¹Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
²Department Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Occupational therapy, Linköping University, Norrköping, Sweden
³Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University, Linköping, Sweden
⁴Occupational and Environmental Medicine Centre, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Clinical medicine, Linköping University, Linköping, Sweden
⁵Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, Sweden
⁶Unit of Intervention and Implementation Research for worker health, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

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Introduction: The healthcare environment with high demands, complex patient needs, and limited resources presents challenges to the safety and health of the workforce. Healthcare workers (HCWs) are at high risk for work-related musculoskeletal disorders (MSDs), implying a need to scrutinize their perspective of the work environment and impact on work performance. The aim of this study was to describe HCWs’ perceptions of the work environment, prevalence of MSDs and impact on work performance, including work ability, sickness presenteeism and sickness absence.

Methods: This is a multicentre cross-sectional study conducted within Swedish healthcare in 2023. In total, 1214 HCWs working at hospital care units (n=510), or nursing homes (n=704) responded to a survey (64% response rate) regarding perceptions of musculoskeletal pain, aspects of work ability, work environment and conditions, and sickness presenteeism and absence. The survey included the Nordic Pain Questionnaire, the Work Ability Index and validated questions. Descriptive statistics were used for data analysis.

Results: In total, 90% of the responders were women and the majority worked as assistant nurses (70%) or registered nurses (18%). Almost all the responders (94%) reported musculoskeletal pain the past 12 months and 79% reported pain the past week. Pain locations were the neck (41%), back (47%), upper (54%) and lower extremities (47%). In mean, 2.3 pain locations were reported per HCW. Two thirds of the respondents perceived that the pain was related to work tasks.

The demands at work were reported as both mentally and physically demanding (78%). About one-fourth (24%) reported their current work ability to be moderate or bad in relation to the physical demands, and 27% in relation to the mental demands at work. In mean, current work ability compared with the lifetime best was 8.6 on a scale from 0–10, which is considered good to excellent work ability. Forty percent reported that they can do their job despite receiving symptoms, 15% reduced the pace of work or changed the way they worked and 4% worked part-time.

Forty percent of the respondents reported problems in the work environment the past seven days and the same proportion experienced health problems the past seven days but chose still to go to work (41%). Nevertheless, few reported that any of these problems affected their work performance (3% and 2.5% respectively). In total 28% of the responders had been on sick leave 8 days or more the past 12 months.

Discussion: This study highlights a physical and mental demanding work environment in healthcare and a noteworthy proportion of HCWs described weekly challenges in their work environment. In line with previous research, prevalence of work-related MSDs was high and work ability moderate or poor in one of four HCWs. Although work performance was seldom affected, attention needs to be paid on the high sickness presenteeism.

Conclusion: The findings from this study suggest improvements in the work environment to reduce the prevalence of musculoskeletal disorders and secure a healthy workforce in future healthcare. The improvements need to address both physical and mental work demands.