Context – The world of work is facing more risks : psychosocial risks. Chronic exposure to stress at work can lead to physical consequences (musculoskeletal pain) and psychological consequences (burnout). Few studies were conducted on these two phenomena together. It seems relevant to study the place of burnout in triggering musculoskeletal pain by taking into account interpersonal dimensions that will better understand the relationship between these two clinical presentations.
Objective – This research investigates the relationship between burnout, musculoskeletal pain and disabilities with the consideration of psychological risk factors : fear avoidance beliefs and perceived injustice. These risk factors could promote the initiation and maintenance of burnout and musculoskeletal pain.
Hypothesis – First, we hypothesized that the high level of emotional exhaustion and depersonalization increases pain intensity and disability and high level of professional efficacy decreases pain intensity and disability. Second, we hypothesized that a high level of fear-avoidance belief and perception of perceived injustice increases the painful intensity and functional repercussions associated with it. Finally, we thought there is a positive correlation between psychological risk factors, emotional exhaustion and cynicism. Then, there was a negative correlation between psychological risk factors and feelings of personal and professional accomplishment.
Method – This is a quantitative study conducted with 62 patients from the University Hospital of Angers, 20 participants has musculoskeletal pain and consult at the « professional pathologies resource center » and 42 participants has chronic low back pain and consult in the center « lombaction ». The collection of data was based on self-questionnaires validated in French. For subjects with musculoskeletal pain, it is the visual analogue pain scale that measures pain intensity, Örebro Musculoskeletal Pain Screening Questionnaire (OMPSQ) assesses the risk of disability, Tampa Scale of Kinesiophobia (TSK) interests in the fear of pain, the Injustice Experience Questionnaire (IEQ) measures perceived injustice and the Maslach Burnout Inventory (MBI) assesses burnout. For patients with low back pain, it is the visual analogue pain scale, the Dallas questionnaire (DRAD) measures functional implications, questionnaire Oswestry measures functional disability, Fear Avoidance Belief Questionnaire (FABQ) interests at fear-avoidance beliefs, Injustice Experience Questionnaire (IEQ) and Maslach Burnout Inventory (MBI). Statistical analyzes rely on variance, correlations and multiples regressions on the SPSS software.
Results – Burnout is not correlated with pain intensity. However, emotional exhaustion is the dimension most related to disability. Depersonalization is related to the risk of disability in patients with musculoskeletal pain. Regarding psychological factors, perceived injustice are strongly related to pain intensity and disability, however, this risk factor has not predictive value. Then, fear-avoidance beliefs about work are an important predictor of functional repercussions on work and leisure.
Conclusion – This research highlights the importance of taking into account psychological risk factors and more particularly the perceived injustice in understanding chronic pain such as musculoskeletal pain or low back pain. In clinical practice, it seems essential to focus on the dysfunctional beliefs that underlie these risk factors.
Keywords : burnout – chronic pain – risk factors – perceived injustice – fear avoidance beliefs
Words I have learned :
- fear avoidance beliefs = croyances peur-évitement
- perceived injustice = sentiment d’injustice
- psychosocial risks = risques psychosociaux
- low back pain = lombalgie chronique
- musculoskeletal pain = TMS
Alexia Vachon, M2 PCPI