Factors Determinants of Musculoskeletal Disorders among Nurses in Indonesia: Evidence from A Cross-Sectional Study

Lilis Suryani, Agni Laili Perdani, Apryadno Jose Al Freadman Koa

Abstract


Introduction: Musculoskeletal disorders (MSDs) remain a significant occupational health issue among nurses, influenced by demographic factors, workload, stress, and ergonomic posture. Nurses are particularly vulnerable due to heavy physical demands, non-ergonomic postures, and psychosocial pressures. Objective: This study aimed to determine factors that contribute to MSDs among nurses in Indonesia. Methods: A quantitative descriptive design was employed with a convenience sampling method. Data were collected from nurses in a one-month period in September–October 2024.  Four validated instruments were used consisting of the Nordic Musculoskeletal Questionnaire (NMQ), the NASA Task Load Index (NASA-TLX), REBA (Rapid Entire Body Assessment)  and HSE (Health and Safety Executive). Health Data was analyzed using bivariate (ANOVA) with SPSS Version 25. Results: A total of 108 participants agreed to participate in this study. The majority of respondents were aged 26–45 years (67.6%), and most were female. Findings revealed a significant relationship between work burden, work stress, and work duration with MSDs. Conclusion: Factors contributing to MSDs among nurses are work burden, work stress and work duration with MSDs. Hospital management should implement workload evaluations, shift management, and ergonomic training, while the nursing profession should strengthen awareness of proper working postures, physical health maintenance, and stress management strategies.


Keywords


Nurses, Musculoskeletal disorders (MSDs), Stress, Work Burden.

Full Text:

PDF

References


Alrimali, A. M., Alreshidi, N. M., Alshammari, A. A., Alenzy, A. R., Thomas, R., Dinoy, M. A., Alanzi, F. A., & Pasay-An, E. (2024). Patterns of Musculoskeletal Disorders among Staff Nurses in the Emergency Department in Saudi Arabia: A Cross-sectional Study. Nurse Media Journal of Nursing, 14(1), 74–84. https://doi.org/10.14710/nmjn.v14i1.62203.

Arsalani, N., Fallahi-Khoshknab, M., Josephson, M., & Lagerström, M. (2014). Musculoskeletal disorders and working conditions among iranian nursing personnel. International Journal of Occupational Safety and Ergonomics, 20(4), 671–680. https://doi.org/10.1080/10803548. 2014.11077073.

Babapour, A. R., Gahassab-Mozaffari, N., & Fathnezhad-Kazemi, A. (2022). Nurses’ job stress and its impact on quality of life and caring behaviors: a cross-sectional study. BMC Nursing, 21(1), 1–10. https://doi.org/10.1186/s12912-022-00852-y.

Bakker, A. B., & Demerouti, E. (2007). The Job Demands-Resources model: State of the art. Journal of Managerial Psychology, 22(3), 309–328. https://doi.org/10.1108/ 02683940710733115.

Balaputra, I., & Sutomo, A. H. (2017). Pengetahuan ergonomi dan postur kerja perawat pada perawatan luka dengan gangguan. (BKM Journal of Community Medicine and Public Health) Volume, 33(9), 445–448.

Bezzina, A., Austin, E., Nguyen, H., & James, C. (2023). Workplace Psychosocial Factors and Their Association With Musculoskeletal Disorders: A Systematic Review of Longitudinal Studies. Workplace Health and Safety, 71(12), 578–588. https://doi.org/10.1177/ 21650799231193578.

Crawford, J. O. (2007). The Nordic Musculoskeletal Questionnaire. Occupational Medicine, 57(4), 300–301. https://doi.org/10.1093/occmed/kqm036.

Dartey, A. F., Tackie, V., Worna Lotse, C., Dziwornu, E., Affrim, D., & Delanyo Akosua, D. R. (2023). Occupational Stress and Its Effects on Nurses at a Health Facility in Ho Municipality, Ghana. SAGE Open Nursing, 9, 1–11. https://doi.org/10.1177/ 23779608231186044.

