Health beliefs, low mood, and somatizing tendency: contribution to incidence and persistence of musculoskeletal pain with and without reported disability

Risk factors and consequences of mental health problems in nurses: A scoping review of cohort studies

Mental health problems in nurses are prevalent and impairing. To date, no literature has comprehensively synthesised cohort evidence on mental health among nurses. This scoping review aimed to synthesise the existing literature on the risk factors and consequences of mental health problems in nurses. A systematic search was conducted on PubMed, EMBASE, Epistemonikos database, Web of Science, CINAHL, and PsycINFO from inception to March 2023. We identified 171 cohort studies from 16 countries, mostly (95.3%) from high-income economies. This review indicated that nurses worldwide encountered significant mental health challenges, including depression, cognitive impairment, anxiety, trauma/post-traumatic stress disorder, burnout, sleep disorder, and other negative mental health problems. These problems were closely related to various modifiable risk factors such as nurses' behaviours and lifestyles, social support, workplace bullying and violence, shift work, job demands, and job resources. Moreover, nurses' mental health problems have negative effects on their physical health, behaviour and lifestyle, occupation and organisation, and intrapersonal factors. These findings provided an enhanced understanding of mental health complexities among nurses, and shed light on policy enactment to alleviate the negative impact of mental health problems on nurses. Addressing mental health among nurses should be a top priority.

Do Human Capital Investment and Technological Innovation Have a Permanent Effect on Population Health? An Asymmetric Analysis of BRICS Economies

This study examines the asymmetric impact of human capital investment, and technological innovation on population health from the years spanning from 1991 to 2019, by using a panel of the BRICS countries. For this purpose, we have employed the PMG panel NARDL approach, which captures the long-run and short-run dynamics of the concerned variables. The empirical results show that human capital investment and technological innovation indeed happen to exert asymmetric effects on the dynamics of health in BRICS countries. Findings also reveal that increased human capital investment and technological innovation have positive effects on health, while the deceased human capital investment and technological innovation tend to have negative effects on population health in the long run. Based on these revelations, some policy recommendations have been proposed for BRICS economies.

Individual recovery expectations and prognosis of outcomes in non-specific low back pain: prognostic factor review

BACKGROUND

Low back pain is costly and disabling. Prognostic factor evidence can help healthcare providers and patients understand likely prognosis, inform the development of prediction models to identify subgroups, and may inform new treatment strategies. Recent studies have suggested that people who have poor expectations for recovery experience more back pain disability, but study results have differed.

OBJECTIVES

To synthesise evidence on the association between recovery expectations and disability outcomes in adults with low back pain, and explore sources of heterogeneity.

SEARCH METHODS

The search strategy included broad and focused electronic searches of MEDLINE, Embase, CINAHL, and PsycINFO to 12 March 2019, reference list searches of relevant reviews and included studies, and citation searches of relevant expectation measurement tools.

SELECTION CRITERIA

We included low back pain prognosis studies from any setting assessing general, self-efficacy, and treatment expectations (measured dichotomously and continuously on a 0 - 10 scale), and their association with work participation, clinically important recovery, functional limitations, or pain intensity outcomes at short (3 months), medium (6 months), long (12 months), and very long (> 16 months) follow-up.

DATA COLLECTION AND ANALYSIS

We extracted study characteristics and all reported estimates of unadjusted and adjusted associations between expectations and related outcomes. Two review authors independently assessed risks of bias using the Quality in Prognosis Studies (QUIPS) tool. We conducted narrative syntheses and meta-analyses when appropriate unadjusted or adjusted estimates were available. Two review authors independently graded and reported the overall quality of evidence.

