Underreporting of work-related low back pain among registered nurses: A mixed method study

Am J Ind Med. 2023 Nov;66(11):952-964. doi: 10.1002/ajim.23530. Epub 2023 Aug 27.

Abstract

Background: Identifying and addressing work-related health problems early is crucial, but workers often perceive barriers in reporting these to management. This study aimed to investigate the factors associated with nurses' reporting of work-related low back pain to their managers and explored the reasons why nurses with patient handling injuries did not report them.

Methods: This study is a concurrent mixed-method analysis of data from two statewide cross-sectional surveys of California registered nurses conducted in 2013 and 2016. The reporting of work-related low back pain to management (n = 288) was examined for associations with individual, occupational, and organizational factors. For qualitative analysis, the reasons for not reporting patient handling injuries were explored using open-ended responses (n = 42).

Results: Reporting was associated with BIPOC (Black, Indigenous, and People of Color) men (adjusted odds ratio [AOR]: 1.31, 95% confidence interval [CI]: 1.07-1.59) compared to non-Hispanic White women; being a non-US educated nurse (AOR: 0.90, 95% CI: 0.80-1.01); experiencing greater low back pain (AOR: 1.07, 95% CI: 1.02-1.12); missing work (AOR: 1.38, 95% CI: 1.21-2.62); perceiving high physical workload (AOR: 0.89, 95% CI: 0.81-0.98); perceiving high people-oriented culture (AOR: 1.14, 95% CI: 1.04-1.25); and perceiving high ergonomic practices (AOR: 0.89, 95% CI: 0.81-0.98). Identified themes on the reasons for not reporting injuries included organizational-culture attitudes toward work-related injuries and injury characteristics of musculoskeletal disorders.

Conclusions: The findings indicate a need for management to remove structural barriers and improve organizational practices, and for a culture that promotes trust and open communication between workers and management.

Keywords: incident reports; low back pain; musculoskeletal disorders; nurses; organizational culture; patient handling injury; underreport.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cross-Sectional Studies
  • Data Collection
  • Female
  • Humans
  • Low Back Pain* / epidemiology
  • Low Back Pain* / etiology
  • Male
  • Musculoskeletal Diseases*
  • Nurses*
  • Occupational Diseases* / epidemiology
  • Occupational Diseases* / etiology