Demissie, B., Bayih, E. T., & Demmelash, A. A. (2024). A systematic review of work-related musculoskeletal disorders and risk factors among computer users. Heliyon, 10(3), e25075. https://doi.org/10.1016/j.heliyon.2024.e25075.

Devi Azhari. (2024). Faktor yang berhubungan dengan Stress Kerja Perawat di Ruang Rawat Inap RSUD Pringsewu Tahun 2024. Jurnal Ventilator, 2(4), 125–151. https://doi.org/10.59680/ ventilator.v2i4.1539.

Dewi, N. F. (2020). Identifikasi Risiko Ergonomi dengan Metode Nordic Body Map Terhadap Perawat Poli RS X. Jurnal Sosial Humaniora Terapan, 2(2). https://doi.org/10.7454/jsht. v2i2.90.

Ekpenyong, C. E., Daniel, N. E., & Aribo, E. O. (2013). Associations between academic stressors, reaction to stress, coping strategies and musculoskeletal disorders among college students. Ethiopian Journal of Health Sciences, 23(2), 98–112.

Grasiaswaty, N., Pradita, L., & Sadida, N. (2022). Health and Safety Executive Work Related Stress Scale-Indonesian Version: Reliability and Convergent Validity. Indonesian Journal of Occupational Safety and Health, 11(3), 402–411. https://doi.org/10.20473/ijosh.v11i3. 2022.402-411.

Hart, S. G., & Staveland, L. E. (1988). Development of NASA-TLX (Task Load Index): Results of Empirical and Theoretical Research. Advances in Psychology, 52(C), 139–183. https://doi. org/10.1016/S0166-4115(08)62386-9.

Jacquier-Bret, J., & Gorce, P. (2023). Prevalence of Body Area Work-Related Musculoskeletal Disorders among Healthcare Professionals: A Systematic Review. International Journal of Environmental Research and Public Health, 20(1). https://doi.org/10.3390/ijerph20010841.

Kang, M., Kim, I., Park, C., & Min, A. (2025). Relationship Between Musculoskeletal Disorders and Productivity Loss Among Hospital Nurses: An Analytical Cross-Sectional Study With Secondary Data Analysis. Journal of Nursing Scholarship, 789–798. https://doi.org/10.1111/ jnu.70020.

Kolovou, A., Gkougkoulias, A. N., Stefanou, N., Samaila, E. M., Tsekoura, M., Vlychou, M., Matzaroglou, C., & Dailiana, Z. H. (2025). Musculoskeletal disorders in nursing staff. World Journal of Methodology, 15(2), 1–7. https://doi.org/10.5662/wjm.v15.i2.98043.

Kuorinka, I., Jonsson, B., Kilbom, A., Vinterberg, H., Biering-Sørensen, F., Andersson, G., & Jørgensen, K. (1987). Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Applied Ergonomics, 18(3), 233–237. https://doi.org/10.1016/0003-6870(87) 90010-X.

Laal, F., Mohammadian, F., Khoshakhlagh, A., Madvari, R. F., Dehghan, S. F., & Pordanjani, S. R. (2022). Effect of anthropometric and demographic factors on musculoskeletal disorders in nurses’ aides. Work, 72(4), 1205–1213. https://doi.org/10.3233/WOR-210027.

McAtamney, L., & Hignett, S. (2004). Rapid Entire Body Assessment. Handbook of Human Factors and Ergonomics Methods, 31, 8-1-8–11. https://doi.org/10.1201/9780203489925.ch8

NAOUM, S., MITSEAS, P., KOUTSERIMPAS, C., SPINTHOURI, M., KALOMIKERAKIS, I., RAPTIS, K., SARAFIS, P., GOVINA, O., & KONSTANTINIDIS, T. (2022). Musculoskeletal Disorders and Caring Behaviors among Nursing Staff in Greek Hospitals: a Prospective Multicenter Study. Maedica - A Journal of Clinical Medicine, 17(1). https://doi. org/10.26574/maedica.2022.17.1.52.

