title: Pain-related psychological cognitions and behaviours associated with sick leave due to neck pain: findings from the Nurses and Midwives e-Cohort Study.
abstract: BACKGROUND
  Sick leave due to neck pain (NP-SL) is costly and negatively impacts the productivity of the nursing and midwifery workforce. Identification of modifiable risk indicators is necessary to inform preventive efforts. This study aimed to investigate the role of pain-related psychological features (pain catastrophizing, fear of movement, and pain coping) in NP-SL alongside other potential risk indicators.
  
  
  METHODS
  A cross-sectional analysis of a large cohort study of Australian and New Zealand nurses and midwives, established between 1st April 2006 to 30th March 2008, was undertaken. Recruitment procedures adopted within each Nursing Council jurisdiction were governed by the individual regulatory authorities and their willingness to engage with the study. Invitations directed potential participants to a purpose-built internet-based survey, where study information was provided and consent requested. Once consent was obtained, a range of standardized tools combined into one comprehensive electronic questionnaire was elicited. Exposure variables assessed included pain characteristics and a broad range of psychological, psychosocial, occupational, general health and demographic factors. Two-way interactions between age and gender and candidate exposures were also assessed. Binary logistic regression was performed using manual backward stepwise elimination of non-significant terms.
  
  
  RESULTS
  The cohort included 4,903 currently working nurses or midwives aged 18-65 years. Of these, 2,481 (50.6%) reported neck pain in the preceding 12 months. Our sample comprised of 1,854 working nurses and midwives with neck pain in the preceding year who supplied sick leave data. Of these, 343 (18.5%) reported taking sick leave in the preceding year due to their neck pain. The final most parsimonious multivariable model demonstrated neck pain severity (adjusted odds ratio, [aOR] = 1.59), passive pain coping (aOR = 1.08) and fear of movement (aOR = 1.06) increased the likelihood of NP-SL in the previous year. Interactions between demographic and general health factors exhibited both protective and risk relationships with NP-SL, and there was no association between pain catastrophizing and NP-SL.
  
  
  CONCLUSIONS
  Findings demonstrate that sick leave due to neck pain was associated with pain severity, fear of movement and passive pain coping. In addition, there were complex interactions found between demographic and general health factors. These features represent potentially modifiable targets for preventive programs.
authors.affiliation: School of Health Sciences, University of Canterbury, Private Bag 4800, Christchurch, CHCH 8140, New Zealand.|School of Nursing and Midwifery, University of Queensland, Brisbane, QLD 4072, Australia.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Schluter
authors.affiliation: School of Nursing and Midwifery, University of Queensland, Brisbane, QLD 4072, Australia.|Sansom Institute for Health Research, University of South Australia, Adelaide, SA 5000, Australia.
authors.forename: Anna P
authors.initials: AP
authors.lastname: Dawson
authors.affiliation: School of Nursing and Midwifery, University of Queensland, Brisbane, QLD 4072, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Turner