MAIN RESULTS

We screened 4635 unique citations to include 60 studies (30,530 participants). Thirty-five studies were conducted in Europe, 21 in North America, and four in Australia. Study populations were mostly chronic (37%), from healthcare (62%) or occupational settings (26%). General expectation was the most common type of recovery expectation measured (70%); 16 studies measured more than one type of expectation. Usable data for syntheses were available for 52 studies (87% of studies; 28,885 participants). We found moderate-quality evidence that positive recovery expectations are strongly associated with better work participation (narrative synthesis: 21 studies; meta-analysis: 12 studies, 4777 participants: odds ratio (OR) 2.43, 95% confidence interval (CI) 1.64 to 3.62), and low-quality evidence for clinically important recovery outcomes (narrative synthesis: 12 studies; meta-analysis: 5 studies, 1820 participants: OR 1.89, 95% CI 1.49 to 2.41), both at follow-up times closest to 12 months, using adjusted data. The association of recovery expectations with other outcomes of interest, including functional limitations (narrative synthesis: 10 studies; meta-analysis: 3 studies, 1435 participants: OR 1.40, 95% CI 0.85 to 2.31) and pain intensity (narrative synthesis: 9 studies; meta-analysis: 3 studies, 1555 participants: OR 1.15, 95% CI 1.08 to 1.23) outcomes at follow-up times closest to 12 months using adjusted data, is less certain, achieving very low- and low-quality evidence, respectively. No studies reported statistically significant or clinically important negative associations between recovery expectations and any low back pain outcome.

AUTHORS' CONCLUSIONS

We found that individual recovery expectations are probably strongly associated with future work participation (moderate-quality evidence) and may be associated with clinically important recovery outcomes (low-quality evidence). The association of recovery expectations with other outcomes of interest is less certain. Our findings suggest that recovery expectations should be considered in future studies, to improve prognosis and management of low back pain.

Assessment of risk factors for non-specific chronic disabling low back pain in Japanese workers-findings from the CUPID (Cultural and Psychosocial Influences on Disability) study

The majority of patients with non-specific low back pain (LBP) suffer from chronic pain. Psychosocial factors play an important role in the chronicity of LBP. To explore the risk factors for chronic disabling LBP in detail, we assessed its various risk factors in Japanese workers, using data from the Cultural and Psychosocial Influences on Disability (CUPID) study. Data were drawn from a 1 yr follow-up of 20‒59 yr-old workers who participated in the CUPID study. A self-administered questionnaire assessed various factors, including individual characteristics, ergonomic work demands, and work-related or other psychosocial factors. Logistic regression analyses were performed to assess the associations between these factors and chronic disabling LBP. Of 198 participants, 35 (17.7%) had chronic disabling LBP during the 1 yr follow-up. Multivariate logistic regression analysis revealed that the interaction effect of the two factors, expectation of LBP problems and excessive working hours (≥ 60 h per week), was associated with chronic disabling LBP. Chronic disabling LBP was present in 42.5% of participants with both of these two risk factors, whereas it was present in 11.8% of participants without these risk factors. In conclusion, among various factors, the combination of two psychosocial factors was particularly associated with chronic disabling LBP.

Prevention and management of musculoskeletal pain in nursing staff by a multifaceted intervention in the workplace: design of a cluster randomized controlled trial with effectiveness, process and economic evaluation (INTEVAL_Spain)

Background

Musculoskeletal pain (MSP) is the leading cause of years lived with disability. In consequence, to reduce MSP and its associated sickness absence is a major challenge. Previous interventions have been developed to reduce MSP and improve return to work of workers with MSP, but combined approaches and exhaustive evaluation are needed. The objective of the INTEVAL_Spain project is to evaluate the effectiveness of a multifaceted intervention in the workplace to prevent and manage MSP in nursing staff.

Methods

The study is designed as a two-armed cluster randomized controlled trial with a late intervention control group. The hospital units are the clusters of randomization and participants are nurses and aides. An evidence-based multi-component intervention was designed combining participatory ergonomics, case management and health promotion. Both the intervention and the control groups receive occupational health care as usual. Data are collected at baseline, and after six and 12 months. The primary outcomes are prevalence of MSP and incidence and duration of sickness absence due to MSP. Secondary outcomes are work role functioning and organizational preventive culture. The intervention process will be assessed through quantitative indicators of recruitment, context, reach, dose supplied, dose received, fidelity and satisfaction, and qualitative approaches including discussion groups of participants and experts. The economic evaluation will include cost-effectiveness and cost-utility, calculated from the societal and the National Health System perspectives.

