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DOI: 10.1111/nuf.

12269

ORIGINAL ARTICLE

Prevalence of low back pain and associated factors among


nurses in Jordan
Mohammad Suliman BSN, MSN, PhD

Faculty of Nursing, Community and Men-


tal Health Nursing Department, Al al-Bayt Abstract
University, Mafraq, Jordan Background: Low back pain (LBP) is a significant work-related problem, especially among nurses.
Correspondence This is due to its high prevalence and impact on the healthcare system, either directly through
Mohammad Suliman, PhD, RN, Faculty of Nurs-
treating affected nurses, or indirectly through the decrease in nurses’ productivity.
ing, Community and Mental Health Nursing
Department, Al al-Bayt University, P.O. Box Aim: The aim of this study is to measure the prevalence rates of LBP among nurses in Jordan, and
130040, Mafraq, 25113 Jordan.
Email: mms189@case.edu
to uncover the associated factors and consequences.

Funding information Methods: A cross-sectional design study. Data were collected through a data collection sheet,
AL alBayt University, Grant/Award Number:
developed based on literature, from seven public hospitals and one university hospital over a
2014/2015/9
period of 2 months.

Results: A total of 384 nurses completed the data sheet with a response rate of 76.8%. Current
prevalence of LBP was 69% (n = 265), 1-year prevalence was 78.9% (n = 303), while accumulative
prevalence was 83.6% (n = 321). Factors associated with LBP were older age, female gender, being
overweight, and having longer experience in nursing; 40% of nurses agreed that the LBP increased
their number of sick leaves, 58.7% agreed it lowered their productivity, and 9% reported that it
forced them to change unit.

Conclusion: LBP is a significant work-related problem among Jordanian nurses, with high-
prevalence rates, and debilitating medical and professional consequences. Interdisciplinary
efforts are needed to reduce these consequences.

KEYWORDS
Jordan, low back pain, nurses, prevalence

1 INTRODUCTION across the different studies because of differences among the defi-
nitions of LBP, methodologies, and points of prevalence measures.7
Nurses, given the nature of their profession, are prone to a plethora Nevertheless, the literature indicates that nurses are a high-risk group
of physical and mental problems. Low back pain (LBP) is considered as for LBP and longitudinal studies should be conducted to discover the
one of the most frequently reported work-related problems affecting magnitude of the problem.
nurses.1 LBP is a musculoskeletal disorder that affects bone, muscle, The etiology of LBP is determined by several individual and work-
and the neural system of the back for at least 1 day; it might radiate to related factors.8 The literature reports many individual factors, such as
one or both lower limbs in the area between the lower margins of the genetic predisposition, age, gender, and physical characteristics, beside
twelfth ribs and the lower gluteal folds.2 many occupational factors, such as stress and workload.2 Bejia et al.,9
Many international studies have indicated that LBP is a preva- found that the main factors associated with reporting LBP among
lent problem among healthcare workers.3,4 Studies conducted in nurses were older age, female gender, being overweight, being mar-
Switzerland found that the 1-year prevalence of LBP among health- ried or divorced, smoking, past history of LBP, high workload, multiple
care workers was 67.3%; it was highest among nurses (75.6%) and pregnancies, migraine headache, years of experience, and lifting heavy
lowest among support staff (54.9%).3 June and Cho5 found that 90.3% weights. Similarly, Bandpei et al.,7 identified factors: older age, high
of the intensive care unit nurses in South Korea experienced LBP at body mass index (BMI), smoking, reporting unhealthy conditions, lack
least once a month. However, only 18.3% of them had sought medical of assistance, low-job satisfaction, not using prevention strategies, and
advice. The prevalence of lifelong LBP among nurses in Taiwan was years of experience, while Genevay et al.,3 added working under poor
82.03%, and the point prevalence was 43.78%.6 Prevalence varied conditions and working for a long time in the same position. A recent

