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Association between perceived inadequate staffing and musculoskeletal pain among hospital patient care workers

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Abstract

Objective

To examine association between perceived inadequate staffing and musculoskeletal pain and to evaluate the role of work-related psychosocial and physical work factors in the association among hospital patient care workers.

Methods

A cross-sectional study was conducted among 1,572 patient care workers in two academic hospitals. Perceived inadequate staffing was measured using the “staffing adequacy subscale” of Nursing Work Index, which is a continuous scale that averages estimates of staffing adequacy by workers in the same units. Musculoskeletal pain (i.e., neck/shoulder, arm, low back, lower extremity, any musculoskeletal pain, and the number of area in pain) in the past 3 months was assessed using a self-reported Nordic questionnaire. Multilevel logistic regression was applied to examine associations between perceived inadequate staffing and musculoskeletal pain, considering clustering among the workers in the same units.

Results

We found significant associations of perceived inadequate staffing with back pain (OR 1.50, 95 % CI 1.06, 2.14) and the number of body area in pain (OR 1.42, 95 % CI 1.01, 2.00) after adjusting for confounders including work characteristics (job title, having a second job or not, day shift or not, and worked hours per week). When we additionally adjusted for physical work factors (i.e., use of a lifting device, and the amount of the time for each of five physical activities on the job), only the association between perceived inadequate staffing and back pain remained significant (OR 1.50, 95 % CI 1.03, 2.19), whereas none of the associations was significant for all of musculoskeletal pains including back pain (OR 0.96, 95 % CI 0.66, 1.41) when we additionally adjusted for work-related psychosocial factors (i.e., job demands, job control, supervisor support, and co-worker support) instead of physical work factors.

Conclusions

Perceived inadequate staffing may be associated with higher prevalence of back pain, and work-related psychosocial factor may play an important role in the potential pathway linking staffing level to back pain among hospital workers.

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Acknowledgments

This work was supported by a grant from the National Institute for Occupational Safety and Health (U19 OH008861) for the Harvard School of Public Health Center for Work, Health and Wellbeing. This study would not have been accomplished without the participation of Partners HealthCare System and leadership from Dennis Colling, Sree Chaguturu, and Kurt Westerman. The authors would like to thank Partners Occupational Health Services including Marlene Freeley for her guidance, as well as Elizabeth Taylor, Elizabeth Tucker O’Day, and Terry Orechia. We also thank individuals at each of the hospitals including Jeanette Ives Erickson and Jacqueline Somerville in Patient Care Services leadership, and Jeff Davis and Julie Celano in Human Resources. Additionally, we wish to thank Charlene Feilteau, Mimi O’Connor, Margaret Shaw, Eddie Tan and Shari Weingarten for assistance with supporting databases. We also thank Chris Kenwood of NERI for his statistical and programming support, Evan McEwing, Project Director, and Linnea Benson-Whelan for her assistance with the production of this manuscript. Our thanks also go to Anne M. Stoddard for her comments about data analyses.

Conflict of interest

Dr. Hashimoto is employed by Partners HealthCare System, and the two studied hospitals are Partners hospitals. There is no other possible conflict of interests to report.

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Authors and Affiliations

  1. Department of Healthcare Management, Korea University, Seoul, Republic of Korea

    Seung-Sup Kim

  2. Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA, USA

    Cassandra A. Okechukwu & Glorian Sorensen

  3. Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA

    Jack T. Dennerlein & Dean M. Hashimoto

  4. Department of Physical Therapy, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA

    Jack T. Dennerlein

  5. Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA

    Leslie I. Boden

  6. College of Nursing, University of Illinois at Chicago, Chicago, IL, USA

    Karen Hopcia

  7. Occupational Health Services, Partners HealthCare System, Boston, MA, USA

    Dean M. Hashimoto

  8. Dana-Farber Cancer Institute, Center for Community-Based Research, Boston, MA, USA

    Glorian Sorensen

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  1. Seung-Sup Kim
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  2. Cassandra A. Okechukwu
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  3. Jack T. Dennerlein
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  4. Leslie I. Boden
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  7. Glorian Sorensen
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Correspondence to Seung-Sup Kim.

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Kim, SS., Okechukwu, C.A., Dennerlein, J.T. et al. Association between perceived inadequate staffing and musculoskeletal pain among hospital patient care workers. Int Arch Occup Environ Health 87, 323–330 (2014). https://doi.org/10.1007/s00420-013-0864-y

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  • DOI: https://doi.org/10.1007/s00420-013-0864-y

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