title: Changes in job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions among nurses after the adoption of a computerized order communication system.
abstract: OBJECTIVE
  Order communication system (OCS) is a real-time computerized hospital information system that supports communication of orders from the ward users to the service departments. The adoption of an OCS may profoundly alter the service patterns of healthcare workers. As a result, job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions can be expected to increase. This study investigated changes in job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions among nurses after an OCS had been adopted and whether adoption of the system affected the changes.
  
  
  METHODS
  A group of nurses employed in a university hospital in Korea was surveyed 1 month before and 3 months after the OCS had been adopted. We used Karasek's job contents questionnaire (JCQ) to evaluate job stress. The cumulative trauma disorder (CTD) questionnaire was used to assess the presence of musculoskeletal symptoms. The presence of unfavorable working conditions was also assessed. Next, we evaluated whether non-work factors (such as demographic factors and life events) had influence on job stress, musculoskeletal symptoms, and complaints of unfavorable working conditions after adoption of the OCS.
  
  
  RESULTS
  One hundred thirty nurses from the hospital (51.2%) responded to both surveys. Several JCQ scales were notably altered after OCS adoption; psychological job demand was significantly decreased (P < 0.01), although subjective assessment for hazardous conditions was significantly increased (P < 0.01). There was a significant increase in back complaints (P < 0.05). There was considerable decrease in the number of nurses who complained of 'increase in work intensity' (P < 0.05), 'increase of staying time to deal with remaining duties' (P < 0.05), and 'abrupt change of duties' (P < 0.01). According to the analysis for the associations between non-work factors and significantly changed variables, only two non-work factors, 'tenure' and 'conflicts with friend(s)', showed statistical significance with complaints of 'increase in work intensity' (P < 0.05) CONCLUSIONS. This study suggests that a newly adopted computerized system might have provoked changes in job stress, musculoskeletal symptoms, and the complaints of unfavorable working conditions. It was found that, despite the overall favorable changes, complaints of hazardous conditions and back symptoms increased.
authors.affiliation: Department of Occupational and Environmental Medicine, Hallym University, Hangang Sacred Heart Hospital, Seoul, South Korea.
authors.forename: Hyung-Joon
authors.initials: HJ
authors.lastname: Jhun
authors.forename: Sung-Il
authors.initials: SI
authors.lastname: Cho
authors.forename: Jong-Tae
authors.initials: JT
authors.lastname: Park
mesh_terms: D000328:Adult; D006751:Hospital Information Systems; D006801:Humans; D007723:Korea; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000209:etiology / Q000523:psychology*; D009726:Nurses / Q000523:psychology*; D009784:Occupational Diseases / Q000209:etiology / Q000523:psychology*; D013315:Stress, Psychological / Q000150:complications / Q000209:etiology*; D014937:Work