Psychosocial Risk Factors Research Articles

Social determinants of health and language outcomes in preterm infants with public and private insurance.

To evaluate associations of maternal social determinants of health (SDOH) with language outcomes of preterm infants with public and private insurance. Single center study of 375 neonates born ≤ 28 weeks. Perinatal characteristics were collected, and the Bayley III was administered at 18-24 months. Primary outcome was language scores of <85. Bivariate and multivariable analyses were used to compare groups. Mothers with public insurance had higher rates of psychosocial risk factors. In regression analysis, People of Color (aOR 2.4, 1.47-4.04), non-English speaking household (aOR 4.05, 1.47-11.15) and public insurance (aOR 2.03, 1.18-3.49) significantly increased the odds of having a language composite score of <85, whereas breast milk (aOR 0.47, 0.28-0.79) was protective. Preterm infants with public insurance are at increased risk of exposure to multiple SDOH which are independently associated with language delay at 18-24 months.

Evaluation of psychosocial risks affecting academician using the sine trigonometric pythagorean fuzzy (ST-PFN) DEMATEL method.

In the realm of academia, psychosocial risk factors play a pivotal role, exerting considerable influence on the well-being and performance of scholars. Factors such as excessive workloads, unrelenting performance expectations, time constraints, and competitive atmospheres can detrimentally affect their health and overall quality of life. Moreover, issues like social isolation, work-life imbalance, and academic anxiety further compound these challenges, impeding academic progress and success. Thus, it is imperative to identify, mitigate, and manage psychosocial risk factors effectively to foster a conducive academic environment conducive to productivity and achievement. This study employs a novel approach, integrating expert opinions and utilizing sine trigonometry Pythagorean fuzzy numbers to ascertain the degrees of importance and rank psychosocial risk factors through the DEMATEL method. This methodology presents a unique contribution to existing literature, offering fresh insights into this critical area of study. Evaluation of 25 factors reveals burnout, job dissatisfaction, precarious working conditions, lack of trust, unfair treatment, job insecurity, and limited developmental opportunities as primary concerns, underscoring the multifaceted nature of these challenges. In the occupational sphere, active participation from all stakeholders in addressing psychosocial risks is paramount for effective problem resolution. It is incumbent upon parties involved to discharge their duties, foster collaboration, enhance working conditions, ensure equity, and facilitate avenues for professional growth. Each identified risk factor addressed and preempted translates into a tangible reduction in workplace accidents and occupational ailments, underscoring the tangible benefits of proactive risk management.

Occupational Health, Psychosocial Risks and Prevention Factors in Lesbian, Gay, Bisexual, Trans, Queer, Intersex, Asexual, and Other Populations: A Narrative Review

Despite advances in legislation and social attitudes, workplace discrimination against sexual and gender minority populations remains prevalent, posing significant psychosocial risks. This study aims to explore the occupational health challenges faced by LGBTQIA+ populations, examining factors of discrimination, support, and prevention strategies. Methods: A narrative review of articles from the Scopus, PubMed, and Web of Science databases was carried out, focusing on studies published between 2011 and 2024. Articles in English, Spanish, and Portuguese were considered. Results: 359 studies were identified, and 11 articles were selected for analysis. The findings reveal pervasive discrimination experienced by LGBTQIA+ workers in the workplace, impacting their mental health and job satisfaction. Factors influencing disclosure of sexual or gender identity at work were identified, including workplace characteristics and anti-discrimination policies. Conclusions: Promoting inclusive and supportive work environments is crucial to the well-being of LGBTQIA+ employees. Recommendations include strengthening anti-discrimination protections, improving education and training on LGBTQIA+ issues, and promoting explicit communication about support and equality. Despite progress, more research is needed to address gaps in understanding and effectively promote the occupational health of sexual and gender minority populations.

