title: The influence of perceived stress and musculoskeletal pain on work performance and work ability in Swedish health care workers.
abstract: OBJECTIVE
  To evaluate the influence of perceived stress and musculoskeletal ache/pain, separately and in combination, at baseline, on self-rated work ability and work performance at two-year follow-up.
  
  
  METHODS
  Survey data were collected with a 2-year interval. Health care workers participating at both waves were included. Inclusion criteria were good self-reported work ability and unchanged self-rated work performance at baseline, resulting in 770 participants; 617 women and 153 men. Musculoskeletal pain was assessed using the question "How often do you experience pain in joints and muscles, including the neck and low back?", perceived stress with a modified version of a single item from the QPS-Nordic questionnaire, work performance by the question "Have your work performance changed during the preceding 12 months?" and work ability by a single item from the work ability index. Associations between baseline data and the two outcomes at follow-up were analysed by means of the log binomial model and expressed as risk ratios (RR) with 95% confidence intervals (CI).
  
  
  RESULTS
  A combination of frequent musculoskeletal pain and perceived stress constituted the highest risk for reporting decreased work performance (RR 1.7; CI 1.28-2.32) and reduced work ability (RR 1.7; CI 1.27-2.30) at follow-up. Separately, frequent pain, but not stress, was clearly associated with both outcomes.
  
  
  CONCLUSIONS
  The results imply that proactive workplace interventions in order to maintain high work performance and good work ability should include measures to promote musculoskeletal well-being for the employees and measures, both individual and organizational, to minimize the risk of persistent stress reactions.
authors.affiliation: Institute of Stress Medicine, 413 19, Göteborg, Sweden, agneta.lindegard@vgregion.se.
authors.forename: A
authors.initials: A
authors.lastname: Lindegård
authors.forename: P
authors.initials: P
authors.lastname: Larsman
authors.forename: E
authors.initials: E
authors.lastname: Hadzibajramovic
authors.forename: G
authors.initials: G
authors.lastname: Ahlborg
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel / Q000523:psychology*; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000523:psychology*; D012307:Risk Factors; D057566:Self Report; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D013548:Sweden; D013647:Task Performance and Analysis; D014937:Work / Q000523:psychology*