نبذة مختصرة : Middle managers have demanding roles and often experience themselves between a rock and a hard place, and their jobs are characterized by heavy workload and stress. They have not received adequate attention in management science, in particular within healthcare. We know, for example, little about how stressful factors in the work environment are related to musculoskeletal pain and sleep. The purpose of this study was to examine this relationship. This is a descriptive cross-sectional study in which data was collected by a questionnaire which was sent electronically to 137 nursing managers through the Outcome-survey system. The response rate was 80.9%. Descriptive statistics and inferential statistics were used for statistical analysis. The results showed a clear link between stressful factors in the work environment and insufficient sleep, after controlling for the effects of age, marital status and the number of staff in the nursing unit. Stressful factors in the work environment and sleep affected the intensity of pain in the neck and shoulder area, and sleep correlated with the intensity of pain in the lower back. Taking sleep into account, more stress meant more pain in the neck and shoulder area. Taking into account stressful factors, insufficient sleep meant more pain in all three body regions. Together, stressful factors in the work environment and insufficient sleep explained 17% of the total variation in the intensity of pain in the neck area, 21% in the shoulder area, and 14% in the lower back, taking into account age, marital status and the number of staff in the nursing unit. There was a statistically significant interaction between stressful factors in the work environment and sleep regarding the intensity of musculoskeletal pain in the neck area. The results of this study will hopefully lead to better consideration of stressful factors in the work environment, sleep and musculoskeletal pain of middle managers.
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