Abstract
Objective: This study aimed to investigate the association between perceived stress and odds of low-back pain (LBP) in a population of Danish healthcare workers.Methods: Utilizing a prospective cohort design with 1-year follow-up, a total of 1,944 healthcare workers from 389 departments at 19 hospitals responded to questionnaires containing items related to lifestyle, health, and working environment. Using Cohen's Perceived Stress Scale, associations between baseline stress levels and LBP intensity (0–10 scale) at follow-up were modeled using cumulative logistic regression, accounting for clustering at the department level and adjusting for age, sex, baseline intensity of LBP, education, seniority, number of daily patient transfers, psychosocial work environment, and lifestyle factors.Results: For the entire population, moderate and high stress (reference: low stress) at baseline increased the odds of LBP at 1-year follow-up with odds ratios (ORs) of 1.39 (95% CI 1.13–1.71) and 1.99 (95% CI 1.49–2.66), respectively. Sensitivity analyses among female nurses showed similar results [i.e., OR 1.40 (95% CI 1.08–1.80) and OR 2.08 (95% CI 1.44–3.00) for moderate and high stress, respectively], while only high stress significantly increased the odds among those without LBP at baseline.Conclusions: Psychological stress increases the odds of LBP among healthcare workers. Identifying and diminishing work-related psychosocial stressors should be included in strategies that aim to prevent musculoskeletal disorders in this population.
Highlights
The physiological phenomenon known as “stress” is—in animals and humans alike—most often characterized as the result of real or perceived threat to the organism, typically as a reaction to various external exposures [1]
It is likely that certain job groups within the realm of healthcare are exposed to more work-related stressors than others: For example, a recent study among healthcare workers showed that nurses in primary care experience higher levels of perceived stress and lower levels of subjective well-being compared with their colleagues [23], indicating that this subgroup of the working population may exhibit an increased risk of negative health outcomes due to work-related stress
Among healthcare workers who were pain-free at baseline, we report low-back pain (LBP) intensities of 0.65 (SD 1.57), 0.74 (SD 1.42), and 1.52 (SD 2.06) at 1-year follow-up for the low, moderate, and highstress groups, respectively
Summary
The physiological phenomenon known as “stress” is—in animals and humans alike—most often characterized as the result of real or perceived threat to the organism, typically as a reaction to various external exposures [1]. It is likely that certain job groups within the realm of healthcare are exposed to more work-related stressors than others: For example, a recent study among healthcare workers showed that nurses in primary care experience higher levels of perceived stress and lower levels of subjective well-being compared with their colleagues [23], indicating that this subgroup of the working population may exhibit an increased risk of negative health outcomes due to work-related stress. This notion needs to be considered in relation to the myriad of work-related factors known to influence pain among healthcare workers [24, 25], among which indicators of stress (e.g., emotional exhaustion, high emotional demands, and poor psychosocial safety climate) are known to significantly amplify the risk of musculoskeletal pain [24, 26]
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