Tools used to measure prognostic factors were assessed using psychometric and usability criteria. From the 78 studies that met inclusion criteria, 19 (for MSDs) and 5 (for CMDs) factors reaching moderate or strong evidence were extracted. These factors included work accommodations, RTW expectations, job demands (physical), job demands (psychological), job strain, work ability, RTW self-efficacy, expectations of recovery, locus of control, referred pain (back pain), activities as assessed with disability questionnaires, pain catastrophizing, coping strategies, fears, illness behaviours, mental vitality, a positive health change, sleep quality, and participation. Measurement tools ranged from single-item tools to multi-item standardized questionnaires or subscales. The former generally showed low psychometric properties but excellent usability, whereas the later showed good to excellent psychometric properties and variable usability. The rigorous approach to the selection of eligible studies allowed the identification of a relatively small set of prognostic factors, but with a higher level of certainty. For each factor, the present tool assessment allows an informed choice to balance psychometric and usability criteria.
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Affiliation(s)
- Patrizia Villotti
- Department of Education and Pedagogy–Career Counseling, Université du Québec à Montréal, Montréal, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Montréal, Canada
| | - Ann-Christin Kordsmeyer
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jean-Sébastien Roy
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Rehabilitation Institute, Quebec City, Canada
| | - Marc Corbière
- Department of Education and Pedagogy–Career Counseling, Université du Québec à Montréal, Montréal, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Montréal, Canada
| | - Alessia Negrini
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail, Montréal, Canada
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail, Montréal, Canada
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Stagg AL, Madan I, Fear N, Stevens MJ, Wainwright E, Hoving JL, Macfarlane GJ, Hollick R, Morton L. Do current methods of measuring the impact of chronic pain on work reflect the experience of working-age adults? An integrated mixed-methods systematic narrative review. Pain 2024; 165:1472-1481. [PMID: 38381946 PMCID: PMC11190898 DOI: 10.1097/j.pain.0000000000003169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/09/2023] [Accepted: 12/03/2023] [Indexed: 02/23/2024]
Abstract
ABSTRACT Chronic pain affects individuals' work participation. The impact of chronic pain on work has historically been measured through sickness absence, though it is now appreciated that the impacts on work are far wider. This mixed-methods review aimed to identify the full range of impacts of pain on work in addition to impacts that are currently measured quantitatively to inform the development of a new questionnaire assessing the wider impacts of chronic pain on work. MEDLINE, Embase, PsychINFO, and CINAHL were searched for studies that included quantitative measures of the impact of chronic pain on work and for qualitative studies where individuals described impacts of their chronic pain on work. Quantitative measures, and text from qualitative studies, were analysed thematically. A thematic framework was developed for establishing the types of impacts measured or described in the literature. Forty-four quantitative and 16 qualitative papers were identified. The literature described impacts within 5 areas: changes at work and to working status; aspects of the workplace and work relationships; pain and related symptoms at work; psychological factors; and factors and impacts outside the work environment related to work. Quantitative measures mainly assessed impacts related to the quantity and quality of work (29 of 42 measures). Seventeen aspects were only discussed within the qualitative literature. This study identifies a discrepancy between the impacts that have been the focus of quantitative measures and the range that individuals working with chronic pain experience and highlights the need for a new measure assessing a wider range of issues.