Nurs Forum. 2018;1–7. wileyonlinelibrary.com/journal/nuf 


c 2018 Wiley Periodicals, Inc. 1
2 SULIMAN

systematic review and meta-analysis showed that studies with high- causes, and radiating or not), medical consequences of LBP (medical
quality evidence agreed that high-psychosocial demands with low-job consultation, medication, hospitalization, radiological tests, and opera-
control are highly associated with LBP among nurses.10 Although most tion), professional consequences (reduced work performance, absence
studies have focused on ergonomic factors being related to LBP among from work, and change of workplace), and hospitals’ strategies to
nurses, these studies are considered to be of poor quality due to the protect workers’ backs (availability of preventive equipment, nurses’
restricted number of settings and because they utilized a convenience training, lifting teams).
sampling procedure. Three types of LBP prevalence were measured: (1) current preva-
Surveys from various countries show that LBP has many conse- lence (do you currently have LBP?), (2) year prevalence (during the last
quences on individuals and healthcare institutions. For individuals, year have you complained of LBP?), and (3) cumulative prevalence (at
these include restriction of activities and loss of productivity. The any time before last year have you complained of LBP?). Responses
institutional consequences include using up healthcare resources, and were yes/no for all three questions; if the answer was yes, a Likert
financial burden.2 D'Errico et al.,11 found that the prevalence of pre- scale that ranged from none of the time to all of the time was used
senteeism (attending work despite illness) due to LBP was very com- to measure the duration of pain. The severity of LBP was assessed
mon (58%) among nurses and nurses’ aids in Italy. LBP is responsi- using the Numeric Pain Rating Scale from 0 (no pain) to 10 (worst pain
ble for 3.15% of emergency visits and 65% of injuries sustained at imaginable).16 According to Hoy et al.,2 LBP is defined as pain for at
home.12 Abolfotouh et al.,13 in Qatar found that the outcomes of LBP least 1 day that might radiate to one or both lower limbs in the area
included: 18.1% of nurses took sick leave, 34.3% sought medical treat- between the lower margins of the twelfth ribs to the lower gluteal
ment, 76.8% took days off, and many reduced their daily activities, such folds. Acute LBP is defined as any LBP that lasts for less than 12 weeks,
as climbing stairs (50.7%) and walking (42.8%). In this context, the lit- and chronic LBP is defined as pain that lasts for 12 weeks or more.
erature reports that LBP is not an isolated phenomenon; its conse-
quences are reflected in decreased productivity and increased costs.14
2.3 Data collection procedure
In the United States of America, these costs may be as high as $100–
$200 billion annually.15 No figures were available in the literature for Following ethical approval (from the author's home university review
such costs in Jordan. board, and the participating hospitals’ ethical committee) to carry out
Few studies have examined LBP and its prevalence in middle- and the study, fourth-year nursing students from the author's home uni-
low-income countries,2 but such studies are necessary. To our knowl- versity were assigned to distribute the data collection sheets to par-
edge, there is no published study about LBP among nurses in Jor- ticipating nurses for completion. Completed sheets were returned to
dan. Thus, the present study was conducted to investigate Jordanian the unit manager's office, then recollected by the principal investigator.
nurses’ reporting: prevalence rates of LBP, its associated factors, its The students were given full details about the study and the inclusion
medical and professional consequences, and the availability of preven- criteria for the research subjects. The data collection sheet contained
tive measures in their hospitals. The results will help in identifying the information about the goals of the study as well as further information,
magnitude of the problem in Jordan, and will be a baseline for future such as the risks and benefits from the study, and the confidentiality of
efforts to decrease the problem of LBP among nurses in the country. the data. All data sheets were collected and stored in the researcher's
office.

2 METHODS
2.4 Data analysis
2.1 Design and sampling All data were analyzed using Statistical Package for Social Sciences
This study used a cross-sectional design and the data were collected version 17 (IBM, Chicago, IL). Descriptive statistics described the
over a period of 2 months from seven public hospitals and one univer- nurses’ demographic data and the prevalence of LBP. Univariate (t-test
sity hospital in the north and middle areas of Jordan. Nurses with a min- and 𝜒 2 test) and multivariate (logistic regression) analysis were used
imum of 1 year's work experience on a unit/ward were selected using to answer the remaining research questions. Having pain was coded
convenience sampling. as 1, no pain as 0, male gender was coded as 0, and female as 1, being
overweight was coded as 1, and normal weight as 0. The age and work
experience were treated as continuous variables. Alpha level of 0.05
2.2 Data collection sheet
was used to investigate significant findings.
A data collection sheet was developed based on the literature. It
was composed of 40 items that included: demographic data, num-
3 RESULTS
ber of pregnancies, education level, nursing experience (the amount
of time worked as a nurse), hospital experience, weight, height,
3.1 Sample characteristics
smoking, chronic disease, exercise, work-related conditions (hospitals,
units/wards, number of patients, number of working hours, working A total of 384 out of 500 nurses (response rate = 76.8%) agreed to par-
shifts, weight lifting at work), prevalence rates of LBP (current, last ticipate and completed the survey from the selected hospitals. Respon-
year, accumulative prevalence), pain description (pain acuity, duration, dents were generally young (M = 32.59, SD = 7.48), approximately
SULIMAN 3

