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Article

Effects of Occupational Hazards, Musculoskeletal Pain, and Work on the Overall Fatigue, Anxiety, and Depression of Female Nurses

by
Woo Jin Kim
1 and
Byung Yong Jeong
2,*
1
Environmental Hygiene Team, Incheon Area Office, Korean Industrial Health Association, Incheon 22146, Republic of Korea
2
Industrial and Systems Engineering, Hansung University, Seoul 02876, Republic of Korea
*
Author to whom correspondence should be addressed.
Appl. Sci. 2024, 14(9), 3869; https://doi.org/10.3390/app14093869
Submission received: 25 March 2024 / Revised: 20 April 2024 / Accepted: 30 April 2024 / Published: 30 April 2024
Browse Figure
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Abstract

:
Nurses face not only musculoskeletal disorders but also psychological health issues. The purpose of this study is to analyze the factors influencing overall fatigue, anxiety, and depression, respectively, by comprehensively considering work characteristics, exposure to hazards, and the presence of musculoskeletal pain. This study used binary logistic regression to analyze factors influencing fatigue, anxiety, and depression, respectively. The independent variables were occupation; age; work experience; healthcare organization; working hours per week; shift type; exposure time to physical, biochemical, and ergonomic hazards; and the presence of back, upper limb, or lower limb pain. The factors influencing overall fatigue were shift type (p = 0.007), exposure to vibration (p = 0.042), awkward posture (p = 0.001), repetitive motion (p = 0.017), and presence of back (p = 0.002) or upper (p < 0.001) limb pain. The factors influencing anxiety were age (p = 0.031), hours worked per week (p = 0.006), performing patient lifting/carrying (p = 0.041), and presence of upper (p = 0.022) or lower (p = 0.039) limb pain. In addition, the factors influencing depression were found to be hours worked per week (p = 0.042), exposure to infection (p = 0.005), and the presence of lower limb pain (p = 0.011). This study found that musculoskeletal pain has a significant impact on psychological health problems, suggesting that integrated management of musculoskeletal pain and psychological health problems may be effective in addressing health problems in the nursing profession.

1. Introduction

1.1. Purpose of Study

Nurses experience not only musculoskeletal disorders but also psychological health problems while performing their duties [1,2,3,4]. Psychological health problems encountered in the nursing profession include depression, anxiety, and overall fatigue [5]. Overall fatigue, also known as chronic fatigue, is a state of being very tired or sleepy due to various causes such as lack of sleep, long mental or physical work, stress, or anxiety [6]. Anxiety is a feeling of unease and tension that occurs due to anticipation of internal or external danger [7,8]. Depression is a subjective state characterized by feelings of sadness, hopelessness, and unhappiness [7].
Psychological health problems are caused by worker characteristics such as shift work [9,10], exposure to physical, biochemical, and ergonomic hazards [1,11,12], and musculoskeletal pain [13,14]. However, most analyses only consider the impact of individual factors on psychological health problems. Therefore, it is necessary to comprehensively consider work characteristics, occupational hazards, and musculoskeletal pain to derive the factors affecting psychological health issues and their relative importance.
Kim and Jeong [15] investigated the impact of physical, biochemical, and ergonomic hazards on musculoskeletal pain among nurses, considering their work characteristics and exposure time to hazards. This study extends Kim and Jeong’s research. It aims to derive factors that influence overall fatigue, anxiety, and depression, respectively, by comprehensively considering work characteristics, exposure to hazards, and the presence of musculoskeletal pain.

1.2. Theoretical Background

1.2.1. Psychological Factors

Psychological factors in this study are synonymous with psychological variables and include individual-level processes and meanings that affect mental states [16]. Psychological health problems refer to problems of exposure to psychological risks due to the nature of work and include depression, anxiety, and overall fatigue [17,18]. Studies on overall fatigue, anxiety, and depression based on subjective questionnaires include nursing occupations [19], construction industry field workers [20], commercial vehicle drivers [21], and a study on automobile production workers [22].