Adherence to low back pain clinical guidelines in Australian hospital emergency departments: a public and private comparison

Managing LBP via clinical practice guidelines in healthcare settings is recommended, yet burgeoning evidence suggests adherence is suboptimal in emergency department settings. Whether adherence differs between public and private settings is unknown. A retrospective audit of two Australian emergency departments matched 86 private patients to 86 public patients by age (±5 years), sex (male/female) and LBP duration (first time/history of LBP). Patient charts were reviewed according to the Australian clinical guidelines for the management of LBP. Guidelines were considered individually and via a collective guideline adherence score (GAS). Management GAS was lower in private patients compared to public patients (d [95%CI]: -0.67 [-0.98, -0.36], P<0.001). Public patients were more likely to have documentation of guideline-based advice (OR [95%CI]: 4.4 [2.4, 8.4], P<0.001) and less likely to be sent for imaging (OR [95%CI]: 5.0 [2.6, 9.4], P<0.001). Private patients were more likely to have documented screening for psychosocial risk factors (OR [95%CI]: 21.8 [9.1, 52.1], P<0.001) and more likely to receive guideline-based medication prescriptions at patient discharge (OR [95%CI]: 2.2 [1.2, 4.2], P=0.013). Differences exist in public and private hospital emergency department guideline adherence. Exploring barriers and facilitators underpinning these differences will assist in guiding future implementation science approaches.

Prevalence and Risk Factors of Work-Related, Non-Specific Low Back Pain Among Physiotherapists in Ahmedabad City

Introduction: Low back pain (LBP) is the major public health problem across the world. Physiotherapy professionals are more prone to work related LBP because they are linked to major physical efforts such as transfers and patient handling manoeuvres, uncomfortable or prolonged working positions, trunk flexion and rotation movements and reactions to a fall or unexpected movement by the patient. LBP is a multifactorial condition. Various factors like, personal, biomechanical, psychosocial and organisational are associated with work related LBP among physiotherapists. Methodology: A link to an online self-questionnaire was sent to physiotherapists working in Ahmedabad city since last 12 months. The various patterns of practice were compared with regard to the prevalence of LBP, the total number of days with LBP during last 12 months, and the degree of exposure to organisational, biomechanical and psychosocial risk factors. Results: The result was carried out by using Microsoft excel. Results showed that there is 95% prevalence of work-related low back pain among physiotherapists specifically, those working since last 12 months. The mean score of NPRS was 7. Conclusion: There is significant prevalence of work-related low back pain among physiotherapists in Ahmedabad city. Keywords: physiotherapists, work-related, low back pain, Ahmedabad city

The social status adversity and health in daily life moments study: ecological momentary assessment and ambulatory health assessments to examine meaning and mechanisms

BackgroundAfrican Americans and those of lower socioeconomic status (SES) are at disproportionate risk for hypertension- and cardiovascular-disease-related mortality relative to their counterparts. Progress in reducing these disparities is slowed by the facts that these disparities are difficult to mitigate in older adults and early origins of these disparities are poorly understood. The Social Status Adversity and Health in Daily Life Moments Study aims to precisely understand the proximal cognitive-emotional mechanisms by which unique social exposures disproportionately impacting these populations influence blood pressure (BP) parameters early in the lifespan and determine which individuals are more at risk.MethodsThe study uses ecological momentary assessment (EMA) and ambulatory blood pressure (ABP) monitoring to assess race- and SES-based factors as they manifest in daily life moments alongside simultaneously manifesting cognitive-emotional states and ABP. A sample of 270 healthy African Americans between the ages of 18 and 30 is being recruited to complete two periods of 2-day, 2-night hourly ABP monitoring alongside hourly EMA assessments of socioeconomic strain, unfair treatment, and neighborhood strain during the waking hours. ABP data will be used to calculate ecologically valid measures of BP reactivity, variability, and nocturnal dipping. Other measures include actigraphy equipment worn during the monitoring period and comprehensive assessment of behavioral and psychosocial risk and resilience factors. Multilevel and multiple linear regression analyses will examine which momentary social adversity exposures and cognitive-emotional reactions to these exposures are associated with worse BP parameters and for whom.DiscussionThis is the first time that this research question is approached in this manner. The Social Status Adversity and Health in Daily Life Moments Study will identify the cognitive-emotional mechanisms by which the most impactful race- and SES-based exposures influence multiple BP parameters in African American emerging adults. Further, it will identify those most at risk for the health impacts of these exposures. Achievement of these aims will shape the field’s ability to develop novel interventions targeting reduction of these exposures and modification of reactions to these exposures as well as attend to those subpopulations most needing intervention within the African American emerging adult population.

