Unraveling the Psychological Pathways Between Job Strain and Musculoskeletal Disorders: The Mediating Roles of Work-Related Fatigue and Burnout Among Hospital Nurses.

Aim: This study examines the association between musculoskeletal disorders, job strain index, work-related fatigue, and burnout among hospital nurses. Additionally, the mediating roles of work-related fatigue and burnout in the correlation between job strain and musculoskeletal disorders were evaluated. Background: Musculoskeletal disorders often arise from high workloads and prolonged work hours among nurses. Despite extensive research, the definitive impact of psychological factors, work-related fatigue, and burnout on musculoskeletal disorders remains inconclusive. Methods: A cross-sectional study was conducted at a public hospital. The study adhered to STROBE guidelines and included 471 nurses who participated voluntarily and anonymously by completing a web-based questionnaire. The data were collected from January to December 2022. The questionnaire covered demographics, job characteristics, the job control-demand-support model, work-related fatigue, burnout, and other relevant factors. The mediating roles of work-related fatigue and burnout in the relationship between job strain and musculoskeletal disorders were evaluated using Hayes Model 7. Results: Musculoskeletal disorders across nine body sites exhibited significant correlations with levels of job strain, work-related fatigue, and burnout. Work-related fatigue showed a significant association with burnout but did not directly associate with musculoskeletal disorders. Burnout, however, directly influenced the prevalence of musculoskeletal disorders. Notably, both work-related fatigue and burnout served as mediators in the relationship between job strain and musculoskeletal disorders, with burnout being the primary contributor. Conclusion: Given that burnout is identified as the principal contributing factor to musculoskeletal disorders among nurses, it is recommended to implement empowerment initiatives within nursing departments. Prioritizing the reduction of work-related fatigue and burnout through tailored prevention programs for nurses is essential. Implications for the Profession: The rising prevalence of musculoskeletal disorders calls for nurse managers to act promptly. They should implement intervention programs to reduce psychological stress and workload, enhance nursing management, and ensure an ergonomic workplace environment for nurses.