title: Job stress and work-related musculoskeletal symptoms among intensive care unit nurses: a comparison between job demand-control and effort-reward imbalance models.
abstract: BACKGROUND
  The aims of this study were to compare job demand-control (JDC) and effort-reward imbalance (ERI) models in examining the association of job stress with work-related musculoskeletal symptoms and to evaluate the utility of a combined model.
  
  
  METHODS
  This study analyzed cross-sectional survey data obtained from a nationwide random sample of 304 intensive-care unit (ICU) nurses. Demographic and job factors were controlled in the analyses using logistic regression.
  
  
  RESULTS
  Both JDC and ERI variables had strong and statistically significant associations with work-related musculoskeletal symptoms. Effort-reward imbalance had stronger associations than job strain or iso-strain with musculoskeletal symptoms. Effort-reward imbalance alone showed similar or stronger associations with musculoskeletal symptoms compared to combined variables of the JDC and ERI models.
  
  
  CONCLUSIONS
  The ERI model appears to capture the magnitude of the musculoskeletal health risk among nurses associated with job stress at least as well and possibly better than the JDC model. Our findings suggest that combining the two models provides little gain compared to using effort-reward imbalance only.
authors.affiliation: Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California.
authors.forename: Soo-Jeong
authors.initials: SJ
authors.lastname: Lee
authors.forename: Joung Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Marion
authors.initials: M
authors.lastname: Gillen
authors.forename: Niklas
authors.initials: N
authors.lastname: Krause
mesh_terms: D000328:Adult; D064648:Critical Care Nursing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D059352:Musculoskeletal Pain / Q000453:epidemiology*; D009784:Occupational Diseases / Q000453:epidemiology*; D017009:Professional Autonomy; D012201:Reward; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology; D017132:Workplace / Q000523:psychology*
keywords: effort-reward imbalance; job strain; job stress; musculoskeletal symptom; nurses