UF researchers aim to show whether effective stress and pain management can prevent back injuries in nurses
A University of Florida nursing researcher is examining whether stress and pain management techniques can prevent work-related injuries and improve the overall health of nursing professionals, potentially avoiding a worsening of the nation’s nursing shortage.
Nancy Menzel, Ph.D., R.N., an assistant professor at the UF College of Nursing, will study two groups of 32 nursing staff members who have reported working with back pain in the past year. One group will attend six weeks of classes on stress and pain management before receiving state-of-the-art patient handling and movement technology equipment, such as motorized lifts and friction-reducing devices, for use on the job.
The other group only will receive the ergonomic equipment, which is designed to reduce the risk of back injuries associated with patient handling and is being loaned for the study by commercial vendors.
The stress and pain management classes are designed to reduce stress, back pain and disability in nursing staff members. UF investigators will examine whether such classes can enhance the benefits of using patient handling equipment.
The study is among four pilot studies of the UF Biobehavioral Research Center launched this year and will be conducted at Brooks Rehabilitation Hospital in Jacksonville.
Menzel will evaluate study results to determine whether standardized measurements of stress, pain, disability, emotional burnout and job satisfaction can predict the incidence and length of unscheduled absences from work due to back pain.
Federal regulators and researchers have focused almost exclusively on reducing the physical risk factors associated with back injuries in nursing work environments, so Menzel says the project is needed to investigate psychosocial factors.
“In many instances pain and stress are intertwined,” Menzel said. “We want to be able to set up an effective and convenient training schedule that may assist these nurses and nursing assistants with coping with both the pain and stress of their everyday jobs.”
Psychosocial stress has been shown to increase spinal compression and thereby increase the risk of lower back disorder in some people. Previous research has shown that high job demand, low job satisfaction and low social support have been identified as risk factors for work-related musculoskeletal disorders.
Study participants will be Brooks Rehabilitation Hospital full- or-part-time nursing staff, including registered nurses, licensed practical nurses and nursing assistants of any age or gender who spend at least 80 percent of their time providing direct patient care and who report that they have had work-related back pain lasting a week or longer in the past 30 days.
The educational sessions have been adapted from successful stress and pain management programs administered to chronic pain patients at the UF Spine Center and Psychology Clinic. Sessions include instruction on relaxation techniques; time management; distraction techniques; on-the-job stress and conflict management; assertiveness training; communication skills and problem solving; and personal and health education in sleep, hygiene, nutrition and exercise.
In measuring stress, pain, disability, emotional burnout and job satisfaction, Menzel will use various standardized research questionnaires and inventories, including the Beck Depression Inventory, the Maslach Burnout Inventory and the Minnesota Satisfaction Questionnaire. Unscheduled absences will be measured by participants’ reports of sick leave and lost days.
To assess the levels of physical stress from the use of patient handling devices, the study will compare salivary cortisol levels of participants only receiving the technological interventions both before and after introduction of the equipment.
Menzel will work with co-investigator Michael E. Robinson, Ph.D., a professor at the UF College of Health Professions and director of the Center for Pain Research and Behavioral Health at UF, which is dedicated to investigating and understanding the experience of pain in humans.
Results from the pilot study will be used to form the basis for a larger, randomized study.
“The ultimate goal, if stress management is found to be effective, is to promote the widespread adoption by health-care facilities of such training for nursing staff, in lieu of body mechanics classes, which have been of limited usefulness in preventing back injuries,” Menzel said.