ABSTRACT
Introduction: Nursing has long been associated with musculoskeletal disorders. The problem is commonly attributed to different factors such as stressful and poorly designed jobs. Most studies evaluating the association between symptoms and job stress are based on worker perception. However, in new studies observational methods are needed for greater precision. An observational assessment tool has been developed by NIOSH (WMSD Research Consortium) to assess aspects of work organization that can affect employee production and health, but no reports were found associating collective organizational aspects with individual perception of job demands. Thus, the objective of the present study was to evaluate musculoskeletal symptoms, job demands and organizational aspects in an intensive care unit (ICU) and a general ward of a Brazilian hospital. Method: Seventy-four nursing staff members, age 35.9±10 years, from an ICU (N=30) and a general ward (N=44) were recruited for the study. These 67 females and 7 males represented, respectively, 37% of the ICU and 27% of the general ward staff. They were registered nurses and nursing aides who had worked for at least 6 months in their current job with12h day (N=48) or night (n=26) shifts. The study was approved by the university’s ethics committee (CAAE - 1080.0.000.135.10). The professionals completed a questionnaire that included demographic data and a visual analogical scale (VAS) for pain associated with the standardized Nordic musculoskeletal
questionnaire, as well as a job stress scale. The collective organizational aspects of the sectors were evaluated with the NIOSH assessment tool. The data were evaluated with the chi-square test and relative risk calculation (odds ratio - OR). Results and Discussion: A high number (85%) of workers reported low back (42%), neck (28%) and shoulder (22%) symptoms. No associations between job stress and body regions or general pain (p=0.8380) were identified, even when considering the three stress scale domains as different entities (demand, control and social support). However, an association was identified between the work sector and job stress (p=0.030), indicating that ICU workerswere2.88 times (IC 1.097-7.607) as likely to present higher levels of stress than general ward workers. Considering the different job stress scale domains, only control was associated with work sector (p=0.030), such that ICU workers were 1.52 times (IC 0.57-3.99) as likely to report lower levels of control than general ward workers. Organizational analysis of the sectors showed that the ICU requires higher levels of attentiveness, specificity, responsibility and skill than the ward, even considering that the ICU sector includes more supervisors (1 supervisor/10 nursing aides) than the ward (1/24). More sensitive observational tools for the evaluation of collective organizational aspects are still necessary to improve the understanding of the complex interaction between pain and stress in the hospital context.