Atherosclerotic Cardiovascular Disease Novel and Traditional Risk Factors in Middle Eastern Young Women. The ANCORS-YW Study.

There is paucity of data on the prevalence of novel and traditional cardiovascular risk factors in young women with atherosclerotic cardiovascular disease (ASCVD) in the Middle East. We sought to evaluate clinical profiles and prevalence of novel and traditional risk factors in Middle Eastern young women with ASCVD compared with age-matched controls. Women 18-50 years of age who have ASCVD were enrolled and each was aged-matched with two women with no ASCVD. Prevalence of novel and traditional risk factors was compared in the two groups. Multivariable analyzes examined the independent association of 16 factors with ASCVD. Of 627 young women enrolled mean age 44.1 ± 5.2 years; 209 had ASCVD and 418 served as controls. Women with ASCVD had significantly higher prevalence of five of the studied traditional risk factors (hypertension, type 2 diabetes [T2D], smoking, low-density lipoprotein cholesterol serum levels, and family history of premature ASCVD [FHx]) than women with no ASCVD. Additionally, of the 11 novel and psychosocial risk factors studied, four showed significantly higher prevalence in young women with ASCVD (preterm delivery, hypertensive disease of pregnancy gestational diabetes, and low level of education). Multivariable analyzes showed hypertension, T2D, smoking, FHx, persistent weight gain after pregnancy and low level of education were independently associated with ASCVD. In this study of young Middle Eastern women; traditional risk factors as well as persistent weight gain after pregnancy were more prevalent in women with ASCVD compared with controls.The study is registered with ClinicalTrials.gov, unique identifier number NCT04975503.

Psychosocial Risks and Adolescent Mental Health: The Moderating Role of Objective Neighborhood Characteristics

PurposeAlthough previous studies have examined the association between youth psychosocial risks and their perceptions of their neighborhood, it is unclear how objective neighborhood characteristics are associated with psychosocial risks and mental health symptoms among adolescents. We investigated how neighborhood characteristics moderate the relationship between youth psychosocial characteristics and mental health symptoms. MethodsThis cross-sectional study examined 13,837 emergency department visits by 14–18-year-olds who completed a standardized Behavioral Health Screening in a tertiary pediatric hospital in Philadelphia from 2013 to 2020. Psychosocial risk factors and mental health symptoms were assessed based on self-reported survey responses. We characterized neighborhoods as low-, moderate-, and high-stress based on gun violence incidence from 2013 to 2020 and the census tract–level Child Opportunity Index. Mixed effects logistic regression and Poisson models were used to examine moderation effects. ResultsThe 9,814 included patients were 64% female and 64% non-Hispanic Black. The following psychosocial risk factors were associated with two to eight times higher odds of depressive symptoms and suicide risk: exposure to trauma, bullying at school, at-risk substance use, fighting, and retaliation. Adolescents living in high-stress neighborhoods were twice as likely to report fighting and retaliation and reported more psychosocial risk factors than those in low-stress neighborhoods. Odds of mental health symptoms increased with the number of psychosocial risk factors, particularly in youth from low-stress neighborhoods. DiscussionObjective neighborhood characteristics had a significant interaction effect on the relationship between psychosocial risks and depression and suicide risk among adolescents seeking care in a pediatric emergency department.

INTEGRATE-ADHD: Comparison and Integration of Administrative and Epidemiological ADHD Diagnosis Data through Clinical Assessment - Presentation of the Project

