Knutsen Rigmor Harang, Nielsen Morten Birkeland, Lunde Lars Kristian, Fostervold Knut Inge, Johannessen Håkon A
Research Group for Work Psychology and Physiology, National Institute for Occupational Health, 0363 Oslo, Norway.
Department of Psychology, University of Oslo, 0373 Oslo, Norway.
Int J Nurs Stud Adv. 2025 Jul 6;9:100376. doi: 10.1016/j.ijnsa.2025.100376. eCollection 2025 Dec.
In Norway, home care workers experience particularly high levels of medically-certified sick leave. A substantial percentage of sick leave is due to musculoskeletal disorders, which may be attributed to risk factors at work. Due to limited knowledge of the impact of working conditions on sick leave in this sector, an improved understanding of occupation-specific risk factors is needed.
To examine the impact of psychosocial and mechanical work factors on subsequent sick leave due to musculoskeletal disorders.
Prospective cohort study.
A probability sample of 130 Norwegian municipalities and their respective home care services.
1819 home care workers.
Participants were surveyed on work environment factors and followed for 26 months between 2019 and 2021 using registry data on sick leave from the Norwegian Labour and Welfare Administration. Registry data comprised complete registrations of all medically-certified sick leave, including the relevant diagnostic codes of the International Classification of Primary Care system. Incidence risk ratios and 95 % confidence intervals were calculated using negative binomial regression with robust standard deviations. Population attributable risk and population preventable fractions were calculated to estimate the contribution of the significant work factors to sick leave in the sample.
The following factors were associated with excessive risk of sick leave due to musculoskeletal disorders: Lifting or supporting the patient between bed and chair or wheelchair, heavy physical exertion without aids or assistance, heavy physical exertion despite aids or assistance, walking/standing, forward bending of the upper body, squatting/kneeling, and experiencing the work as physically demanding. Control over work pacing, fair leadership, empowering leadership, and support from immediate supervisor were associated with reduced risk of sick leave.
Preventive efforts to reduce sick leave due to musculoskeletal disorders among home care workers should adopt a multifactorial approach, including both psychosocial and mechanical work factors and the context in which they occur. There may be considerable potential for risk reduction by targeting awkward postures and heavy physical exertions, facilitating control over work pacing, and developing relationship-oriented leadership skills.
Clinical Trials - NCT03855163.
在挪威，家庭护理人员的医学认证病假水平特别高。相当一部分病假是由于肌肉骨骼疾病，这可能归因于工作中的风险因素。由于对该部门工作条件对病假的影响了解有限，因此需要更好地了解特定职业的风险因素。
研究心理社会和机械工作因素对随后因肌肉骨骼疾病导致的病假的影响。
前瞻性队列研究。
从挪威130个市政当局及其各自的家庭护理服务机构中抽取概率样本。
1819名家庭护理人员。
对参与者进行工作环境因素调查，并在2019年至2021年期间使用挪威劳动和福利管理局的病假登记数据对其进行26个月的跟踪。登记数据包括所有医学认证病假的完整记录，包括国际初级保健分类系统的相关诊断代码。使用具有稳健标准差的负二项回归计算发病风险比和95%置信区间。计算人群归因风险和人群可预防比例，以估计样本中显著工作因素对病假的贡献。
以下因素与因肌肉骨骼疾病导致病假的风险过高有关：在床与椅子或轮椅之间抬起或支撑患者、在没有辅助工具或协助的情况下进行重体力劳动、尽管有辅助工具或协助仍进行重体力劳动、行走/站立、上身向前弯曲、蹲下/跪着以及感觉工作对体力要求很高。对工作节奏的控制、公平领导、赋能领导以及直属上级的支持与病假风险降低有关。
减少家庭护理人员因肌肉骨骼疾病导致病假的预防措施应采用多因素方法，包括心理社会和机械工作因素及其发生的背景。通过针对笨拙姿势和重体力劳动、促进对工作节奏的控制以及培养以关系为导向的领导技能，可能有很大的降低风险潜力。
临床试验 - NCT03855163。
