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      Is Workstyle a Mediating Factor for Pain in the Upper Extremity Over Time?

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          Abstract

          Introduction Upper extremity musculoskeletal disorders influence workers’ quality of life. Workstyle may be one factor to deal with in workers with pain in the upper extremity. The objective of this study was to determine if workstyle is a mediating factor for upper extremity pain in a changing work environment of office workers over time. Methods Office workers with upper extremity pain filled out a Workstyle questionnaire (WSF) at baseline ( n = 110). After 8 and 12 months follow-up assessment took place. Participants were divided into a good and an adverse workstyle group at baseline. The presence of upper extremity pain in both groups was calculated and relative risks were determined. Chi-square tests were used. Results Eight months after baseline, 80% of the adverse and 45% of the good workstyle group reported pain. The relative risk (RR) of having upper extremity pain for the adverse compared to the good workstyle group was 1.8 (95% CI 1.08–2.86) ( P = 0.055). Twelve months after baseline, upper extremity pain was more often presented in the adverse workstyle compared to the good workstyle group (RR = 3.0, (95% CI 1.76–5.11), P = 0.003). Twelve months after baseline, 100% of the adverse workstyle group and 33% of the good workstyle group reported pain in the upper extremity. Conclusion Workstyle seems to be a mediating factor for upper extremity pain in office workers in a changing work environment. It is recommended to assess workstyle among office workers with upper extremity pain, and to include workstyle behaviour in treatments.

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          Most cited references33

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          The cognitive activation theory of stress.

          This paper presents a cognitive activation theory of stress (CATS), with a formal system of systematic definitions. The term "stress" is used for four aspects of "stress", stress stimuli, stress experience, the non-specific, general stress response, and experience of the stress response. These four meanings may be measured separately. The stress response is a general alarm in a homeostatic system, producing general and unspecific neurophysiological activation from one level of arousal to more arousal. The stress response occurs whenever there is something missing, for instance a homeostatic imbalance, or a threat to homeostasis and life of the organism. Formally, the alarm occurs when there is a discrepancy between what should be and what is-between the value a variable should have (set value (SV)), and the real value (actual value (AV)) of the same variable. The stress response, therefore, is an essential and necessary physiological response. The unpleasantness of the alarm is no health threat. However, if sustained, the response may lead to illness and disease through established pathophysiological processes ("allostatic load"). The alarm elicits specific behaviors to cope with the situation. The level of alarm depends on expectancy of the outcome of stimuli and the specific responses available for coping. Psychological defense is defined as a distortion of stimulus expectancies. Response outcome expectancies are defined as positive, negative, or none, to the available responses. This offers formal definitions of coping, hopelessness, and helplessness that are easy to operationalize in man and in animals. It is an essential element of CATS that only when coping is defined as positive outcome expectancy does the concept predict relations to health and disease.
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            Are psychosocial factors, risk factors for symptoms and signs of the shoulder, elbow, or hand/wrist?: A review of the epidemiological literature.

            In 1993, an extensive review on the role of psychosocial factors in the development of musculoskeletal problems was published by Bongers et al (1993). Since then, additional reviews on this topic have been published; however, none of these focussed on upper limb problems. In this systematic review, the methodological quality of all studies was assessed and levels of evidence were apriori defined. The large majority of the studies reported an association between at least one work-related psychosocial factor and adverse upper extremity symptoms or signs. High-perceived job stress was consistently associated with all upper extremity problems (UEP) in high and lower quality studies. Although not often studied, non-work-related stress was also consistently associated with UEP. In addition, there was some evidence for a relationship between high job demands and UEP, although the results did not meet the pre-set criterion for consistency. High job stress and non-work-related stress reactions are consistently associated with UEP. In addition, high job demands is also in most studies associated with these disorders. Firm conclusions on the role of these factors in the etiology of UEP are not possible due to the cross-sectional nature of most studies.
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              The effect of office concepts on worker health and performance: a systematic review of the literature.

              Conventional and innovative office concepts can be described according to three dimensions: (1) the office location (e.g. telework office versus conventional office); (2) the office lay-out (e.g. open lay-out versus cellular office); and (3) the office use (e.g. fixed versus shared workplaces). This review examined how these three office dimensions affect the office worker's job demands, job resources, short- and long-term reactions. Using search terms related to the office concept (dimensions), a systematic literature search starting from 1972 was conducted in seven databases. Subsequently, based on the quality of the studies and the consistency of the findings, the level of evidence for the observed findings was assessed. Out of 1091 hits 49 relevant studies were identified. Results provide strong evidence that working in open workplaces reduces privacy and job satisfaction. Limited evidence is available that working in open workplaces intensifies cognitive workload and worsens interpersonal relations; close distance between workstations intensifies cognitive workload and reduces privacy; and desk-sharing improves communication. Due to a lack of studies no evidence was obtained for an effect of the three office dimensions on long-term reactions. The results suggest that ergonomists involved in office innovation could play a meaningful role in safeguarding the worker's job demands, job resources and well-being. Attention should be paid, in particular, to effects of workplace openness by providing acoustic and visual protection.
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                Author and article information

                Contributors
                +31-20-5665325 , +31-20-6977161 , j.sluiter@amc.nl
                Journal
                J Occup Rehabil
                Journal of Occupational Rehabilitation
                Springer US (Boston )
                1053-0487
                1573-3688
                8 August 2008
                September 2008
                : 18
                : 3
                : 262-266
                Affiliations
                Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands
                Article
                9145
                10.1007/s10926-008-9145-0
                2522379
                18688697
                864dac8d-2293-4289-aa8d-a27e3d2d17e8
                © The Author(s) 2008
                History
                : 11 March 2008
                : 3 July 2008
                Categories
                Article
                Custom metadata
                © Springer Science+Business Media, LLC 2008

                Occupational & Environmental medicine
                upper extremity pain,uemsd,workstyle,questionnaires—psychometrics

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