ارتباط بین معنای کار و احساس ناراحتی عضلانی اسکلتی

This exploratory study was conducted to see if there was an association between the meaning of working and musculoskeletal discomfort and if that association was predictive of the severity of discomfort. Each of 170 telecommunication personnel at two sites completed a Meaning of Working Survey form and a Musculoskeletal Discomfort Questionnaire. Seven component composites of the meaning of working (work centrality, obligation, entitlement, comfort, promotion/power, expressive, and social support) were entered into a linear multiple regression model. The results suggested that there was a moderate, significant association (R2=0.19,p=0.0002) between overall musculoskeletal discomfort and promotion/power as well as the control variables age, gender, job satisfaction, average hours worked, and site. A logistic linear regression found that these composites, along with social support, could accurately identify who was in a none/mild discomfort category or a moderate/severe discomfort category 72% of the time. The overall pattern suggested that females who worked longer hours, valued promotion and power and disliked social support were most likely to develop moderate to severe musculoskeletal discomfort. This study provides a preliminary exploration of the association between meaning and MSD in the workplace and provides one hypothesis why meaning may be associated with MSD.

In the past 20 years there has been a steady increase in musculoskeletal disorders (MSD) in the work place. The Occupational Health and Safety Administration (OSHA) recently attempted to pass an ergonomic standard that focused on reducing the biomechanical and work practice hazards that have been associated with MSD in the workplace (OSHA, 1999). However, concurrent with the development of the OSHA standards has been the development of a body of evidence that biomechanical hazards alone cannot completely explain the development of MSD. Reviews of the research on the association between biomechanical factors and MSD have suggested that the research in this area is flawed and often poorly designed (Baker, 1999; Vender et al., 1995). Many researchers have suggested that the etiology of MSD is complex, poorly understood, and involves not only the physical work environment, but also psychosocial job factors (Bongers et al., 1993). Recent studies on the etiology of MSD have suggested that it may be more of a mind/body phenomenon than previously described (Moon and Sauter, 1996). Psychosocial job factors are a complex interplay between the work set-up, the social climate, and the culture of the work environment. The connection between psychosocial variables and stress-related musculoskeletal problems, such as MSD, has been studied extensively in the literature (see Bongers et al., 1993; Smith, 1997 for literature reviews). Many different psychosocial factors have been significantly associated with MSD. However, no one psychosocial factor has consistently been associated with MSD in all studies. There seems to be a missing link between the presence of potentially adverse psychosocial job conditions and the presence of MSD. This piece could be the framework used to appraise job conditions as stressful. As psychosocial factors are assumed to have some unique psychological meaning to each individual (Sauter and Swansen, 1996) it is possible that meaning of working may be the interpretive element that shapes an individual's appraisal of the job environment, dictating whether the psychosocial environment will influence the development of MSD. 1.1. The meaning of working The meaning of working (MOW), is the generalized significance of the role of working (Meaning of Working International Research Team, 1987; Trombly, 1995). This significance relates to the perception that participation in that role will meet individual beliefs and achieve valued outcomes (Jackson et al., 1998; Meaning of Working International Research Team, 1987). MOW, therefore, provides an individualized method of structuring job performance by providing a framework for ranking, selecting, and implementing tasks and activities. MOW governs an individual's interpretation of the relevance of features of the job to the beliefs and values associated with the worker role. If a job feature is perceived to be inconsistent with the beliefs and valued outcomes associated with the role of working this may cause stress. However, identifying the meaning of working of an individual can be difficult as there are many potential beliefs and valued outcomes associated with working. 1.2. Measuring the meaning of working (MOW) The Meaning of Working International Research Team (Meaning of Working International Research Team, 1987) has developed one successful method of researching the MOW of populations. The Meaning of Working International Research Team considers MOW to be a stable personal attribute, one that remains relatively constant. They use three separate, but intertwined elements to understand and study MOW: (1) work centrality; (2) societal norms about working; and (3) valued work outcomes. 