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Affiliation(s)
- Anne L. Stagg
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (Guy's & St Thomas' NHS Foundation Trust and King's College London), London, United Kingdom
| | - Ira Madan
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (Guy's & St Thomas' NHS Foundation Trust and King's College London), London, United Kingdom
| | - Nicola Fear
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (King's Centre for Military Health Research, King's College London), London, United Kingdom
| | - Martin J. Stevens
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (University of Aberdeen), Aberdeen, United Kingdom
| | - Elaine Wainwright
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (University of Aberdeen), Aberdeen, United Kingdom
| | - Jan L. Hoving
- Department of Public and Occupational Health, Cochrane Work, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Gary J. Macfarlane
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (University of Aberdeen), Aberdeen, United Kingdom
| | - Rosemary Hollick
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (University of Aberdeen), Aberdeen, United Kingdom
| | - LaKrista Morton
- Versus Arthritis/Medical Research Council Centre for Musculoskeletal Health and Work (University of Aberdeen), Aberdeen, United Kingdom
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Silva-Junior JS, Martinez MC, Sekiya FS, de Miranda CB, Fischer FM. Return to work after sick leave due to musculoskeletal disorder or injury: a longitudinal study conducted in Brazil. BMC Public Health 2023; 23:1881. [PMID: 37770862 PMCID: PMC10540424 DOI: 10.1186/s12889-023-16789-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Musculoskeletal disorders and injuries (MSDI) are conditions that affect the locomotor system characterized by pain and impairment of functionality. They are the leading cause of years lived with disability. The aim of this study was to analyze the factors that influence the return to work (RTW) among workers on sick leave due to MSDI. METHODS: A longitudinal study was conducted in the city of São Paulo, Brazil, between 2020-2022. The participants were 216 workers who required social security compensation due to MSDI. They filled out online questionnaires about their sociodemographic characteristics, health risk behaviors, work characteristics and health conditions. They were followed for 365 days after their first day of sick leave. A Cox regression was performed to identify the factors that influenced their first RTW. RESULTS Most participants were male (53.0%), mean age was 39.5 years (SD 10.6), 70.4% returned to work within the one-year follow-up period. The mean duration of sick leave was 192.6 days. Factors associated with a lower RTW were age 40 years and older (HR 0.54; 95%CI 0.39-0.76) and the interaction between perceptions of the need for improvement in the physical and psychological domains of quality of life (HR 0.67; 95%CI 0.48-0.94). CONCLUSIONS Occupational healthcare professionals should pay greater attention to patients who are aging and those with perceived worse physical and psychological conditions, in order to facilitate the reintegration process and promote sustained RTW after sick leave due to musculoskeletal disorder or injury.
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Affiliation(s)
- João Silvestre Silva-Junior
- Department of Forensic Medicine, Bioethics, Occupational Medicine and Physical and Rehabilitation Medicine, University of São Paulo Medical School (FMUSP), São Paulo, Brazil.
- Department of Medicine, São Camilo University Center, São Paulo, Brazil.
- Occupational Medicine Residency Program, Clinics Hospital, University of São Paulo Medical School (FMUSP), São Paulo, Brazil.
| | | | - Felipe Seiti Sekiya
- Occupational Medicine Residency Program, Clinics Hospital, University of São Paulo Medical School (FMUSP), São Paulo, Brazil
| | - Cristiano Barreto de Miranda
- General Coordination of Occupational Health Surveillance, Department of Environmental Health Surveillance and Occupational Health, Secretariat for Health and Environment Surveillance, Ministry of Health, Brasília, Brazil
| | - Frida Marina Fischer
- Department of Environmental Health, School of Public Health, University of São Paulo, São Paulo, Brazil
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Silva FG, Costa LO, Hancock MJ, Palomo GA, Costa LC, da Silva T. No prognostic model for people with recent-onset low back pain has yet been demonstrated to be suitable for use in clinical practice: a systematic review. J Physiother 2022; 68:99-109. [PMID: 35400608 DOI: 10.1016/j.jphys.2022.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/11/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE What model development and external validation studies exist that focus on the prognosis of patients with recent-onset low back pain (LBP)? What is the performance (in terms of discrimination and calibration) of these clinical prediction models? METHODS Systematic searches on MEDLINE, Embase and CINAHL were conducted. Model development and/or external validation studies of patients with recent-onset LBP were selected. Models predicting outcomes of pain, disability, sick leave, work absence and self-reported recovery, with at least 12 weeks of follow-up, were included. Risk of bias was assessed using the PROBAST instrument. RESULTS We identified 17 prognostic models developed to predict outcomes in people with recent-onset LBP: six models were in the development phase and 11 were in the validation phase. The most assessed prediction model was the Original Örebro Musculoskeletal Pain Questionnaire. The Da Silva Clinical Prediction Model was the only model, from a study with low risk of bias, that presented acceptable discrimination, demonstrating 'good' performance in predicting recovery from pain (C-statistic 0.71, 95% CI 0.63 to 0.78) and overall acceptable agreement in calibration. CONCLUSION Most prediction models for prognosis of patients with recent-onset LBP did not perform well at discrimination, few studies reported calibration and their performance varied across studies. It seems premature to advocate use of the available models, at their current state of development and validation, for low back pain in primary care, considering their generally poor methods and performance. REGISTRATION CRD42020160988.