Discussion

Workplace health programs are one of the best options for the prevention and control of non-communicable diseases. The main feature of this study is its multifaceted, multidisciplinary and de-medicalized intervention, which encompasses three evidence-based interventions and covers all three levels of prevention, which have not been previously unified in a single intervention. Also, it includes a comprehensive quantitative and qualitative evaluation of the intervention process, health results, and economic impact. This study could open the possibility of a new paradigm for the prevention and management of MSP and associated sickness absence approach at the workplace.

Trial registration

Current Controlled Trials ISRCTN15780649 Retrospectively registered 13th July 2018.

Prevalence and environmental impact factors of somatization tendencies in eastern Chinese adolescents: a multicenter observational study

The aim of this study is at examining the prevalence and impact factors of adolescent somatization tendencies (ST) across three eastern Chinese provinces. A multicenter school-based cross-sectional study was conducted in these provinces from 2015 to 2016. The sample included 11,153 middle-school students aged 13-18 years, who were randomly selected using a multi-phase stratified cluster sampling technique. We also designed a multicenter school-based case-control study to evaluate the potential environmental impact of ST factors on this population. The overall positive rate of ST among the eastern Chinese adolescents was 12.1%. Somatic symptoms score (SSS) and positive ST rate were higher in females than males. Additionally, the SSS and positive ST rate for the 18-year-old group were significantly higher than in other age groups. In comparison to those in urban areas, adolescents in rural areas had significantly higher SSS and positive ST rate. Multiple conditional regression analyses revealed that family medical history, anxiety and depression scores; superstitious beliefs; left-behind adolescents; teacher-student support; family conflict; and family independence and achievement orientation were significantly linked to ST in adolescents. The models also indicated family medical history was the strongest impact factor to adolescent ST, even though ST were prevalent in the three studied eastern Chinese provinces. Gender, age, and dwelling differences were very significant in the SSS and positive ST rate in adolescents. This study concludes that adolescent ST are influenced by multiple environments.

Disability due to knee pain and somatising tendency in Japanese adults

BACKGROUND

Knee pain is common and related to knee osteoarthritis. However, there is a discrepancy between knee pain and radiographic osteoarthritis. In the general population, knee pain is associated with psychological and cognitive factors, which would be one explanation for the discrepancy. Limited evidence demonstrates that somatization is associated with knee pain. This study examined the association between disability due to knee pain and a high somatising tendency.

METHODS

Japanese adults (aged 20-64 years) who had experienced knee pain in the past four weeks were included in this study (n = 14,695, 50% women). Data were extracted from a large internet survey. Somatising tendency was assessed using the Somatic Symptom Scale-8 (SSS-8). Disability due to knee pain was categorized into three levels: 1) knee pain without difficulty with activities of daily living (ADL), 2) knee pain with ADL difficulty but without requiring sick leave, and 3) knee pain requiring sick leave. The association between ≥ high somatising tendency (SSS-8 score ≥ 12) as well as very high somatising tendency (SSS-8 score ≥ 16) and disability due to knee pain was examined using logistic regression models adjusted for age, sex, body mass index, depressive symptoms, education level, regular exercise, chronicity of knee pain (≥3 months), osteoarthritis, rheumatoid arthritis, and fibromyalgia.

RESULTS

Greater disability due to knee pain was associated with a higher odds ratio for ≥ high somatising tendency (adjusted odds ratio (aOR) = 2.36 [2.10-2.66] in group 2 vs. group 1, aOR = 3.23 [2.66-3.92] in group 3 vs. group 1). Stronger associations were found for a very high somatising tendency (aOR = 2.80 [2.42-3.23] in group 2 vs. group 1, aOR = 4.51 [3.64-5.58] in group 3 vs. group 1).

CONCLUSIONS

Somatization may play a role in disability due to knee pain in the general adult population with knee pain, similar to the role of somatization in low back pain.

Constructs of health belief and disabling distal upper limb pain

BACKGROUND

Musculoskeletal pain in the distal upper limb is common and is a cause of disability and healthcare consultation. At the time of presentation individuals reporting similar pain severities may report different levels of related disability. The biopsychosocial model proposes that health beliefs may help explain this difference. The aim of this cross-sectional study was to identify underlying constructs of health belief in those referred to physiotherapy with pain in the distal upper limb and investigate whether these constructs moderated the relationship between pain severity and extent of disability.