1.2.2. Overall Fatigue

Fatigue is a multifactorial, multifaceted, non-specific, and subjective phenomenon caused by prolonged activity and psychological, socioeconomic, and environmental factors [23,24]. Additionally, fatigue can be experienced as an acute phenomenon that occurs at temporary intervals or as a chronic condition that persists for extended periods [23,25]. Work-related fatigue is a multidimensional condition in workers who are overly stressed by their work, environment, or schedule. It can affect their physical and cognitive abilities and interfere with their ability to function normally [23,26]. Work characteristics (such as unexpected working hours [27,28]), ergonomic hazards (such as handling heavy objects [6]), physical hazards (such as noise [23]), and biochemical hazards (such as cigarette smoke [22]) have been identified as factors that affect overall fatigue. The subjective survey question regarding overall fatigue in this study was “Have you experienced overall fatigue in the past year? If so, was it caused by the work you do?” [6,27,29].

1.2.3. Anxiety

Anxiety is a feeling of unease, worry, and nervousness accompanied by physical symptoms such as increased heart rate and muscle tension [8]. Additionally, there may be obsessive thoughts or concerns that are usually recurring, and physical symptoms such as sweating, tremors, dizziness, or rapid pulse may appear [8]. In previous studies, factors affecting anxiety included unexpected working hours [27,28], long working hours [12,27], and shift work [10]. The subjective survey question regarding anxiety in this study was “Have you experienced anxiety in the past year? If so, was it caused by the work you do?” [6,27,29].

1.2.4. Well-Being and Depression

WHO’s Well-Being Index is the most widely used survey question to assess subjective well-being [30,31,32]. It has been confirmed to have high validity as a tool to screen for depression [30]. Depression is an emotional state characterized by feelings of sadness, unhappiness, and hopelessness [7,30].
In this study, depression was assessed using the WHO 5-index questionnaire. The questionnaire includes five questions [29]: ‘Please indicate how frequently you have experienced the following emotions in the past two weeks: (1) I feel happy and content; (2) I feel calm and relaxed; (3) I am active and energetic; (4) I feel refreshed and well-rested when I wake up. (5) My daily life is filled with interesting things.’ Each question is scored on a scale of 0 to 5: 0 = ‘always’, 1 = ‘most of the time’, 2 = ‘it occurs more than half of the two weeks’, 3 = ‘it happens less than half of the two weeks’, 4 = ‘sometimes’, and 5 = ‘never’. The depression was determined if the total score was less than 13 or any question received 0 or 1 point [30,31].

1.2.5. Occupational Hazards

Nurses are exposed to various potential hazards in their workplace. These hazards include biochemical hazards [3], physical hazards [3,15,27], and ergonomic hazards [3,15,33,34]. Ergonomic hazards are most closely associated with musculoskeletal pain [15,33,34], but physical and biochemical hazards are also related to pain [15,27].

1.2.6. Musculoskeletal Pains in Nurses

Musculoskeletal pain is prevalent among nurses in the back, upper limbs, and lower limbs [15,35]. In this study, the upper limbs include the shoulders, elbows, and hands, and the lower limbs have the knees, ankles, and feet [29]. Musculoskeletal pain in nurses is associated with work/worker characteristics such as age, gender, work experience [15,33,36], institution type, workload [19,34,37], and type of shift [15,38]. Women are more likely to experience musculoskeletal pain than men [39].

2. Methods

2.1. Data Collection and Subjects

This study analyzed data from the 6th Korea Working Conditions Survey (KWCS). The 6th KWCS was conducted nationally over 22 weeks from 5 October 2020 to 11 April 2021, using a systematic sampling method that stratified Korea into 17 regions [29]. The survey investigated the working and employment conditions of 50,538 workers through 1:1 individual interviews conducted by professional investigators [29]. Based on the Korean Standard Occupational Classification [40], the study subjects were selected from nurses and nursing assistants who work in hospitals. Only 24 male nurses were excluded from the study. The final sample comprised 462 female hospital nurses, including 277 nurses and 185 nursing assistants. Of these, 230 work in hospitals, and 232 work in clinics.

