title: Work-family conflicts and self-reported work ability: cross-sectional findings in women with chronic musculoskeletal disorders.
abstract: BACKGROUND
  Under conditions of gender-specific division of paid employment and unpaid childcare and housework, rising employment of women increases the likelihood that they will be faced with work-family conflicts. As recent research indicates, such conflicts might also contribute to musculoskeletal disorders. However, research in patient samples is needed to clarify how important these conflicts are for relevant health-related measures of functioning (e.g., work ability). We therefore examined, in a sample of women with chronic musculoskeletal disorders, the indirect and direct associations between the indicators of work-family conflicts and self-reported work ability as well as whether the direct effects remained significant after adjustment for covariates.
  
  
  METHODS
  A cross-sectional questionnaire-based study was conducted. Participants were recruited from five rehabilitation centers. Work-family conflicts were assessed by four scales referring to time- and strain-based work interference with family (WIF) and family interference with work (FIW). Self-reported work ability was measured by the Work Ability Index. A confirmatory factor analysis was performed to approve the anticipated four-factor structure of the work-family conflict measure. Direct and indirect associations between work-family conflict indicators and self-reported work ability were examined by path model analysis. Multivariate regression models were performed to calculate adjusted estimators of the direct effects of strain-based WIF and FIW on work ability.
  
  
  RESULTS
  The study included 351 employed women. The confirmatory factor analysis provided support for the anticipated four-factor structure of the work-family conflict measure. The path model analysis identified direct effects of both strain-based scales on self-reported work ability. The time-based scales were indirectly associated with work ability via the strain-based scales. Adjusted regression analyses showed that a five-point increase in strain-based WIF or FIW was associated with a four- and two-point decrease in self-reported work ability, respectively. The standardized regression coefficients were β = 0.35 and β = 0.12.
  
  
  CONCLUSIONS
  Our findings indicate that work-family conflicts are associated with poor work ability in female patients with chronic musculoskeletal disorders. However, longitudinal research is needed to establish a causal relationship. Better compatibility of work and family life might be an environmental facilitator of better rehabilitation outcomes in female patients with musculoskeletal disorders.
authors.affiliation: Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany. matthias.bethge@uksh.de.|Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany. matthias.bethge@uksh.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Bethge
authors.affiliation: Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany. yvonne.borngraeber@charite.de.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Borngräber
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003220:Conflict, Psychological; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000523:psychology*; D012044:Regression Analysis; D012307:Risk Factors; D057566:Self Report; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014937:Work / Q000523:psychology*; D000066477:Work Performance; D016526:Workload / Q000523:psychology