METHOD

Health beliefs were assessed using an instrument included in a questionnaire completed before randomisation to the Arm Pain Trial (ISRCTN79085082). Ordinal responses to statements about health beliefs were used to generate a polychoric correlation matrix. The output from this matrix was then used for Exploratory Factor Analysis to determine underlying constructs. The moderating influence of the identified health belief constructs was then tested using interaction terms in linear regression models.

RESULTS

476 trial participants contributed data, age range 18-85 (mean 48.8, SD 13.7), 54% female. Five health belief constructs were identified: beliefs about hereditary factors, beliefs about movement and pain, beliefs about locus of control, beliefs about the role of lifecourse/lifestyle factors, and beliefs about prognosis. The only health belief construct found to moderate the pain-disability relationship was beliefs about prognosis, with greater pessimism resulting in higher levels of disability at mild-to-moderate levels of pain severity (B -0.17, 95% CI -0.30, -0.036).

CONCLUSION

This exploratory cross-sectional study identified five constructs of health belief from responses to a previously used set of statements investigating fear avoidance and illness beliefs in a clinical population with pain in the distal upper limb. Of these constructs, beliefs about prognosis were found to moderate the relationship between pain and disability.

IMPLICATIONS

At the time of referral to physiotherapy it may be beneficial to assess patients' perception of prognosis. For those with higher than expected disability for the presenting level of pain, and pessimism about prognosis, focused reassurance may play an important part in initial consultation. Longitudinal study is required to support the findings from this study and investigate whether a causal relationship exists. Future investigations should confirm the health belief constructs proposed.

Maternal Smoking During Pregnancy Is Associated With Offspring's Musculoskeletal Pain in Adolescence: Structural Equation Modeling

Introduction

Smoking and behavioral problems are related to musculoskeletal (MS) pain in adolescence. Maternal smoking during pregnancy (MSDP) is associated with offspring's behavioral problems but its relation to MS pain in adolescence is unknown. Our purpose was to investigate whether there is an association between MSDP, the number of pain sites in adolescence, and the factors that potentially mediate this relationship.

Methods

We evaluated the association of MSDP with offspring's MS pain at 16 years among participants of the Northern Finland Birth Cohort 1986 (n = 6436, 3360 girls, 68% of all births) using Chi-square test and independent samples t test. We used structural equation modeling to assess the mediating factors stratified by gender.

Results

MSDP was frequent (22%) associating with paternal smoking (p < .001), externalization problems at 8 years (p = .009 boys, p = .002 girls), offspring's smoking at 16 years (p < .001), externalizing problems at 16 years (p < .001), family's social class (p < .001) and intactness of the family status (p < .001). The mean number of offspring's MS pain sites was higher among adolescents whose mothers had smoked during pregnancy than among those whose mothers were nonsmokers (p = .002 boys, p = .012 girls). The association between MSDP and MS pain at 16 years was mediated by externalizing problems at 8 years (p < .001) and 16 years (p < 0.001).

Conclusions

MSDP increased the risk of offspring's MS pain in adolescence, and the association was mediated by offspring's externalizing problems during childhood and early adolescence.

Implications

This study indicates that MSDP increases the risk of MS pain in adolescence and the effect is mediated by externalizing problems. Our results add to the evidence on harmfulness of MSDP for offspring, and can be used as additional information in interventions aiming to influence MSDP.

Low back pain among office workers in three Spanish-speaking countries: findings from the CUPID study

OBJECTIVES

To assess the differences in the prevalence and incidence of low back pain (LBP) and associated disability among office workers in Costa Rica, Nicaragua and Spain.

METHODS

Data were collected at baseline (n=947, 93% response) in November 2007 and at follow-up after 12 months (n=853, 90% response). Six outcome measures were examined: baseline prevalence of (1) LBP in the past 12 months, (2) LBP in the past month and (3) disabling LBP in the past month; and at follow-up: (4) incidence of new LBP in the past month, (5) new disabling LBP and (6) persistent LBP. Differences in prevalence by country were characterised by ORs with 95% CIs, before and after adjustment for covariates.