2.2. Research Variables

The study focused on three dependent variables, namely, overall fatigue, anxiety, and depression. The independent variables consisted of work characteristics, exposure level to hazards, and the presence of musculoskeletal pain. Work characteristics include occupation (nurse (ref), nursing assistant), age (under 40 (ref), 40–49, 50 years or older), work experience (less than 3 (ref), 3–6, 6 years or more), type of institutions (clinics (ref), hospitals), weekly working hours (less than 41 (ref), more than 41 h), shift type (day duty (ref), daily split shifts, fixed shifts, rotating shifts).
The hazard factors have been categorized into three types: physical, biochemical, and ergonomic hazards [29]. Physical hazards are conditions such as vibration, noise, high temperature, and low temperature. Biochemical hazards refer to exposure to fumes and dust, vapor, skin contact with chemicals, tobacco smoke, and infection. Ergonomic hazards include awkward posture, patient lifting/carrying, heavy load handling, standing posture, and repetitive motion [29]. The duration of exposure to each hazard factor was classified as under two hours (reference), between two and four hours, or over four hours [17,19,22]. Musculoskeletal pain includes pain in the back, upper limbs, and lower limbs [6,27,29].

2.3. Data Analysis

This study used binomial logistic regression analysis to identify factors contributing to overall fatigue, anxiety, and depression, respectively. The analysis was performed using the backward Wald entry method. The ‘sitting posture’ item was removed from the ergonomic hazard variables after a reliability analysis was conducted to determine the internal consistency of the independent variables. The statistical package used for statistical analysis was SPSS 18.0, and the significance level was 0.05. The Hosmer–Lemeshow test was used to test the goodness-of-fit of the binomial logistic regression model. In addition, Nagelkerke’s R2 was used to determine the model’s explanatory power, and the prediction accuracy of the model was also presented in %.

3. Results

3.1. Factors Influencing Overall Fatigue

The proportion of nurses reporting overall fatigue was 24.7% (114 out of 462). Table 1 displays the results of binomial logistic regression analysis for overall fatigue as the dependent variable. The explanatory power of the model was satisfactory (Nagelkerke value = 0.419). In addition, the Hosmer–Lemeshow test (χ2 = 4.653, significance value = 0.702) indicated appropriate goodness of fit, and the prediction accuracy was 83.1%.
According to the findings of the binomial logistic regression analysis, nurses experience overall fatigue due to several factors. These factors include the type of shift work (p = 0.007), exposure to vibration (p = 0.042), maintaining awkward postures (p = 0.001), performing repetitive motions (p = 0.017), as well as experiencing complaints of back pain (p = 0.002) or upper limb pain (p < 0.001). Rotating shift nurses had a 3.052 times higher likelihood of experiencing overall fatigue compared to day duty nurses. Nurses exposed to vibration for more than 4 h were 5.191 times more likely to complain of overall fatigue than those exposed for less than 2 h. Nurses exposed to awkward postures for 2 to 4 h reported overall fatigue 2.227 times more than those under 2 h. Furthermore, nurses exposed to awkward postures for more than 4 h were 3.120 times more likely to report overall fatigue than those under 2 h. Nurses exposed to repetitive motions for 2 to 4 h were 2.464 times more likely to report overall fatigue than those exposed to repetitive motions for less than 2 h. Similarly, nurses who engaged in repetitive motions for more than 4 h were 2.464 times more likely to experience overall fatigue than those for less than 2 h. Nurses who complained of back pain were 2.818 times more likely to complain of overall fatigue than those who did not. Complaining of upper limb pain increased the likelihood of overall fatigue by 4.044 times more than those who did not.

