Prevalence of and Factors Associated with Work-Related Musculoskeletal Symptoms in Nursing Assistants Working in Nursing Homes
Abstract
:1. Introduction
2. Methods
2.1. Design and Sampling
2.2. Data Collection Procedure
2.3. Measures
2.3.1. Demographic Data
2.3.2. Self-Reported Musculoskeletal Symptoms
2.3.3. Perceived Physical Exertion (PE)
2.3.4. Workstyle
2.3.5. Ergonomic and Manual Handling Knowledge
2.3.6. Perceived Ergonomic Exposures (EEs)
2.3.7. Job Content Questionnaire (JCQ)
2.3.8. Other Work-Related Factors
2.4. Data Analysis
3. Results
3.1. Characteristics of the NAs
3.2. Prevalence of WRMSs
3.3. Factors Associated with WRMSs by Bivariate Analysis
3.4. Predictors of WRMSs by Multivariable Logistic Regression Analysis
4. Discussion
5. Conclusions
Acknowledgements
Author Contributions
Conflicts of Interest
Funding
Appendix A
Categorical Variables | With WRMSs | Without WRMSs | |||
Personal Characteristics | Number (%) | Number (%) | p-Value | ||
Marital Status | n = 388 | n = 51 | 0.09 (χ2 4.81; df 2) (Phi 0.11) | ||
Single | 28 (7.2%) | 8 (15.7%) | |||
Married | 312 (80.4%) | 39 (76.5%) | |||
Divorced/widow/others | 48 (12.4%) | 4 (7.8%) | |||
Education Level | n = 385 | n = 49 | 0.49 (χ2 0.48; df 1) (Phi −0.03) | ||
Primary school | 129 (33.5%) | 14 (28.6%) | |||
Secondary school or above | 256 (66.5%) | 35 (71.4%) | |||
Exercise for 20 min | n = 387 | n = 51 | 0.72 (χ2 1.35; df 3) (Phi 0.04) | ||
Never | 121 (31.3%) | 20 (39.2%) | |||
Not often | 89 (23.0%) | 11 (21.6%) | |||
Sometimes | 97 (25.1%) | 11 (21.6%) | |||
Always | 80 (20.7%) | 9 (17.6%) | |||
Daily Stretching Exercise | n = 389 | n = 51 | 0.94 (χ2 0.006; df 1) (Phi 0.06) | ||
Yes | 231 (59.4%) | 30 (58.8%) | |||
No | 158 (40.6%) | 21 (41.2%) | |||
Daily Muscle Strengthening Exercise | n = 387 | n = 51 | 0.71 (χ2 0.14; df 1) (Phi −0.02) | ||
Yes | 39 (10.1%) | 6 (11.8%) | |||
No | 348 (89.9%) | 45 (88.2%) | |||
Smoking Habits | n = 388 | n = 51 | 0.70 (χ2 0.15; df 1) (Phi −0.02) | ||
Yes | 5 (1.3%) | 1 (2.0%) | |||
No | 383 (98.7%) | 50 (98.0%) | |||
History of Surgery | n = 389 | n = 51 | 0.07 (χ2 3.41; df 1) (Phi 0.09) | ||
Yes | 159 (40.9%) | 14 (27.5%) | |||
No | 230 (59.1%) | 37 (72.5%) | |||
Work Characteristics | |||||
Job Title | n = 389 | n = 51 | 0.40 (χ2 0.72; df 1) (Phi 0.04) | ||
Care workers | 352 (90.5%) | 48 (94.1%) | |||
Health workers | 37 (9.5%) | 3 (5.9%) | |||
Job Satisfaction | n = 386 | n = 51 | 0.37 (χ2 0.79; df 1) (Phi 0.04) | ||
Very satisfactory/satisfactory | 368 (95.3%) | 50 (98.0%) | |||
Very unsatisfactory/unsatisfactory | 18 (4.7%) | 1 (2.0%) | |||
Work Overtime | n = 388 | n = 51 | 0.30 (χ2 1.06; df 1) (Phi 0.05) | ||
Yes | 102 (26.3%) | 10 (19.6%) | |||
No | 286 (73.7%) | 41 (80.4%) | |||
Lifting/Transferring Training | n = 388 | n = 51 | 0.66 (χ2 0.20; df 1) (Phi −0.02) | ||
Yes | 350 (90.2%) | 47 (92.2%) | |||
No | 38 (9.8%) | 4 (7.8%) | |||
Expected to Work Next 2 years | n = 379 | n = 50 | 0.06 (χ2 2.88; df 1) (Phi −0.08) | ||
Surely yes | 276 (72.8%) | 42 (84.0%) | |||
No/not sure | 103 (27.2%) | 8 (16.0%) | |||
Continuous Variables | Mean | SD | t-Test (df) | p-Value | |
Personal Characteristics | |||||
BMI | With WRMSs (n = 388) Without WRMSs (n = 51) | 24.59 25.30 | 3.29 4.40 | 1.11 (57.56) | 0.27 |
Waist to Hip Ratio | With WRMSs (n = 389) Without WRMSs (n = 51) | 0.87 0.87 | 0.06 0.07 | −0.01 (59.87) | 0.99 |