RESULTS

Prevalence of LBP in the past month among office employees in Costa Rica (46.0%) and Nicaragua (44.2%) was higher than in Spain (33.6%). Incidence of new LBP was 37.0% in Nicaragua (OR=2.49; 95% CI 1.57 to 3.95), 14.9% in Costa Rica (OR=0.74; 95% CI 0.41 to 1.34) and 19.0% in Spain (reference). Incidence of new disabling LBP was higher in Nicaragua (17.2%; OR=2.49; 95% CI 1.43 to 4.34) and Costa Rica (13.6%; OR=1.89; 95% CI 1.03 to 3.48) than Spain (7.7%), while persistence of LBP was higher only in Nicaragua.

CONCLUSIONS

Prevalence of LBP and disabling LBP was higher in Costa Rican and Nicaraguan office workers than in Spain, but the incidence was higher mainly in Nicaragua. Measured sociodemographic, job-related and health-related variables only partly explained the differences between countries, and further research is needed to explore reasons for the remaining differences.

Anxiety and depression predict musculoskeletal disorders in health care workers

Incidence of musculoskeletal disorders (MSDs) is high among health care workers (HCWs). To determine whether MSDs are associated with preexisting anxiety and/or depression, a case-control study was carried out in female HCWs (56 cases/55 controls). Cases were HCWs with a first-time clinical diagnosis of MSD within the previous 2 years. Occupation, workplace, work shift, direct patient assistance, and anxiety/depression scores (Goldberg scale) were assessed. Increased risk of incident MSDs (multivariate logistic regression) was found in workers with preexisting anxiety/depression compared to those without (OR 5.01; 95% CI 2.20-12.05; p < .01). Other significant risk factors were direct patient assistance (OR 2.59; 95% CI 1.03-6.92; p = .04) and morning work shift (OR 2.47; 95% CI 0.99-6.48; p = .05). Preexisting anxiety/depression was associated with incident MSDs in HCWs, adjusting for occupational exposure risk factors.

Association between upper extremity musculoskeletal disorders and mental health status in office workers

BACKGROUND

Musculoskeletal Disorders (MSDs) can lead to potential adverse consequences for individuals and their organizations, and in various research, its relationship to physical and mental health of workforce has been studied.

OBJECTIVE

The purpose of this study was to determine the prevalence of MSDs of upper extremities among office workers and its association with mental health status.

METHODS

In this cross sectional study, 1488 out of 1630 office workers completed the Standardized Nordic Musculoskeletal Disorders Ques-tionnaire and General Health Questionnaire (GHQ-28) (response rate = 91.3%).

RESULTS

Upper extremity MSDs were reported in 410 (27.5%) office workers, including 269 (18.1%) shoulder, 79 (5.3%) elbow and 207 (13.9%) hand/wrist symptoms. Based on GHQ-28, 254 (17.1%) participants were found to be at risk of developing a psychiatric disorder that were observed in 26.7% of workers with MSDs symptoms. Shoulder (p < 0.001), elbow (p < 0.001) and hand/wrist (p < 0.001) MSDs were associated with poor mental health. Among the four GHQ-28 subscales (somatic symptoms, anxiety/insomnia, social dysfunction, and depression), anxiety/insomnia was strongly correlated with shoulders (P < 0.001), elbows (P = 0.002), and hands/wrists (P < 0.001) symptoms.

CONCLUSION

Office workers with upper extremity MSDs were more likely to be experiencing mental distress. This indicates a need for greater emphasis on preventive programs at workplace to support their psychological well-being.

Web-Based Interventions for Chronic Back Pain: A Systematic Review

Background

Chronic low back pain is one of the most common presenting complaints to a physician’s office. Treatment is often challenging and recovery depends on various factors, often resulting in significant investments of time and resources.

Objective

The aim of this review is to determine which Web-based interventions aimed at chronic low back pain are of benefit to patients.