Popova, M. S., Nikolova, S. P., & Filkova, S. I. (2025). Demographic and Occupational Determinants of Work-Related Musculoskeletal Disorders: A Cross-Sectional Study. Journal of Functional Morphology and Kinesiology, 10(2), 1–11. https://doi.org/10.3390/ jfmk10020137.

Santosa, N. A. W., & Porusia, M. (2025). Persepsi Beban Kerja dan Dukungan Sosial terhadap Stres Kerja Perawat Rumah Sakit Jiwa. Jurnal Keperawatan Profesional (KEPO), 6(1), 90–99.

Soares, C. O., Pereira, B. F., Pereira Gomes, M. V., Marcondes, L. P., De Campos Gomes, F., & De Melo-Neto, J. S. (2019). Preventive factors against work-related musculoskeletal disorders: Narrative review. Revista Brasileira de Medicina Do Trabalho, 17(3), 415–430. https://doi.org/10.5327/Z1679443520190360.

Soylar, P., & Ozer, A. (2018). Evaluation of the prevalence of musculoskeletal disorders in nurses: A systematic review. Medicine Science | International Medical Journal, September, 1. https://doi.org/10.5455/medscience.2017.06.8747.

Sun, W., Yin, L., Zhang, T., Zhang, H., Zhang, R., & Cai, W. (2023). Prevalence of Work-Related Musculoskeletal Disorders among Nurses: A Meta-Analysis. Iranian Journal of Public Health, 52(3), 463–475. https://doi.org/10.18502/ijph.v52i3.12130.

Wåhlin, C., Stigmar, K., & Nilsing Strid, E. (2022). A systematic review of work interventions to promote safe patient handling and movement in the healthcare sector. International Journal of Occupational Safety and Ergonomics, 28(4), 2520–2532. https://doi.org/10.1080/ 10803548.2021.2007660.

Wang, K., Zeng, X., Li, J., Guo, Y., & Wang, Z. (2024). The prevalence and risk factors of work-related musculoskeletal disorders among nurses in China: A systematic review and meta-analysis. International Journal of Nursing Studies, 157, 104826. https://doi.org/10.1016/ j.ijnurstu.2024.104826.

Yanti, S. D., Fujianti, S., Apriandini, S. N., Fathaddin, A. T. A., Fikriya, A., Mardhiyah, A., & Hendrawati, S. (2024). Gangguan muskuloskeletal pada perawat di rumah sakit: A literature review. Holistik Jurnal Kesehatan, 18(8), 1011–1020. https://doi.org/10.33024/hjk.v18i8.450.

Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar, A. (2017). The impact of stress on body function: A review. EXCLI Journal, 16, 1057–1072. https://doi.org/10.17179/ excli2017-480.

Yilmaz, T., & Isik Andsoy, I. (2022). Musculoskeletal system disorders among surgical nurses related to the health industry in northwestern Turkey: a cross-sectional study. International Journal of Occupational Safety and Ergonomics, 28(4), 2119–2124. https://doi.org/10.1080/ 10803548.2021.1956797.

Zaitoon, R. A., Said, N. B., Snober, R. H., Hussein, R. F., Abdoon, A. H., Shehadeh, A. M. A., Battat, M. M., & Sakleh, I. R. (2024). Low back pain prevalence and associated factors among nurses: cross sectional study from Palestine. BMC Public Health, 24(1), 1–8. https://doi.org/ 10.1186/s12889-024-20481-1.




DOI: https://doi.org/10.17509/jpki.v11i2.90721

Refbacks

  • There are currently no refbacks.


Bookmark and Share


Jurnal Pendidikan Keperawatan Indonesia(JPKI) published by Indonesia University of Education. JPKI is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. 

View My Stats

Office :
Nursing Department. FPOK UPI.
229, Dr. Setiabudhi Street. Bandung 40154
West Java , Indonesia
E-mail : [email protected]