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Association between psychosocial factors and musculoskeletal disorders across different cultural backgrounds: a comparative study among Brazilian and Italian nursing personnel

Objectives Musculoskeletal disorders are a major cause of disability and absenteeism among nurses worldwide, but established risk factors do not adequately explain the observed differences in prevalence across countries. Pain prevalence has been linked with job satisfaction, mental health, somatising tendency and cultural background. We compared associations of risk factors with musculoskeletal symptoms and associated work-absence among nurses from Italy and Brazil. Methods Through the standardised CUPID-Questionnaire, we ascertained age, gender, workload, job satisfaction, psychosocial factors, musculoskeletal pain and associated absence, among 193 Brazilian and 560 Italian nurses. Differences between countries were investigated using the χ2 test and multivariate logistic regression models. Results Gender distribution was similar (85% female) but Italian nurse were younger (52% aged<40 vs 40%) with a shorter duration of employment. Back pain prevalence in the past month was comparable (45% Brazil, 49% Italy) but with a higher prevalence of related absence in Italy. Italian nurses reported more neck disorders while Brazilians reported more shoulder disorders (41% vs 33%, p=0.03). Somatising tendency had a similar prevalence between countries (38%) and in both countries was associated with pain in all investigated anatomical sites and with associated absenteeism. Job satisfaction (92% in Brazil vs 83% in Italy, p=0.002) was negatively associated with musculoskeletal disorders in both countries, and especially with low back pain in Italy and shoulder pain in Brazil. Conclusions Our results confirm that job satisfaction and psychological characteristics are importantly linked with musculoskeletal disorders. The influence of psychosocial risk factors may vary in different cultural environments.