Musculoskeletal Pain and Reported Workplace Assault: A Prospective Study of Clinical Staff in Nursing Homes

• Published in: Human factors 2014-02, Vol.56 (1), p.215-227
• Main Authors: Miranda, Helena, Punnett, Laura, Gore, Rebecca J.
• Format: Article
• Language: English
• Subjects: Adjustment; Adult; Cross-Sectional Studies; Depression; Female; Human factors research; Humans; Interference; Male; Medical personnel; Middle Aged; Musculoskeletal diseases; Musculoskeletal Pain - epidemiology; Musculoskeletal Pain - etiology; Musculoskeletal Pain - psychology; Nursing Homes; Occupational Diseases - epidemiology; Occupational Diseases - etiology; Occupational Diseases - psychology; Occupational health; Occupational safety; Pain; Pain Measurement; Prevalence; Prospective Studies; Risk; Risk Factors; Sleep; Surveys and Questionnaires; Time Factors; United States - epidemiology; Violence; Workplace; Workplace violence; Workplaces
• ISSN: 0018-7208; 1547-8181
• DOI: 10.1177/0018720813508778

Objective: This study examined prospectively the effect of workplace violence on musculoskeletal symptoms among nursing home workers. Background: Previously we reported a cross-sectional relationship between physical assaults at work and musculoskeletal pain. This follow-up provides stronger evidence of the effect of workplace violence on musculoskeletal outcomes within the same workforce over two years. Method: Nursing home workers who responded to three consecutive annual surveys formed the study cohort (n = 344). The outcomes were any musculoskeletal pain, widespread pain, pain intensity, pain interference with work and sleep, and co-occurring pain with depression. The main predictor was self-reported physical assault at work during the 3 months preceding each survey. Prevalence ratios (PRs) were assessed with log-binomial regression, adjusting for other workplace and individual factors. Results: Every fourth nursing home worker, and 34% of nursing aides, reported persistent workplace assault over the 2 years. Among respondents assaulted frequently, two thirds experienced moderate to extreme musculoskeletal pain, and more than 50% had pain interfering with work and/or sleep. Baseline exposure to assault predicted pain outcomes 1 year later. Repeated exposure was associated with a linear increase over 2 years in the risks of pain intensity, interference with work, and interference with sleep; co-occurring pain and depression had an adjusted PR of 3.6 (95% CI = 1.7–7.9). Conclusion: Workplace assault, especially when repeated over time, increases the risk of pain that may jeopardize workers’ ability to remain employed. Application: More effective assault prevention would protect and support the workforce needed to care for our increasing elderly and disabled population.