title: Links between nurses' organisational work environment and upper limb musculoskeletal symptoms: independently of effort-reward imbalance! The ORSOSA study.
abstract: The role of psychosocial factors in the development of upper limb musculoskeletal disorders has now been clearly demonstrated. However, only a few studies have analysed the association between the organisational work environment and musculoskeletal disorders in health care workers. The main goal of this study was to test the hypothesis that some specific organisational constraints may be related to upper limb musculoskeletal symptoms experienced by registered nurses, independently of the effort/reward imbalance model and major confounding factors. In 2006, 2194 female registered nurses in 7 French teaching hospitals, recruited from the baseline screening of an epidemiological cohort study (the ORSOSA study), responded to valid self-report questionnaires (ERI [effort-reward imbalance], Nordic-style questionnaire). The organisational work environment was assessed by the self-rated Nursing Work Index-Extended Organisation scale. Multilevel models were used for analyses. We found that 2 organisational health care constraints: low level of shared values about work between members in the unit and lack of support from the administration were significantly associated with upper limb symptoms, independently of ERI perceptions. This study identified and quantified specific health care organisational factors that have an impact on nurses' upper limb symptoms, sometimes independently of ERI perception. A prospective study is needed to clarify the causal role of psychosocial and organisational work factors in upper limb injury in nurses. Organisational approaches may be more effective in improving health at work and may also have a longer-lasting impact than individual approaches.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale (INSERM) Unit 558, Toulouse F-31000, France Centre Hospitalier Universitaire (CHU) Toulouse, Service des Maladies Professionnelles, Toulouse F-31000, France CHU Nancy, Centre de consultations de pathologies professionnelles, Vandoeuvre-lès-Nancy F-54511, France INSERM Unit 954, Vandoeuvre-Lès-Nancy F-54505, France CHU Toulouse, Service de Médecine du Travail du Personnel Hospitalier, Toulouse F-31000, France CHU Nancy, Service de Médecine du Travail du Personnel Hospitalier, Nancy F-54000, France Médecine du Travail et Pathologies Professionnelles, Clinique de Santé Publique, Centre Hospitalier Régional Universitaire (CHRU)-Université Lille 2, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Herin
authors.forename: Christophe
authors.initials: C
authors.lastname: Paris
authors.forename: Aude
authors.initials: A
authors.lastname: Levant
authors.forename: Marie-Chantal
authors.initials: MC
authors.lastname: Vignaud
authors.forename: Annie
authors.initials: A
authors.lastname: Sobaszek
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Soulat
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000523:psychology*; D009726:Nurses / Q000458:organization & administration / Q000523:psychology*; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D012201:Reward; D011795:Surveys and Questionnaires; D034941:Upper Extremity / Q000503:physiopathology*; D016526:Workload / Q000523:psychology*; D055815:Young Adult