Musculoskeletal symptoms and biopsychosocial factors among nursing students: implications for protecting the future health workforce.

BACKGROUND

Musculoskeletal disorders are an important occupational health concern among healthcare professionals and may emerge before entry into the workforce. Identifying musculoskeletal symptoms and their biopsychosocial correlates among nursing students may provide opportunities for early prevention and health promotion.

OBJECTIVE

This study aimed to investigate the prevalence of musculoskeletal symptoms and identify associated biopsychosocial factors among nursing students in Türkiye.

METHODS

A cross-sectional study was conducted among 213 nursing students (77% female) in Türkiye. Data were collected through an online survey between February and April 2022. Musculoskeletal symptoms, physical activity, perceived stress, biopsychosocial wellbeing, and coping behaviors were assessed using validated instruments. Associations were examined using chi-square tests and independent-samples t-tests; logistic regression analyses, using a simplified set of six predictors (age, BMI, gender, physical activity, total perceived stress, and total biopsychosocial response score) and Firth's penalized-likelihood method, were performed to identify factors associated with musculoskeletal symptoms.

RESULTS

Overall, 62% of nursing students reported musculoskeletal symptoms during the previous 12 months. The most frequently reported symptoms were in the upper back (41%), followed by the low back and neck (33% each). High physical activity showed a significant association with lower odds of upper back symptoms (OR = 0.19, p = 0.047) and a borderline association with lower odds of any 12-month musculoskeletal symptom (OR = 0.25, p = 0.060). Female students had higher odds of neck, shoulder, and upper back symptoms than male students (OR = 0.05-0.19 for male vs. female). No stress or biopsychosocial measure was significantly associated with any 12-month musculoskeletal outcome; findings for the hip/thigh region should be considered exploratory given a low events-per-variable ratio.

CONCLUSIONS

Musculoskeletal symptoms were highly prevalent among nursing students, highlighting the importance of addressing musculoskeletal health before entry into the nursing workforce. The findings suggest that physical factors may be more relevant to symptom occurrence than stress or biopsychosocial wellbeing in this sample. Although a biopsychosocial framework provides a useful perspective for understanding musculoskeletal health, further longitudinal research is needed to clarify the role of stress and wellbeing and to inform targeted interventions.