title: Musculoskeletal pain and reported workplace assault: a prospective study of clinical staff in nursing homes.
abstract: OBJECTIVE
  This study examined prospectively the effect of workplace violence on musculoskeletal symptoms among nursing home workers.
  
  
  BACKGROUND
  Previously we reported a cross-sectional relationship between physical assaults at work and musculoskeletal pain. This follow-up provides stronger evidence of the effect of workplace violence on musculoskeletal outcomes within the same workforce over two years.
  
  
  METHODS
  Nursing home workers who responded to three consecutive annual surveys formed the study cohort (n = 344). The outcomes were any musculoskeletal pain, widespread pain, pain intensity, pain interference with work and sleep, and co-occurring pain with depression. The main predictor was self-reported physical assault at work during the 3 months preceding each survey. Prevalence ratios (PRs) were assessed with log-binomial regression, adjusting for other workplace and individual factors.
  
  
  RESULTS
  Every fourth nursing home worker, and 34% of nursing aides, reported persistent workplace assault over the 2 years. Among respondents assaulted frequently, two thirds experienced moderate to extreme musculoskeletal pain, and more than 50% had pain interfering with work and/or sleep. Baseline exposure to assault predicted pain outcomes 1 year later. Repeated exposure was associated with a linear increase over 2 years in the risks of pain intensity, interference with work, and interference with sleep; co-occurring pain and depression had an adjusted PR of 3.6 (95% CI = 1.7-7.9).
  
  
  CONCLUSIONS
  Workplace assault, especially when repeated over time, increases the risk of pain that may jeopardize workers' ability to remain employed.
  
  
  CONCLUSIONS
  More effective assault prevention would protect and support the workforce needed to care for our increasing elderly and disabled population.
authors.forename: Helena
authors.initials: H
authors.lastname: Miranda
authors.forename: Laura
authors.initials: L
authors.lastname: Punnett
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Gore
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D009735:Nursing Homes; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014754:Violence; D017132:Workplace