3.2. Factors Influencing Anxiety

The percentage of nurses who experienced anxiety was 6.3% (29 out of 462). The results of a binary logistic regression analysis with anxiety are presented in Table 2. The model was found to have a satisfactory level of explanatory power, with a Nagelkerke value of 0.450. The accuracy of the model’s prediction was 95.2%. In addition, the Hosmer–Lemeshow test (χ2 = 5.482, significance value = 0.705) found the model’s goodness of fit appropriate.
According to Table 2, the factors influencing anxiety were age (p = 0.031), working hours per week (p = 0.006), performing patient lifting/carrying (p = 0.041), and experiencing complaints of upper (p = 0.022) or lower (p = 0.039) limb pain. In terms of age, nurses under 40 years of age were 17.543 (1/0.057) times more likely to complain of anxiety than nurses between 40 and 49 years of age. Nurses who worked over 41 h per week reported 4.53 times more anxiety than those working less than 41 h. Nurses who spend more than 4 h lifting/carrying patients have a 5.847 times higher risk of experiencing anxiety than those for less than 2 h. Nurses with upper limb pain were 3.943 times more likely to report anxiety than those without. Nurses who reported pain in their lower limbs were 3.331 times more likely to report symptoms of anxiety compared to those who did not.

3.3. Factors Influencing Depression

Out of 462 nurses, 168 experienced depression, which is equivalent to 36.4%. Table 3 shows the findings of the binomial logistic regression analysis with depression. The model had a reasonable level of explanatory power (Nagelkerke value = 0.107), and the goodness of fit was appropriate based on the Hosmer–Lemeshow test (χ2 = 2.989, significance value = 0.886). The prediction accuracy of the model was 67.7%.
In Table 3, the factors associated with depression were weekly working hours (p = 0.042), exposure to infection (p = 0.005), and complaints of lower limb pain (p = 0.011). Nurses who worked more than 41 h per week were 1.576 times more likely to complain of depression than nurses who worked less than 41 h. Nurses exposed to infection for more than 4 h were 3.147 times more likely to experience depression than those exposed for less than 2 h. Nurses who complained of lower limb pain were 2.028 times more likely to have depression than those who did not.

