Effort-reward imbalance and low back pain among eldercare workers in nursing homes: a cross-sectional study in Kagawa Prefecture, Japan.

Objectives: To clarify effort-reward imbalance among eldercare workers in nursing homes and to examine the association between the effort-reward imbalance (ERI) and low back pain (LBP) among them.

Methods: A total of 549 questionnaires were distributed to a random sample comprising 23% of the 79 special elderly nursing homes in Kagawa in 2013. A total of 467 eldercare workers (response rate 85%) participated in this study. Of the 467 eligible respondents, 372 (80%) completed all items of the ERI questionnaire. Complete data were available for 342 (73%) eldercare workers.

Results: Of the 342 respondents, 215 (63%) had LBP at the time of the study, and 291 (85%) showed a critical "high cost/low gain" condition as determined by an effort-reward ratio >1. Multiple logistic regression analyses adjusted for age, gender, previous LBP experience, high-risk work and K6 score showed that eldercare workers with a high ERI had a higher risk for LBP than workers with a low ERI (OR, 1.96; 95% CI, 1.02-3.77).

Conclusions: Most eldercare workers have a high ERI, and their LBP is associated with their ERI. Balancing effort and reward may be an important factor for improving LBP among eldercare workers in nursing homes.