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Title: Predictors of work-related musculoskeletal symptoms in shoulders among nursing assistants working in nursing homes
Authors: Cheung, K 
Ma, KY 
Cheung, HH 
Lee, CH 
Chan, IMM 
Cheung, ST 
Chung, WY 
Yeung, SS 
Lo, WC 
Issue Date: 2021
Source: PeerJ, 2021, v. 9, e11152
Abstract: Nursing assistants (NAs) working in nursing homes (NHs) are at higher risk for work-related musculoskeletal symptoms (WRMSs) than their counterparts working in other health care settings. Worldwide, NAs have ranked shoulders in the top three body parts at risk of WRMSs. However, factors associated with their shoulder WRMSs are currently unknown. The aim of this study was to identify these associated risk factors among NAs working in NHs. 440 NAs from 47 nursing homes (with 60–90% response rate from each nursing home), recruited by convenience sampling, participated in this cross-sectional study in 2014–2015. A validated and reliable questionnaire was used for data collection. Information on demographic, job content questionnaire (JCQ), perceived physical exertion (PE), workstyle, ergonomic and manual handling knowledge and other work-related factors was collected using a self-administered questionnaire. 53% of the participants reported experiencing with WRMSs in their shoulders. Nine associated factors of shoulder WRMSs were identified using bivariate analysis. With the adjustment of age and gender using multivariable logistic regression, body mass index (OR = .931, 95% CI [.874–.991]), job title of health workers (OR = 2.72, 95% CI [1.18–6.25]) and workstyle-working through pain (OR = 1.06, 95% CI [1.01–1.11]) remained as predictors. Effort should be directed at integrating ‘‘workstyle intervention’’ into lifestyle physical activity training for NAs.
Keywords: Body mass index
Musculoskeletal health
Publisher: PeerJ, Ltd.
Journal: PeerJ 
EISSN: 2167-8359
DOI: 10.7717/peerj.11152
Rights: © 2021 Cheung et al. Licence
This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.
The following publication Cheung K, Ma KY, Cheung HH, Lee CH, Chan IMM, Cheung ST, Chung WY, Yeung SS, Lo WC. 2021. Predictors of work-related musculoskeletal symptoms in shoulders among nursing assistants working in nursing homes. PeerJ 9:e11152 is available at
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