4. Discussion

This study investigated the prevalence of fatigue, anxiety, and depression among nurses. Nurses reported overall fatigue at a rate of 24.7%, which is lower than the 30.5% complaint rate of construction workers [18] but higher than the 21.1% complaint rate of automobile production workers [22]. In addition, the rate of complaints of depression among nurses was 36.4%, which was lower than the rate of complaints of 48.2% among construction workers [18]. On the other hand, 6.3% of nurses complained of anxiety, which was higher than 4.3% of construction workers [18].
In this study, binary logistic regression analysis was conducted to derive factors influencing the overall fatigue, anxiety, and depression of nurses, respectively. Factors influencing overall fatigue were shift types, vibration, awkward posture, repetitive motion, back pain, and upper limb pain. Regarding back pain, nurses who complained of back pain were 2.818 times more likely to complain of overall fatigue than nurses who did not. This is supported by research indicating that workers who report back pain also experience more overall fatigue compared to those who do not [41]. Nurses who reported experiencing upper limb pain were 4.044 times more likely to experience overall fatigue than those who did not. This finding is consistent with research that workers who complain of upper limb pain complain of overall fatigue more than those who do not [40]. In the case of shift work, rotating shift nurses were 3.052 times more likely to complain of overall fatigue than day duty nurses. This is consistent with research showing that workers on rotating shifts experience more fatigue than those who do not [11,42]. In the case of vibration, nurses exposed to more than 4 h were 5.191 times more likely to complain of overall fatigue than nurses exposed to less than 2 h. This is in line with studies that show that workers exposed to vibration are prone to overall fatigue [43,44]. In the case of awkward posture, nurses exposed for more than 4 h showed 3.120 times compared to nurses exposed for less than 2 h. This aligns with studies showing that working in an awkward posture increases symptoms of overall fatigue [45,46]. Repetitive movements were 2.464 times higher in nurses exposed for 2–4 h than those exposed for less than 2 h. This finding is consistent with the results of a study that shows that overall fatigue increases with repetitive movements [47].
Factors associated with anxiety included age, working hours per week, lifting/carrying patients, and the presence of upper or lower limb pain. Nurses who complained of upper limb pain were 3.943 times more likely to complain of anxiety than nurses who did not complain of upper limb pain. Also, nurses who complained of lower limb pain were 3.331 times more likely to complain of anxiety than workers who did not. This aligns with research indicating that complaints of musculoskeletal pain, such as upper and lower limb pain, lead to anxiety [48,49]. In terms of age, nurses under the age of 40 were found to be 17.543 (1/0.057) times more likely to complain of anxiety than nurses between the ages of 40 and 49. This is in line with previous research showing that younger nurses complain of anxiety due to inexperience in their work, lack of experience, and adaptation to a new environment [50]. In terms of weekly working hours, nurses who worked more than 41 h were 4.530 times more likely to complain of anxiety than nurses who worked less than 41 h. This is in line with research showing that the more hours worked per week, the more workers people complained of anxiety [51]. In the case of lifting/carrying patients, nurses who were exposed for more than 4 h complained of anxiety 5.847 times more than nurses who were exposed for less than 2 h. This is thought to be due to lower limb pain occurring due to the load on the lower limb when lifting/carrying a patient and anxiety occurring due to lower limb pain. In addition, it is consistent with research results showing that complaints of musculoskeletal pain, such as leg pain, lead to anxiety [48,49,51].
Factors influencing depression were working hours per week, infection, and the presence of lower limb pain. Nurses who complained of lower limb pain were 2.028 times more likely to complain of depression than nurses who did not. This aligns with research showing that complaints of musculoskeletal pain, such as lower limb pain, lead to depression [48,49,51]. In terms of weekly working hours, nurses who worked more than 41 h were 1.576 times more likely to complain of depression than workers who worked less than 41 h. This is consistent with research indicating that workers who work long hours have higher complaints of depression than workers who do not work long hours [52,53]. In the case of infection, nurses exposed for more than 4 h were 3.147 times more likely to be infected than those exposed for less than 2 h. This is in line with research findings that the experience of depression increases as exposure time to infection rises [54].
Figure 1 shows the results of Kim and Jeong’s research [15] and this study as a structural diagram. According to Kim and Jeong’s research [15], work characteristics and exposure to hazards influence nurses’ musculoskeletal pain. Our study, on the other hand, found that work characteristics, hazard exposure, and musculoskeletal pain are related to overall fatigue, anxiety, and depression.
This study suggests that to effectively manage nurses’ overall fatigue, anxiety, and depression, it is necessary to improve musculoskeletal pain, hazard factors, worker management, and workplace management. First, since overall fatigue is related to back pain and upper limb pain, anxiety is related to upper and lower limb pain, and depression is linked to lower limb pain, this suggests that musculoskeletal pain, overall fatigue, anxiety, and depression must be managed in an integrated manner to be effective. Second, since overall fatigue is related to shift work, anxiety is associated with the beginner age group and weekly work hours, and depression is related to weekly work hours, this suggests that measures and management for shift workers, those working more than 41 h, and the beginner age group are effective. Third, since overall fatigue is related to vibration exposure for more than 4 h and depression is related to exposure to infection for more than 4 h, this suggests that management of exposure time to physical hazards and biochemical hazards is necessary. Lastly, overall fatigue is related to awkward posture and repetitive motion for more than 2 h, and anxiety is related to lifting/carrying patients for more than 4 h, suggesting the need for ergonomic workplace improvement.
This study has some limitations. First, this study only focused on nurses working in hospitals. It did not include nurses working in other types of facilities, so caution should be taken when interpreting the entire nursing occupation. Second, caution is required when interpreting depression because the screening criteria are not based on clinical judgment but are based on a simplified method based on a subjective questionnaire. Third, we identified factors that affect psychological health problems, targeting only factors related to musculoskeletal pain. We did not include social psychological factors such as work and family conflicts, sleep problems, job stress, social support, and organizational satisfaction. Also, this study does not include nurses’ burnout or mental disorders in nursing practice, so it is limited in its inclusion of all nurses’ mental health problems. Further research that comprehensively includes these is expected. Fourth, since the research subjects in this study do not include male nurses, caution is required when targeting nurses, including men.

