Moral distress and musculoskeletal disorders in Iranian prehospital EMS workers.

BACKGROUND: Prehospital emergency personnel are exposed to a high prevalence of musculoskeletal disorders (MSDs), and moral distress. This study aimed to assess the impact of moral distress on MSDs among prehospital emergency workers. METHODS: This cross-sectional study, conducted in 2024, by using a census sampling approach, involved 125 employees from the prehospital emergency centers of Semnan University of Medical Sciences. Data collection tools included a demographic questionnaire, a moral distress scale, and the Nordic Musculoskeletal Questionnaire (NMQ) for assessing ergonomic complications and discomforts. Data analysis methods were structural equation modeling (SEM). RESULTS: The results indicated that the most common pain complaints were in the lower back and buttocks (52.8%) and the back (42.4%). Over the past week, neck pain was the most frequently reported (44%), followed closely by lower back and buttocks pain (42.4%). At the time of the study, the highest pain prevalence was in the neck (73.6%) and the lower back and buttocks (36.8%). The mean moral distress score was 54.5 ± 41.9, with 86.4% of participants reporting low levels of moral distress. The moral distress was not significantly affect MSDs (P = 0.061). However, age and work experience were significantly associated with MSDs (P = 0.001) and moral distress (P = 0.005). CONCLUSION: The findings demonstrate that nearly half of the prehospital emergency workers experienced MSDs, particularly in the neck and back. Most participants reported low levels of moral distress, which did not significantly influence MSDs. This P-value may indicate the presence of a true effect that could become more apparent with a larger sample size or a different study design. It is recommended to include intervention studies and qualitative research. In order to reduce moral distress and MSDs in prehospital emergency workers, in addition to regular screenings, it is recommended that the amount of work-related pressure be reduced, especially for older employees and those with more extensive work experience. CLINICAL TRIAL NUMBER: Not applicable.