Back or neck-pain-related disability of nursing staff in hospitals, nursing homes and home care in seven countries--results from the European NEXT-Study.

BACKGROUND Musculoskeletal disorders are a widespread affliction in the nursing profession. Back or neck-pain-related disability of nursing staff is mainly attributed to physical and psychosocial risk factors. OBJECTIVES To investigate which-and to what extent-physical and psychosocial risk factors are associated with neck/back-pain-related disability in nursing, and to assess the role of the type of health care institution (hospitals, nursing homes and home care institutions) within different countries in this problem. DESIGN Cross-sectional secondary analysis of multinational data of nurses and auxiliary staff in hospitals (n=16,770), nursing homes (n=2140) and home care institutions (n=2606) in seven countries from the European NEXT-Study. METHODS Multinomial logistic regression analysis with raw models for each factor and mutually adjusted with all analysed variables. RESULTS Analysis of the pooled data revealed effort-reward imbalance as the predominant risk factor for disability in all settings (odds ratios for high disability by effort-reward ratio: hospital 5.05 [4.30-5.93]; nursing home 6.52 [4.04-10.52] and home care 6.4 [3.83-10.70] [after mutual adjustment of psychosocial and physical risk factors]). In contrast, physical exposure to lifting and bending showed only limited associations with odds ratios below 1.6; the availability and use of lifting aids was-after mutual adjustment-not or only marginally associated with disability. These findings were basically confirmed in separate analyses for all seven countries and types of institutions. CONCLUSIONS The findings show a pronounced association between psychosocial factors and back or neck-pain-related disability. Further research should consider psychosocial factors and should take the setting where nurses work into account.