title: Association of psychological distress and work psychosocial factors with self-reported musculoskeletal pain among secondary school teachers in Malaysia.
abstract: BACKGROUND
  Musculoskeletal pain is common among teachers. Work-related psychosocial factors are found to be associated with the development of musculoskeletal pain, however psychological distress may also play an important role.
  
  
  OBJECTIVE
  To assess the prevalence of self-reported low back pain (LBP), and neck and/or shoulder pain (NSP) among secondary school teachers; and to evaluate the association of LBP and NSP with psychological distress and work-related psychosocial factors.
  
  
  METHODS
  This was a cross-sectional study conducted among teachers in the state of Penang, Malaysia. The participants were recruited via a two stage sampling method. Information on demographic, psychological distress, work-related psychosocial factors, and musculoskeletal pain (LBP and NSP) in the past 12 months was collected using a self-administered questionnaire. Poisson regression was used to estimate the prevalence ratio (PR) for the associations between psychological distress and work-related psychosocial factors with LBP and NSP.
  
  
  RESULTS
  The prevalence of self-reported LBP and NSP among 1482 teachers in the past 12 months was 48.0% (95% Confidence Interval (CI) 45.2%, 50.9%) and 60.1% (95% CI 57.4%, 62.9%) respectively. From the multivariate analysis, self-reported LBP was associated with teachers who reported severe to extremely severe depression (PR: 1.71, 95% CI 1.25, 2.32), severe to extremely severe anxiety (1.46, 95% CI 1.22, 1.75), high psychological job demand (1.29, 95% CI 1.06, 1.57), low skill discretion (1.28, 95% CI 1.13, 1.47) and poorer mental health (0.98, 95% CI 0.97, 0.99). Self-reported NSP was associated with mild to moderate anxiety (1.18, 95% CI 1.06, 1.33), severe to extremely severe anxiety (1.25, 95% CI 1.09, 1.43), low supervisory support (1.13, 95% CI 1.03, 1.25) and poorer mental health (0.98, 95% CI 0.97, 0.99).
  
  
  CONCLUSIONS
  Self-reported LBP and NSP were common among secondary school teachers. Interventions targeting psychological distress and work-related psychosocial characteristics may reduce musculoskeletal pain among school teachers.
authors.affiliation: Julius Centre University of Malaya, Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.|Cluster of Lifestyle Science, Advanced of Medical & Dental Institute, Pulau Pinang, Malaysia.
authors.forename: E N
authors.initials: EN
authors.lastname: Zamri
authors.affiliation: Julius Centre University of Malaya, Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: F M
authors.initials: FM
authors.lastname: Moy
authors.affiliation: Centre for Occupational and Environmental Health-UM, Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: V C W
authors.initials: VC
authors.lastname: Hoe
mesh_terms: D000328:Adult; D000886:Anthropometry; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000150:complications / Q000523:psychology*; D009784:Occupational Diseases; D016012:Poisson Distribution; D015995:Prevalence; D011584:Psychology; D012044:Regression Analysis; D000070777:School Teachers; D012574:Schools; D057566:Self Report; D020069:Shoulder Pain; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013663:Teaching