As one of the most frequently diagnosed mental disorders in children and adolescents with sometimes serious individual, family and social consequences, attention deficit/hyperactivity disorder (ADHD) is highly relevant to society and health policy. In Germany, data from statutory health insurance companies has reported increasing ADHD diagnosis prevalence rates over years, while epidemiological data has shown constant and recently even decreasing prevalence rates. The clinical validity of diagnoses from either data sources is unknown. In the framework of the consortium project INTEGRATE-ADHD, 5461 parents of children aged 0 to 17 years with a confirmed administrative ADHD diagnosis insured with the third-largest German statutory health insurance provider (DAK-Gesundheit) in at least one quarter of 2020 were surveyed with the questionnaires from the epidemiological German Health Interview and Examination Survey (KiGGS study) and its in-depth module on child mental health (BELLA study) on their child's ADHD diagnosis and symptoms and on other topics, including comorbidity, utilisation of healthcare services, quality of care and satisfaction, psychosocial risk and protective factors and health-related quality of life. In addition, a subsample of 202 children and adolescents with a clinical diagnosis based on the AMWF S3 guideline on ADHD was analysed. An important aim of the project is to use data linkage on person-level to identify possible causes for the often divergent prevalence estimates from epidemiological and administrative data and to integrate and validate the data sources using a guideline-based clinical diagnosis, thereby contributing to a more accurate population-based prevalence estimate of ADHD in children and adolescents and clarifying actual or supposed contradictions between the data sources. The INTEGRATE-ADHD data linkage project combines administrative, epidemiological and clinical ADHD diagnosis data to create a "three-dimensional view" of the ADHD diagnosis. The results will be used to identify fields of action for healthcare policy and self-administration in the German healthcare system and to derive recommendations for the actors and stakeholders in the field of ADHD. The first results will be published in 2024.

Vietnamese Insights into Cognitive Aging Program (VIP): Objectives, study design, and cohort description.

There is a dearth of research on cognitive aging and dementia in Asian Americans, particularly in Vietnamese Americans, the fourth largest Asian subgroup in the United States. The Vietnamese Insights into Cognitive Aging Program (VIP) investigates early life adversity and war-related trauma and their associations with cognitive health in a community-based sample of older Vietnamese Americans in Northern California (i.e., Sacramento and Santa Clara counties). Baseline measurements include a comprehensive neuropsychological battery, including measures of global cognition along with executive function, semantic memory, and episodic memory. Data also include measures of functioning, early life adversity and trauma exposure, and psychosocial and traditional cardiovascular disease risk factors. Cognitive assessments will be repeated twice over the course of the data collection period, approximately 12- and 24- months post-baseline. Blood samples collected during Wave 2 will be assayed for biochemical risk factors. Baseline assessments were conducted from January 2022 to November 2023, with N=548 Vietnamese Americans; mean age ± SD was 73 ± 5.31 years and 55% of participants were women. There were significant differences in social factors by site, with Santa Clara participants having higher education (some college or higher: Sacramento, ≈25%; Santa Clara: ≈48%) and marginally higher incomes compared to Sacramento participants. A higher percentage of Santa Clara participants reported speaking English well or very well (24%) compared to Sacramento participants (13%), although the majority of the entire sample (81%) reported speaking some to no English (response options: not at all; some/a little bit; well/very well). This longitudinal study providea a unique opportunity to more fully delineate psychosocial factors that contribute to dementia disparities in diverse and under-engaged populations. Future work will examine cognition, the prevalence of mild cognitive impairment and dementia, and other health outcomes, while controlling for site differences in all analyses. Vietnamese Insights into Cognitive Aging Program (VIP) is a new study.VIP has detailed early life and health data on 548 older Vietnamese Americans.History of war and trauma may contribute to Alzheimer's disease and related dementias (ADRD)-related burden.VIP may provide insight into ADRD burden in other understudied groups.

Nivel de riesgo psicosocial en carga de trabajo y tipo de contrato en trabajadores de H. Matamoros, Tamaulipas

The objective of the work was to identify whether there is a difference between the level of psychosocial risk associated with the workload, and the type of contract of the workers of a factory in the city of H. Matamoros, Tamaulipas, Mexico. The followingwork of investigation is merely descriptive, transversal, correlationaland non-experimental. The sample was 1240 workers distributed in administrativepositions, indirect personnel of confidence, indirect unionized and direct unionized personnel. The instrument used was aquestionnaire to identify psychosocial risk factors and evaluate the organizational environment in workplaces,generated by the Secretariat of Labor and Social Security, through the Official Mexican Standard 035 of 2018. The results show that trusted personnel, both base and indirect, have a high prevalence of psychosocial risk associated with the workload.