1.2.1. Work centrality and beliefs about working Work centrality is the degree of general importance that working has in the life of an individual at any given point in time (Meaning of Working International Research Team, 1987). The construct of work centrality, therefore, provides the overall measurement of the significance of working. This significance depends upon the beliefs and valued outcomes associated with it. Societal norms about working are beliefs and expectations concerning specific rights and duties attached to working. (Ruiz-Quintanilla and Wilpert, 1991, p. 94). These beliefs are related to the idea of reciprocity. Workers have an obligation to do certain things, and in return, receive certain benefits or entitlements. This aspect of the MOW represents two opposite but balanced social concepts: entitlements and obligations. 1.2.2. Valued outcomes The third component of meaning, valued outcomes, is believed to directly shape the behavior and actions of workers (Roberson et al., 1989; Sagie et al., 1996). Valued work outcomes are the preferred results of working. Individuals work to obtain certain vital outcomes such as income, security, personal growth, working conditions, and social interactions (Ruiz-Quintanilla and Claes, 2000; Roberson et al., 1989; Pryor, 1982). 1.3. Health outcomes associated with individual meaning of working components Thus far, no one has examined the association between health outcomes and these three components combined. There is, however, research that suggests that individual components of meaning are associated with health outcomes. High work centrality has been associated with positive health outcomes (Meleis et al., 1989; Simon, 1997; Verbrugge, 1983; Wickrama et al., 1995). While there is no research that has directly studied the associations between societal norms and health outcomes, Rousseau (1995) in her discussion of psychological contracts in organizations suggests that when entitlements are not met, a state of inequity occurs. This state causes dissatisfaction and anger with the system. The speculation that unmet entitlements cause dissatisfaction suggests that individuals who have a high entitlement score may be more prone to MSD. The association between the presence of valued work outcomes and health has been extensively evaluated. The perception that working can lead to valued outcomes such as pay, personal growth, and comfort, and that the outcomes are attainable has been shown to be a direct antecedent of job satisfaction (Butler, 1983; Locke, 1976; Roberson, 1990). Workers who are dissatisfied with their job have more reports of ill health than those who are satisfied do (Graetz, 1993; Meleis et al., 1989; O'Brien and Feather, 1990; Thoits, 1995). Specific psychosocial variables, too, are often a form of valued work outcomes. The extensive literature on psychosocial variables suggests that there is an association between MSD and a lack of valued outcomes such as autonomy, social interaction, and job security (Bernard, 1997; Holt, 1993; Lindström, 1994; Moon and Sauter, 1996). In this study we examined the associations between the severity of musculoskeletal discomfort and both the single sub-components of MOW (centrality, beliefs, and valued outcomes) and MOW as a interconnected construct in a sample of telecommunication workers. 1.4. Research questions The aim of this exploratory research was to discover whether each of the components of MOW was associated with severity of musculoskeletal discomfort, how large those associations were, and if these different components associations were modified when examined as one overall MOW construct. The following research questions were examined. • Were the single components of MOW associated with the severity of musculoskeletal discomfort, and what were those associations? • How did the components of MOW associate with musculoskeletal discomfort when examined together in one model? • What pattern of the components of MOW best identified those individuals with moderate to severe musculoskeletal discomfort?

We found that components of MOW, promotion/power and social support, had significant associations with the severity of musculoskeletal discomfort. This study justifies a further examination of MOW and its association with workplace health. Research must be done that further identifies the components of meaning associated with working; particularly in identifying the beliefs associated with working. A study that examines the individual's meaning of work and his or her perception of the presence or absence of that meaningful attribute in the workplace must also be completed. This study would help to further clarify the importance of matching the meaning of working and the working environment. Understanding the causes MSD has implications for protecting the health of workers. Interventions based on an understanding of an individual's meaning of working might include assisting workers to identify what they believe and value about working and incorporate these into their job selection and job-related stress management techniques. Employers may shape certain psychosocial aspects of a job to meet common beliefs and values held by most of their workers. This study has provided a first step toward understanding the relationship between the beliefs and values associated with working and MSD. Examining the association between MOW and MSD provides yet another clue in understanding the strong relationship between the mind and the body, and how that relationship shapes and molds the health of an individual.