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Affiliation(s)
- Fernanda G Silva
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Brazil.
| | - Leonardo Op Costa
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Brazil
| | - Mark J Hancock
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Gabriele A Palomo
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Brazil
| | - Lucíola Cm Costa
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Brazil
| | - Tatiane da Silva
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Brazil
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Drăgoi II, Popescu FG, Lăzurean PC, Anculia R, Ghigulescu M, Marin I, Păuncu EA. Back pain in a group of computer workers assessed in a physiotherapy unit. HUMAN SYSTEMS MANAGEMENT 2021. [DOI: 10.3233/hsm-201044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Modern society work implies computer-based activities generating back pain because of prolonged sitting positions and non-ergonomic postures. OBJECTIVE: The aim of the study was to analyse the back-pain characteristics in a group of office workers in comparison with potential risk factors. METHODS: The design of the study was retrospective; a group of 109 computer workers with back pain was selected from a private physiotherapy unit between Jan 2018 - Dec 2019. Anthropometric, occupational and behaviour data, symptoms, the diagnosis on the first visit, previous medical diagnosis and specific physical activities were collected from medical records. RESULTS: The studied group (research sample) is formed of information technology operators, engineers and economists, had the mean age 38.91±10.25, with 14.04±9.12 years seniority at work. Most of them addressed to the physiotherapist directly, or they were referred by their family physician; 60% had MRI investigation on the first physiotherapy visit with no medical referral or diagnosis. The symptoms were not reported to the occupational physician. The back pain appeared independent of BMI; the low back pain had higher prevalence in males. Patients reported 6 months of back pain in 57,8% of all cases. The pain was favoured by continuous activity, more than 4 hours, in the sitting posture. CONCLUSIONS: A complex and interdisciplinary team that included an occupational physician, an ergonomist and a physiotherapist could prevent and control back pain in computer workers. Workplace conditions adaptation, proper physiotherapy and periodical medical check-ups could improve the health status of these workers.
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Affiliation(s)
- Iulia Iovanca Drăgoi
- “Victor Babes” University of Medicine and Pharmacy Timisoara, Romania
- Fast Fizio Clinic, Timisoara, Romania
| | - Florina Georgeta Popescu
- “Victor Babes” University of Medicine and Pharmacy Timisoara, Romania
- Municipal Clinical Emergency Hospital Timisoara, Romania
| | | | - Ramona Anculia
- Municipal Clinical Emergency Hospital Timisoara, Romania
| | | | - Ioana Marin
- “Victor Babes” University of Medicine and Pharmacy Timisoara, Romania
| | - Elena-Ana Păuncu
- “Victor Babes” University of Medicine and Pharmacy Timisoara, Romania
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Aasdahl L, Granviken F, Meisingset I, Woodhouse A, Evensen KAI, Vasseljen O. Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes. BMC Musculoskelet Disord 2021; 22:455. [PMID: 34011349 PMCID: PMC8132354 DOI: 10.1186/s12891-021-04332-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 05/05/2021] [Indexed: 12/29/2022] Open
Abstract
Background There are large variations in symptoms and prognostic factors among patients sharing the same musculoskeletal (MSK) diagnosis, making traditional diagnostic labelling not very helpful in informing treatment or prognosis. Recently, we identified five MSK phenotypes across common MSK pain locations through latent class analysis (LCA). The aim of this study was to explore the one-year recovery trajectories for pain and functional limitations in the phenotypes and describe these in relation to the course of traditional diagnostic MSK groups. Methods We conducted a longitudinal observational study of 147 patients with neck, back, shoulder or complex pain in primary health care physiotherapy. Data on pain intensity and function were collected at baseline (week 0) and 1, 2, 3, 4, 6, 8, 12, 26 and 52 weeks of follow up using web-based questionnaires and mobile text messages. Recovery trajectories were described separately for the traditional diagnostic MSK groups based on pain location and the same patients categorized in phenotype groups based on prognostic factors shared among the MSK diagnostic groups. Results There was a general improvement in function throughout the year of follow-up for the MSK groups, while there was a more modest decrease for pain intensity. The MSK diagnoses were dispersed across all five phenotypes, where the phenotypes showed clearly different trajectories for recovery and course of symptoms over 12 months follow-up. This variation was not captured by the single trajectory for site specific MSK diagnoses. Conclusion Prognostic subgrouping revealed more diverse patterns in pain and function recovery over 1 year than observed in the same patients classified by traditional diagnostic groups and may better reflect the diversity in recovery of common MSK disorders. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04332-3.
