A Critique of the Article “Sick Leave Due to Back Pain in a Cohort of Young Workers A Cohort Study.”

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ACritique of the Article “Sick Leave Due to Back Pain in a Cohort ofYoung Workers: A Cohort Study.”


ACritique of the Article “Sick Leave Due to Back Pain in a Cohort ofYoung Workers: A Cohort Study.”

Description ofthe Article

The article SickLeave Due to Back Pain in a Cohort of Young Workers deals with theinvestigation of how back pain relates to the number of sick leavesin young workers. It was written by Van Nieuwenhuyse, Burdorf A,Crombez G, Verbeke G, Masschelein R, Mairiaux P, and Moens G.F. Thepaper takes the format of other similar articles with a title, anintroduction, study methods, findings, discussions, conclusion,recommendations, and references. The paper has an excellent abstractthat covers the problem, methods, results and conclusions of thestudy. The researchers express themselves in a professional andclinical manner that gives one an assurance that the informationprovided can be trusted.

The researchershave further given a proper statement of the problem whichillustrates the intensity of the matter and justifies the need forthis research. A look at the introduction provides the reader with ageneral idea about the entire article. The introductory chapter hasincorporated the literature review and touches on the important areasof the research. The methodology, on the other hand, has been writtenin such a way that the processes of carrying out the study are clear.

The Title

The title of thisstudy is “Sick Leave Due to Back Pain in a Cohort of Young Workers:A Cohort Study”. The study under review deals with theinvestigation of how back pain relates to the number of sick leavesin young workers. This title is adequate as it mentions two keyvariables of the study. The two variables are the back pain and thesick leave. Back pain can be described as an independent factor thatcontributes to the independent variable of the sick leave. The titleincludes the target population of young workers. The two things thatmay be added here are the age bracket of the young workers understudy and the location of the study. The word ‘young’ can berelative when the specific age bracket is not included. Differentcountries have different age limits for young and adult populations.The general feel, however, is that the title of the study isadequate.

The Abstract

The abstract ofthis study manages to summarize the problem of the study and refersto it as the purpose of the study. The abstract identifies theproblem as the insufficiency in the available studies and the need tocarry out more research. Previous similar studies concentrate onother risk factors that are associated with the older populations andfail to consider risk factors for younger populations.

The abstractaddresses more on the methods that have been applied in this study. Astudy sample is included as 716 workers and the criteria forselecting them described as those having minimal or none of thesymptoms associated with lower back pain in the year before they areincluded in the study. The abstract also explores the use of the Coxregression as used in the study. It allows for the investigation ofthe risk factors at baseline before the dependent variable sets in.

There is asummary of the findings of the study, and this is a pertinent featurefor any adequate abstract. It gives a rough figure of six percent ofworkers having reported sick leaves a year later. A majority of thesick leaves were attributable to low back pains as compared to otherrisk factors. By providing the predictive values in the 95%confidence interval, the study can be considered to be followingresearch rules. The abstract provides a conclusion at the endregarding a solution to the title of the study. The problem liesbetween the two variables, and the aim of the study is to come upwith a solution as a means of bridging the gap. This abstract issufficient as it manages to suggest an intervention. The wholeproject has been summarized in this abstract, with the inclusion ofkeywords immediately after.

The Introduction

Statement of theproblem

The problem inthis study is the rise in the number of sick leaves that has beenattributed to different risk factors (Van Nieuwenhuyse, Burdorf,Crombez, &amp Verbeke, 2013). The study specifically aims atidentifying the role of back pains as a risk factor in contributingto the problem. The researchers have made the problem clear and notambiguous at all. This can be considered as an ideal problemstatement that leads the reader to the main issue underinvestigation.

The introductionexplores how the knowledge regarding risk factors for back painremains to be an inadequate tool. There aren’t enough studies onthe same topic, making it worth considering in the new study. Thestudy also points out some assumptions that have been developedregarding lower back pain as a cause of sick leaves. No substantialevidence supports the assumptions, and the researchers describe thisas a gap that prompts them to carry out a similar study. Currentstudies have concentrated on the role of other factors in aggravatingthe severity of the pains, but there is little support forpsychosocial factors. The study has, to a great extent, managed todiscuss the need for the probable investigation. The problemstatement has in itself built a rational and persuasive argumentconcerning the new study.