TA B L E 1 Sample characteristics (N = 384) P = 0.007). The prevalence was also higher in overweight nurses

Character Frequency (n, %) (66.7%, n = 202) compared with nurses of normal body weight (32.3%,
n = 98) (𝜒 2 (1, N = 384) = 1.21, P = 0.001). Other individual factors,
Gender
such as smoking, exercising regularly, and having a chronic condition,
Male 127 (33.1)
such as diabetes or hypertension were not significantly associated with
Female 257 (66.9)
LBP (Table 2).
Age
The length of nursing experience was the only professional factor
20–30 years 201 (52.3)
associated with LBP. The results of the t test show that the prevalence
31–40 years 140 (36.5) of LBP was more common in nurses with longer experience in their
41–50 years 42 (10.9) hospitals (M = 7.82, SD = 6.41) than in those with shorter experience
> 50 years 1 (0.3) (M = 6.31, SD = 5.61) (t (383) = 2.08, P = 0.03). The study found that
Marital Status the other occupational factors were not significantly associated with
Single 97 (25.3) LBP: hospital type, place of work, number of working hours per week,
Married 287 (74.7) lifting weight at work, number of patients, and shift type (Table 3).
Nursing experience Logistic regression was performed on variables that turned out to

1–5 years 161 (41.9) be significant in univariate analysis to assess if these factors were
independently associated with LBP while controlling the confound-
6–10 years 102 (26.6)
ing effects of other variables. The logistic model contained four inde-
> 10 years 121 (31.5)
pendent variables (age, nursing experience, gender, and weight). The
Hospital type
full model containing all predictors was statistically significant, (𝜒 2 (4,
Ministry of Health 291 (75.8)
N = 384) = 74.03, P < 0.001), indicating that the model was able to dis-
University 93 (24.2)
tinguish between nurses who reported LBP and nurses who did not. As
shown in Table 4, all the four variables made a unique statistically sig-
nificant contribution to the model.
two-thirds (n = 257, 66.9%) were female, and 265 (69.0%) had a bach-
The strongest predictor of the four variables was gender, with an
elor's degree in nursing. Other details are shown in Table 1.
odds ratio of 2.13, 95%confidence of interval (CI) = (1.22, 3.71). This
indicated that female nurses had more than double the chance of hav-
3.2 Prevalence rates ing LBP compared to male nurses, controlling all other factors in the
model. Nursing experience comes in second place, with an odds ratio
At the time of the survey, many nurses complained of LBP, with current
of 1.15, 95%CI = (1.07, 1.23), indicating that, with each additional year
prevalence being 69.0% (n = 265). The 1-year prevalence of LBP was
of experience, the nurses are 1.15 times more likely to report LBP, con-
78.9% (n = 303), the cumulative prevalence was 83.6% (n = 321), and
trolling all other factors in the model. In third place comes age, with an
the prevalence of chronic LBP was 46.4% (n = 178).
odds ratio of 0.8, 95%CI = (0.74, 0.86), indicating that, for every addi-
tional year of age, nurses are 0.8 more likely to report LBP, controlling
3.3 Pain characteristics all other factors in the model. The fourth place goes to weight, with an
Most of the nurses who reported current LBP were female, 70.3% odds ratio of 0.52, 95%CI = (0.25, 0.63) indicating that, with each addi-
(n = 213); sufferers’ mean age was 31.88 (SD = 6.93). Approximately 56 tional kilogram of weight, the nurses are 0.52 more likely to report LBP,
of the nurses (14.6%) reported that they had experienced pain every controlling all other factors in the model.
day over recent years. Many who sought medical advice were diag-
nosed with herniated disc (17.2%, n = 66), spinal stenosis (13%, n = 60),
3.5 Low back pain consequences
and sciatica (3.4%, n = 13). On average, nurses reported a moderate
pain of 5.23 (SD = 1.75) on a scale from 0 to 10 (where 0 is no pain, 10 is Many professional and medical consequences of LBP were reported.
the worst pain ever), and 111 (28.9%) reported that the pain radiated Most of the nurses reported an effect on their professional perfor-
to their lower limbs. mance, such as loss of productivity (47.1%, n = 181), absence from
work (18.2%, n = 70), changing their working area (18.2%, n = 70), or
reducing their activities of daily living (70.3%, n = 270) (see Table 5).
3.4 Factors associated with LBP
LBP also has medical consequences, for example, seeking medical
The results demonstrated older age, female gender, and being over- advice, consuming analgesics, hospitalization, and having back surgery
weight were individual factors associated with LBP. The results of the (see Table 5 for details).
t test show that the prevalence of LBP was higher in older nurses
(M = 33.38, SD = 7.37) than in younger nurses (M = 27.98, SD = 5.98)
3.6 Availability of preventive measures
(t (383) = 4.71, P = 0.001). In addition, the results of the 𝜒 2 test show
that the female nurses significantly reported higher prevalence of LBP Nurses were also asked about their perception regarding the availabil-
(82.9%) compared to the male nurses (70.9%) (𝜒 2 (1, N = 384) = 7.37, ity of preventive measures for LBP. Most admitted a lack of preventive
4 SULIMAN