5. Conclusions

This study suggests that improving musculoskeletal pain, hazard factors, worker management, and workplace management can effectively manage nurses’ overall fatigue, anxiety, and depression. In addition, this study has implications in that musculoskeletal pain factors and psychological health problems should be managed in an integrated manner by deriving the results that musculoskeletal pain affects psychological health problems.

Author Contributions

Conceptualization, W.J.K. and B.Y.J.; methodology, W.J.K. and B.Y.J.; data collection and analysis, W.J.K.; resources, W.J.K. and B.Y.J.; data curation, W.J.K. and B.Y.J.; writing—original draft preparation, W.J.K. and B.Y.J.; writing—review and editing, W.J.K. and B.Y.J.; supervision, B.Y.J.; funding acquisition, B.Y.J. All authors have read and agreed to the published version of the manuscript.

Funding

This research was financially supported by Hansung University.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Publicly available datasets were analyzed in this study. This data can be found here: https://www.kosha.or.kr/eoshri/resources/KWCSDownload.do (accessed on 24 March 2024).

Acknowledgments

The authors are grateful to the Occupational Safety and Health Research Institute (OSHRI) and the Korea Occupational Safety and Health Agency (KOSHA) for providing the raw data from the KWCS.

Conflicts of Interest

The authors declare no conflicts of interest.

