Association between pain-related fear and presenteeism among eldercare workers with low back pain.

BACKGROUND: Presenteeism (work productivity loss at work) and low back pain (LBP) are prevalent among eldercare workers. Presenteeism is a serious emerging problem in an occupational setting. While many studies report the impact of pain-related fear on absenteeism, its impact on presenteeism remains unclear. METHODS: We conducted a cross-sectional study to investigate the association between pain-related fear and presenteeism among 505 eldercare workers with LBP. We measured pain-related fear using the 11-item Tampa Scale for Kinesiophobia (TSK-11). We used the Work Limitations Questionnaire (WLQ) to estimate productivity loss due to presenteeism with items including Time Management, Mental-Interpersonal Demands, Physical Demands and Output Demands. The presenteeism was categorized into no (<5%), mild (5%-10.9%), moderate (11%-16.9%) and severe presenteeism (≥17%). We further performed ordinal logistic regression analyses, and the covariates were age, sex, pain intensity, pain disability and psychosocial factors. Multiple imputation was conducted to provide informed estimates for observations with missing data. RESULTS: After adjustment, a higher TSK score was significantly associated with a higher presenteeism (proportional OR = 1.10, 95% CI = 1.06-1.15). A significant association of TSK with all WLQ subscales was retained even after the adjustment (Time Management: proportional OR = 1.04, 95% CI = 1.01-1.08; Mental-Interpersonal Demands: proportional OR = 1.08, 95% CI = 1.04-1.12; Physical Demands: proportional OR = 1.04, 95% CI = 1.01-1.08; and Output Demands: proportional OR = 1.06, 95% CI = 1.02-1.10). CONCLUSIONS: Our findings suggest that pain-related fear is an important factor related to presenteeism among eldercare workers with LBP. SIGNIFICANCE: This study describes an independent association of pain-related fear with presenteeism among eldercare workers with low back pain. Pain-related fear could be considered a vital factor of presenteeism in addition to absenteeism.

Association between metabolic syndrome and disability due to low back pain among care workers.

OBJECTIVES: To elucidate the association between metabolic syndrome (MetS) and disability due to low back pain (LBP) among care workers. MATERIAL AND METHODS: This cross-sectional study enrolled 656 care workers having experienced LBP in the year prior to the year of this study. The Roland-Morris Disability questionnaire (RDQ) and self-reported questionnaires regarding LBP, fear of movement, depressive symptom, psychosocial factors, intensity of pain, and duration of pain were administered, and a medical examination was performed. Metabolic syndrome was defined according to the international definition agreed in 2009. Out of the 656 care workers, we included 316 care workers (response rate: 48.2%) who had fully completed the questionnaires as the study sample (males: 13.6%, median age = 51 years old, range: 35-74 years old). To examine the association between MetS and the level of disability due to LBP, we used the Poisson regression analysis and estimated crude and adjusted prevalence ratios (PR). RESULTS: Out of the 316 care workers, 52 (16.5%) were diagnosed as having MetS. Metabolic syndrome was significantly associated with the RDQ score (adjusted PR: 1.57, 95% confidence interval (CI): 1.17-2.11) after adjusting for covariates, such as age, sex, fear of movement, job demands, social support, intensity of pain, and duration of pain. CONCLUSIONS: This study showed that MetS was independently associated with disability due to LBP among care workers. A multidisciplinary intervention taking MetS into consideration may be an effective way to reduce disability due to LBP in people with both LBP and MetS. Int J Occup Med Environ Health 2018;31(2):165-172.

The Association Between Perceived Stress and Low Back Pain Among Eldercare Workers in Japan.

OBJECTIVE: We investigated the association between perceived stress and low back pain (LBP) among Japanese eldercare workers. METHODS: Self-reported questionnaires were completed regarding perceived stress (Perceived Stress Scale-14), presence of memorable LBP in the preceding month, and other relevant factors (age, sex, body mass index, smoking status, job demands, job control, and social support) among 954 eldercare workers. Univariate and multivariate logistic regression analysis were performed to estimate odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: Data from 571 eldercare workers were analyzed. In the multivariate logistic regression model, higher perceived stress was significantly associated with a higher prevalence of memorable LBP (adjusted OR [95% CI] = 1.05 [1.02 to 1.08]). CONCLUSIONS: Higher perceived stress was independently associated with LBP among eldercare workers. Our study indicates the importance of considering perceived stress as one of the factors related to LBP.

Social support, self-efficacy and psychological stress responses among outpatients with diabetes in Yogyakarta, Indonesia.

We attempted to study whether social support promotes self-efficacy and reduces stress responses of patients with diabetes in Yogyakarta, Indonesia. Diabetic outpatients at Dr. Sardjito Hospital voluntarily participated in a questionnaire survey. Data from 125 patients were subjected to analysis. The questionnaires included the scales and subscales of social support, self-efficacy, psychological stress response, and demographic measure. Data were analyzed by Spearman's rank correlation test to examine the relationships between parameters, Mann-Whitney U-test and Kruskal-Wallis test to compare the scales by characteristics, and structural equation modeling to explore the best-fit model. This study was performed in September 2003. It was found that augmentation of emotional support to patients significantly increased the 'active coping for the disease' and 'controllability of health', and that 'helplessness' was reduced significantly. Behavioral support affected only 'controllably of health'. Self-efficacy reduced stress response of the patients. It was also found that subjects who received support from their children significantly scored higher in perceived availability of social support than those without support from their children. To know their behavioral support better as well as emotional support may be one area to focus on in improving the health status of people with diabetes in Yogyakarta.