Abstract
BackgroundThe Nurse Work Instability Scale (Nurse-WIS) is an occupation-specific instrument that ascertains “work instability,” the interval before restricted work ability or prolonged sick leave occurs. The objective of the study was to assess if nurses with a high risk baseline-score in the Nurse-WIS take longer periods of sick leave due to musculoskeletal diseases and/or psychological impairments than other nurses.MethodsA total of 4500 nurses randomly selected from one of the largest health insurance funds in Germany (DAK-Gesundheit) were invited by letter to participate in the study. The participants answered a questionnaire at baseline and gave consent to a transfer of data concerning sick leave during the twelve months following completion of the questionnaire from the health insurance to the study centre. Sensitivity, specificity and positive and negative predictive values (PPV and NPV) for long-term sick leave were calculated. In order to analyze the association between the Nurse-WIS and sick leave during follow-up, a multiple ordinal logistic model (proportional odds model) was applied.ResultsA total of 1592 nurses took part in the study (response 35.6%). No loss of follow-up occurred. The number of nurses with a high score (20–28 points) in the Nurse-WIS was 628 (39.4%), and 639 (40.1%) had taken sick leave due to musculoskeletal diseases or psychological impairment during the follow-up period. The odds ratio for sick leave in nurses with a high Nurse-WIS score was 3.42 (95%CI 2.54–4.60). Sensitivity for long-term sick leave (< 42 days) was 64.1%, specificity 63.4%, PPV 17.0% and NPP 93.8%.ConclusionThe German version of the Nurse-WIS predicts long-term sick leave, but the PPV is rather low. Combining questionnaire data with secondary data from a health insurer was feasible. Therefore further studies employing this combination of data are advisable.
Highlights
The Nurse Work Instability Scale (Nurse-WIS) is an occupation-specific instrument that ascertains “work instability,” the interval before restricted work ability or prolonged sick leave occurs
The Nurse-WIS was complemented by an entry criterion so that the scale is mainly used for nurses who exhibit the first signs of musculoskeletal disease but have not yet sought medical help
Even though the odds ratio for sick leave increased with a Nurse-WIS > 10 points, the sensitivity and specificity of the Nurse-WIS with regard to long-term sick leave during follow-up were rather modest, which is reflected in a low Positive predictive value (PPV)
Summary
The Nurse Work Instability Scale (Nurse-WIS) is an occupation-specific instrument that ascertains “work instability,” the interval before restricted work ability or prolonged sick leave occurs. Work instability is the interval before restricted work ability when the subject has increasing difficulty in performing his or her duties at work, and can be ascertained with this occupation-specific instrument for nurses. Interventions during this interval can prevent impending loss of work ability. A cohort of nurses aged 40+ was selected, as long-term sick leave occurs more frequently with increasing age [15]
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