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Applsci 14 03869 g001
Figure 1. Structural diagram on musculoskeletal pain-related factors [15] and psychological health-related factors.
Figure 1. Structural diagram on musculoskeletal pain-related factors [15] and psychological health-related factors.
Applsci 14 03869 g001
Table 1. Results of binary logistic regression analysis with overall fatigue.
Table 1. Results of binary logistic regression analysis with overall fatigue.
VariablesNComplaint Rate (%)Bp-ValueOR95% C.I. for OR
LowerUpper
Shift system 0.007 *
Day duty (ref)31518.1%
Daily split shifts560.0%1.0760.4642.9340.16552.150
Permanent shifts5827.6%0.2530.5301.2880.5852.835
Rotating shifts 8445.2%1.1160.001 *3.0521.6205.747
Vibration 0.042 *
<2 h (ref)43423.0%
2–4 h1844.4%0.8960.1572.4490.7078.480
≥4 h1060.0%1.6470.033 *5.1911.13923.649
Infection 0.056
<2 h (ref)40421.5%
2–4 h2733.3%0.7550.1572.1280.7476.065
≥4 h3158.1%0.9990.038 *2.7161.0596.965
Awkward posture 0.001 *
<2 h (ref)28013.9%
2–4 h6330.2%0.8010.040 *2.2271.0384.777
≥4 h11947.1%1.138<0.001 *3.1201.7235.649
Repetitive motion 0.017 *
<2 h (ref)21213.2%
2–4 h4932.7%0.9020.047 *2.4641.0106.007
≥4 h20134.8%0.8020.008 *2.2311.2364.027
Back pain 0.002 *
No (ref)37416.6%
Yes8859.1%1.0360.002 *2.8181.4595.442
Upper limb pain <0.001 *
No (ref)34214.3%
Yes12054.2%1.397<0.001 *4.0442.1797.503
Constant −3.381<0.001 *0.034
* significant at 0.05, ref = reference, OR = odds ratio, C.I. = confidence interval.
Table 2. Results of binary logistic regression analysis with anxiety.
Table 2. Results of binary logistic regression analysis with anxiety.
VariablesNComplaint Rate (%)Bp-ValueOR95% C.I. for OR
LowerUpper
Age (years) 0.031 *
<40 (ref)2147.9%
40–491510.7%−2.8680.008 *0.0570.0070.480
≥509711.3%−0.2540.6470.7750.2612.308
Establishment 0.085
Clinic (ref)2322.6%
Hospital23010.0%1.1250.0853.0790.85511.085
Working hour/week 0.006 *
<41 (ref)2813.9%
≥411819.9%1.5110.006 *4.5301.55613.183
Patient lifting/carrying 0.041 *
<2 h (ref)3382.7%
2–4 h959.5%1.1090.0673.0330.9269.930
≥4 h2937.9%1.7660.017 *5.8471.36325.081
Upper limb pain 0.022 *
No (ref)3422.0%
Yes12018.3%1.3720.022 *3.9431.21812.769
Lower limb pain 0.039 *
No (ref)3922.8%
Yes7025.7%1.2030.039 *3.3311.06110.461
Constant −5.308<0.001 *0.005
* significant at 0.05, ref = reference, OR = odds ratio, C.I. = confidence interval.
Table 3. Results of binary logistic regression analysis with depression.
Table 3. Results of binary logistic regression analysis with depression.
VariablesNComplaint Rate (%)Bp-ValueOR95% C.I. for OR
LowerUpper
Occupation 0.071
Nurses (ref)27733.9%
Nursing assistants18540.0%0.399 0.071 1.4900.967 2.298
Working experience (years) 0.064
<3 (ref)14243.0%
3–615429.2%−0.5950.019 * 0.552 0.335 0.908
≥616637.3%−0.3230.189 0.724 0.447 1.173
Establishment 0.059
Clinic (ref)23232.8%
Hospital23040.0%0.440 0.059 1.5520.983 2.451
Working hour/week 0.042 *
<41 (ref)28133.1%
≥4118141.4%0.455 0.042 *1.5761.0162.445
Infection 0.005 *
<2 h (ref)40433.2%
2–4 h2751.9%0.748 0.069 2.112 0.944 4.727
≥4 h3164.5%1.1460.004 *3.1471.4286.932
Lower limb pain 0.011 *
No (ref)39233.2%
Yes7054.3%0.707 0.011 *2.0281.1793.488
Constant −1.066<0.001 *0.344
* significant at 0.05, ref = reference, OR = odds ratio, C.I. = confidence interval.
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Kim, W.J.; Jeong, B.Y. Effects of Occupational Hazards, Musculoskeletal Pain, and Work on the Overall Fatigue, Anxiety, and Depression of Female Nurses. Appl. Sci. 2024, 14, 3869. https://doi.org/10.3390/app14093869

AMA Style

Kim WJ, Jeong BY. Effects of Occupational Hazards, Musculoskeletal Pain, and Work on the Overall Fatigue, Anxiety, and Depression of Female Nurses. Applied Sciences. 2024; 14(9):3869. https://doi.org/10.3390/app14093869

Chicago/Turabian Style

Kim, Woo Jin, and Byung Yong Jeong. 2024. "Effects of Occupational Hazards, Musculoskeletal Pain, and Work on the Overall Fatigue, Anxiety, and Depression of Female Nurses" Applied Sciences 14, no. 9: 3869. https://doi.org/10.3390/app14093869

APA Style

Kim, W. J., & Jeong, B. Y. (2024). Effects of Occupational Hazards, Musculoskeletal Pain, and Work on the Overall Fatigue, Anxiety, and Depression of Female Nurses. Applied Sciences, 14(9), 3869. https://doi.org/10.3390/app14093869

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