title: Association between perceived inadequate staffing and musculoskeletal pain among hospital patient care workers.
abstract: OBJECTIVE
  To examine association between perceived inadequate staffing and musculoskeletal pain and to evaluate the role of work-related psychosocial and physical work factors in the association among hospital patient care workers.
  
  
  METHODS
  A cross-sectional study was conducted among 1,572 patient care workers in two academic hospitals. Perceived inadequate staffing was measured using the "staffing adequacy subscale" of Nursing Work Index, which is a continuous scale that averages estimates of staffing adequacy by workers in the same units. Musculoskeletal pain (i.e., neck/shoulder, arm, low back, lower extremity, any musculoskeletal pain, and the number of area in pain) in the past 3 months was assessed using a self-reported Nordic questionnaire. Multilevel logistic regression was applied to examine associations between perceived inadequate staffing and musculoskeletal pain, considering clustering among the workers in the same units.
  
  
  RESULTS
  We found significant associations of perceived inadequate staffing with back pain (OR 1.50, 95 % CI 1.06, 2.14) and the number of body area in pain (OR 1.42, 95 % CI 1.01, 2.00) after adjusting for confounders including work characteristics (job title, having a second job or not, day shift or not, and worked hours per week). When we additionally adjusted for physical work factors (i.e., use of a lifting device, and the amount of the time for each of five physical activities on the job), only the association between perceived inadequate staffing and back pain remained significant (OR 1.50, 95 % CI 1.03, 2.19), whereas none of the associations was significant for all of musculoskeletal pains including back pain (OR 0.96, 95 % CI 0.66, 1.41) when we additionally adjusted for work-related psychosocial factors (i.e., job demands, job control, supervisor support, and co-worker support) instead of physical work factors.
  
  
  CONCLUSIONS
  Perceived inadequate staffing may be associated with higher prevalence of back pain, and work-related psychosocial factor may play an important role in the potential pathway linking staffing level to back pain among hospital workers.
authors.affiliation: Department of Healthcare Management, Korea University, Seoul, Republic of Korea, ssk3@korea.ac.kr.
authors.forename: Seung-Sup
authors.initials: SS
authors.lastname: Kim
authors.forename: Cassandra A
authors.initials: CA
authors.lastname: Okechukwu
authors.forename: Jack T
authors.initials: JT
authors.lastname: Dennerlein
authors.forename: Leslie I
authors.initials: LI
authors.lastname: Boden
authors.forename: Karen
authors.initials: K
authors.lastname: Hopcia
authors.forename: Dean M
authors.initials: DM
authors.lastname: Hashimoto
authors.forename: Glorian
authors.initials: G
authors.lastname: Sorensen
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001900:Boston; D015984:Causality; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology* / Q000523:psychology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration* / Q000706:statistics & numerical data; D010564:Personnel, Hospital / Q000523:psychology*; D016526:Workload / Q000523:psychology*; D055815:Young Adult