The statement ofthe problem is of significance to nursing. Other risk factors tolower back pains, other than the most common pathological ones, havebeen described. The nurse has a huge role to play in helping in thealleviation of the risk factors that aggravate the pain and reducethe number of sick leaves (Van Nieuwenhuyse, Burdorf, Crombez, &ampVerbeke, 2013). At this point, the health system interacts with thelegal system and a nurse are responsible for assessing the patientand making a decision regarding the benefit entitlement. In thisview, the problem statement is relevant to nursing. The problemstatement matches adequately with the methods applied in the study.As earlier mentioned, the Cox regression as used in the study allowsfor the investigation of the risk factors at baseline before thedependent variable sets in. As much as the qualitative research isimportant, a quantitative approach is superior since it looks intothe extent and magnitude of the problem. It forms a basis for theadvocacy of evidence-based practice.

Hypothesis orResearch Questions

This studyconcentrates more on research questions than it does on thehypothesis. Prudent researchers use either of the two as theyconsider the use of both as a repetition since they serve a similarfunction and carry the same message. My statement justifies theabsence of the hypotheses in this study under review. The researchersopted to combine the hypothesis and research questions and presentedthem together in the aims of the study. Three aims are related to thebrief literature review which has been provided in the study report.One of the aims describes the occurrence, duration, and frequency ofthe independent variable of the study. The other aim explores theeffect of other work-related factors in the number of sick leaves bypatients. Finally, the study has the aim of identifying the impact ofeach of the mentioned risk factors. The aims of the study areconsistent with the review of the literature as well as theconceptual framework of the study.

The LiteratureReview

I do notunderstand why the researchers of this study opted to combine the twosections and failed to mention the point where each of the two startsand ends. Normal studies require a separate section for theintroduction chapter and another one for the literature review.However, reading through the introduction part, an individual easilyunderstands the aspect of the literature review that has beenincorporated.

The strength ofthe literature review is its provision of the state-of-the-earthsynthesis of the problem under discussion. It allows the reader tounderstand the relationship between the two main variables as well asthe factors associated with the independent factor. Considering thatthe study was carried out and published in 2013, the use of sourcespublished from the year 2000 is appropriate. I would, however, be anadvocate of references that are not more than five years old. Thereis an article that has been dated 1995 and appears to be a very oldand outdated source. The medical and nursing fields are dynamic andconstantly undergo changes. It is always prudent for an individual tobe up to date with their information regarding the same. The strengthof this literature review is that it provides a strong basis for thenew study and that it uses relevant references with similar studies.


The mention of aframework makes one think of a tabular and diagrammaticrepresentation of the relationship between variables. It is a form ofa mind map that guides the reader in connecting the various variablesthat are under study. In most cases, a conceptual framework ispresented as a drawing. Its absence, however, does not mean that thestudy is not adequate. The relationship between variables can be seenin many parts of the study, beginning with the abstract, introductionand even in the literature review. I do not know why the researchersdecided not to include one, but for any reason the absence isjustified. In the sections of introduction and the aims of the study,there is a description of the relationship between the main variablesof the study. Many factors are associated with sick leaves.

There is a cleardirection in that the independent factors are always resulting todependent variables (Van Nieuwenhuyse, Burdorf, Crombez, &ampVerbeke, 2013). It is the lower back pains in this study which areleading to the increment in the number of sick leaves. The factorsthat make the pain worse have also been described in the literaturereview. The second aim of this study is stated as the otherwork-related and individual factors that contribute to sick leaves.To remain relevant, the researchers ensure that there is a connectionbetween all independent variables to the main variable of the lowerback pains. One cannot state the appropriateness of the conceptualframework as there is no map in the first place. The absence of theframework is, however, justified as the ideas can be derived fromanother forum.


