Job stress and work-related musculoskeletal symptoms among intensive care unit nurses: a comparison between job demand-control and effort-reward imbalance models

Background The aims of this study were to compare job demand‐control (JDC) and effort‐reward imbalance (ERI) models in examining the association of job stress with work‐related musculoskeletal symptoms and to evaluate the utility of a combined model. Methods This study analyzed cross‐sectional survey data obtained from a nationwide random sample of 304 intensive‐care unit (ICU) nurses. Demographic and job factors were controlled in the analyses using logistic regression. Results Both JDC and ERI variables had strong and statistically significant associations with work‐related musculoskeletal symptoms. Effort‐reward imbalance had stronger associations than job strain or iso‐strain with musculoskeletal symptoms. Effort‐reward imbalance alone showed similar or stronger associations with muscusloskeletal symptoms compared to combined variables of the JDC and ERI models. Conclusions The ERI model appears to capture the magnitude of the musculoskeletal health risk among nurses associated with job stress at least as well and possibly better than the JDC model. Our findings suggest that combining the two models provides little gain compared to using effort‐reward imbalance only. Am. J. Ind. Med. 57:214–221, 2014. © 2013 Wiley Periodicals, Inc.