title: Effort-reward imbalance and low back pain among eldercare workers in nursing homes: a cross-sectional study in Kagawa Prefecture, Japan.
abstract: OBJECTIVE
  To clarify effort-reward imbalance among eldercare workers in nursing homes and to examine the association between the effort-reward imbalance (ERI) and low back pain (LBP) among them.
  
  
  METHODS
  A total of 549 questionnaires were distributed to a random sample comprising 23% of the 79 special elderly nursing homes in Kagawa in 2013. A total of 467 eldercare workers (response rate 85%) participated in this study. Of the 467 eligible respondents, 372 (80%) completed all items of the ERI questionnaire. Complete data were available for 342 (73%) eldercare workers.
  
  
  RESULTS
  Of the 342 respondents, 215 (63%) had LBP at the time of the study, and 291 (85%) showed a critical "high cost/low gain" condition as determined by an effort-reward ratio >1. Multiple logistic regression analyses adjusted for age, gender, previous LBP experience, high-risk work and K6 score showed that eldercare workers with a high ERI had a higher risk for LBP than workers with a low ERI (OR, 1.96; 95% CI, 1.02-3.77).
  
  
  CONCLUSIONS
  Most eldercare workers have a high ERI, and their LBP is associated with their ERI. Balancing effort and reward may be an important factor for improving LBP among eldercare workers in nursing homes.
authors.affiliation: Department of Anesthesiology, Graduate School of Medicine, Kagawa University.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Hirao
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoda
authors.forename: Akira
authors.initials: A
authors.lastname: Yoshioka
authors.forename: Gotaro
authors.initials: G
authors.lastname: Shirakami
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan; D007588:Job Satisfaction; D017116:Low Back Pain / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology; D005082:Physical Exertion; D011584:Psychology; D012201:Reward; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D016526:Workload