Workplace violence and musculoskeletal pain: A 2-year follow-up of nursing home workers

BACKGROUND & OBJECTIVES: We have previously published cross-sectional findings of an exposure-response relationship between exposure to physical assaults at work and musculoskeletal pain among nursing home workers. This 2-year follow-up study provides further evidence on the effect of workplace violence on musculoskeletal pain assessed with several parallel outcomes measured at 3 time points. METHODS: Nursing home workers with complete data from the 3 consecutive annual surveys formed the study cohort (n=344). The 6 outcomes were musculoskeletal pain at any site, widespread nature of symptoms, pain intensity, pain interference with work and sleep, and co-occurring symptoms of pain and depression. The main predictor was exposure to physical assault(s) at work during the preceding 3 months. RESULTS: Every fourth nursing home worker, and every third nursing aide, reported persistent exposure to workplace violence over the 2 years. Of these workers, 80% experienced musculoskeletal pain; one-fourth had widespread pain symptoms; pain was moderate to extreme in two out of three; pain had interfered with work for 50% and had affected sleep for over 50%; and about one-third felt depressed in addition to experiencing significant pain. Baseline exposure to violence predicted pain outcomes one year later and long-term exposure was associated with a linear increase in the risks of all pain-related outcomes at the end of the 2-year follow-up. CONCLUSIONS: Workplace violence, especially when long-term, is strongly associated with pain, separate from the effects of other job features. The outcomes are severe enough that they could influence nursing home staff to leave employment.