Integrating ‘psychosocial’ factors into a theoretical model for work-related musculoskeletal disorders

Abstract

The psychosocial aspects of jobs, in addition to their biomechanical aspects, have demonstrated significant relationships with work-related musculoskeletal symptoms and disorders (WRMSDs). Current models that seek to explain these associations build on the stress paradigm and propose that job strain impacts WRMSDs through increases in muscle tension; alterations in endocrine, immune, neurological and vascular systems that condition tissue injury and repair; and higher cognitive processes that alter symptom awareness and evaluation. These models vary in the emphasis placed on worker characteristics as opposed to work stressors. The paper provides a critical review of these models and draws on concepts advanced in the field of occupational safety to propose a modification of these approaches. The model advanced here integrates psychosocial and biomechanical risk factors as characteristics of work environment and emphasizes the role of management systems and the work environment as key sources of strain. Strain, as indicated by the physiological, behavioural and other responses of the worker, in turn influences WRMSDs and related outcomes as well as worker performance and productivity. The integrated model also takes into account the importance of viewing the work environment as a dynamic phenomenon with interaction among risk factors and between workers and managers.

Keywords:

• Psychosocial
• Theory
• Ergonomics
• Musculoskeletal

Notes

About the authors

Julia Faucett , RN, PhD, FAAN, is a Professor at the University of California, San Francisco. She obtained her PhD and MS degree from the University of California, San Francisco, her BA in psychology from Stanford and BSN from Winona State University (Minnesota). Dr Faucett’s programme of research focuses on the prevention and management of musculoskeletal disorders in the workplace. Her research investigates organizational, psychosocial and biomechanical factors that contribute to these disorders and related disability from work.