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Affiliation(s)
- Lene Aasdahl
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway. .,Unicare Helsefort Rehabilitation Centre, Rissa, Norway.
| | - Fredrik Granviken
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway.,Department of Physical Medicine and Rehabilitation, St.Olavs Hospital, Trondheim, Norway
| | - Ingebrigt Meisingset
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway
| | - Astrid Woodhouse
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway
| | - Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway.,Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway.,Unit for Physiotherapy Services, Trondheim Municipality, Trondheim, Norway
| | - Ottar Vasseljen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491, Trondheim, Norway
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Barakat A, Blankers M, Cornelis JE, van der Post L, Lommerse NM, Beekman ATF, Dekker JJM. Police Encounters, Agitation, Diagnosis, and Employment Predict Psychiatric Hospitalisation of Intensive Home Treatment Patients During a Psychiatric Crisis. Front Psychiatry 2021; 12:602912. [PMID: 33633607 PMCID: PMC7901988 DOI: 10.3389/fpsyt.2021.602912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/13/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: This study aims to determine factors associated with psychiatric hospitalisation of patients treated for an acute psychiatric crisis who had access to intensive home treatment (IHT). Methods: This study was performed using data from a randomised controlled trial. Interviews, digital health records and eight internationally validated questionnaires were used to collect data from patients on the verge of an acute psychiatric crisis enrolled from two mental health organisations. Thirty-eight factors were assigned to seven risk domains. The seven domains are "sociodemographic", "social engagement", "diagnosis and psychopathology", "aggression", "substance use", "mental health services" and "quality of life". Multiple logistic regression analysis (MLRA) was conducted to assess how much pseudo variance in hospitalisation these seven domains explained. Forward MLRA was used to identify individual risk factors associated with hospitalisation. Risks were expressed in terms of relative risk (RR) and absolute risk difference (ARD). Results: Data from 183 participants were used. The mean age of the participants was 40.03 (SD 12.71), 57.4% was female, 78.9% was born in the Netherlands and 51.4% was employed. The range of explained variance for the domains related to "psychopathology and care" was between 0.34 and 0.08. The "aggression" domain explained the highest proportion (R 2 = 0.34) of the variance in hospitalisation. "Quality of life" had the lowest explained proportion of variance (R 2 = 0.05). The forward MLRA identified four predictive factors for hospitalisation: previous contact with the police or judiciary (OR = 7.55, 95% CI = 1.10-51.63; ARD = 0.24; RR = 1.47), agitation (OR = 2.80, 95% CI = 1.02-7.72; ARD = 0.22; RR = 1.36), schizophrenia spectrum and other psychotic disorders (OR = 22.22, 95% CI = 1.74-284.54; ARD = 0.31; RR = 1.50) and employment status (OR = 0.10, 95% CI = 0.01-0.63; ARD = -0.28; RR = 0.66). Conclusion: IHT teams should be aware of patients who have histories of encounters with the police/judiciary or were agitated at outset of treatment. As those patients benefit less from IHT due to the higher risk of hospitalisation. Moreover, type of diagnoses and employment status play an important role in predicting hospitalisation.
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Affiliation(s)
- Ansam Barakat
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam University Medical Centres (UMC), Location VUmc, Amsterdam Public Health Research Institute Amsterdam UMC, Amsterdam, Netherlands
| | - Matthijs Blankers
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, Netherlands.,Trimbos-Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.,Department of Psychiatry, Amsterdam University Medical Centres (UMC), Location AMC, Amsterdam Public Health Research Institute Amsterdam UMC, Amsterdam, Netherlands
| | - Jurgen E Cornelis
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, Netherlands.,Department of Emergency Psychiatry, Arkin Institute for Mental Health Care, Amsterdam, Netherlands
| | - Louk van der Post
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, Netherlands
| | - Nick M Lommerse
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam University Medical Centres (UMC), Location VUmc, Amsterdam Public Health Research Institute Amsterdam UMC, Amsterdam, Netherlands.,Department of Research and Innovation, GGZ InGeest Specialized Mental Health Care, Amsterdam, Netherlands
| | - Jack J M Dekker
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, Netherlands.,Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute Amsterdam UMC, Amsterdam, Netherlands
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Employee Musculoskeletal Complaints and Supervisor Support: Implications for Behavioral Stress Reactions. J Occup Environ Med 2020; 62:728-737. [PMID: 32890212 DOI: 10.1097/jom.0000000000001949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This research investigated the moderating role of supervisor support for employees with musculoskeletal complaints and their intentions to seek medical advice; take sick leave; transfer jobs; and resign. METHODS Cross-sectional questionnaire data were collected from 1024 Australian employees. RESULTS Regressions with bootstrapping revealed no support for the buffering role of supervisor support. In contrast to expectations, high supervisor support heightened, rather than lowered, musculoskeletal complaints on intentions to transfer jobs. For sick leave and resignation intentions, high supervisor support buffered the negative effects of musculoskeletal complaints for full-timers but exacerbated such intentions for part-timers. Furthermore, full-timers with high musculoskeletal complaints appeared more vulnerable to the exacerbating effects of low supervisor support compared with part-timers. CONCLUSIONS Supervisor support for employees with musculoskeletal complaints both weakens and strengthens behavioral stress reactions, depending on employment status.
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