Abstract
BackgroundHigh prevalence of low back pain (LBP) in nurses has been reported globally. Ergonomic factors and work-related psychosocial factors have been focused on as risk factors. However, evidence on the role of fear-avoidance beliefs (FABs) concerning LBP in nurses is lacking. This study examined LBP prevalence and the association between FABs and chronic disabling LBP that interfered with work and lasted ≥ 3 months.MethodsFemale nurses (N = 3066; mean age = 35.8 ± 10.6 years) from 12 hospitals in Japan participated. A self-reported questionnaire was used to collect information on sociodemographics, LBP, work-related factors, and psychological distress. FABs about physical activity were assessed using a subscale from the FAB Questionnaire (score range = 0–24). The participants were asked to choose one of four statements regarding their LBP in the past 4 weeks: 1) I did not have LBP, 2) I had LBP without work difficulty, 3) I had LBP with work difficulty but without requiring absence from work, and 4) I had LBP requiring absence from work. If the participant had LBP in the past 4 weeks, it was also inquired if the LBP had lasted for ≥ 3 months. Chronic disabling LBP was defined as experiencing LBP with work difficulty in the past 4 weeks which had lasted for ≥ 3 months. In the nurses who had experienced any LBP in the past 4 weeks, we examined the association between FABs and experiencing chronic disabling LBP using multiple logistic regression models adjusting for pain intensity, age, body mass index, smoking status, psychological distress, hospital department, weekly work hours, night shift work, and the12 hospitals where the participants worked.ResultsFour-week and one-year LBP prevalence were 58.7 and 75.9%, respectively. High FABs (≥ 15) were associated with chronic disabling LBP (adjusted odds ratio = 1.76, 95% confidence interval [1.21–2.57], p = 0.003).ConclusionsLBP is common among nurses in Japan. FABs about physical activity might be a potential target for LBP management in nurses.Trial registrationUMIN-CTR UMIN000018087. Registered: June 25, 2015.
Highlights
High prevalence of low back pain (LBP) in nurses has been reported globally
This study found that LBP was common in nurses based on a relatively large sample of female nurses working in 12 hospitals across Japan
Smith and colleagues reported a one-year prevalence of 59%, ranging from 50 to 71% depending on the hospital department; they examined 305 nurses working in a rural Japanese university hospital [3]
Summary
High prevalence of low back pain (LBP) in nurses has been reported globally. Evidence on the role of fearavoidance beliefs (FABs) concerning LBP in nurses is lacking. A high prevalence of LBP among nurses has been reported worldwide. The reported one-year prevalence of LBP is 60–70% [3,4,5,6,7]. In Japan, LBP is the leading occupational ailment that requires sick leave ≥ 4 days, and the number of cases is especially high in the health and hygiene industry [8], including hospitals and nursing facilities. For LBP in nurses, ergonomic factors such as patient handling and other nursing duties have been focused on primarily as risk factors [9]. For LBP prevention, using assistive devices like lifts and sliding boards and manual handling training to reduce the physical load on nurses’ backs have been recommended, there is a lack of strong evidence of their efficacy [10]
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