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Disabling musculoskeletal pain in working populations: is it the job, the person, or the culture?

ABSTRACT: To compare the prevalence of disabling low back pain (DLBP) and disabling wrist/hand pain (DWHP) among groups of workers carrying out similar physical activities in different cultural environments, and to explore explanations for observed differences, we conducted a cross-sectional survey in 18 countries. Standardised questionnaires were used to ascertain pain that interfered with everyday activities and exposure to possible risk factors in 12,426 participants from 47 occupational groups (mostly nurses and office workers). Associations with risk factors were assessed by Poisson regression. The 1-month prevalence of DLBP in nurses varied from 9.6% to 42.6%, and that of DWHP in office workers from 2.2% to 31.6%. Rates of disabling pain at the 2 anatomical sites covaried (r = 0.76), but DLBP tended to be relatively more common in nurses and DWHP in office workers. Established risk factors such as occupational physical activities, psychosocial aspects of work, and tendency to somatise were confirmed, and associations were found also with adverse health beliefs and group awareness of people outside work with musculoskeletal pain. However, after allowance for these risk factors, an up-to 8-fold difference in prevalence remained. Systems of compensation for work-related illness and financial support for health-related incapacity for work appeared to have little influence on the occurrence of symptoms. Our findings indicate large international variation in the prevalence of disabling forearm and back pain among occupational groups carrying out similar tasks, which is only partially explained by the personal and socioeconomic risk factors that were analysed.

SUBMITTER: Coggon D

PROVIDER: S-EPMC3675684 | biostudies-literature | 2013 Jun

REPOSITORIES: biostudies-literature

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Disabling musculoskeletal pain in working populations: is it the job, the person, or the culture?

Coggon David D Ntani Georgia G Palmer Keith T KT Felli Vanda E VE Harari Raul R Barrero Lope H LH Felknor Sarah A SA Gimeno David D Cattrell Anna A Serra Consol C Bonzini Matteo M Solidaki Eleni E Merisalu Eda E Habib Rima R RR Sadeghian Farideh F Masood Kadir M M Warnakulasuriya Sudath S P SS Matsudaira Ko K Nyantumbu Busisiwe B Sim Malcolm R MR Harcombe Helen H Cox Ken K Marziale Maria H MH Sarquis Leila M LM Harari Florencia F Freire Rocio R Harari Natalia N Monroy Magda V MV Quintana Leonardo A LA Rojas Marianela M Salazar Vega Eduardo J EJ Harris E Clare EC Vargas-Prada Sergio S Martinez J Miguel JM Delclos George G Benavides Fernando G FG Carugno Michele M Ferrario Marco M MM Pesatori Angela C AC Chatzi Leda L Bitsios Panos P Kogevinas Manolis M Oha Kristel K Sirk Tuuli T Sadeghian Ali A Peiris-John Roshini J RJ Sathiakumar Nalini N Wickremasinghe A Rajitha AR Yoshimura Noriko N Kelsall Helen L HL Hoe Victor C W VC Urquhart Donna M DM Derrett Sarah S McBride David D Herbison Peter P Gray Andrew A

Pain 20130601 6

To compare the prevalence of disabling low back pain (DLBP) and disabling wrist/hand pain (DWHP) among groups of workers carrying out similar physical activities in different cultural environments, and to explore explanations for observed differences, we conducted a cross-sectional survey in 18 countries. Standardised questionnaires were used to ascertain pain that interfered with everyday activities and exposure to possible risk factors in 12,426 participants from 47 occupational groups (mostly ...[more]

PMID: 23688828

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Project description:BackgroundBurnout is common in professions such as medicine in which employees have frequent and often stressful interpersonal interactions where empathy and emotional control are important. Burnout can lead to decreased effectiveness at work, negative health outcomes, and less job satisfaction. A relationship between burnout and job satisfaction is established for several types of physicians but is less studied among surgeons who treat musculoskeletal conditions.Questions/purposesWe asked: (1) For surgeons treating musculoskeletal conditions, what risk factors are associated with worse job dissatisfaction? (2) What risk factors are associated with burnout symptoms?MethodsTwo hundred ten (52% of all active members of the Science of Variation Group [SOVG]) surgeons who treat musculoskeletal conditions (94% orthopaedic surgeons and 6% trauma surgeons; in Europe, general trauma surgeons do most of the fracture surgery) completed the Global Job Satisfaction instrument, Shirom-Malamed Burnout Measure, and provided practice and surgeon characteristics. Most surgeons were male (193 surgeons, 92%) and most were academically employed (186 surgeons, 89%). Factors independently associated with job satisfaction and burnout were identified with multivariable analysis.ResultsGreater symptoms of burnout (?, -7.13; standard error [SE], 0.75; 95% CI, -8.60 to -5.66; p < 0.001; adjusted R(2), 0.33) was the only factor independently associated with lower job satisfaction. Having children (?, -0.45; SE, 0.0.21; 95% CI, -0.85 to -0.043; p = 0.030; adjusted R(2), 0.046) was the only factor independently associated with fewer symptoms of burnout.ConclusionsAmong an active research group of largely academic surgeons treating musculoskeletal conditions, most are satisfied with their job. Efforts to limit burnout and job satisfaction by optimizing engagement in and deriving meaning from the work are effective in other settings and merit attention among surgeons.Level of evidenceLevel II, prognostic study.

Project description:Resistance to change and organizational culture are essential factors to consider in change management in health care settings. Implementation of structural change remains a challenge. There is a lack of studies providing information on the impact of implementation processes on the organization. The aim of this study was to describe the impact of implementing a systematic change process concerning postoperative person-centred pain management on resistance to change and organizational culture in an orthopaedic spine surgery unit. The study was set in an orthopaedic spine surgery unit at a university hospital. Person-centred bundles of care for postoperative pain management of spine surgery patients were developed in co-creation by a multi-professional expert group and implemented throughout the care pathway. The intervention was underpinned by theories on organizational culture and inspired by principles of person-centred care. Quantitative data were collected using the Resistance to Change Scale and the Organizational Culture Assessment Instrument and analysed using descriptive statistics. The findings showed a low resistance to change decreasing during the study. The organizational culture shifted from a result-oriented to a formalized and structured culture after the implementation. The culture preferred by the staff was team-oriented and participation-focused throughout the study. The discrepancy between the current and preferred cultures remained extensive over time. It is challenging to describe the influence of the development and implementation of a postoperative pain management program on organizational culture as well as in terms of resistance to change, in a complex health care setting. In the current study the unit was under organizational strain during the implementation. Albeit, the important discrepancy between the current and preferred organizational culture could imply that structural changes aren't enough when implementing person-centred pain management structures and needs to be combined with relational aspects of change.

Dataset Information

Disabling musculoskeletal pain in working populations: is it the job, the person, or the culture?

Publications

Disabling musculoskeletal pain in working populations: is it the job, the person, or the culture?

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