Protection ofHuman Rights

This research wascarried out in a proper manner since proper procedures were adheredto. The credentials and identity of the research participants shouldbe safeguarded as a way of protecting human rights and keeping themoff the hands of criticism in the society. The study does notspecifically mention about the protection of human rights. Theapproval of the study by the Commission for Medical Ethics is anindication that the researchers had promised to protect the rights ofthe participants. One can, however, deduce from the results that therights of the participants were safeguarded as there is no mention ofthe names. There is also no specific mention on how the researchersensured a minimization of risks and maximization of benefits to theparticipants included in the study.

Research Design

The research useda prospective cohort study. It is one of the most rigorous designsthat requires a lot of time and resources to be completed. Given thepurpose of the study, it is the most appropriate design to beemployed. It takes time for the independent variable of lower backpains to lead to a deterioration in health and subsequent sickleaves. The study failed to make a comparison of the differentstudies that are available as a means of enhancing theinterpretability of the study results. Regarding this study, thenumber of data collection points was sufficient. There is no mentionof any technique aimed at increasing the validity of the study. It iscommon for such studies to include such methods as blinding andminimization of attrition.

Population Sample

The studyinvolved 716 health workers who had met the age criteria. They arethe individuals with minimal or absent lower back pain antecedents inthe year before inclusion. The participants were selected randomlyand subjected to specific criteria. Out of the 851 employees who wereselected, 716 are the ones who ended up filling the questionnaires.The sample size of the study was adequate as it was not too big ortoo small for this specific research. It is a variable that affects amajority of employees, and this made it easy for sample selection.There is no mention of the methods used to minimize the samplingbiases.

Data Collectionand Measurement

In this sectionof the study, there is congruency in the conceptual as well asoperational definitions. The use of interviews was used tooperationalize the two main variables of lower back pains and thesick leaves. It may seem to be more of a quantitative study, butthere is a tinge of qualitative aspect that makes the use ofquestionnaires to be an important instrument in data collection. Fromthe report, it is almost evident that the methods used to collectdata were appropriate and gave rise to data that is valid andreliable. The only thing that is lacking is the evidence of theefficiency of validity and data collection methods.


The inclusion ofconfounders in the study was an intervention and a means of reducingdata bias. In this specific study, the researchers opted to includegender and age as the main confounders. SPSS was employed as a meansof analyzing the collected data and an attributable fractioncalculated at the end of the data collection procedure.


Data Analysis andPresentation

The report isorganized well after a detailed and in-depth analysis. Theresearchers of this study undertook some important analyses as ameans of addressing the various aspects of the aims of the study. Theemployment of SPSS turned out to be a great input as it is a packagewith excellent output in data collection. Different variables wereanalyzed with no mention of either type I or II errors. There is nocomment of any missing errors, and it is an assumption that such werenot witnessed in the study.


It is one of thesections of the study that has been presented very well. Much of thetime of the researchers was spent here. Information concerning thesignificance of the statistics is presented with a 95% confidenceinterval adhered to all the time. Tables have been used to summarizethe findings and can be of use when it comes to meta-analysis.


Interpretation ofthe findings

The study managedto interpret and discuss the findings from this study and relate themto previous findings. There is a good flow of ideas and a goodconnection of the variables. The report is a generalized address ofthe results. The numerical values are discussed and explained aboutthe literature review.


Just before the reference section, there is a conclusion to thehealth professionals and policy makers. The ideas discussed in thissection are the recommendations for change and the areas that mayrequire further studies.

Global Issues


In my opinion,the report is written well, with proper organization and havingsufficient details for critical analysis. There is no CONSORT flowchart provided, but the report is written in a way that is accessibleto any practicing nurse.

ResearcherCredibility and Summary Assessment

From thediscussions, there is substantive and clinical evidence to make thereader confident with the information. There may be limitations inthe research, but the study appears to be valid and can be employedin the present evidence-based practice.


Polit, D., &amp Beck, C. (2012). Nursing research: generating and assessing evidence for nursing practice (Ninth Ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams &amp Wilkins.

Van Nieuwenhuyse, A., Burdorf, A., Crombez, G., &amp Verbeke, G. (2013). Sick Leave Due to Back Pain in a Cohort of Young Workers. International Archive of Occupational and Environmental Health, 887-899.

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