TA B L E 2 Individual factors associated with LBP

Factors With LBP (n=303) Without LBP (n=81) Test Test value P-value
Age (M±SD) 33.38±7.37 27.98±5.98 t-test t=4.71 0.001
Gender
Male 90 (70.9) 37 (29.1) 𝜒2 𝜒 2 =7.37 0.007
Female 213 (82.9) 44 (17.1)
Weight
Normal weight 98 (32.3) 32 (39.5) 𝜒2 𝜒 2 =1.21 0.001
Over weight 202 (66.7) 45 (55.6)
Missing 3 (1.0) 4 (4.9)
Smoking
Yes 81 (26.7) 29 (35.8) 𝜒2 𝜒 2 =2.14 0.14
No 222 (73.3) 52 (64.2)
Exercise
Regular 33 (10.9) 12 (14.8) 𝜒2 𝜒 2 =0.61 0.43
None or irregular 270 (89.1) 69 (85.2)
Chronic conditions
Yes 43 (14.2) 7 (8.6) 𝜒2 𝜒 2 =1.28 0.25
No 260 (85.8) 74 (91.4)

P-value significant at ≤ 0.05.

TA B L E 3 Occupational factors associated with LBP

Factors With LBP (n=303) Without LBP (n=81) Test Test value P-value
Nursing experience (M±SD) 7.82±6.41 6.31±5.61 t-test t=2.08 0.03
Hospital type
Ministry of Health 233 (76.9) 58 (71.6) 𝜒2 𝜒 2 =0.98 0.2
University 70 (23.1) 23 (28.4)
Place of work
Floor 171 (56.4) 49 (60.5) 𝜒2 𝜒 2 =0.43 0.53
Critical area 132 (43.6) 32 (39.5)
Working hours per week (M±SD) 42.95±9.82 44±11.13 t-test t=−0.83 0.4
Lifting weight
Never 15 (5.0) 5 (6.2) 𝜒2 𝜒 2 =1.00 0.65
Sometimes 94 (31.0) 29 (35.8)
Always 194 (64.0) 47 (58.0)
Number of patients (M±SD) 12.82±13.51 12.01±12.42 t-test t=0.63 0.47
Shift worked
Day 153 (50.5) 33 (40.7) 𝜒2 𝜒 2 =2.92 0.23
Night 131 (43.2) 40 (49.4)
Both 19 (6.3) 8 (9.9)

P-value significant at ≤ 0.05.

TA B L E 4 Logistic regression of all significant risk factors

Factors B SE Wald df P Odds ratio 95%CI for Odds ratio


Age 0.23 0.04 35.54 1 0.000 0.80 (0.74, 0.86)
Nursing experience 0.14 0.04 12.26 1 0.000 1.15 (1.07, 1.23)
Gender 0.75 0.28 4.77 1 0.008 2.13 (1.22, 3.71)
Weight 4.19 0.544 59.22 1 0.000 0.52 (0.25, 0.63)

P-value significant at ≤ 0.05.


