Abstract
BackgroundUntil now there has been a lack of effective screening instruments for health care workers at risk. To counteract the forecast shortage for health care workers, the offer of early interventions to maintain their work ability will become a central concern. The Nurse-Work Instability Scale (Nurse-WIS) seems to be suitable as a screening instrument and therefore a prospective study of a cohort of nursing staff from nursing homes was undertaken to validate the Nurse-Work Instability Scale (Nurse-WIS).MethodsThe follow-up data was used to test the sensitivity, specificity and the predictive values of the Nurse-WIS. The participants answered a questionnaire in the baseline investigation (T1) and in a follow-up 12 month after baseline. The hypothesis was that geriatric care workers with an increased risk according to the Nurse-WIS in T1 would be more likely to have taken long-term sick leave or drawn a pension for reduced work capacity in T2.Results396 persons took part in T1 (21.3% response), 225 in T2 (42.3% loss-to-follow-up). In T1, 28.4% indicated an increased risk according to the Nurse-WIS. In T2, 10.2% had taken long-term sick leave or had drawn a pension for reduced work capacity. The sensitivity is 73.9% (95%-CI 55.7%–92.3%), the specificity is 76.7% (95%-CI 71.2%–82.8%). The ROC AUC indicated a moderate precision for the scale, at 0.74 (95%-CI 0.64–0.84).The PPV of the Nurse-WIS is 26.6%, and the NPV is 96.3%. For those with an increased risk according to the Nurse-WIS, the probability in T2 of long-term sick leave or a pension for reduced work capacity is around eight times higher (OR 8.3, 95%-CI 2.90–23.07). Persons who had indicated a long-term sick leave or made an application for a pension for reduced work capacity in T1 had a 17 times higher risk (OR 17.4, 95%-CI 3.34–90.55).ConclusionThe German version of the Nurse-WIS appears to be a valid instrument with satisfactory predictive capabilities for recording an impending long-term sick leave. Whether the Nurse-WIS can be used as a screening tool which helps to design risk adjusted prevention programs for the afflicted nurse should be studied.
Highlights
As in other countries, the number of people in need of care is increasingly noticeably in Germany, and in order to ensure that they are provided for, an increase in the demand for health care workers is anticipated – a demand that can hardly be satisfied [1,2].Nursing is among the high-risk occupations as regards work-related back pain, in particular low back problems, with a point prevalence of approximately 17%, an annual prevalence of 40–50% and a lifetime prevalence of 35–80% [3,4,5,6,7,8]
Testing the predictive values The hypothesis is that participants who showed an increased risk according to the Nurse-WIS in T1 will be more likely to take long-term sick leave in the follow-up
At the times of both surveys, the majority of study participants were female, Sensitivity and specificity, likelihood ratios and the receiver operating characteristic curve (ROC) At T1, 28.4% of the 225 individuals who were followed up had an increased risk according to the Nurse-WIS
Summary
Nursing is among the high-risk occupations as regards work-related back pain, in particular low back problems, with a point prevalence of approximately 17%, an annual prevalence of 40–50% and a lifetime prevalence of 35–80% [3,4,5,6,7,8]. Harling et al [17] established that health care workers are more likely to undergo rehabilitation due to musculoskeletal disorders than other occupational groups and that the risk of a pension due to reduced work capacity was higher following rehabilitation. Health care workers were more likely to draw a pension for reduced work capacity than all other occupational groups. Until now there has been a lack of effective screening instruments for health care workers at risk. The Nurse-Work Instability Scale (Nurse-WIS) seems to be suitable as a screening instrument and a prospective study of a cohort of nursing staff from nursing homes was undertaken to validate the Nurse-Work Instability Scale (Nurse-WIS)
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