Psychosocial correlates in cases of marital discord: A cross-sectional study

BackgroundMarital discord is associated with adverse psychosocial outcomes not just for the couple but also for their children. Identifying psychosocial risk factors can help devise targeted interventions. This study aimed to determine the psychosocial correlates of marital discord through a cross-sectional design. MethodsFifty married couples presenting with marital discord were recruited through purposive sampling. Self-reported data were gathered using standardized questionnaires on marital adjustment, intimacy, psychological distress, alcohol abuse, and internet addiction. Statistical analysis was conducted to examine correlations between these psychosocial variables and the degree of marital discord. ResultsA higher number of females (90%) compared to men (72%) had poor marital adjustment. Couples valued emotional and recreational intimacy the most. There was a negative correlation between marital adjustment with psychological distress and alcohol abuse. ConclusionThe findings that highlight intimacy in all domains is essential for marital satisfaction, and a significantly positive correlation exists between the experience of intimacy and marital satisfaction. Clinicians need to screen for these psychosocial variables and address them through targeted marital counseling programs focusing on improving intimacy, addressing psychological distress, and dealing with alcohol abuse among discordant couples.

The Equitable Benefit Approach to guide the assessment of medical and psychosocial factors in liver transplant candidacy.

Lack of available organs poses a significant challenge in meeting the needs of patients with life-threatening liver disease who could benefit from liver transplantation (LT). Psychosocial vulnerability markers have been linked to post-transplant outcomes, raising questions about their use in patient selection. However, their incorporation into selection criteria raises concerns about health equity and potential discrimination. As a result, there is a pressing need to refine fair allocation systems that consider both clinical and psychosocial factors to ensure equitable access and optimize post-transplant outcomes. The Equitable Benefit Approach (EBA) proposed in this paper by the multidisciplinary group of clinical experts in LT from the Italian Society for the Study of the Liver seeks to address these concerns. It presents four procedural principles, the two allocative principles usually applied in transplantation (urgency and utility) and introduces a new one, the principle of health equity. The EBA aims to prioritize patients with the highest transplant benefit while addressing health inequalities. It emphasizes evidence-based decision-making and standardized assessment tools to reliably evaluate psychosocial risk factors. Implementing the EBA involves a multi-step process, including stakeholder engagement, prospective studies to validate its efficacy, development of institutional policies and algorithms, and ongoing monitoring and revision. By following these steps, health care providers can ensure that LT allocation decisions are transparent and responsive to evolving clinical and social contexts. Ultimately, the EBA should offer a comprehensive framework for fair patient selection in LT, considering both biomedical and psychosocial aspects.

Leadership Styles that generate Risk Factors in teaching work: High School Education

Introduction: Psychosocial Risk Factors (PRF) in the workplace are a current topic that is visible in any type of organization, and the causes that originate them are diverse. Objective: The purpose of the present study is to demonstrate the correlation between certain leadership styles and the generation of Psychosocial Risk Factors in teaching work at a public high school educational institution located in Guadalupe, Zacatecas, México. Method: The research approach is quantitative, non-experimental, cross-sectional, with a descriptive-correlational scope. For the collection of information, a self-developed instrument with a Cronbach's alpha of 0.865 was used, applied to a random sample of50 teachers. Results: The findings reveal a statistically significant correlation between permissive and bureaucratic administrative styles and teacher harassment in three of its dimensions: physical, psychological, and economic aggression, the last two being the most recurrent. Conclusion: Leadership styles or administrative styles have a transcendent influence, affecting the physical and psychological health of the recipient.

Danish short form Örebro Musculoskeletal Pain Screening Questionnaire: Translation, cross-cultural adaptation, and evaluation of measurement properties.