SULIMAN 5

TA B L E 5 Occupational and medical consequences cumulative prevalence of LBP in our study was 69.0%, 78.9%, and
Consequence Frequency (n, %) 83.6%, respectively. The prevalence of chronic LBP was 46.4%. These

Loss of productivity
results suggest that LBP is an existing and prevalent problem. This is
congruent with other studies that confirmed LBP as a significant prob-
Yes 181 (47.1)
lem among healthcare workers.5,7,9,17,18
No 203 (52.9)
Absence
Yes 70 (18.2) 4.2 Factors associated with LBP
No 314 (81.8)
In our study, age, female gender, and being overweight were the indi-
Change unit vidual factors associated with LBP. Advanced age leads to spinal degen-
Yes 70 (18.2) eration and accumulation of stress over the spinal cord. Also, being
No 314 (81.8) a female makes these degenerative changes more rapid as a result
Reduce daily activity of female hormones.19 Being overweight also increases stress on the
Yes 270 (70.3) lower back, increasing the chance of spinal herniation and compres-
No 114 (29.7) sion. In Jordan, most nurses are relatively young,20 so being over-
Visiting doctor or physiotherapy weight could be the more important factor. For example, more than

Yes 169 (44)


half of the nurses (n = 247, 64%) were overweight (BMI > 25). This
indicates that maintaining nurses’ fitness and normal body weight
No 215 (56)
could be an effective strategy in protecting them from back injuries.
Analgesics for LBP
However, the literature showed conflicting results regarding the asso-
Yes 317 (82.6)
ciation between BMI and suffering from LBP: some studies found
No 67 (17.4)
no relationship at all between being overweight and having LBP,13
Admission to hospital because of LBP
while others did find a relation.18 Different methodologies used could
Yes 33 (8.6) explain the contradicting results.
No 351 (91.4) The univariate analysis revealed that nursing experience was the
Radiology study only professional factor associated with LBP. The multivariate analy-
X-ray 53 (13.8) sis showed that, even after controlling for nurses’ ages, their length of
CT scan 24 (6.3) experience still predicts whether or not they will complain of LBP. The
MRI 48 (12.5) association between more years of practice and suffering from LBP has
None 259 (67.4) been reported in previous studies.5,7 This relationship might explain

Back surgery
because with more years of practice, nurses will be exposed to more
events of inappropriate use of the back mechanism and accumulated
Yes 8 (2.1)
back stress. Nurses need to be trained how to use their body mech-
No 376 (97.9)
anism effectively and how to maintain an optimal workload. These
strategies could prevent the degeneration of their musculoskeletal sys-
measures in their hospitals. For instance, the majority of nurses, 86.2% tem that results from work stress over time.
(n = 331), reported that they never attended workshops or training
programs on how to protect their back; the rest of the nurses reported
4.3 Consequences of LBP
that these were only for new staff, 6.3% (n = 24), or that they attended
such sessions only once a year, 4.4% (n = 17), with only 1% (n = 4) stat- Our results show that fewer than half of the nurses who partici-
ing that they attended such sessions more than once per year. Most pated in this study, 169 (44%), sought medical advice for their back
reported that the equipment used in their units was basic, for example, pain, whether visiting a doctor or a physiotherapist. Similarly, Bejia
lifting sheets, 74.7% (n = 287), and only 7.1% (n = 27) reported using et al.,9 found that only 42% of nurses sought medical treatment, such
advanced lifting devices, for example, lifting machines. Few had lifting as thermal water care and physiotherapy. Thirty-three (8.6%) of our
teams in their units (5.9%, n = 23). nurses had been admitted to hospital because of their back pain and
eight (2.1%) of them had undergone back surgery. However, a high-
percentage of them, self-medicated (82.6%), were taking analgesics.
The results demonstrated that, despite the high prevalence of LBP,
4 DISCUSSION
nurses depend more on analgesics to overcome their pain. One expla-
nation for this is, because they are in a medical setting, they have an
4.1 Prevalence rates of LBP
access to medication or can easily acquire prescriptions from their
This study aimed to measure the prevalence rates of LBP among Jorda- doctor colleagues, in addition to their knowledge about medication. In
nian nurses, as well as investigating-associated factors, consequences, the case of chronic LBP, nurses should seek medical advice and con-
and the availability of preventive measures. The current, last year, and sider early treatment before their back pain develops into a serious
6 SULIMAN

