UCSF

Background: Work-related musculoskeletal disorders among direct care workers have been a major concern in long-term care facilities worldwide. However, many work-related musculoskeletal disorders went unreported due to perceived barriers of direct care workers. Workers are encouraged to report even minor injury or near misses to their managements in many countries, but in Korea, the injury reporting responsibility of workers is not defined or described.Methods: This dissertation study used cross-sectional survey data from 377 direct care workers in 19 long-term care facilities in South Korea from May 2022 ~ August 2022. Long-term care facilities included long-term care hospitals and nursing homes in three cities in Gyeonggi, which is one out of eight provinces and represents 26% of Korean population. In the study, direct care workers refer to trained care staffs providing the most direct personal care such as feeding, bathing, dressing, and toileting regardless of the certification. Direct care workers who were employed for at least three months or longer in their current job, and able to read, write, and understand Korean were eligible to participate in the study. Results: A systematic review showed a high level of underreporting of work-related injuries or illnesses to management or Workers’ Compensation programs, ranging 20%-91% in the United States and identified contributing factors and reasons for underreporting of work-related injuries or illnesses. Analysis of the survey data from direct care workers in long-term care facilities showed that more than half of direct care workers had a work-related musculoskeletal disorder in the past 12 months, but only 13.5% of them reported it to their management. Also, half of direct care workers had no intention to report their symptoms. Direct care workers’ reporting behavior was associated with their attitudes toward reporting, safety climate, symptom severity, and witnessing injury reporting of others. Direct care workers’ reporting attitudes were associated with duration of work, work arrangement, safety training, safety climate, experience of work-related musculoskeletal disorders, and frequency and severity of symptoms. Direct care workers having positive reporting attitudes were more likely to have intention to reporting and actual reporting of work-related musculoskeletal disorders. Conclusion: This study provides important insight into workers’ reporting behaviors and attitudes of work-related musculoskeletal disorders and informs future efforts to reduce underreporting and underestimation of occupational health problems.