Methods

Randomized controlled trials (RCTs) studying Web-based interventions directed at adults with chronic low back pain were included. Retrospective studies, narrative reviews, nonrandomized trials, and observational studies were excluded. Electronic databases and bibliographies were searched.

Results

In total, nine unique RCTs were identified (total participants=1796). The number of patients randomized in each trial ranged from 51 to 580. Four trials studied online cognitive behavioral therapy (CBT) and five trials studied other Web-based interventions with interactive features. Empowerment/control was improved in six studies. Use of CBT was associated with reduced catastrophization among patients. Mixed results were reported with regards to reduction in pain levels and disability, although some studies showed promise in reducing disability in the short term. One study that measured health care utilization reported reduced utilization with the use of moderated email discussion.

Conclusions

Limited data are available regarding effective Web-based interventions to improve outcomes for patients with chronic low back pain. Nine RCTs with small sample sizes were identified in this review. Online CBT appears to show some promise in terms of reducing catastrophization and improving patient attitudes. Further research in this area with larger-scale studies focusing on appropriate outcomes appears to be a priority.

Mind-Body Exercises for Nurses with Chronic Low Back Pain: An Evidence-Based Review

Background. Chronic low back pain (CLBP) among nurses is a growing health concern. The multimodal nature of mind-body exercises has potential to impact physiological and psychological processes associated with chronic pain, affording possible advantages over conventional unimodal therapies. This paper summarizes the prevalence of and risk factors for CLBP among nurses, reviews the effectiveness in treating pain and disability of mind-body exercises (yoga and tai chi) for CLBP among the general and nursing population, and describes implications. Methods. Articles, published during or prior to 2015, were systematically identified through the PubMed/MEDLINE, Web of Science, and ScienceDirect databases using the following search terms: nurses, mind-body, integrative, biopsychosocial, yoga, tai chi, back pain, and/or risk factors. Results. Prevalence estimates of CLBP among nurses ranged from 50% to 80%. Associated risk factors for CLBP included lifestyle and physical, psychological, psychosocial, and occupational factors. No published studies were identified that evaluated yoga or tai chi for nurses with CLBP. Studies in the general population suggested that these interventions are effective in reducing pain and disability and may improve factors/processes predictive of CLBP. Conclusion. This review suggests that evaluating the impact of multimodal interventions such as yoga and tai chi for nurses with CLBP warrants investigation.

Upper extremity musculoskeletal pain among office workers in three Spanish-speaking countries: findings from the CUPID study

OBJECTIVES

To estimate the prevalence and incidence of upper extremity musculoskeletal pain (UEMP) and related disability among office workers in Costa Rica, Nicaragua and Spain.

METHODS

Data from the multinational Cultural and Psychosocial Influences on Disability (CUPID) study on 947 (93%) participants at baseline with 90% follow-up after 12 months were employed. Logistic regression was used to estimate the associations (ORs and corresponding 95% CIs) between country and six outcomes: baseline prevalence of (1) UEMP in past 12 months, (2) UEMP in past month and (3) disabling UEMP in past month; (4) incidence of new UEMP at follow-up; (5) incidence of new disabling UEMP at follow-up and (6) persistence of UEMP at follow-up, after adjustment for sociodemographic, job-related and health-related covariates.

RESULTS

Baseline prevalence of UEMP in the past month was higher in Costa Rica (53.6%) (OR=1.89; 95% CI 1.36 to 2.62) and Nicaragua (51.9%) (OR=1.74; 95% CI 1.28 to 2.35) than in Spain (38.4%). Compared to Spain (33.2%), the incidence of new UEMP was 50.4% in Costa Rica (OR=2.04; 95% CI 1.34 to 3.12) and 60.2% in Nicaragua (OR=3.04; 95% CI 2.06 to 4.50). The incidence of disabling UEMP was higher in Nicaragua (OR=2.57; 95% CI 1.50 to 4.41) and Costa Rica (OR=2.16; 95% CI 1.22 to 3.84) when compared to Spain.

CONCLUSIONS

Prevalence of UEMP was approximately twofold higher and its incidence twofold to threefold higher in Costa Rica and Nicaragua as compared with Spain. Between-country differences were only partially explained by the covariates analysed. Research is needed to explore other aspects of work and cultural attributes that might explain the residual differences in UEMP.

