The relationship between protective and risk characteristics of acting and experienced workload, and musculoskeletal disorder cases among nurses

Problems: Limited research is available on the acting (work characteristics) and experienced (perceived stress) workload of nurses. The relationship between risk and protective characteristics of work-related factors and the prevalence of musculoskletal symptoms in different body regions is also unclear. Methods: The study was a cross-sectional design with 97 female registered nurses working in a hospital setting. Two surveys were used to document the workload exposure of the nurses. One survey consisted of 148 items aimed to measure the acting workload variables from the environment; the other survey included 33 items that were aimed to measure the nurses' experienced workload. The musculoskeletal outcomes were documented with a modified version of the Nordic Musculoskeletal Symptom Survey. Results: Factor analyses revealed three factors that accounted for 56% of the total variance. Factor 1 (i.e., integrated experienced energy replenishment/expenditure) represented the psychological effects of work characteristics, effort, perceived risk, and performance. Factor 2 (i.e., acting energy replenishment/expenditure) consisted of non-physical variables of the work characteristics, while Factor 3 (i.e., acting energy expenditure) included both acting and experienced workload. Logistic regression analyses indicated that Factor 3 was significantly associated with the musculoskeletal symptoms of lower and upper back, hands/wrists, and knees/lower legs (odds ratios > 1.0). Factor 2 was significantly associated with the musculoskeletal symptoms of the upper back and knees/lower legs (odds ratios < 1.0). Summary: Both the acting and experienced workloads exhibited associations with musculoskeletal outcomes in the lower back, upper back, hands/wrists, and knees/lower legs in terms of risk and protective effects.