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This presentation:

Literature review - back pain/musculoskeletal

disorders in the NHS and risk factorsOverview of the Extending Working Lifeprogramme at LeedsWork in progress: Understandingmusculoskeletally related sickness absenceand job loss in Nurses and Nursing Assistants


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Musculoskeletal Disorders:

Average sickness rate for UK industry is 3.7%.

The NHS averages 5.6%The link between Nursing and MSD is welldocumented ( HSE 2002, Hignett 1996 )MSDs are the most common reason for earlyretirement due to ill-health in the NHS ( Pattani et al 2001 )


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Back pain in Nurses

Studies have been reporting high levels of

back pain in Nurses for many years.

Hignett (1996) in a review paper re-affirmednursing as one of the occupations with thegreatest prevalence of back pain .


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MS pain in nurses, risk factors:

Individual factors:

Age ( Seacombe & Ball 1992, Myers et al 2002 )

Experience ( Heap 1987 )

Speciality ( Stubbs et al 1986 )


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MS pain in nurses, risk factors Psychosocial factors:

Job satisfaction ( Aitken et al 2001 )

Stress/Emotional job demands ( Aitken et al 2001 )

Autonomy/respect ( Shaiman et al 2001 )


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Risk factors in Physiotherapy(Cromie et al 2000)

A number of risk factors have been reported as

increasing prevalence of MS pain:Work factors such as working in awkwardpositions/posturesWorkload particularly of mobilisation andmanipulationsFrequency and repetitiveness of treatment


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Younger

physiotherapistsare more at risk

50% have first

episode as astudent

most vulnerable during first 4-5years of practice


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Risk factors physiotherapists: workspeciality

Bork et al (1996) identified neurologicalrehabilitation had the highest prevalence of reported MSD in lower and upper backPaediatrics highest prevalence of MSD upper back


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Low back pain/MSDs in Doctors

There are less studies on low

back pain in doctors

A telephone survey of 55 junior doctors was reported in the BMJin 1997


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Everybody seems to appreciate the gravity of the

problem, yet nobody has the courage to be the firstto take the lead in openly debating the matter andproposing possible solutions. This could be becauseof the inability to obtain an accurate picture of the

causes of the problem itself ( Ootim,2002 )


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Leeds University Extending

Working Life programme:

Rheumatoid Arthritis Work Instability Scale

Understanding musculoskeletally relatedsickness absence and job loss in Nurses anddevelopment of a Nurse-Work Instability ScaleDevelopment of a WIS for TBIEpilepsy-Work Instability ScaleMS-Work Instability Scale

? Back pain Work Instability Scale


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Improving Job Retention

in Nurses:

Understanding musculoskeletally

related sickness absence and jobloss in Nurses and NursingAssistants

Funded by the Department of Health


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The current research project :

Survey of Leeds nursing staff

The Qualitative study and development of theNurse Work Instability Scale

The tracking of care pathways


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Work Instability, a definition:

Work Instability is a state in which the

consequences of a mis-match betweenan individuals functional (and possiblycognitive) abilities and the demands of their job could threaten continuingemployment if not resolved.


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Nurses survey:demographics

N = 1496 returned 92% Female Age range 20 65 years (mean 39.91)

59.96% Musculoskeletal symptoms in past 3months


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Nurses survey WIS scores:

0 1 2 3 Missing

Backs(N =631)20.8%

(131)26.6%

(168)16.2%

(102) 15.7%(99) 20.8%

(131)

Neck/Shoulder(N=440)

25.2%

(111)27%

(119)12.3%

(54)14.5%(64)

20.9%

(92)Other(N=90)

37.8% (34)

24.4% (22)

6.7%

(6)8%

(8.9) 20%

(3)No Symptoms(N =597)

71%

(424)16.2%

(97)2.7%

(16)1.0%(6)

9%

(54)

WIS Score


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Ongoing work - Qualitative study

and development of the Nurse WIS:

Qualitative interviews to generate items and

form draft measureFace to face content validityLarge postal surveyRasch AnalysisGold standard assessmentTest re-test postal survey


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Ongoing work

The tracking of care pathways:

Nurses who go off work with musculoskeletalsymptoms will be identifiedThese staff will be interviewed regularly over the phone

All participants in this stage of the study will beexamined by Professor of MS medicine

All findings will be used to evaluate currentpractise and identify gaps in the service


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Acknowledgements:

The Department of Health have funded thisproject.The research team at Leeds:Gill GilworthProf. Alan TennantProf. M. Anne ChamberlainSophie Eyres

Amy Carey

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