Association between perceived inadequate staffing and musculoskeletal pain among hospital patient care workers

Seung Sup Kim, Cassandra A. Okechukwu, Jack T. Dennerlein, Leslie I. Boden, Karen Hopcia, Dean M. Hashimoto, Glorian Sorensen

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


Objective: To examine association between perceived inadequate staffing and musculoskeletal pain and to evaluate the role of work-related psychosocial and physical work factors in the association among hospital patient care workers. Methods: A cross-sectional study was conducted among 1,572 patient care workers in two academic hospitals. Perceived inadequate staffing was measured using the "staffing adequacy subscale" of Nursing Work Index, which is a continuous scale that averages estimates of staffing adequacy by workers in the same units. Musculoskeletal pain (i.e., neck/shoulder, arm, low back, lower extremity, any musculoskeletal pain, and the number of area in pain) in the past 3 months was assessed using a self-reported Nordic questionnaire. Multilevel logistic regression was applied to examine associations between perceived inadequate staffing and musculoskeletal pain, considering clustering among the workers in the same units. Results: We found significant associations of perceived inadequate staffing with back pain (OR 1.50, 95 % CI 1.06, 2.14) and the number of body area in pain (OR 1.42, 95 % CI 1.01, 2.00) after adjusting for confounders including work characteristics (job title, having a second job or not, day shift or not, and worked hours per week). When we additionally adjusted for physical work factors (i.e., use of a lifting device, and the amount of the time for each of five physical activities on the job), only the association between perceived inadequate staffing and back pain remained significant (OR 1.50, 95 % CI 1.03, 2.19), whereas none of the associations was significant for all of musculoskeletal pains including back pain (OR 0.96, 95 % CI 0.66, 1.41) when we additionally adjusted for work-related psychosocial factors (i.e., job demands, job control, supervisor support, and co-worker support) instead of physical work factors. Conclusions: Perceived inadequate staffing may be associated with higher prevalence of back pain, and work-related psychosocial factor may play an important role in the potential pathway linking staffing level to back pain among hospital workers.

Original languageEnglish
Pages (from-to)323-330
Number of pages8
JournalInternational Archives of Occupational and Environmental Health
Issue number3
Publication statusPublished - 2014 Apr


  • Back pain
  • Hospital worker
  • Inadequate staffing
  • Musculoskeletal pain

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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