Ergonomic and Manual Handling Knowledge | With WRMSs (n = 387) Without WRMSs (n = 51) | 76.04 73.20 | 8.84 12.31 | −1.60 (56.99) | 0.12 |
Work Characteristic | |||||
Years of Work Experience | With WRMSs (n = 389) Without WRMSs (n = 51) | 10.47 9.78 | 6.29 7.20 | −0.73 (438) | 0.47 |
Physical Exertion (PE) | With WRMSs (n = 382) Without WRMSs (n = 46) | 5.21 4.54 | 2.21 2.36 | −1.92 (426) | 0.06 |
Work Ability | With WRMSs (n = 387) Without WRMSs (n = 51) | 7.80 7.61 | 1.42 1.81 | −0.74 (58.38) | 0.46 |
JCQ—Decision Authority | With WRMSs (n = 387) Without WRMSs (n = 51) | 4.31 4.33 | 1.26 1.16 | 0.13 (436) | 0.90 |
JCQ—Skill Discretion | With WRMSs (n = 387) Without WRMSs (n = 51) | 10.64 10.86 | 2.22 2.18 | 0.68 (426) | 0.49 |
JCQ—Psychological Job Demand | With WRMSs (n = 387) Without WRMSs (n = 51) | 13.29 12.82 | 2.72 2.69 | −1.17 (436) | 0.24 |
JCQ—Physical Job Demand | With WRMSs (n = 387) Without WRMSs (n = 51) | 7.77 7.41 | 2.58 2.32 | −0.95 (436) | 0.34 |
JCQ—Supervisor Support | With WRMSs (n = 387) Without WRMSs (n = 51) | 7.32 7.47 | 1.64 1.50 | 0.62 (436) | 0.54 |
JCQ—Resident Support | With WRMSs (n = 387) Without WRMSs (n = 51) | 7.48 7.73 | 1.63 1.51 | 1.02 (436) | 0.31 |
Workstyle Characteristics | |||||
Self-Imposed Workpace/Workload | With WRMSs (n = 388) Without WRMSs (n = 51) | 3.78 3.25 | 2.73 2.61 | −1.29 (437) | 0.20 |
Breaks | With WRMSs (n = 388) Without WRMSs (n = 51) | 1.55 1.49 | 1.62 1.69 | −0.26 (437) | 0.79 |
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Characteristics | Number (%) |
---|---|
Gender | N = 440 |
Female | 431 (98.0%) |
Male | 9 (2.0%) |
Marital Status | N = 440 |
Single | 36 (8.2%) |
Married | 351 (79.8%) |
Divorced | 22 (5.0%) |
Widow | 29 (6.6%) |
Others | 2 (0.5%) |
Education Level | N = 434 |
Primary school | 143 (32.9%) |
Secondary school | 276 (63.6%) |
Post-secondary | 13 (3.0%) |
University | 2 (0.5%) |
Self-rated Health | N = 440 |
Very good | 2 (0.5%) |
Good | 57 (13.0%) |
Fair | 174 (39.5%) |
Not good | 197 (44.8%) |
Very bad | 10 (2.3%) |
Exercise for 20 min (at least 3 times per week) | N = 438 |
Never | 141 (32.2%) |
Not often | 100 (22.8%) |
Sometimes | 108 (24.7%) |
Always | 89 (20.3%) |
Daily Stretching Exercise | N = 440 |
Yes | 261 (59.3%) |
No | 179 (40.7%) |
Daily Muscle Strengthening Exercise | N = 438 |
Yes | 45 (10.3%) |
No | 393 (89.7%) |
Job Title | N = 440 |
Personal care workers | 400 (90.9%) |
Health workers | 40 (9.1%) |
Work Overtime | N = 439 |
Yes | 112 (25.5%) |
No | 327 (74.5%) |
Lifting/Transferring Training | N = 439 |
Yes | 397 (90.4%) |
No | 42 (9.6%) |
Mean ± SD (Range) | |
Age | N = 439 |
51.1 ± 9.6 (19–69) | |
Years of Work Experience | N = 440 |
10.4 ± 6.4 (1–36) | |
Physical Exertion (PE) | N = 428 |
5.14 ± 2.23 (0–10) | |
Body Mass Index (BMI) | N = 440 |
24.7 ± 3.4 (17.1–40.4) |
Body Parts with WRMSs | Number (%) |
---|---|
Neck | 109 (24.8%) |
Shoulders | 233 (53.0%) |
Elbows/Forearms | 121 (27.5%) |
Palms/Wrists | 96 (21.8%) |
Fingers | 113 (25.7%) |
Upper Back | 28 (6.4%) |
Lower Back | 182 (41.4%) |
Hips/Thighs | 51 (11.6%) |
Knees | 165 (37.5%) |
Calves | 78 (17.7%) |
Ankles/Feet | 124 (28.2%) |
At Least One Body Part with WRMSs | 389 (88.4%) |
Categorical Variables | With WRMSs | Without WRMSs | |||
Personal Characteristics | Number (%) | Number (%) | p-Value | ||
Gender | n = 389 | n = 51 | 0.04 (χ2 4.24; df 1) (Phi 0.10) | ||
Female | 383 (98.5%) | 48 (94.1%) | |||
Male | 6 (1.5%) | 3 (5.9%) | |||