Descriptive Epidemiology of Somatising Tendency: Findings from the CUPID Study

Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposure-response relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait.

Association between pain catastrophising and musculoskeletal disorders is modified by past injuries in Malaysian military recruits

OBJECTIVES

Pain catastrophising is defined as exaggerated negative thoughts, which can occur during an actual or anticipated painful experience, such as musculoskeletal injuries (MSI) or disorders (MSD). The aims of this study are to examine the association between pain catastrophising and MSI and MSD in Malaysian Army male recruits, and evaluate the effects of past injury.

METHODS

A cohort of 611 male Malaysian Army recruits were recruited and followed up at 3 and 6 months. Pain catastrophising, MSD, sociodemographic and work factors were measured using a self-administered questionnaire, and MSI incidence was retrieved from the medical records. Multivariable fixed effects regression was used to model the cumulative incidence of MSD and MSI.

RESULTS

Approximately 12% of the recruits were diagnosed with incident MSI and 80% reported incident MSD. Higher pain catastrophising at baseline was associated with higher 6 month MSD risk (adjusted OR (aOR) 1.6 per 1 SD increase of Pain Catastrophising Scale (PCS) scores; 95% CI 1.2 to 2.0), and longitudinally associated with MSD incidence (aOR 1.2, 95% CI 1.1 to 1.4). Pain catastrophising was not associated with MSI incidence (aOR 1.0, 95% CI 0.8 to 1.3). The association between pain catastrophising and self-reported MSD was stronger among recruits with self-reported past injury (p for interaction <0.001).

CONCLUSIONS

Pain catastrophising was able to predict symptomatic MSD, and not physician-diagnosed MSI, and these findings are directly related to individual health beliefs. Pain catastrophising has a greater influence on how military recruits perceived their musculoskeletal conditions during training, and efforts to reduce pain catastrophising may be beneficial.

Psychological and psychosocial determinants of musculoskeletal pain and associated disability

Although much attention has been given to the physical determinants of common musculoskeletal complaints such as back and arm pain, research points to a stronger influence of psychological factors. Multiple studies have implicated poor mental health and somatisation (a tendency to worry about the common somatic symptoms) in the incidence and chronicity of musculoskeletal pain and associated disability. Also important are adverse beliefs about the prognosis of such disorders, and about the role of physical activity in their development and persistence. Differences in societal beliefs may have contributed to major variation in the prevalence of disabling musculoskeletal pain that has been observed between countries and in the same countries over time. Psychosocial aspects of work have also been linked with musculoskeletal pain, although relative risks have generally been smaller. There is a need to take account of psychological factors in the clinical management of patients with back, neck and arm pain.

Persistent of Neck/Shoulder Pain among Computer Office Workers with Specific Attention to Pain Expectation, Somatization Tendency, and Beliefs

BACKGROUND

Neck and shoulder pains are the prevalent complaints among computer office workers. The purpose of this study was to assess the relationship of somatization tendency, expectation of pain, mental health and beliefs about causation of pain with persistence of neck/shoulder pains among computer office workers.

METHODS

This research is a kind of prospective cohort study with 1-year follow-up. It has done among all eligible computer office workers of Shahroud universities (n = 182) in 2008-2009 and 1-year later. Data were collected using the Cultural and Psychosocial Influences on Disability questionnaire. Multiple logistic regression analysis was used to analyze the data through SPSS (P < 0.05).

RESULTS

At the baseline 100 (54.9%) of participants reported neck/shoulder pains and at follow-up 34.3% of them reported persistence pains. Significant relationships were found between persistence of neck/shoulder pains and negative expectation about pain in next 1-year P = 0.002, (odds ratio [OR] =8.3, 95% confidence interval [CI]: 2.1-32.9) and somatization tendency P = 0.01, (OR = 6.5, 95% CI: 1.6-27.4).

CONCLUSIONS

Pain expectation and somatization tendency recognized as associated risk factors of persistent neck/shoulder pain among computer operators. This confirmed some other similar studies on work-related musculoskeletal disorders in Europe countries in recent years.