Low back pain (LBP) is the leading cause of disability and an increasing sick leave in Denmark. Psychosocial risk factors have been linked to the development of LBP-related disability and work-absenteeism. The short form Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-sf) was developed to screen for psychosocial risk factors and assess the risk of long-term disability and work-absenteeism. To translate and cross-culturally adapt ÖMPSQ-sf into Danish and evaluate test-retest reliability with relative and absolute reliability and internal consistency in LBP-patients in a secondary setting. A six-step translation and cross-culturally adaptation process was used. Forty-four patients with subacute and chronic LBP were recruited at an outpatient clinic. Test-retest reliability (n= 37) was found to be excellent (ICC2.1= 0.92), Internal Consistency (n= 44) was adequate (Cronbach's alpha = 0.72). Absolute reliability included Standard Error of Measurement (SEM = 3.97 points), 95% Limits of Agreement (95% LOA = 0.08, -15.90-15.74), and Smallest Detectable Change (SDC = 10.87points). The Danish ÖMPSQ-sf showed acceptable measurements properties in subacute and chronic LBP-patients. Further research is needed to assess other measurement properties of the ÖMPSQ-sf, in relation to validity, responsiveness, and the predictive ability before application in research or clinical practice.

Risk factors for PTSD symptoms following PICU admission for childhood septic shock.

ObjectivePaediatric intensive care unit (PICU) admission represents a traumatic event for many children. Follow-up studies have found post-traumatic stress disorder (PTSD) rates of 10-30%, with a particular prevalence following admission for sepsis. Dysregulated inflammatory responses are associated with PTSD. Sepsis involves a marked inflammatory response but the relationship between this and PTSD have not been clearly established. In this study we investigate associations between the inflammatory response, psychosocial risk factors, and PTS symptoms following PICU admission for septic shock.We investigate the outcomes for children aged > 3 years, discharged from one PICU following admission for septic shock between 2010 and 2017. The study was a retrospective analysis of PICU-specific PTS symptoms reported by parents at any time since discharge via the Trauma and Behavior Health screen. Demographics, pre-morbid health characteristics, and exposure to other traumatic events were assessed. Clinical characteristics and blood test results at admission and at 48 h were recorded from clinical records. Multiple linear regression was used to investigate relationships between PTS symptom scores and predictor variables.Data for 65 participants (48% male, median assessment age 8.0 years) was available. Median time since admission was 5.1 years. 30.8% children scored at risk of PTSD at any time since discharge Symptoms were significantly associated with acute CRP rise (p 0.03), other trauma exposures (p = 0.01), and female gender (p =0.04).PTS symptoms in children who have survived septic shock are prevalent. These findings support a possible contribution of acute inflammatory changes, cumulative traumatic exposure, and female gender in post-PICU PTSD development.

Post-Pandemic Insomnia in Healthcare Workers: A Prospective Study including Sociodemographic, Occupational and Psychosocial Variables.

Background/Objectives: Previous research points to the prevalence of insomnia during the COVID-19 pandemic among healthcare workers (HCWs). However, longitudinal studies on its evolution, including the post-pandemic stage, are less abundant, with a special lack of research about possible psychosocial risk factors. The aim of the current study is to analyze the evolution of insomnia in Spanish HCWs from the beginning of the pandemic until two years later, examining the influence of sociodemographic, occupational and psychosocial variables. Methods: This was a prospective longitudinal design with three data collection periods in which insomnia was assessed using the Insomnia Severity Index (ISI), in addition to sociodemographic, occupational and psychosocial (i.e., social support, self-efficacy, resilience and cognitive fusion) variables in HCWs (n = 216) who were in direct contact with COVID-19 patients. Results: High scores were observed for insomnia, with a clear decrease throughout the periods studied (F = 30.198, p < 0.001). An association was observed between insomnia and certain sociodemographic and occupational variables (i.e., work category, p = 0.001; availability of Personal Protective Equipment (PPE), p < 0.001; workload, p < 0.001; worry about self or family contagion, p = 0.002, p = 0.003, respectively). Insomnia had negative relationships with social support (p = 0.014), self-efficacy (p < 0.001) and resilience (p < 0.001) and positive relationships with cognitive fusion (p < 0.001). Interaction effects between the evolution of insomnia and social support from friends (p = 0.024, ƞ2 = 0.34) and between the evolution of insomnia and cognitive fusion (p = 0.047; ƞ2 = 0.25) were found. Conclusions: Social support, self-efficacy and resilience act as buffers for insomnia. Cognitive fusion acts as a clear precipitator of insomnia as well as directly influencing its evolution. Social support from friends also affects the evolution of insomnia. Within the specific circumstances of the COVID-19 pandemic, a long-term effect of social support from friends and a short-term effect of cognitive fusion on the evolution of insomnia was observed. The findings emphasize the need to implement specific interventions to promote the mental well-being of HCWs, particularly in crisis contexts that involve an increase in occupational stress, emphasizing the role of certain psychosocial variables as protective factors.