Self-Rated Health | n = 389 | n = 51 | 0.001 (χ2 14.87; df 2) (Phi 0.18) | ||
Good/Very good | 44 (11.3%) | 15 (29.4%) | |||
Fair | 153 (39.3%) | 21 (41.2%) | |||
Not good/Very bad | 192 (49.4%) | 15 (29.4%) | |||
Work Characteristics | |||||
Job Stress | n = 387 | n = 51 | <0.0001 (χ2 13.58; df 1) (Phi 0.12) | ||
Very stressful/stressful | 280 (72.4%) | 24 (47.1%) | |||
Not stressful/very not stressful | 107 (27.6%) | 27 (52.9%) | |||
Intention to Leave | n = 386 | n = 51 | 0.013 (χ2 6.18; df 1) (Phi 0.18) | ||
Yes | 144 (37.3%) | 10 (19.6%) | |||
No | 242 (62.7%) | 41 (80.4%) | |||
Continuous Variables | Mean | SD | t-Test (df) | p-Value | |
Personal Characteristics | |||||
Age | With WRMSs (n = 388) Without WRMSs (n = 51) | 51.48 48.55 | 9.36 11.09 | −2.06 (437) | 0.04 |
Physical Characteristics | |||||
Ergonomic Exposures (EE) (contribution to WRMSs) | With WRMSs (n = 387) Without WRMSs (n = 37) | 4.72 3.11 | 2.63 2.72 | −3.55 (422) | <0.0001 |
EE (encounter frequency) | With WRMSs (n = 388) Without WRMSs (n = 37) | 15.01 11.27 | 7.93 8.42 | −2.72 (423) | 0.007 |
Work Characteristics | |||||
JCQ—Coworker Support | With WRMSs (n = 387) Without WRMSs (n = 51) | 10.05 10.61 | 1.58 1.87 | 2.32 (436) | 0.021 |
Workstyle Characteristics | |||||
Workstyle (total) | With WRMSs (n = 388) Without WRMSs (n = 51) | 34.99 21.69 | 17.97 13.92 | −5.09 (437) | <0.0001 |
Working Through Pain | With WRMSs (n = 388) Without WRMSs (n = 51) | 9.77 4.25 | 5.06 3.62 | −7.528 (437) | <0.0001 |
Social Reactivity | With WRMSs (n = 388) Without WRMSs (n = 51) | 4.18 2.51 | 4.81 3.32 | −2.40 (437) | 0.017 |
Workplace Stressors | With WRMSs (n = 388) Without WRMSs (n = 51) | 8.54 5.59 | 6.30 5.16 | −3.20 (437) | 0.001 |
Variables | Crude Odds Ratio (OR) (95% CI) | OR Adjusted for Age and Gender (95% CI) | OR Adjusted for Age, Gender, and EE (95% CI) | OR Adjusted for Age, Gender, EE, and Workstyle (95% CI) |
---|---|---|---|---|
Age | 1.03 (1.00–1.06) * | 1.03 (0.99–1.07) | ||
Male (0) | Reference | |||
Female (1) | 0.25 (006–1.04) | 0.62 (0.06–7.05) | ||
EE-contribution to WRMSs | 1.26 (1.10–1.45) ** | 1.26 (1.10–1.44) ** | 1.14 (0.98–1.32) | |
Workstyle (total) | 1.06 (1.04–1.09) *** | 1.06 (1.04–1.09) *** | 1.05 (1.01–1.08) ** | 1.04 (1.01–1.08) * |
Job Stress | ||||
Not stressful/stressful (1) | Reference | |||
Very stressful/stressful (0) | 2.94 (1.63–5.33) *** | 2.88 (1.58–5.25) ** | 1.89 (0.92–3.86) | 1.48 (0.70–3.09) |
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Cheung, K.; Szeto, G.; Lai, G.K.B.; Ching, S.S.Y. Prevalence of and Factors Associated with Work-Related Musculoskeletal Symptoms in Nursing Assistants Working in Nursing Homes. Int. J. Environ. Res. Public Health 2018, 15, 265. https://doi.org/10.3390/ijerph15020265
Cheung K, Szeto G, Lai GKB, Ching SSY. Prevalence of and Factors Associated with Work-Related Musculoskeletal Symptoms in Nursing Assistants Working in Nursing Homes. International Journal of Environmental Research and Public Health. 2018; 15(2):265. https://doi.org/10.3390/ijerph15020265
Chicago/Turabian StyleCheung, Kin, Grace Szeto, Godfrey Kin Bun Lai, and Shirley S. Y. Ching. 2018. "Prevalence of and Factors Associated with Work-Related Musculoskeletal Symptoms in Nursing Assistants Working in Nursing Homes" International Journal of Environmental Research and Public Health 15, no. 2: 265. https://doi.org/10.3390/ijerph15020265