back injury.21 However, Wong et al.17 found that a low percentage of not reflect the exact situation in the hospital, because some nurses
healthcare workers (34.1%) sought medical advice, despite having eas- might be unaware of certain hospital resources. Nevertheless, self-
ier access to medical care. reported data reflects the situation from a nursing point of view. Using
As nurses are allowed to take sick leave only in situations of seri- a cross-sectional design is another limitation, which could prevent the
ous pain, only a small percentage (18.2%) of those reporting LBP did researcher from drawing firm conclusions regarding the risk factors of
so. One reason could be the shortage of nurses, as there are few sub- LBP; however, this type of design is time-saving and suitable for base-
stitute nurses in Jordan.20 Lin et al.,6 found that 87.74% of nurses go to line studies such as the current one.
work despite their back pain. The authors demonstrated that requiring
nurses to work in spite of their back pain could lead to medical errors
6 CONCLUSION
and low quality of care.
Although 70.3% of nurses reported a decrease in their daily activ-
This study is the first of its kind to investigate LBP among nurses in Jor-
ity, only 181 (47.1%) reported that LBP reduced their productivity,
dan, and it warns of high-prevalence rates. LBP has associated factors,
and only 70 (18.2) reported that it forced them to change unit. This is
such as higher age, being overweight, and long amount of time work-
related to the high percentage (82.6%) using analgesics to overcome
ing as a nurse (hospital experience). These results suggest an increased
LBP, so they can maintain productivity and not leave their units. Hos-
burden on the healthcare system from a decrease in nurses’ produc-
pital administrations may consider improving working conditions in
tivity, an increase in days absent, and movement of nurses changing to
order to protect nurses’ musculoskeletal system and improve their job
different units. More effort from hospital administrations in collabora-
performance.
tion with the nurses themselves needs to be dedicated to reduce the
problem of LBP.
4.4 Availability of preventive measures
ACKNOWLEDGMENT
Nurses were asked about the availability of preventive measures for
LBP in their hospitals. The results show that these were inadequate. This research project would not have been possible without the sup-
For example, 331 (86.2%) of nurses reported that there were no train- port of Al al-Bayt University, represented by the Deanship of Academic
ing programs about protecting the musculoskeletal system, and 287 Research (Fund Number 7760/2015).
(74.7%) reported that the only available lifting equipment was a lift-
ing sheet. Only 27 (7.1%), reported having advanced mechanical lifting ORCID
devices in their units. In addition, the majority of nurses, 361 (94.1%),
Mohammad Suliman BSN, MSN, PhD
reported a lack of lifting teams to implement lifting activities in their
http://orcid.org/0000-0001-6457-9304
units. The results indicated that there was a lack of safety measures in
place to protect nurses from back injuries in Jordanian hospitals.
Burdorf, Koppelaar, and Evanoff22 conducted a systemic litera-
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the United States: incidence and risk factors for presentation AUTHOR'S BIOGRAPHY
in the emergency setting. Spine J. 2012;12:63–70. http://doi.org/
10.1016/j.spinee.2011.09.002. Mohammad Suliman, BSN, MSN, PhD, is an assis-
tant professor and dean assistant for students
13. Abolfotouh SM, Mahmoud K, Faraj K, Moammer G, ElSayed A, Abol-
fotouh MA. Prevalence, consequences and predictors of low back affairs at School of Nursing, Al al-Bayt Univer-
pain among nurses in a tertiary care setting. Int Orthop. 2015;39: sity, Jordan. He was a staff nurse at King Abdal-
2439–2449. lah University Hospital (2003–2009), AL Ramtha,
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ing (2009–2011), Al al-Bayt University, Mafraq, Jordan; and a research
15. Katz JN. Lumbar disc disorders and low-back pain: socioeconomic fac-
fellow in Harrington Heart and Vascular Institution at University Hos-
tors and consequences. J Bone Joint Surg Am. 2006;88(suppl 2):21–24.
pitals (2013–2014) in Cleveland, Ohio. His research projects include
16. McCaffery M, Beebe A. Pain: Clinical Manual For Nursing Practice. St.
“Prevalence of Low Back Pain Among Jordanian Nurses: An Epidemi-
Louis, Missouri: Mosby; 1997.
ological Study,” “Exploring Safety Culture in Jordanian Hospitals: A
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low back pain among health care providers in a district hospital. Malays Baseline Study,” and “School Nurses Role in Helping Children With
Orthop J. 2010;4:23–28. Attention-Deficit/Hyperactivity Disorders.”
18. Bin Homaid M, Abdelmoety D, Alshareef W, et al. Prevalence and risk
factors of low back pain among operation room staff at a Tertiary
How to cite this article: Suliman M. Prevalence of low back
Care Center, Makkah, Saudi Arabia: a cross-sectional study. Ann Occup
Environ Med. 2016;28:1–8. pain and associated factors among nurses in Jordan. Nurs Forum.
19. Kalichman L, Li L, Kim D, et al. Facet joint osteoarthritis and low back 2018;1–7. https://doi.org/10.1111/nuf.12269
pain in the community-based population. Spine. 2008;33:2560–2565.

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