688-P: Psychosocial Protective and Risk Factors and Transition Readiness in Young Adults (YA) with Type 1 Diabetes (T1D)

688-P: Psychosocial Protective and Risk Factors and Transition Readiness in Young Adults (YA) with Type 1 Diabetes (T1D)

Workload, general perceived stress, body function, musculoskeletal pain, and their mutual relationships in nurses - a pilot study.

Both physical and psychosocial risk factors contributing to musculoskeletal disorders occur in the professional nursing group, and previous literature suggested that their interaction may increase the risk of musculoskeletal pain among nurses. The aim of the study was to examine perceived workload and stress as well as physical findings and musculoskeletal complaints in nurses. The participants consisted of 42 female nurses, age range 23-60 years. They marked on a pain drawing the site/sites that was/were painful at the moment of testing, its duration and intensity. Thereafter they were examined using the movement and respiration domains from the Global Physiotherapy Examination (GPE). Furthermore, a subjective workload measure was made using the paper version of the National Aeronautics and Space Administration Task Load Index and stress was assessed using the Perceived Stress Questionnaire. Almost the entire study group declared that pain experienced in at least 1 location was chronic, i.e., had lasted ≥1 year (97%). The most frequent locations of pain were low back (22.4%) and cervical/head (21.6%) regions. In the GPE, most scores indicated restricted and reduced movement, with the subdomain flexibility having the highest deviation from the predefined standard. Furthermore, the results indicated hampered respiration, especially visible in standing position. Out of all workload scores, the highest was obtained for temporal demand. Perceived stress level was found to be moderate and significantly associated to chronic chest/ thoracic pain. Interestingly, the compression of thorax test positively correlated with mental (r = 0.42, p < 0.05) and physical demand (r = 0.35, p < 0.05), whereas the elbow drop test and temporal demand correlated negatively (r = -0.37, p < 0.05). To sum up, the majority of nurses participating in this study had long-lasting pain and limited flexibility of the body and hampered respiration, which both may enhance intensity of experienced musculoskeletal pain. Int J Occup Med Environ Health. 2024;37(3):257-70.

‘Leaving my comfort zone’. A qualitative study of physiotherapists' experiences blending an eHealth psychosocial intervention with face-to-face physiotherapy

BackgroundMany physiotherapists do not feel adequately equipped to address psychosocial risk factors in people with complex pain states. Hence, a biopsychosocial blended intervention (Back2Action) was developed to assist physiotherapists to manage people with persistent spinal pain and coexisting psychosocial risk factors associated with the development or maintenance of persistent pain. ObjectiveThis study aimed to gain insight into the experiences of physiotherapists with this blended psychosocial intervention. Designand methods: This was an interpretative qualitative study with a reflexive thematic analysis of semi-structured interviews with physiotherapists (N = 15) who delivered Back2Action. The interview started with the grand-tour question: “What was your experience in using Back2Action?” Physiotherapist were encouraged to provide examples, and follow-up questions were posed to ensure a deeper understanding could be reached. ResultsFour themes were constructed: Physiotherapists became increasingly aware of (1) their own implicit expectations, biases and skills, and underlying treatment paradigms, and (2) the implicit expectations from their patients towards them. This led to (3) creating a deeper and stronger therapeutic alliance with the patient, but also (4) an understanding that implementation of a true biopsychosocial intervention – even if offered in a blended form – requires more practice, confidence and resources. ConclusionsBack2Action is considered a valuable treatment to deliver a biopsychosocial intervention in primary care. Considering the high level of knowledge, skills and competency of the participating physiotherapists, the perceived barriers may be more difficult to overcome for more junior physiotherapists.