Early career demanding psychosocial work environment and severe back pain and neck/shoulder pain in experienced nurses: A cohort study

TL;DR

Nurses exposed to a stressful work environment early in their careers are more likely to experience severe back and neck/shoulder pain 11–15 years later.

Contribution

This study links early career psychosocial stressors to long-term musculoskeletal pain in nurses.

Findings

Nurses with a demanding work environment for three years had 2.82x higher risk of severe back pain later.

Exposure to a stressful work environment for two years increased the risk of severe back pain by 2.08x.

Long-term severe neck/shoulder pain risk increased with prolonged early career psychosocial demands.

Abstract

Back pain and neck/shoulder pain are common among nurses. The aim of this study was to investigate the association between nurses’ exposure to a demanding psychosocial work environment during the first three years after graduation and the occurrence of severe back pain and neck/shoulder pain in the longer term, 11–15 years later.

The Longitudinal Analysis of Nursing Education (LANE) study (nursing graduates from 26 Swedish universities in the years 2002, 2004 and 2006) was used to create two risk cohorts of nurses not reporting severe back pain (n=1764) or neck/shoulder pain (n=1707). Nurses exposed to a demanding psychosocial work environment for one, two or three of the first three years in their career were compared to nurses not having a demanding psychosocial work environment for any of these three years regarding the incidence of severe back pain or neck/shoulder pain at follow-up, 11–15 years later. Relative risks (RR) with 95% confidence intervals (CI) were calculated using binomial regression.

The RR (95% CI) of having severe back pain for nurses who had a demanding psychosocial work environment for one of the three years was 1.36 (0.82–2.28) and 2.08 (1.21–3.57) for two of the three years and 2.82 (1.43–5.55) for all three years. Corresponding RRs (95% CIs) for severe neck/shoulder pain were 1.35 (0.87–2.10), 1.49 (0.88–2.51) and 1.41 (0.62–3.20), respectively.

Nurses who were repeatedly exposed to a demanding psychosocial work environment early in their career reported severe back pain to a higher extent in the longer term.

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